How to Choose and Use a Walking Stick or Walker

How to pick a cane, quad stick, frame or rollator, set the right height, and use it correctly on stairs, kerbs and wet floors, with Malaysian tips.

Choose the device for the problem you have: a single cane for mild pain or slight unsteadiness, a quad cane for more support on one side, and a frame or rollator when balance or leg strength is poor on both sides. The handle should reach the crease of your wrist, and a cane goes in the hand opposite the weaker leg. A well-fitted device helps; a badly fitted one raises your risk of falling.

If you or your parent has fallen more than once, had a stroke or surgery, or has numb feet, see a physiotherapist before buying.

Does using a walking aid mean you are getting weaker?

No. An aid takes over some of the work your legs cannot do safely right now, and it protects the confidence to keep walking. Walking speed is also linked with health outcomes. In a pooled analysis of nine cohorts, faster gait speed was associated with longer survival, and speeds of 1.0 m/s or more were linked with longer survival than expected for age and sex (Studenski et al., 2011). Staying active matters more than avoiding a stick.

One caution: CDC research found that cane and walker users were more likely than non-users to report recent falls (CDC, assistive device study). That partly reflects people who already struggle with mobility, but it also shows that a device is not a cure. Fit, technique and continued leg and balance training all count.

Which type of aid suits which problem?

A quad cane gives a larger base of support, and a walker increases base of support and takes some body weight, although it can be hard to manoeuvre and may reduce arm swing and encourage a stooped posture (Bradley and Hernandez, 2011).

How do you set the right height?

Do this with your normal shoes on and a helper beside you.

1. Stand tall with your arms hanging relaxed.
2. Have a helper mark the crease of your wrist, where the hand meets the forearm.
3. Adjust the handle to that height.
4. Hold the handle. Your elbow should bend about 15 to 30 degrees.
5. Check posture: shoulders level, not hiking up, and no forward lean.

The same height rule applies to frames and rollators (Bradley and Hernandez, 2011). If you wear different shoes at home and outside, check both. Keep rubber tips fresh. A worn tip slides on wet tiles.

How do you walk with a cane?

1. Hold the cane on the side opposite the weaker or painful leg.
2. Move the cane and the weaker leg forward together.
3. Step through with the stronger leg.
4. Keep the cane about one forearm length ahead, no further.
5. Look ahead, not at your feet.

Practise 5 to 10 minutes in a corridor with a helper beside you. Take shorter steps than usual.

Stairs, kerbs and wet floors

• Going up: stronger leg first, then the weaker leg, then the cane. Remember “up with the good”.
• Going down: cane first, then weaker leg, then stronger leg. Remember “down with the bad”.
• Use a handrail if there is one, with the cane in the other hand.
• At kerbs, treat them as one-step stairs.
• On wet floors or polished marble in shopping malls, shorten steps and test the cane tip before committing weight.

How do you walk with a frame or rollator?

1. Stand inside the frame, not behind it. Your hips should be roughly level with the back bar.
2. Move the frame forward about one step length.
3. Step the weaker leg in, then the stronger leg, without stepping beyond the back legs.
4. For rollators, lock the brakes before sitting and before standing up.
5. Never use a rollator or frame on escalators. Take the lift.

Do not push the frame too far ahead. That makes you lean forward and shifts the load off your legs.

Sitting down and standing up with a frame

Never pull up on the frame itself when you stand. Back up until you feel the chair on the backs of your legs, reach back for the armrests and sit slowly. To stand, scoot forward, push up from the armrests, then take hold of the frame once you are upright. A frame that tips towards you is a common cause of falls at home.

What are the common mistakes?

• Cane on the wrong side. This is the most common error.
• Handle too high or too low, leading to a hunched back or sore shoulder.
• Using a borrowed cane. A cane fitted for someone else can be the wrong height and weight.
• Leaving worn rubber tips on. Replace them when the tread is smooth.
• Using a rollator as a wheelchair. Do not push someone while they sit unless it is designed for it.
• Cluttered homes. Loose rugs and electrical cords catch frame legs.

Where do you buy one in Malaysia, and what should you look for?

Medical supply shops, pharmacies and larger hospitals sell canes and frames, and prices vary widely by brand and features. Rather than quoting prices, I suggest you ask for: adjustable height, a non-slip tip you can replace, a comfortable grip, a folding mechanism if you travel by car, and a weight rating above your body weight.

For tropical conditions, choose a handle that does not become slippery with sweaty hands. Clean rubber tips regularly because wet-season mud and monsoon puddles wear them. In older shophouse areas with uneven five-foot ways, a cane with a firm tip or a larger-wheeled rollator copes better than small wheels.

Hospital rehabilitation units and private clinics can fit the device and teach technique, often in a single session.

When should you see a physiotherapist or doctor?

See a professional before buying if you:

• have fallen two or more times in the past year
• have had a stroke, Parkinson’s disease or numbness in your feet
• have had a hip, knee or spine operation
• feel dizzy when standing
• have severe pain that worsens with weight-bearing

The fall risk check and gait speed tool give a quick picture of where you stand, but neither replaces an assessment.

Should a walking aid replace exercise?

No. A device makes walking safer, but leg strength and balance are what reduce falls. A systematic review of 88 trials found exercise reduced the rate of falls by 21% in community-dwelling older people, with larger effects from programmes that challenged balance (Sherrington et al., 2017).

Keep training. Try the chair balance routine and the balance and stability hub. Safe home set-up matters too; see reduce fall risk at home and safe stairs and bathroom set-up. If a parent is reluctant to use a stick, read persuading a reluctant parent to exercise and our ageing parents page.

Key takeaways

• Match the device to the problem: cane for mild issues, quad cane for one-sided weakness, frame or rollator for bilateral weakness.
• The handle should meet the wrist crease; hold a cane opposite the weaker leg.
• Learn stairs, kerbs and wet floors with a helper: up with the good, down with the bad.
• Get a fitting from a physiotherapist if you have fallen, had a stroke or surgery, or have numb feet.
• A walking aid does not replace leg strength and balance exercise.