Do I need a walker? Check these 5 things

Eventually, most of us will need to walk with some help.  The body becomes weaker, our balance declines, and we get tired much quicker.  It’s a rule of life that we all will face one day.  How do we know that that time has come?  Are there easy to notice signs that clearly tell someone they need a walking device?  These are the questions that will be answered in this post

To know what it is time for someone to get a walking device (cane, walker, rollator), I watch them walk and look for specific aspects of their gait.  This will tell me quickly if a device is needed.

Here are the 5 most common.

1. Step Length

   - A full step will make walking most efficient as the person is able to take less steps to cover a certain distance. The step length should allow the heel of the forward foot to fully pass the toe of the trailing foot at a minimum.  If this is not happening, without question, the person should be using a device. A good rule of thumb to follow is 6 inches between the toe of trailing foot to heel of leading foot is a good step where I don’t think the person needs a device.

   
   

2. Foot Clearance

   - Our bodies are trained to do the bare minimum with step height with walking as even a safe step only clears the ground by a few centimeters. Our bodies should naturally make adjustments to this depending on the surface (tall carpeting) and possible obstacles, but this is not always the case and is a reason that some falls occur. For this reason, I watch someone walk on hard surfaces, thick carpeting, grass and as many surfaces as the current situation allows.  If I regularly hear scuffing with each foot contact, that is a clear indicator that there is inadequate foot clearance. This is reason enough to recommend a walking device as any unexpected height change in surface would likely lead to a trip since there is already such limited toe clearance.

   
   

3. Distance

   - In a perfect world, I want all of my patients to be at least able to walk 1000’. Research shows that this is generally enough to go about your day without too many limitations. If somebody meets this distance with a device but is not able to without one, I will recommend a device 9 times out of 10.  I want to promote maintaining these endurance level distances for the patients I work with. Seen this way, the device can be seen as a liberating addition rather than an impediment.

   
   

4. Turns

   - Walking in straight lines is one thing, but eventually a person will need to turn, change direction and go around other people or obstacles.  This is when falls can happen. I will typically have a person go through an obstacle course that includes quick pivots, quick changes in direction and figure 8 walking. If the person stumbles, drastically reduces their step length and increases step width, these are signs that a device may be needed to improve stability when in more variable conditions like shopping at the grocery store.

   
   

5. Continuous Steps

   - This last one is very obvious and stands out easily.  The person should continuously walking with good flow without any major breaks in their gait cycle/steps. If a person is frequently starting and stopping or their steps are inconsistent (height, width and length), this is another clear sign that a device is needed.

I will look at these 5 aspects again when they are using a device.  Most times, you will see many if not all of these aspects improve with a little practice using a walking device.  I allow a few sessions and days to use the device until I make a final decision on if the device is helping or not. 

As a PT, I will check many additional aspects such as gait speed, obstacle navigation and dynamic walking tasks to name a few but these are much more involved.  This list I provided should be a good guide to better know when a walking device is needed.

If you are not sure which device you need, please consult with your healthcare team and ask for a walking assessment by a Physical Therapist.

Thank you for reading.

Keep moving and stay strong!