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Walking aids: canes, crutches and walkers

  • Procedure

A well-fitted, well-used cane, crutch or walker gives support and prevents falls; a badly fitted one causes them.

Updated

What it is

Walking aids widen the base of support and take weight off a weak or injured leg. A physiotherapist usually decides which one to use; nursing checks the fit, teaches and supervises its use, and walks with the patient using a gait belt when needed. The cane goes in the hand on the strong side; the walker is moved forward first and then the weak leg steps; with crutches the weight goes on the hands, never on the armpits. On stairs the rule is "up with the good, down with the bad".

Indications

  • Weakness, pain or injury of one leg, or an ordered weight-bearing restriction.
  • Balance problems or fall risk.
  • Rehabilitation after hip or knee surgery, or after immobility.

Contraindications and precautions

  • Use the aid prescribed by physiotherapy or the doctor, with the weight-bearing restrictions in the order.
  • Dizziness, chest pain, breathlessness or orthostatic hypotension: do not start walking and report.
  • Stairs only after training with physiotherapy.
  • Wet floors, loose rugs, cords and clutter raise the fall risk: remove them.
  • With a walker, do not pull on or tilt it to stand up: push up from the chair or the bed.

Equipment

  • Cane (single-point or wide-based) with a rubber tip in good condition.
  • Underarm or forearm crutches with non-slip tips and tight screws.
  • Standard, two-wheeled or four-wheeled walker, as prescribed.
  • Gait belt, non-slip footwear and a chair nearby for rest.

Step by step (and why)

  1. Check the order: type of aid, weight-bearing allowed and distance — using something other than prescribed raises the risk.
  2. Take vital signs if there is a risk of hypotension and sit the patient on the edge of the bed — prevents falls from dizziness.
  3. Check the equipment (tips, brakes, screws) and the non-slip footwear — a worn tip slips.
  4. Set the height: handle at wrist or hip, elbow slightly bent; crutches two fingers below the armpit — so the weight goes to the hands.
  5. Help the patient stand by pushing up from the bed or chair, not the aid — the walker or cane can tip over.
  6. Cane: in the hand on the strong side, move cane and weak leg, then the strong leg — widens the base of support on the weak side.
  7. Walker: move it forward, all four legs or wheels down, step with the weak leg, then the strong one — support comes before weight.
  8. Walk on the weak side, slightly behind, with a hand on the gait belt — lets you steady the patient or guide a fall.
  9. Record the aid, distance, tolerance and what was taught — measures progress and shows the teaching given.

Complications

  • Falls from poor fit, worn tips or slippery floors.
  • Arm nerve injury from leaning on the armpits with crutches (tingling, numbness).
  • Shoulder, wrist or hand pain from misuse.
  • Orthostatic hypotension or fatigue while walking.

Next step: when to call for help

  • If the patient starts to fall, guide them to the floor protecting the head, do not move them and report at once.
  • Report tingling or numbness in the arms or hands when using crutches.
  • Report if the patient cannot use the aid safely after practice: they may need another aid or more physiotherapy.
  • Report dizziness, chest pain, breathlessness or new leg pain while walking.

Test yourself

Think of the answer, then tap the question to see it.

In which hand is the cane held?

In the hand on the strong side, that is, opposite the weak leg. The cane moves forward together with the weak leg.

Where should the weight go when walking with underarm crutches?

On the hands, on the handgrips. There should be about two fingers of space below the armpit: leaning on the armpit can injure the arm nerves.

What rule is used to go up and down stairs with a cane or crutches?

"Up with the good, down with the bad": go up first with the healthy leg, and go down first with the aid and the affected leg.

On which side does the nurse walk when helping a patient walk?

On the weak side, slightly behind the patient, with one hand on the gait belt.

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Connections

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Nursing Assistant, 8.5: Assisting With Ambulation (Chippewa Valley Technical College, Open RN remix (LibreTexts), 2022); Using a cane (MedlinePlus, U.S. National Library of Medicine, 2025); Using a walker (MedlinePlus, U.S. National Library of Medicine, 2025); Crutches and children: proper fit and safety tips (MedlinePlus, U.S. National Library of Medicine, 2024).

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