Patient education: How to use a walker (The Basics)

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What is a walker? — A walker is a type of "mobility aid," or a device to help you move around. You might need to use a walker if you:

●Have a leg or foot injury

●Are recovering from surgery

●Have a health problem that makes it hard to walk

●Need help with support or balance due to age

There are different types of walkers (figure 1). They include:

●"Front-wheel" or "2-wheel" – This type of walker has 4 legs. The 2 legs in the front have small wheels. This allows you to push the walker forward as you walk, without picking it up off of the ground. You can attach forearm supports to the handles if needed. This lets you lean on the walker more.

●"4-point" or "pick-up" – This type of walker has 4 legs but no wheels. You need to pick it up each time you take a step.

●"4-wheel" or "rollator" – This type of walker has handles with brakes, similar to bicycle handles, and can move faster than other walkers. They are also sometimes called "Canadian walkers." You can get them with or without a seat or basket. You need good balance and coordination to use this type of walker. A 4-wheel scooter with a seat is often a good choice for people who need to take breaks or rest often while walking. There is also a version of this walker that has 3 wheels instead, but it does not have a seat.

●"Knee walker" or "knee scooter" – This type of walker has 4 wheels, handles with brakes, and a pad to rest your knee on. It is often used by people who need to stay off of their foot or ankle after surgery or an injury.

●"Hemi walker" – This is a walker you use with 1 hand instead of 2. It can be used by people who have trouble moving or using 1 of their hands or arms. It is more stable than a cane because it is wider at the bottom.

Many walkers fold up to become smaller, so it is easier to bring them places.

Your doctor, nurse, or physical therapist can help you decide which type of walker to use. It depends on what kind of support you need and how long you will need it. They will also help you learn how to use your walker safely.

How do I use the walker? — It depends on why you are using the walker. If you have an injured leg or foot, your doctor or nurse will tell you if you need to avoid putting any weight on it. Sometimes, you can put some weight on it, but will need to use the walker for extra support.

If you use a walker to help with overall balance and support, your doctor, nurse, or physical therapist will show you how to do this safely. It is best to use the kind of walker that they recommend. If possible, do not borrow a walker from a friend or relative. A borrowed walker might not be the right type or size for you.

Some general tips for using a walker:

●Make sure that your walker is the right height – You can adjust the height if needed. When you stand up and put your arms down at your side, the handle of the walker should be at the level of your wrist. This way, when you use it to walk, your elbows will be bent slightly.

If the walker is too tall, it won't work well to support your weight. If it is too short, you might need to bend over too much when you walk.

●Practice getting up and sitting down – When getting up, like from a bed or chair, use your hands to push yourself up from a sitting position. Then, hold your walker to support you as you stand up. Do not pull on your walker while you are sitting, since it could tip over.

To sit down, get as close as you can to the bed, chair, or seat. Facing away from it, reach back with your hands so that you can feel where you will sit down. Move slowly, and do not pull on your walker as you sit.

●Practice walking – The way to do this will depend on what type of walker you have. For a front-wheel walker, roll it gently forward about the distance of 1 step. Then, step up to it, stepping with your weaker foot first. As you step, push down on the handles to keep steady. Do not hunch your back as you lean on the walker.

If your walker has hand brakes, make sure that you know how and when to use them. Brakes can help you feel more stable, since they keep the walker from rolling.

●Look where you are going – When walking, look forward, not down at your feet. This will help you see things in your path, so you are less likely to trip.

●Be extra careful on stairs – Your doctor or nurse will talk to you about stairs. Some people need to avoid them completely. Other people can go up and down stairs carefully without their walker, holding a handrail. If this is the case, someone else will need to carry your walker up or down for you.

In some cases, you might be able to take your walker up or down stairs. If you do this, fold up your walker first. If there is a railing, hold it with 1 hand.

•To go up:

-Put the walker 2 steps up from the bottom. Make sure that it is not too close to the edge of the step.

-Step up 1 step. If you have a "good" leg that you can put weight on, step with that leg first. Then, bring your other leg up to meet it.

-Move your walker up to the next step, and repeat stepping up.

•To go down:

-Put the walker 2 steps below you. Make sure that it is not too close to the edge of the step.

-Step down 1 step. If you have a "bad" leg but are able to put weight on it, step with that leg first. Then, bring your other leg down to meet it.

-Move your walker down to the next step, and repeat stepping down.

You should also take care if you are on uneven ground or need to go up or down a curb. Always make sure that all of the wheels or legs are touching the ground, and step slowly and carefully.

●Be careful when using the tub or shower – Many people find it helpful to use a special seat or bench for bathing. Make sure that the seat is stable and does not wobble when you put weight on it. You can also get a non-stick mat to put on the floor of your tub or shower to make it less slippery.

Depending on your situation, you might need to have someone else help you bathe or shower.

•To use the tub:

-Back up toward the tub slowly, with your walker in front of you. Reach back with your hands so you can feel the seat, and sit down carefully. Do not pull on your walker as you sit, since it could tip over.

-Scoot backward so you are fully on the seat.

-Carefully turn so both of your legs are in the tub.

-When you are ready to get out of the tub, do the same steps in reverse. Carefully turn and lift your legs out. Scoot forward and use your hands to push up off of the seat. When you are standing, hold on to your walker.

•To use the shower:

-If your shower is large, you can walk carefully into it with your walker. Then, push your walker aside so it does not get wet.

-Hold on to the grab bars, if your shower has them.

-If you have to step over a ledge to get into the shower, go slowly. Back up to it with your walker in front of you, then carefully step back into the shower.

-Reach back with your hands so you can feel the seat, and sit down carefully. Do not pull on your walker as you sit, since it could tip over.

-When you are ready to get out of the shower, do the same steps in reverse. Use your hands to push up off of the seat. When you are standing, hold on to your walker, then step carefully out of the shower.

There are other things that you can do to make bathing easier. You might want to get a handheld shower head, or a long-handled sponge to wash with. Make sure that your towel is nearby for when you get out. Keep the bathroom floor clear of rugs or anything else that you could trip over.

●Be careful getting in and out of cars – Open the car door all of the way when you need to get in or out. Do not hold on to the door for support, since it could move and cause you to fall. Take your time, and have someone help you if possible. It might help to adjust the position of the seat to give you more space.

●Make your home safer – Remove things that you could trip over, like loose rugs, electrical cords, and clutter.

●Keep your hands free – Don't try to hold anything in your hands while you are using your walker. You can attach a basket or pouch to your walker to carry your things.

When can I stop using my walker? — It depends.

●If you are using a walker while you recover from an injury or surgery, you will need to use it until you have healed enough to walk without help. Your doctor or nurse will talk to you about how long they expect this to take. They might also do a follow-up exam, or imaging tests such as X-rays, to see how you are healing.

●If you are using a walker because of age or a health problem, you might use it for a long time. If your needs change, your doctor or nurse can talk to you about your other options.

Other "mobility aids" include canes, crutches, and wheelchairs. Depending on your situation, you might have the option of using one of these instead of a walker. Or you might use different aids in different situations.

When should I call the doctor? — Call your doctor or nurse for advice if:

●You have any new pain or discomfort after you start using your walker.

●You are having a lot of trouble getting around.

●Your walker gets damaged or broken.

●You hurt yourself while using your walker.

●You need help getting supplies, such as a shower seat or a basket for your walker.

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Patient education: How to use a walker (The Basics)