Understanding Which Leg Moves First with a Walker

According to MedlinePlus, using a walker incorrectly is a significant factor in falls among older adults. Understanding which leg moves first with a walker is a critical, yet often misunderstood, element of mastering proper and safe mobility with this device.

Quick Summary

For most standard walking techniques, you should advance your weaker or injured leg first, followed by your stronger leg, to ensure maximum stability and support while moving forward.

Key Points

• Weaker Leg First: The fundamental rule for a standard gait is to step with your weaker or injured leg first.

• Check Your Stance: Ensure all four tips or wheels of the walker are firmly on the ground before taking any steps.

• Stand Up Straight: Maintain an upright posture and look forward, not down, to ensure better balance and spinal alignment.

• Use Arms, Not the Walker: When standing up or sitting down, use the chair's armrests for support to avoid tipping the walker.

• Take Small Steps: Avoid rushing or taking large strides. Slow, controlled, and even steps are key to maintaining stability.

• Adapt to Your Needs: Adjust your walking pattern based on your doctor's specific weight-bearing instructions.

Mastering the Basic Walker Gait

To use a walker safely and effectively, it's essential to master the foundational movement pattern. This involves a coordinated three-part sequence: move the walker, step with the weaker leg, and then step with the stronger leg.

Step-by-Step Technique

1. Advance the Walker: Push or lift the walker a comfortable distance forward, typically about 6 to 12 inches. Ensure all four tips or wheels are firmly on the ground before moving your feet.
2. Step with the Weaker Leg: Step into the walker with your weaker, injured, or surgically repaired leg. You can place your foot in line with the rear legs of the walker.
3. Step with the Stronger Leg: While putting your weight through the walker handles, step forward with your stronger, non-injured leg. Place this foot even with or slightly ahead of your weaker leg.
4. Repeat: Repeat the sequence, maintaining a steady, controlled pace. Avoid rushing or taking large strides, which can compromise your balance.

Why the Weaker Leg Goes First

This method is designed to provide maximum support to the limb that needs it most. By stepping with the weaker leg first, you can bear weight through your arms and the stable walker frame, reducing strain on the injured leg. The stronger leg then provides a powerful, stable step to complete the movement, balancing your weight as you shift forward.

Adapting Your Technique for Different Weight-Bearing Status

Your gait pattern may need to be adjusted based on your doctor's weight-bearing instructions. Always follow the specific guidance provided by a physical therapist.

Non-Weight Bearing (NWB)

• Technique: Move the walker forward. Put all weight on your arms and hop forward with your stronger leg, keeping the affected leg completely off the ground.
• Support: This technique requires significant upper body strength.

Partial-Weight Bearing (PWB)

• Technique: Advance the walker, then step forward with the affected leg, putting only the designated amount of weight on it. Follow with the stronger leg.
• Support: Use your arms and the walker to offload the rest of your body weight from the injured limb.

Weight Bearing as Tolerated (WBAT)

• Technique: The standard weaker-leg-first technique applies here. The amount of weight you put on the affected leg can be increased as comfort and strength improve.
• Support: The walker is primarily for balance and stability rather than full weight support.

Comparing Walker vs. Rollator Gaits

Choosing between a standard walker and a rollator (wheeled walker) is critical, as the technique varies significantly. A physical therapist can help you determine the best device for your needs.

Feature	Standard Walker (No Wheels)	Rollator (Wheels)
Movement	Lift the walker, move it forward, step.	Push the walker forward, step.
Best For	Individuals needing maximum stability and balance support.	Those who can walk with some support but need assistance with endurance.
Gait Pattern	Discontinuous stop-and-go gait.	More continuous, fluid walking pattern.
Turning	Requires lifting and repositioning the walker.	Can be steered while moving.
Braking	Relies on rubber tips for friction to stop.	Uses hand brakes for control and safety.

Important Considerations and Safety Tips

In addition to mastering the basic forward movement, proper technique for turns, inclines, and sitting is vital for preventing falls. Always keep your focus forward, not down at your feet.

Turning with a Walker

• Avoid Pivoting: Do not pivot sharply. Instead, take small, controlled steps in an arc while moving the walker with you.
• Secure Braking: If using a rollator, apply the hand brakes to keep the device stable while turning.

Using a Walker on Curbs or Stairs

• Disclaimer: Using a walker on stairs is dangerous and should only be done with professional instruction. "Up with the good, down with the bad" is a common phrase to remember.
• To Go Up: Step up with your stronger leg first, followed by your weaker leg, using the walker for stability.
• To Go Down: Place the walker on the lower surface. Step down with your weaker leg first, then your stronger leg.

Standing Up and Sitting Down

• Never Pull on the Walker: Use the armrests of the chair to push yourself up to a standing position. Then, grasp the walker handles.
• Back Up First: To sit, back up until you feel the chair with the back of your legs. Reach for the chair's armrests, then lower yourself slowly while extending your weaker leg slightly forward.

Conclusion

Mastering proper walker technique, including understanding which leg moves first with a walker, is a vital component of safe mobility and fall prevention. By consistently practicing the correct gait and safety maneuvers, you can navigate your daily life with greater confidence and independence. Regular consultations with a physical therapist are recommended to ensure your technique is safe and appropriately adapted for your specific needs.

To learn more about safe mobility practices, consult the comprehensive guide on MedlinePlus.

Frequently Asked Questions

What is the correct way to walk with a wheeled walker?

With a wheeled walker, you push the walker forward, then step into it with your weaker leg, followed by your stronger leg. The key is a fluid, continuous motion rather than lifting the device.

What if both of my legs are weak?

If both legs are weak, your doctor or physical therapist will determine which leg to lead with. The goal is to establish a safe and consistent pattern, often with the first leg alternating.

Can I use a walker on stairs?

Using a walker on stairs is generally not recommended and can be dangerous. A physical therapist can teach you specific techniques if necessary, but using a handrail is often safer.

How do I know if my walker is the right height?

To check the height, stand up straight with your arms relaxed at your sides. The walker's handgrips should be level with the crease in your wrists, and your elbows should have a slight bend (about 15-25 degrees) when you hold the grips.

Is it better to use a walker or a cane?

A walker provides more stability and support than a cane and is better for individuals with significant balance issues. A cane is typically used for less severe balance problems or to offload a small amount of weight.

How do I turn corners safely with a walker?

To turn, take small, incremental steps in the direction you want to go. Avoid pivoting or twisting, which can lead to a loss of balance.

What are common mistakes to avoid with a walker?

Common mistakes include hunching over, looking down at your feet, taking steps that are too long, and not ensuring all walker legs are on the ground before stepping.