How to Set Up a Walking Stick, Cane or Crutch Correctly

Walking sticks, canes and crutches are simple-looking aids, but height, hand choice and walking technique all affect how well they work. In New Zealand, “walking stick” and “cane” are often used for the same single-point aid. Crutches provide a different level and style of support and are especially sensitive to the person's weight-bearing instructions.

A practical starting point for many sticks and forearm crutches is to place the handgrip around wrist-crease height while standing naturally in the footwear normally worn. When the hand is on the grip, the elbow should have a comfortable slight bend and the shoulder should remain relaxed. This is a starting point, not a prescription for every person.

A physiotherapist can help decide which side to use, the walking sequence and how much support is appropriate. An occupational therapist can look at how the aid works around the home and through everyday tasks. If you use a walking frame or rollator, see our separate Walker and Rollator Setup Guide.

Quick walking stick, cane and crutch setup guide

How high should a walking stick or cane be?

Stand upright in normal footwear with the arm relaxed beside the body. Wrist-crease height is a useful starting point for an adjustable cane. When the handle is held, the elbow should remain slightly bent without lifting the shoulder.

A stick that is too high can push the shoulder upward and make the aid feel awkward to place. One that is too low can encourage leaning and may make the user reach down toward the support.

The Goldfern T-Handle Walking Stick is a straightforward adjustable example. The Strider Adjustable Fischer Support Stick uses a broader anatomical grip and comes in separate left- and right-hand versions.

A fixed-height product such as the Premium Wooden Walking Stick only works well if its fixed height actually suits the user. Do not choose a fixed cane on appearance alone if you are uncertain about fit.

Which hand should hold a walking stick?

Where one leg is weaker or painful, a walking stick is commonly held in the hand opposite the affected leg. This allows the stick and affected leg to share part of the walking cycle and can provide a more natural support pattern.

That is not universal. Stroke, other neurological conditions, problems in both legs, shoulder or hand pain, and a clinician-directed gait strategy can change which side is most appropriate. If the person has already been given a technique by their physiotherapist, follow that rather than changing sides because of a general online rule.

What is the usual walking sequence with a cane?

A common pattern for one painful or weaker leg is to move the stick forward with, or just before, the affected leg and then step through with the stronger leg. The stick should be placed far enough ahead to provide support without forcing the person to lean or reach.

If the person cannot coordinate the sequence, repeatedly crosses the stick in front of their feet or needs to load very heavily through the handle, the aid or technique should be reassessed.

For help choosing the type of stick in the first place, see our Walking Stick & Cane Buying Guide.

How to position a quad cane

A quad cane such as the Goldfern Quad Cane or Quad Walking Stick has a wider multi-point base. Before weight is transferred through the handle, all four ferrules should be in secure contact with the floor.

The base should sit beside the user rather than in the path of the feet. Some quad bases have an orientation that allows the longer part of the base to sit away from the body. If the cane repeatedly catches the user's shoe, the orientation, base size or whole aid may need reviewing.

A quad cane offers more ground contact than a single-point stick, but it is not the same as the broader support of a walking frame.

How to fit a forearm or elbow crutch

For a forearm crutch, the handgrip can again be set around wrist-crease height as a practical starting point. The cuff should sit below the elbow so the forearm is supported without preventing normal elbow bending.

MoveSmart's Adult Standard Crutches use a conventional forearm-crutch setup, while the Adult Anatomical Crutches use shaped handgrips. After changing height, make sure every push button or locking mechanism is fully engaged before the crutch is loaded.

Using the correct crutch height is only part of the job. The person must also be able to place the crutch safely, keep the cuff aligned with the forearm and use the walking pattern required for their injury or condition.

Should I use one crutch or two?

The answer depends on why the crutches are being used. Two crutches are commonly used when a person needs to substantially reduce loading through one leg or needs bilateral support. A single crutch may be used later in rehabilitation or where one-sided support is sufficient.

Do not progress from two crutches to one, or from one crutch to a walking stick, simply because walking feels easier on a particular day. After surgery, fracture or injury, progression should follow the treating team's weight-bearing and rehabilitation instructions.

Weight-bearing instructions take priority

Non-weight-bearing, partial-weight-bearing and weight-bearing-as-tolerated instructions are not interchangeable. They change how crutches are used and how much load the recovering leg may take.

If you have been given a specific restriction by a surgeon, physiotherapist or rehabilitation team, that instruction takes priority over general advice in this guide. If you are unsure what your weight-bearing status means, check before changing your gait or reducing the number of crutches.

For broader temporary-recovery equipment, see Recovering at Home After Surgery or Hospital.

Choose a handle that the hand can control comfortably

Handle shape matters if grip strength, arthritis or hand pain is an issue. The hand should be able to maintain control without excessive squeezing or pressure concentrated on a small painful area.

The Strider Fischer Support Stick spreads contact across a broader area of the palm and is hand-specific. It may make gripping more comfortable for some people, but an ergonomic handle does not compensate for using the wrong side, incorrect height or an aid that provides too little support.

Our Arthritis at Home guide covers other everyday aids that can reduce gripping, bending and reaching.

Check ferrules and walking-stick bases regularly

The rubber tip is the main ground-contact component on a single-point cane or crutch. Inspect it for worn tread, cracking, hardening, uneven wear or looseness. Replace it before it becomes smooth or unreliable.

Replacement accessories need to match the shaft correctly. The Walking Stick Non-Slip Foot is designed for compatible 19 mm shafts, while the Mobilis Stability Foot provides a broader self-standing base for compatible sticks.

A broad or self-standing foot can make placing the cane more convenient, but it does not make an unsuitable walking aid safe and does not increase the cane's user-weight rating.

Footwear can change the effective height

Fit the aid while wearing the shoes most commonly used for walking. A substantial change from thin indoor footwear to a much thicker sole can change the user's effective height relative to the handgrip.

Footwear should also be secure on the foot. Loose slippers, badly worn soles and trailing clothing can create problems that a correctly adjusted cane or crutch cannot compensate for.

Stairs need an individual technique

Stair technique depends on the rail available, which leg is affected, the person's balance and any weight-bearing restriction. A quad cane can also be awkward on stairs because its full base may not fit securely on one tread.

Rather than applying a generic stair mnemonic to every person, have the physiotherapist or rehabilitation team demonstrate the technique that matches the injury, rail setup and walking aid. Practise it before relying on the stairs independently.

What an occupational therapist and physiotherapist can add

A physiotherapist can assess gait, balance, lower-limb loading and whether a stick or crutch provides the right level of support. They can teach the walking pattern and decide when it is appropriate to progress to a different aid.

An occupational therapist can assess how the aid works in real daily activities: opening doors, getting through the bathroom, managing clothing, carrying items and moving between different surfaces. They can also identify when the home setup itself is making the walking aid harder to use.

When a stick or crutch may no longer be enough

Frequent falls, needing to put a large amount of body weight through one hand, worsening balance, difficulty coordinating the aid or increasing fatigue can all be reasons to reassess the level of support.

A walking frame or rollator may provide a broader support base for some people, but it should be chosen for the person's gait and environment rather than simply because it looks more stable. See our Walker and Rollator Setup Guide and Walker Buying Guide.

Frequently Asked Questions

What height should a walking stick be?

Wrist-crease height while standing naturally is a useful starting point, usually leaving a comfortable slight bend at the elbow. Individual posture and gait can require a different setting.

Which hand should I hold a walking stick in?

It is commonly held opposite a weaker or painful leg, but neurological conditions, upper-limb problems and individual gait strategies can change this advice.

How bent should my elbow be?

A comfortable slight bend is generally preferred rather than locking the arm straight. The shoulder should remain relaxed.

Where should a forearm-crutch cuff sit?

The cuff should sit below the elbow so it supports the forearm without interfering with normal elbow bending.

Should I use one crutch or two?

That depends on balance, the amount of support required and any prescribed weight-bearing restriction. Follow the rehabilitation plan provided for your injury or condition.

Can I switch from crutches to a walking stick when I feel ready?

After surgery or injury, do not change aids solely based on how one day feels. Progress according to the treating team's advice.

Do all four feet of a quad cane need to touch the floor?

Yes. The base should be placed so all four ferrules have secure contact before weight is transferred through the handle.

How often should a ferrule be replaced?

There is no fixed interval. Replace it when tread is worn, the rubber cracks or hardens, it wears unevenly or it becomes loose.

Is a self-standing cane base safer than a normal ferrule?

It provides a broader footprint and can help the cane stand on suitable surfaces, but it does not remove the need for correct fit, placement and balance.

Do I need to readjust my cane if I change shoes?

A major change in sole height can affect fit. Recheck posture and handgrip position if footwear changes substantially.

Can I use a quad cane on stairs?

It can be difficult to place the full base safely on a tread. Stair technique should be individually assessed rather than assumed.

When should I move to a walker or rollator?

Have the level of support reassessed if a stick or crutch no longer provides enough stability, requires very heavy loading, or is difficult to coordinate safely.