Remember when you got your first job? The idea sounded so wonderful, right? It meant independence and money. Then you started working and you realized that hard work is hard work, and maybe having a job isn’t so fun after all.
That’s kind of what it’s like to get a walker for the first time. Sure, after surgery or a fall you’re glad to have the help to maintain your independence, but as you start feeling better, you feel like the walker is actually more of a chore.
For some, the walker is and will continue to be a necessary part of life and that is okay! I know it doesn’t feel like it right now, but I promise it is!
Using a walker does not make you “old,” “weak,” “feeble,” “frail,” or any less of person!
If you truly need a walker, the only thing it changes about you is that you are now more stable when you walk.
However, I know there are many people who no longer want to use a walker, and they may not need to. I will say that regaining the strength and balance to not need a walker can be a challenge, but if you’re up for it, here are the exercises I recommend you do (with supervision and the approval of your physical therapist) to help achieve that goal.
**Disclaimer: The following is not a guaranteed method! Just a few exercise suggestions, that is all! Once again, there are people who truly need to continue to use a walker, and it’s up to a licensed therapist to make that decision. Additionally, exercise adaptations must be made for each client based on the individual’s diagnoses/precautions/etc.**
Ten Exercises to Help Decrease the Need for a Walker
1. Balance Exercises (4)
A Note on These Balance Exercises: A couple years ago, I got certified in Tai Ji Quan: Movement for Better Balance. I highly encourage you to look up this program (these exercises are adapted from that).
These balance exercises focus on not just standing on one leg or standing with your feet together and eyes closed, but actually moving yourself outside of what we call your “base of support”.
Base of support: Areas where you come in contact with your seat and/or the floor. A wide base of support helps you feel stable, and a narrow base of support may cause you to feel more unbalanced.
We feel most balanced when our center of gravity (where we hold most of our weight) is directly over our base of support.
These exercises work on making you feel more unbalanced by shifting your center of gravity from centered to the front and back limits of your base of support. This forces our brain and body to adjust to the feeling of being more “off balance.” Over time this enables us to be able to increase our stability because our body is trained to react to instability.
If we think about it, it’s really not that revolutionary, right? When we lift weights, we know we need to increase the load in order to gain muscle. The same is true for balance. If it’s not a challenge, we will never make any gains.
1. Shifting Forward in a Chair
1. Sit on the front half on your chair
2. Place your feet flat on the floor
3. Shift your weight from where you feel centered (i.e. most likely sitting upright on your buttocks) to the balls of your feet by leaning forward at your torso. Move your arms forward and upwards to help move you forward as well.
2. Shifting Backward in a Chair
1. Sit on the front half on your chair
2. Place your feet flat on the floor
3. Shift your weight from where you feel centered to your tailbone by shifting backwards at your torso. Move your arms upward to help move you backwards as well.
3. Shifting Forward in Standing
1. Stand with your feet apart (move them as far apart as you need to to feel balanced)
2. Shift your weight from the center of your foot to the balls of your toes. (Your heels may or may not come off the ground)
3. Move your arms forward and upwards to help move you forward as well.
4. You should feel slightly off balance, but not that you’re actually going to fall. Take a breath in and then exhale as you bring yourself back to center (weight shifted to the center of the feet)
4. Shifting Backward in Standing
1. Stand with your feet apart (move them as far apart as you need to to feel balanced)
2. Shift your weight from the center of your foot to your heels. (Your toes may or may not come off the ground). **Do not just lean your shoulders back, actually shift your weight to your heels, so your torso is still straight**
3. Move your arms forward and upwards to help move you backward as well.
4. You should feel slightly off balance, but not that you’re actually going to fall. Take a breath in and then exhale as you bring yourself back to center (weight shifted to the center of the feet)
2. Sit to Stands with No Hands (3)
It’s not a requirement that someone stand without pushing from a chair in order to be able to walk without a walker. I’m sure I push up from my chair without thinking about it all the time.
However, practicing rising from a chair without use of arms to push up requires the abdominals and the muscles of the whole back of the leg to really work, leading to increased functional strength (that’s what you call bang for your buck!)
I break this exercise down to three parts, so if you can’t stand up all the way without use of your hands, start with the first one. I still recommend practicing all parts of the sit to stand, even if you’re able to do this one already, because that will lead to increased muscle control along with increased strength.
1. Lifting Your Buttocks
1. Sit on the front portion of the chair.
2. Shift your weight from your buttocks to your feet by leaning your torso way forward.
3. Move your arms in a forward and upward motion to help lift your buttocks off of the seat.
2. Standing Halfway Up
1. Sit on the front portion of the chair.
2. Shift your weight from your buttocks to your feet by leaning your torso way forward.
3. Move your arms in a forward and upward motion to help lift your buttocks off of the seat.
4. Squeeze your abdominals, buttocks and the muscles in the back of the legs to help you stand halfway up.
5. Slowly lower your buttocks back to the chair.
3. Standing All the Way Up
1. Sit on the front portion of the chair.
2. Shift your weight from your buttocks to your feet by leaning your torso way forward.
3. Move your arms in a forward and upward motion to help lift your buttocks off of the seat.
4. Squeeze your abdominals, buttocks and the muscles in the back of the legs to help you stand all the way up, lifting your arms up towards the ceiling.
5. Slowly lower your buttocks back to the chair.
3. Power Exercises (1)
We’ve all heard that we lose muscle mass as we age, but (unfortunately) what’s not always talked about is that we also lose POWER!
Our muscles are made up of different fiber types. Basically, one type is endurance and one type is speed. As we age, we lose the speed muscle fiber at a higher rate.
Speed+ Strength = Power
Power is arguably more critical to keeping an older adult functioning at a high level. So we need to train speed within our strength workouts.
The way a PT would train power is by using a cue like “Up quickly and down slowly” or “bend quickly and straighten slowly.” We don’t want the whole movement to be fast, because we want to build muscle control during the slow movement. That’s how we get speed and strength together!
I like to do power exercises in the form of sit-to-stands, step-ups on stairs of varying heights, bridging, rolling (“roll forward quickly and backward slowly”)- pretty much anywhere you can combine speed and control.
Since we already practiced sit to stands, let’s turn that into a power exercise.
1. Sit to Stand: “Up Quickly and Down Slowly”
1. Sit on the front portion of the chair.
2. Shift your weight from your buttocks to your feet by leaning your torso way forward.
3. Swing your arms upward with some “umph” to help lift your buttocks off of the seat.
4. Quickly squeeze your abdominals, buttocks and the muscles in the back of the legs to propel you all the way up, lifting your arms up towards the ceiling.
5. Keeping your abdominals tight/engaged, lower your buttocks back to the chair as slowly as you can.
4. Stepping Strategies (2)
In the therapy world, a “stepping strategy” means taking a large step to avoid falling. It’s what you do if you’re standing in line at Disneyland and all of a sudden an excited kid bumps into you from behind. You’re forced to take a step forward to keep your balance.
Warning: You will feel so silly practicing these! But remember! You will feel even more silly if you fall in public!
When most of us are about to fall, we panic! We try to avoid it by grabbing on to someone or something. Training your body to have a good, solid stepping strategy will decrease the panic and increase the chances that your body will react naturally by stepping.
Practicing taking these big steps is creating a new habit in your brain. The more you practice it, the more it’s engrained in you. Then when you’re about to fall, you’ll take a step, without even needing to think about it.
1. Forward Stepping Strategy
1. Stand with your feet apart (move them as far apart as you need to to feel balanced)
2. Shift your weight from the center of your foot to the balls of your toes, until you feel like you may fall forward.
3. Take a HUGE step forward and throw your arms out to the sides.
4. Notice how stable you feel.
5. Reset and repeat using the other foot to step.
2. Backward Stepping Strategy
1. Stand with your feet apart (move them as far apart as you need to to feel balanced)
2. Shift your weight from the center of your foot to the , until you feel like you may fall backward.
3. Take a HUGE step backward and throw your arms in front of you (basically reversing your momentum).
4. Notice how stable you feel.
5. Reset and repeat using the other foot to step.
Stepping strategies need to be practiced forwards, backwards, sideways, diagonals- you get the point. They also need to be practiced A LOT! Habit formation takes time, so practice this as much as you can.
