Clinically reviewed by What is walking difficulty
Difficulty walking is a symptom, not a diagnosis. The first job is to find what is stopping you, because the five common limits need different treatments: pain, weakness, poor balance, breathlessness and fear. In Urdu it is chalne mein takleef.
The most important thing to know is this. When an older person stops walking after an illness or a hospital stay, it is usually lost muscle, not lost ability. A week or two in bed can take away enough leg strength to stop an eighty year old standing up, and most of it comes back with training. This is more often reversible than families assume.
Symptoms you might have
- Shorter, slower steps, and shuffling instead of lifting the feet
- Struggling to stand up, or needing the wall and furniture to cross a room
- One leg dragging, or the toe catching and scuffing the floor
- Pain in the knee, hip, back or foot that stops you after a set distance
- Pain or numbness in both legs that builds as you walk and eases when you sit, suggesting a narrowed spinal canal
- Calf pain that comes at the same distance every time and goes within minutes of stopping, which needs the arteries checked
Why it happens
- Knee or hip osteoarthritis, and foot pain including plantar fasciitis
- Muscle loss after a hospital stay, a long illness, or weeks spent sitting
- Lower back problems and narrowing of the spinal canal
- After a stroke, or with Parkinson's disease
- Numb feet from untreated diabetes, and foot drop from a nerve problem
- After a hip fracture, or a joint replacement that was never properly rehabilitated
- Poor balance and fear of falling, which shortens the stride on its own
- Heart or lung disease, anaemia, and narrowed leg arteries
When you should see a physiotherapist
Come in early, while the problem is weakness and not yet a habit. Also come after a hospital discharge, after a fracture, or whenever walking distance has dropped over a few months. Difficulty that developed over days should be seen by a doctor first.
Go to a hospital immediately for sudden weakness in a leg, slurred speech, a drooping face, or numbness down one side. Go immediately for new numbness around the groin or back passage, loss of bladder or bowel control, or weakness in both legs. Go the same day after a fall where the hip cannot bear weight, and for one calf that is swollen, hot and painful, which must be checked before any exercise.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
Fill this in and WhatsApp will open with your details ready to send.
یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Treatment starts by measuring what you can do now: how far, how fast, how many chair rises, and what makes you stop. The training then targets whichever limit came out worst, and the measurements are repeated so progress is a number.
- Progressive strengthening for hips, thighs, calves and ankles. This is the main treatment for most older people with walking difficulty, and it has to get harder over the weeks
- Gait retraining, working on step length, heel contact, arm swing and turning, usually with a rhythm to walk to
- Walking distance building on a measured route, adding a minute or two a week
- Balance training, because a short careful stride is often fear rather than weakness
- Manual therapy for a stiff hip, knee or ankle blocking a normal step
- Ultrasound and TENS for the painful joint or heel limiting walking, so the strength work becomes possible
- Walking aid selection, sizing and training, including on stairs
Most people referred for difficulty walking need strength and balance training, not an operation. A worn out knee or hip, or a badly narrowed spinal canal, sometimes needs surgery, and that is an orthopaedic surgeon's decision.
Exercises, and what to avoid
What helps
- Sit to stand from a firm chair, ten times twice a day, building towards doing it without hands
- Step-ups onto a low step, heel raises at a counter, and mini squats holding the counter
- Marching on the spot, then walking a fixed route counting minutes rather than steps
- Short frequent walks, five to ten minutes several times a day, not one long walk
What to avoid
- Resting it out. Every week of sitting makes the legs weaker and the next attempt harder
- Pushing through sharp pain, or into a newly swollen joint
- Pulling up on furniture or another person's hands. Push up from the chair arms
- Using a stick or frame that nobody measured. The wrong height makes walking worse and causes wrist and shoulder pain
What you can do at home
Size a walking stick like this: stand upright in your usual shoes with the arm hanging loose. The top of the handle should reach the crease of your wrist, which puts a slight bend in the elbow. Too long and you lean sideways, too short and you stoop.
Hold a stick in the hand opposite the painful or weak leg. Move it in order: stick and weaker leg together, then the stronger leg. On stairs, lead up with the stronger leg and lead down with the weaker leg and the stick. Up with the good, down with the bad.
Replace the rubber tip when it wears smooth. A bald tip on a wet floor is dangerous.
Set up a walking route at home with a chair at each end. Heat before walking eases a stiff joint, and ten minutes of ice after helps a swollen knee.
How long it takes
Walking lost to a hospital stay or a long illness usually comes back substantially in four to eight weeks of daily work, faster in someone who was walking well a month earlier.
Where arthritis pain is the limit, expect eight to twelve weeks for a useful change in distance, then ongoing maintenance.
After a stroke, most recovery happens in the first three to six months and continues more slowly to twelve or eighteen months. See the stroke rehabilitation page.
It goes faster when treatment starts early and the home practice is done daily. It goes slower with several causes together, long bed rest, and low mood, which is common and worth telling the doctor.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
چلنے میں تکلیف بیماری نہیں، ایک علامات ہے۔ پہلے دیکھنا ہوتا ہے کہ اصل رکاوٹ کیا ہے: درد، کمزوری، توازن، سانس، یا ڈر۔
سب سے اہم بات: اگر بزرگ ہسپتال سے آنے کے بعد چلنا چھوڑ دے، تو یہ اکثر گوشت کی کمزوری ہوتی ہے، ہمیشہ کی محرومی نہیں۔ ورزش سے طاقت واپس آ جاتی ہے۔ آرام سے ٹھیک نہیں ہوگا۔
چھڑی صحیح ناپیں: جوتا پہن کر کھڑے ہوں، بازو نیچے لٹکا دیں، چھڑی کا ہینڈل کلائی کی لکیر کے برابر ہو۔ چھڑی دکھتی ٹانگ کے الٹے ہاتھ میں پکڑیں۔ سیڑھی چڑھتے وقت پہلے مضبوط ٹانگ، اترتے وقت پہلے کمزور ٹانگ اور چھڑی۔
دن میں پانچ دس منٹ کے چھوٹے چکر کئی بار لگائیں، ایک لمبی سیر سے بہتر ہے۔
Roman Urdu
Chalne mein takleef bimari nahi, ek alamat hai. Pehle dekhna hota hai ke asal rukawat kya hai: dard, kamzori, tawazun, saans, ya dar.
Sab se ahem baat: agar buzurg hospital se aane ke baad chalna chhor de, to ye aksar gosht ki kamzori hoti hai, hamesha ki mehroomi nahi. Warzish se taqat wapis aa jati hai. Aaram se theek nahi hoga.
Chhari sahi napen: joota pehen kar khare hon, bazu neeche latka den, chhari ka handle kalai ki lakeer ke barabar ho. Chhari dukhti taang ke ulte haath mein pakrein. Seerhi charhte waqt pehle mazboot taang, utarte waqt pehle kamzor taang aur chhari.
Din mein paanch das minute ke chhote chakkar kai bar lagayen, ek lambi sair se behtar hai.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
My mother stopped walking after a hospital stay. Will she walk again?
How do I choose the right walking stick?
Which hand should the walking stick be in?
Does using a walker make you weaker?
Is it too late to start walking training at eighty?
Related conditions
- Parkinson's disease physiotherapy
- Osteoporosis and weak bones
- Bed sores, prevention and care
- Balance problems in older people
- Falls and fall prevention