Walking sticks, in their many forms, serve two broad purposes: they redistribute the physical forces your body absorbs during walking, and they widen your base of support so you are less likely to lose balance. That covers everything from a basic single-point cane used after knee surgery to a pair of trekking poles on a mountain trail. But the people who benefit from them extend well beyond the stereotypical image of an elderly person with a wooden cane. Research over the past two decades has built a surprisingly detailed picture of how walking aids change the mechanics of movement, who gains the most from using them, and how the type of stick matters.
How Walking Sticks Change the Forces on Your Body
The core biomechanical benefit is simple: when you push down on a stick or pole, some of the force that would otherwise travel through your legs gets absorbed by your arms and the ground contact point of the aid. During downhill walking, where knee stress is highest, using hiking poles reduced peak ground reaction forces, knee joint moments, and compressive forces on the tibiofemoral joint by roughly 12 to 25 percent compared with walking unsupported.1PubMed. Knee joint forces during downhill walking with hiking poles That reduction came partly from the poles themselves bearing load and partly from a subtle postural shift: walkers leaned slightly forward, which shortened the lever arm acting on the knee.
The effect isn’t only about forces in the moment. A small study of obese women walking on a steep downhill treadmill found that trekking poles reduced markers of muscle and cartilage damage in blood samples taken after the session. Without poles, creatine kinase, lactate dehydrogenase, and a cartilage-breakdown marker all remained elevated two hours after walking. With poles, those markers had already started returning to baseline.2Journal of Physical Therapy Science. Trekking poles reduce downhill walking-induced muscle and cartilage damage in obese women That suggests the load reduction is large enough to have a real protective effect on joint tissues, not just a comfort improvement.
On level ground and uphill, the picture shifts somewhat. When hikers carried loaded packs on moderate grades, poles did not increase or decrease calorie burn. Heart rate, oxygen consumption, and energy expenditure were statistically identical with and without poles. What did change was how hard the effort felt: perceived exertion was significantly lower with poles for most of the walking bout.3PubMed. Load carriage energy expenditure with and without hiking poles during inclined walking In other words, the work stayed the same, but the walkers felt less strained doing it. That’s a meaningful distinction for anyone covering long distances or managing fatigue.
Knee Osteoarthritis and Joint Pain
If you have knee osteoarthritis, a cane is one of the cheapest and most effective tools available. A randomized trial that assigned patients to use a cane daily for two months found clinically meaningful drops in pain at both the one-month and two-month marks, with the benefit growing over time. Function scores, physical-role quality of life, and even consumption of anti-inflammatory drugs all improved in the cane group compared with controls.4PubMed. Daily use of a cane for two months reduced pain and improved function in patients with knee osteoarthritis A separate randomized controlled trial confirmed the pattern, showing significant improvements in pain, function, and six-minute walk distance when participants used a cane regularly.5PubMed. Impact of cane use on pain, function, general health and energy expenditure during gait in patients with knee osteoarthritis
The mechanism behind these improvements goes beyond simply “leaning on something.” In medial knee osteoarthritis, the damaging force is concentrated on the inner side of the knee joint. Using a cane on the opposite side of the body pushes the ground reaction vector laterally, reducing the knee adduction moment, which is the torque that drives that inner-side loading. Research found that greater body weight support through the cane, combined with holding the cane farther out to the side, amplified this unloading effect in a dose-response fashion.6Osteoarthritis and Cartilage. Contralateral cane use and knee joint load in people with medial knee osteoarthritis This is why physical therapists emphasize holding the cane in the hand opposite the painful knee, not the same side.
Balance and Fall Prevention in Older Adults
Falls are a leading cause of injury in people over 65, and walking sticks address one of the biggest risk factors: poor balance. A study measuring scores on the Berg Balance Scale, a widely used clinical assessment, found that older adults scored significantly better when using a walking stick than without one. The improvement held across weight categories, including those classified as overweight or obese.7PubMed Central. The effect of walking sticks on balance in geriatric subjects
Part of the balance benefit comes from a neurological mechanism that has nothing to do with mechanical support. When your hand contacts a cane touching the ground, your brain receives haptic (touch-based) sensory information about your orientation relative to the floor. Research has shown that this sensory input stabilizes the body in a way that is roughly equivalent to lightly touching a fixed surface with a fingertip. Your nervous system integrates the cane’s feedback into the same neural centers that process visual and vestibular balance cues.8Frontiers in Neuroscience. Haptic Cues for Balance: Use of a Cane Provides Immediate Body Stabilization So even a very light grip on a cane provides balance information that helps your brain keep you upright, before you ever lean weight on it.
Over time, cane users may develop better stability than people who graduate to a rolling walker. A preliminary study compared older adults using single-tip canes with those using rolling walkers and found no initial difference in stability. Five months later, however, cane users had significantly better forward and lateral reach stability than the walker users.9PubMed. Differences in the Limits of Stability Between Older Rolling Walker Users and Older Single-Tip-Cane Users – A Preliminary Study The likely explanation is that cane use still challenges your own balance system enough to maintain or improve it, while a walker does most of the stabilizing work for you. This is a “use it or lose it” effect worth discussing with a physical therapist if you’re choosing between devices.
Posture and Spinal Alignment
Walking aids aren’t posture-neutral. The type you use changes how your spine aligns during walking. A study of patients with adult degenerative scoliosis, a condition where spinal curvature causes progressive difficulty with walking, compared walking sticks to a rolling walker. Patients using walking sticks had a more upright posture: less forward flexion of the head and lumbar spine, and less cervical extension. The rolling walker, by contrast, encouraged a hunched-forward position.10PubMed. Kinematic comparison of the use of walking sticks versus a rolling walker during gait in adult degenerative scoliosis patients For people whose gait problems stem from spinal deformity, this postural difference could influence which compensatory patterns develop over time.
The posture effect matters beyond spinal conditions. Anyone who walks hunched forward shifts their center of gravity in a way that increases fall risk and accelerates fatigue in the lower back. A pair of poles or a well-fitted cane tends to open up the chest and engage the trunk muscles, keeping the torso more vertical. A rolling walker or poorly adjusted cane that’s too short can do the opposite.
Parkinson’s Disease
Walking difficulty is one of the most disabling features of Parkinson’s disease, and Nordic walking, which uses specially designed poles with wrist straps, has emerged as a particularly effective intervention. A systematic review found that symptom severity, walking speed, and gait pattern consistently improved after four to 24 weeks of Nordic walking compared with baseline or other exercise conditions.11Journal of Bodywork and Movement Therapies. The motor and the non-motor outcomes of Nordic Walking in Parkinson’s disease
Individual trials support this. A randomized pilot trial found that an intensive Nordic walking program produced significantly greater improvements in motor symptoms, balance, timed walking tests, and six-minute walk distance compared with treadmill training alone.12PubMed. Effects of an intensive Nordic walking intervention on the balance function and walking ability of individuals with Parkinson’s disease Another trial comparing six weeks of Nordic walking with standard rehabilitation saw gait quality and balance improve in both groups, but the Nordic walking group gained more on a dynamic gait index, though the between-group difference narrowly missed statistical significance.13PubMed Central. Effectiveness of 6-Week Nordic Walking Training on Functional Performance, Gait Quality, and Quality of Life in Parkinson’s Disease
The poles seem to serve as an external rhythmic cue for Parkinson’s patients. The alternating arm-leg pattern of Nordic walking helps bypass the basal ganglia circuitry that Parkinson’s disrupts, essentially giving the brain an external timing signal for each step. This cueing effect is distinct from the mechanical load-sharing that benefits people with joint problems.
Other Clinical Populations
The research extends well beyond arthritis and Parkinson’s. After hip fracture surgery, patients who walked with walking poles showed more symmetrical gait than those using a standard T-cane, both in vertical and forward-backward accelerations. Gait symmetry matters because asymmetric walking patterns after a fracture can overload the healthy side and delay recovery.14PubMed. The effect of using walking poles on the spatiotemporal gait parameters in patients who underwent surgery for hip fractures
People with peripheral arterial disease, who experience cramping leg pain during walking due to restricted blood flow, also benefit. A trial comparing Nordic pole walking with standard treadmill training for these patients found that both groups significantly increased their claudication distance and maximum walking distance, but Nordic pole walking was equally effective and far less expensive, requiring no clinical equipment.15PubMed. Nordic pole walking improves walking capacity in patients with intermittent claudication
For people with multiple sclerosis, an exploratory study comparing trekking poles, single-point canes, and forearm crutches found that both the single-point cane and trekking poles outperformed forearm crutches on walking speed, stride length, and six-minute walk distance. Psychosocial outcomes also favored the cane and trekking poles, with better scores in adaptability, competence, and self-esteem.16PubMed Central. Trekking Poles to Aid Multiple Sclerosis Walking Impairment That last finding hints at something important: the device you carry doesn’t just change how you walk, it changes how you feel about walking.
How Walking Sticks Engage Your Upper Body
One underappreciated aspect of pole-based walking is the degree to which it recruits muscles above the waist. A study comparing Nordic walking with conventional walking found that upper body muscle activation was two to 15 times higher during Nordic walking, depending on the muscle group measured.17PubMed Central. Exploring Muscle Activation during Nordic Walking: A Comparison between Conventional and Uphill Walking The latissimus dorsi (the large back muscle), the posterior deltoid (rear shoulder), and the triceps all showed substantially higher activation during poling than during any other walking condition.18PLOS ONE. Muscular and metabolic responses to different Nordic walking techniques, when style matters
This turns walking into something closer to a whole-body exercise. For people who have difficulty with gym-based upper body workouts, whether due to access issues, motivation, or physical limitations, Nordic walking poles build arm and shoulder engagement into an activity they may already be doing. The flip side is that a standard single-point cane is not designed for this. Its job is to offload the lower body. Electromyographic research on cane and crutch walking shows that these devices reduce leg muscle activity, with reductions of roughly 50 to 65 percent in key leg muscles during non-weight-bearing conditions.19Archives of Physical Medicine and Rehabilitation. Methods for estimating the proper length of a cane That’s the point: if you’re recovering from a leg injury or surgery, you want less leg work, not more upper body training.
Getting the Fit Right
A poorly sized walking stick can make things worse instead of better. A cane that’s too short encourages a hunched posture, and one that’s too long pushes your shoulder into an awkward shrug with each step. Research comparing two common sizing methods found dramatically different results. One method, measuring from the floor to the greater trochanter (the bony bump on your outer hip), produced an appropriate elbow bend of 20 to 30 degrees in only about 8 percent of people. A second method, measuring from the floor to the wrist crease while standing with arms at the sides, produced the correct angle in about 94 percent of people.19Archives of Physical Medicine and Rehabilitation. Methods for estimating the proper length of a cane The takeaway: stand naturally with your arms relaxed at your sides. The top of the cane should be level with the crease of your wrist. When you grip the handle, your elbow should have a slight bend of roughly 20 to 30 degrees.
For trekking and Nordic walking poles, the sizing principle is similar but the numbers differ because poles are used in pairs and the body posture is more upright. Most manufacturers recommend adjusting the pole so your elbow forms a 90-degree angle when the tip is on the ground beside your foot. On steep uphill terrain, shorten them a few inches; on steep downhill, lengthen them. Adjustable poles make this easy. Fixed-length poles save weight but commit you to one setting.
Terrain and the Outdoors
Trekking poles shine on uneven or steep terrain, and the effects differ by slope direction. A review of field-condition studies found that on level ground, poles reduced mean plantar force by about 11 percent and total impulse by nearly 5 percent, with the reduction concentrated in the forefoot.20PubMed Central. A Review of Biomechanical and Physiological Effects of Using Poles in Sports Downhill, the benefit was even more pronounced, with a 14 percent reduction in medial heel impulse and a 13.5 percent reduction in ground contact time. Uphill, the effect largely disappeared.
There’s a metabolic cost that changes with terrain too. During downhill walking, poles increased breathing rate and energy expenditure, likely because the upper body is actively braking on each pole plant.21PubMed Central. Exertion during uphill, level and downhill walking with and without hiking poles For most recreational hikers, that slight extra energy cost is vastly outweighed by the reduction in knee strain and improved stability on descents. Anyone who has limped down a mountain with screaming quadriceps knows the tradeoff is worth it.
Stigma and the Psychology of Using a Walking Aid
One of the biggest barriers to using a walking stick has nothing to do with biomechanics. A qualitative study of seniors from diverse ethnic backgrounds found that many associated mobility aids with shame, loss of independence, and social stigma. Participants described feeling “not normal” and experiencing unwanted attention or pity in public spaces. Concern about discrimination was particularly strong among non-Hispanic Black and Hispanic participants.22PubMed Central. Perspectives on Use of Mobility Aids in a Diverse Population of Seniors
Cultural context shapes these perceptions in unexpected ways. A comparative study found that perceived stigma around walking aids was actually higher in France than in Cameroon, at about 22 percent versus 14 percent. In Cameroon, by contrast, walking aids more often carried symbolic significance as markers of social status or traditional authority.23Journal of Aging and Rehabilitation. Walking aids in geriatric rehabilitation as double-edged swords The framing of a walking stick as a medical device versus a personal accessory or a symbol of wisdom varies enormously across cultures, and that framing directly influences whether people actually use the tools prescribed to them.
This stigma is worth confronting honestly because the consequences are real. People who avoid using a walking aid when they need one fall more, move less, and become more socially isolated. One practical reframe that clinicians sometimes suggest: trekking poles carry almost no social stigma because they are associated with fitness and outdoor recreation rather than disability. For someone who resists a cane but would benefit from bilateral support, a pair of trekking or Nordic walking poles can deliver similar mechanical benefits while avoiding the psychological weight of a “medical” device. The MS study mentioned earlier found that trekking poles scored better on self-esteem measures than forearm crutches, which supports this approach.
Older Adults with Dizziness
Vestibular disorders, which cause dizziness and unsteadiness, are extremely common in older adults. A study of elderly patients with dizziness found that a cane alone did not improve step length or walking speed before vestibular rehabilitation. But after completing a rehab program, using a cane significantly increased step length, and the combination of rehabilitation plus cane use increased walking speed from roughly 90 to 96 centimeters per second.24Auris Nasus Larynx. Effects of using cane and vestibular rehabilitation on the walking function in elderly patients with dizziness The implication is that a cane works best as part of a broader rehabilitation strategy, not as a standalone fix. For people with vestibular problems, the cane appears to amplify the gains from rehab training, perhaps by providing that extra sensory input that helps a retrained balance system perform more confidently.
This finding applies more broadly. A walking stick is a tool, and like most tools, its effectiveness depends partly on the skill of the person using it. A few sessions with a physical therapist to learn proper cane or pole technique, appropriate weight-bearing strategy, and correct sizing can make the difference between a device that gathers dust in the closet and one that meaningfully changes daily mobility.