President Joe Biden has been wearing tennis trainers and having physiotherapy as part of a plan to stop him falling over before the election, according to reports.
Concerns over Mr Biden’s age have become a thorn in the side of his re-election campaign and his team are understood to be fearful another tumble could shatter his November 2024 hopes - especially if it happens weeks before voters go to the polls.
News of the precautions emerged as the 80-year-old became the first president in modern history to join a picket line on Tuesday, as he spoke to striking workers protesting low pay in the car manufacturing industry.
In what historians called an “absolutely unprecedented” move, Mr Biden told members of the United Auto Workers (UAW) trade union in suburban Detroit to “stick with it”and hold out for “a significant raise and other benefits”.
The industrial action, and battle for union support, have become political flashpoints in the 2024 campaign, which has also seen questions raised over Mr Biden’s fitness for re-election come to the fore in recent months.
In June, Mr Biden tripped and fell over a sandbag at the US Air Force Academy graduation in Colorado.
The moment was quickly seized on by his Republican rivals, with former president Donald Trump describing the fall as “sad” and claiming it “happened pretty badly”.
Senior Democrats are understood to have been frustrated with Mr Biden’s team following the incident, and are also said to be concerned that he often looks confused over which way to exit following a speech.
Steps being taken by his team to prevent a repeat include enlisting the help of a physical therapist, Axios reported.
Mr Biden, who is the oldest president in US history, has been doing exercises since November 2021 to help improve his balance after he was diagnosed with “a combination of significant spinal arthritis” and “mild post-fracture foot arthritis” by his doctor.
Mr Biden spends several mornings with physical therapist Drew Contreras, who also worked with former president Barack Obama.
His doctor has also recommended exercises for balance called “proprioceptive maintenance manoeuvres”.
The Democrat leader has also been wearing tennis shoes to avoid slipping, as well as using the short staircase on Air Force One instead of the sometimes-wobbly 18ft staircase to the plane’s upper door.
The Axios report came after the White House was forced to correct Mr Biden’s transcript when he confused “million” for “billion” and stumbled over a four letter acronym on Monday night.
Mr Biden announced the government was investing $40 billion (£33 billion) in the Pacific Islands Infrastructure Initiative – instead of $40 million (£33 million), according to the official transcript.
He then appeared to struggle to pronounce the acronym PIII, saying: “We call it the PG... PI... anyway, it doesn’t matter what we call it, but that’s what it is. I was going to get back to acronyms, and I’m going to... I’m going to... withstand not doing that.”
Help the aged?
A poll published by the Wall Street Journal earlier this month found 73 per cent of Americans, including two-thirds of Democrats, think Mr Biden is too old to run again in next November’s presidential election.
White House spokesperson Andrew Bates told Axios that the president’s physical therapy sessions are not “new” and were “proactively and transparently disclosed in a 2021 report from the president’s doctor and again this year”.
“This article fits an unfortunate pattern of media attempting to sensationalise something that has long been public, rather than covering the president’s very real achievements for hardworking Americans,” Mr Bates added.
The Telegraph has contacted the White House for comment.
Mr Biden’s appearance on the picket line on Tuesday came a day before Mr Trump, the 77-year-old Republican front-runner for president, will speak to auto workers in Michigan.
The rare back-to-back events highlight the importance of union support in the 2024 presidential election, even though their members represent a tiny fraction of US workers.
The UAW strike is directed at three Detroit-based manufacturers: Ford, General Motors and Stellantis, the parent company of Jeep and Peugeot. The union is demanding a 40 per cent pay rise for its members in the next four years.
Mr Biden has long framed himself as the most pro-union president in American history.
Dressed in a baseball cap and sweater, he told workers in Detroit: “Unions built the middle class. It’s a fact – so let’s keep going.”
Erik Loomis, a professor at the University of Rhode Island and an expert on US labour history, said the event was “absolutely unprecedented”.
He added: “no president has ever walked a picket line before,” because they historically “saw themselves more as mediators”.