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Using a cane

Description

It is important to start walking soon after surgery for a leg injury. But you will need support while your leg is healing. A cane can be used for support. It may be a good choice if you only need a little help with balance and stability, or if your leg is only a little weak or painful.

The 2 main types of canes are:

• Canes with a single tip
• Canes with 4 prongs on the bottom

Your surgeon or physical therapist will help you choose the type of cane that is best for you. The type of cane you use will depend on how much support you need.

Talk to your health care provider or therapist if you are having a lot of pain, weakness, or balance problems. Crutches or a walker may be better options for you.

Cane Basics

The most common question about using a cane is, "Which hand should I hold it in?" The answer is the hand opposite the leg that you had surgery on, or that is the weakest.

The tip or all 4 prongs need to be on the ground before you put your weight on your cane.

Look forward when you walk, not down at your feet.

Make sure your cane has been adjusted to your height:

• The handle should be at the level of your wrist.
• Your elbow should be slightly bent when you hold the handle.

Choose a cane with a comfortable handle.

Use a chair with armrests when you can to make sitting and standing easier.

Walking and Turning with a Cane

Follow these steps when you walk with a cane:

1. Stand with a firm grip on your cane.
2. At the same time that you step forward with your weaker leg, swing the cane the same distance in front of you. The tip of the cane and your forward foot should be even.
3. Take some of the pressure off your weaker leg by placing pressure on the cane.
4. Step past the cane with your strong leg.
5. Repeat steps 1 through 3.
6. Turn by pivoting on your strong leg, not the weaker leg.
7. Go slowly. It may take a while to get used to walking with a cane.

Stepping Up or Down a Step or Curb

To go up one step or a curb:

• Step up with your stronger leg first.
• Place your weight on your stronger leg and bring your cane and weaker leg up to meet the stronger leg.
• Use the cane to help your balance.

To go down one step or a curb:

• Set your cane down below the step.
• Bring your weaker leg down. Use the cane for balance and support.
• Bring your stronger leg down next to your weaker leg.

If you had surgery on both legs, still lead with your strong leg when going up and your weak leg when going down. Remember, "up with the good, down with the bad."

Going Up or Down a Set of Stairs

If there is a handrail, hold onto it and use your cane in the other hand. Use the same method for a set of stairs that you do for single steps.

Go up the stairs with your stronger leg first, then your weaker leg, and then the cane.

If you are going down the stairs, start with your cane, then your weaker leg, and then your strong leg.

Take the steps one at a time.

When you reach the top, stop for a moment to regain your balance and strength before moving on.

If you had surgery on both legs, lead with your stronger leg when going up and your weaker leg when going down.

Safety Tips

Make changes around your house to prevent falls.

• Make sure any loose rugs, rug corners that stick up, or cords are secured to the ground so you do not trip or get tangled in them.
• Remove clutter and keep your floors clean and dry.
• Wear shoes or slippers with rubber or other non-skid soles. Do not wear shoes with heels or leather soles.

Check the tip or tips of your cane daily and replace them if they are worn. You can get new tips at your medical supply store or local drug store.

As you are learning to use your cane, have someone close by to give you extra support if needed.

Use a small backpack, fanny pack, or shoulder bag to hold items that you need with you (such as your phone). This will keep your hands free while you are walking.

References

Edelstein J. Canes, crutches, and walkers. In: Webster JB, Murphy DP, eds. Atlas of Orthoses and Assistive Devices. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 36.

Meftah M, Ranawat AS, Ranawat AS, Caughran AT. Total hip replacement rehabilitation: progression and restrictions. In: Giangarra CE, Manske RC, eds. Clinical Orthopaedic Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 66.

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