Physical Therapy Tips for Using Canes and Walkers
Navigating daily life with a cane, walker, or crutches can feel overwhelming at first, but the right guidance can make all the difference. Whether you’re recovering from surgery, managing an injury, or simply looking to improve your mobility, knowing how to choose and use an assistive device properly is key to staying safe and independent.
I’m Lauren Masi, Doctor of Physical Therapy and Board Certified Orthopedic Clinical Specialist. I’m also the owner and Clinical Services Director of Bay Area Physical Therapy and Lafayette Physical Therapy. Today, we’re going to talk about assistive devices, how to tell if you need one, and how to use one safely.
What Is an Assistive Device?
First, what is an assistive device for mobility? It is a device that helps you be able to move with more independence. For example:
- Single point canes – a classic cane with one point of contact on the ground
- Front-wheeled walkers – a walker with two wheels on the front corners and two feet on the back corners
- Axillary crutches – standard crutches that rest under the armpits
Why You Might Need an Assistive Device for Mobility
When it comes to assistive devices, whether or not you need one will depend on your level of balance, strength, and the specific movement challenges you’re experiencing.
Sometimes people need one after a surgery or after an injury, and the one prescribed to you is going to depend on the restrictions that your doctor put upon your weight-bearing status.
For example, after some surgeries, you might not be allowed to put any weight on a particular lower extremity. In that case, your doctor might recommend axillary crutches.
How Your Physical Therapist Helps You with Assistive Devices
Our goal as physical therapists is to try to transition you to the least supportive device as quickly as possible and wean you off appropriately so that you can get back to walking without any assisted device.
Sometimes, you might be using a cane or a walker because your balance is a little poor and we are concerned about your safety, even if you haven’t had an injury or a surgery. Remember, we definitely don’t want you to fall and potentially further injure yourself.
Make Sure You’re Using Your Assistive Device with Good Positioning
The height of the assistive device should be at a level where your elbow is bent about 30 degrees. We don’t want it too high and we don’t want it too low where you can lean on it. Remember, it’s just assistive. It’s not supposed to hold you up completely. And when you step forward, you also want to make sure that you’re not leaning over your assistive device.
How to Use a Walker
When using a front-wheeled walker, you should be standing straight and not leaning over your walker. Then as you push it forward, you would take one foot and try to keep your center of mass in the confines of the walker. Then you can roll the walker slightly forward as your next foot is going.
The key is to not push the walker so far ahead that it feels like you’re trying to catch up with it. That could put too much pressure on the walker, and if you’re leaning on it, it could shoot out in front of you and cause you to fall.
If you have a pickup walker (one without wheels), it’s the same concept. You should be standing straight, then you pick up the walker and move it forward just a few inches—again, you don’t want to be reaching and leaning towards it. And after you place it back on the ground, you walk forward until you have both feet in between the walker.
How to Use a Cane
There are different types of cane bases, and there are different reasons that we might give you one type of cane over another. But no matter if your cane has one foot or four, the most important aspect is its height. If you relax your arm down by your side, the handle of your cane should fit in the crease of your wrist.
When you go to walk with the cane, it does matter which hand you have your cane in. Your cane should be in the hand that is opposite to the side of your body where you are injured or weak. For example, if you have weakness or an injury in your left knee, you want to use your cane with your right hand. In essence, your cane becomes a place that you can put extra weight on to take weight off of the affected leg.
And when you walk, the strategy is to put the cane down at the same time as the affected leg. If your cane is in your right hand, then when your left leg moves forward, so should your cane; and when your left foot hits the ground, so should your cane. Then you can lean on the cane for extra support as your right leg moves forward.
How to Use Crutches
Axillary crutches (axillary meaning they go in your armpits) are most commonly issued post-surgery. When it comes to positioning, your elbow should be bent about 30 degrees, not locked straight or held up too high.
As for its height, you don’t want that crutch jamming up into your armpit. You want to have about a two- to three-finger clearance between the top of the crutch and your armpit, because remember, the crutch isn’t what’s holding you up. You will be holding yourself up by displacing weight onto the handlebar.
And just like with a cane, your crutches are assisting you to take weight off of the affected side of your body. Let’s say that your left leg is injured or recovering from surgery. As you go to walk, there are different ways you might go about it depending on your doctor’s instructions:
- No weight on the left leg – you’d move both crutches forward in place of your left leg, then hop your right leg forward while pushing onto the crutches with your hands. This is called a swing through gait pattern.
- Some weight on the left leg – as you heal and you’re able to put more weight on your leg, you’ll move the crutches forward and place them down at the same time as you move your left leg. Then, you can push into the crutches as much as you need to alleviate the weight on your left leg as you step through with your right leg.
- Using only one crutch – near the end of your recovery, you may be reduced to one crutch. This would be used the same way you use a cane, as described above.
Reach Out to Bay Area Physical Therapy
You want to make sure that you’re using your assistive devices correctly and that they fit your body properly, because any poorly fitted equipment could result in injury or even create bad habits that are going to make things harder when you get back to your normal daily activities.
If you have any other questions or need any assistance, please reach out to Bay Area Physical Therapy today for a complimentary consultation.