Where's the cane supposed to be?
I don’t tend to watch medical dramas on television because I find they are often overdramatic or medically inaccurate. While flipping through channels, I caught a bit of the season premiere of House M.D. For those of you who are familiar with the show, House (Hugh Laurie) walks using a cane due to the pain and weakness caused by an infarction in his thigh muscle. What you may not know is that House does not use the cane in the correct hand. A person should hold the cane in the hand opposite your affected side to improve weight shift, maintain proper arm swing and encourage a normal walking pattern. House’s use of the cane puts more pressure on his affected leg and decreases his base of support. This may cause neck, shoulder and back pain due to his abnormal walking pattern.
Mobility aids, such as canes, are tools used to reduce the risk of falls and to improve balance. It also decreases the weight on an injured or weak leg, as well as the overall effort and energy required to walk. It is important to choose the right mobility aid and learn how to use it correctly to get the most benefit.
The right mobility aid
There are many different types of mobility aids including canes, crutches and walkers. Many factors are considered before choosing the right mobility aid such as your health condition, size and age. With these factors in mind, your physiotherapist can help you find something stable and comfortable to use and suggest modifications as you progress. They can also provide you with information on where to purchase mobility aids and what funding is available for your equipment.
Adjusting a mobility aid
Proper adjustments to your mobility aid can go a long way, especially if you have the proper footwear. It promotes good posture, efficiency and prevents injury.
Canes are standard (1-point), 3-point, or quad (4-point). To measure the proper height of the cane, hold the cane in the hand opposite your affected side. Stand tall with the tip of the cane approximately 15 centimetres away from your foot. With arms resting comfortably at your sides, adjust the height of the cane so that its handle is level with your wrist crease.
Crutches have either a standard (underarm brace) or a forearm brace. Like the cane, you must stand tall and place the tips of both crutches on the floor, approximately 15 centimetres from the side of each foot. Rest your arms at your sides and adjust the height of the crutches to maintain about two fingers breadth between your armpit and the top of the crutch. Once the crutches are measured for the proper height, adjust the crutch handles so that they are level with your wrist creases.
Some walkers are standard (4-points), while others have either 2 or 4 wheels (with or without a seat). Adjust the height of the walker so that its handles are in line with your wrist creases when you are standing tall with your heels in line with the back wheels or points.
When climbing stairs, lead with the stronger leg then follow with the weaker leg and cane or crutch. When going down stairs, the weak leg goes first. One hand should hold the stair rail and the other hand should hold the crutch or cane, always moving it in time with the weak leg. Remember to take one step at a time and think “up with the good, down with the bad.”
Sitting and standing
Before you sit down, make sure you back into the chair or bed until you feel it touch your legs. Then, reach back with your hands one at a time to slowly lower yourself. When standing up, do not use your walking aid to pull yourself up – it is likely to tip over. Instead, position yourself at the edge of the chair with your mobility aid in front of you or within reach. Lean forward, or “nose over your toes,” and use the chair’s armrests to push up to stand.
Walker with a seat
A rolling walker with a seat allows you to take a break when walking. When preparing to sit, position the walker in front of a wall, apply the brakes, turn around and slowly sit down using the handles for support. To stand, push off both of the walker handles. Once standing, turn around slowly, remove both brakes and resume your walk.
Always be sure that you are using your mobility aid properly. After all, they are tools that help you maintain your independence and mobility. House may have the answer to rare and complex cases, but when it comes to using a cane, don’t follow this doctor’s orders.
Adrian Salonga is a graduate of the University of Manitoba with a Bachelor’s degree of Medical Rehabilitation in Physical Therapy. Please send your questions regarding mobility, health promotion, or injury prevention to email@example.com.