How to Walk with a Cane: Your Simple 3-Step Guide
Learning how to walk with a cane after a surgery, injury, or for any other reason does not have to be a frustrating or embarrassing experience. When used properly, canes widen the user’s base of support and lighten the load on stressed joints, which dramatically decreases fall risk so you can remain as active as possible (an especially important point for those needing physical therapy). While it may seem like a piece of cake to the observer, the selection, fitting, and use of a cane can make the difference between a strained, shuffling gait and a smooth one. Before even attempting the ultimate cane strut, however, you must find and fit the perfect hardware for your situation.
Selecting the Right Cane
We are not so lacking in self perception to deny the dryness of this topic. But then again, you might actually be the tiniest bit surprised and maybe even fascinated by some of the different types of canes out there. For example, did you know this was a thing??
Technically, this is a special kind of walker designed for stroke victims who need significant support but can only use one arm functionally. Many physical therapists, however, lump this in with the cane family when they are offering options to patients who need to learn how to use a cane.
More conventionally, you may have seen a four pronged cane, known as a quad cane. These are found in “large-based” and “small-based” versions, each offering different advantages. A large-based quad offers more assistance but is harder to ascend stairs with, where a small-based quad is easier to maneuver through crowds/obstacles with but sacrifices some stability.
Finally, the most common kind of cane that you’re probably think of when you picture someone walking with a cane is referred to as a single point cane. Handle, shaft, and tip. Poised and under-assuming, yet assertive. Usually adjustable. Rarely outclassed. Right, that’s enough.
So which of the above will work for you? It depends on the level of assistance you will need when walking with a cane. In order of increasing assistance, it generally goes as follows: single point cane, small-based quad, large-based quad, hemiplegic “walker,” and then we’re getting into crutches territory. This is not the only factor, however. The amount of distance/time you intend to walk, the terrain you will be walking across/over/around, and the portability will also affect your decision. The best practice when learning how to walk with a cane and trying to decide which one is right for you is simply that – practice. If you follow the below tips on how to use a cane to the letter and you still aren’t comfortable with the current assist level, move up to a more supportive cane.
Fitting Your Cane
Many well-intentioned sources, ignorant to the possibility that the world is not full of anatomists, will say “it’s easy, just line up the handle of the cane to the greater trochanter.” Then, feeling like an idiot, you have to google the greater trochanter (it’s just the bony knob on the outside surface of your upper thigh) just so you can learn how to use a cane. Anyway, we prefer to instruct people in this fashion: simply stand up straight, let your arms fall naturally at your sides with palms facing your legs, and have someone place the cane handle between your arm and your body. The tip of the cane should be just outside either heel. Do not grip the cane yet, just keep your hands at your sides. The handle of the cane should be at the crease of your wrist. Boom, done. But wait – which hand does the cane go in?
Okay, final tip before we review how to use a cane. This one gets a lot of people, so please excuse the over-emphatic delivery: The cane goes in the opposite hand of your bad leg. “But I don’t have a bad leg,” you say. “I just have a bad back and nothing else,” you say. This is technically not true. Everyone has a weaker leg. If you did not play soccer, rugby, or football, and you are unsure of which of your legs is the dominant one, picture if someone attacked you and you had to kick them. Which leg would it be? That’s the dominant leg. Before, during, and after you learn how to walk with a cane, you need to always use the cane on the dominant side.
Ok Really: How to Walk with a Cane
Finally, we’re here. If you intend to be walking with a cane, and falling 0% of the time, practice the following:
- Advance the cane AND your weak leg at the same time.
- Advance your “good leg” next.
The above 3-step list, while accurate, is heavily over-simplified. We just really wanted to be concise for once. Here is our full list of steps for how to use a cane after being neurotically, but lovingly expanded by our assistive device specialist:
1. If you are functional enough when walking with a cane to advance the cane and your weak leg at the same time, excellent. If you have significant limitation in strength, energy, balance, or confidence, you should advance the cane first, and then your bad leg.”
2. Ideally, when walking with a cane, your good leg will advance so that it is at least 75% beyond your bad leg when it hits the ground. Capiche? So, if righty is your good leg, then hopefully you can get your right heel to or past your left toes so that you’re not doing the wedding march everywhere you go.
3. It doesn’t have to be down to the millimeter, but proper placement does matter when walking with a cane. Place the cane tip too wide with each step and it it can mess with your gait mechanics or cause pain to the wrist and elbow, not to mention the possibility of the tip slipping and causing a fall. Too narrow and the assist level suffers because your base of support isn’t as wide, or you can kick the cane and then, you guessed it, fall. It is difficult to assign a specific distance as far as cane placement goes, because everyone is different. Generally, maintaining the tip two to four inches outside of your “good” leg is optimal.
Just turn it off, wait ten seconds, then turn it on again. Just kidding. Following is a rapid-fire list of things that might go wrong as you are practicing walking with a cane, and how to fix them quickly.
Can’t get the sequencing right? This can be one of the most frustrating obstacles when learning how to walk with a cane, but never fear. Slow down and count out loud: when you say “one,” advance the cane and your bad leg. On “two,” advance your good leg. You can even use a metronome or music if you prefer.
Does your hand, elbow, or shoulder hurt? First of all, double check your fitting and placement per above. If that still doesn’t work, ensure the wrist of the arm holding the cane is in as neutral of a position as possible, i.e. the wrist is not excessively bent towards or away from the body. If that doesn’t work, you are possibly trying to put too much weight through the cane. Either put more weight on your bad leg, or if that isn’t tolerated, transition to a more stable cane per above.
You now have everything you need to learn how to use a cane, congratulations and good luck! Remember to always take your time, ensure you have a safe environment to practice in, and take breaks as needed.