CanesWhat’s to know? Seems like a no-brainer, right?  Well, evidently, from what I see on TV, in many films and all the time on the sidewalks around me, using a cane correctly is not as straightforward as it appears.  Just check out Hugh Laurie on the popular show “House” – he plays a doctor and even he can’t get it right!  This, I might add, makes me CRAZY – so much so, in fact, that I can’t watch the show! This one’s for you Dr. House…

1.  To Cane or Not to Cane, That is The Question?

If pain prohibits you from walking normally, you SHOULD use a cane or crutches to offset some weight and ease the pressure on whatever ails in your lower extremities.  That means, if pain causes you to limp, consider assistance to help you walk with a more normal gait pattern.  This will promote healing and prevent stresses to other areas, like your back or otherwise uninvolved areas of your lower body.

2.  Cane or Crutches – Which Should It Be?

If you are not able to put any weight on your foot at all, or were advised to avoid weightbearing through one ankle, knee or hip, crutches it is – there is no other option.  Advance the crutches and follow by swinging your legs through, putting weight only on your non-injured limb.  As you progress to partial weightbearing, gradually increase the weight you put through your involved side as you continue to use two crutches.  Though you are still putting less weight on your injured side, try to walk with a normal heel toe gait as soon as you are able. Ditch one crutch when you can walk with the aid of just the other, or, you may opt to skip this step and go right to a cane if it provides sufficient relief.

3.  Right or Left – It Makes a Difference!

This is where the entertainment industry almost always goes wrong.  Whether you are using one crutch or a cane, hold it with the hand OPPOSITE the side of your injury.  If that seems counter-intuitive, I will explain the rationale.

When we walk, we naturally swing our arms, swinging the right arm forward as we step with the left foot.  It is this natural opposite arm-leg motion that you want to preserve when using a cane or one crutch.  If you are stepping forward with your injured right foot, you will want to advance the cane in the left hand to allow your left hand and upper body to absorb some of your weight.

If a cane is held on the same side as your injury, you will walk robotically.  Try it and you’ll see what I mean!  If you don’t have an injury, walk without a cane and try swinging your right arm forward at the same time as you step with the right.  Keep the pattern going as you step with the left.  Feels strange, doesn’t it?  It is equally awkward and ineffective when using a cane or crutch.

4.  Sizing It Up

One size does not fit all.  Size your cane so that when your hand rests by your side, the very top of it rests at your hip.  Not sure where your hip is?  Put your hand where you think it is and simply rotate your leg in and out; you will feel the prominence of the greater trochanter moving.  Line the cane up there.  This is well below your waist, and about level with the top of the pubic area.  If the cane is sized correctly, your elbow should be bent about 20 degrees.  If the cane is too tall, it will force you to hike your shoulder or lean the other way – onto your injured side.  Too short and you will have to side-bend toward the cane.

To size crutches, stand upright with the base of each crutch about two inches to the side of your feet and six inches in front.  Most important is to allow a couple of fingers to fit comfortably between your armpit and the top of your crutches.  Provided you also avoid leaning on them, this will prevent excess pressure on the axillary nerve.  As with a cane, when sized correctly, your hand should rest at your hip, with your elbow bent about 20 degrees.

For some reason, when hospitals and physicians dispense assistive devices, they often do so without instruction, just assuming people will use them correctly.  Work with a physical therapist to learn how to walk with crutches or a cane, as well as how to negotiate stairs safely.  It is important to re-learn the proper gait pattern to focus on how you can work toward achieving a return to your pre-injury level of function and keep from establishing habits that might be tough to break.  This will also help in your overall recovery.

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About the author

Abby serves as the Injury Expert for CBS New York where, since 2010, her Injury Breakdown Blog examines injuries in professional sports. She also blogs on health & fitness as well as sports injuries for Huffington Post, and Recovery Physical, where her blog earned a top ten mention for physical therapy blogs in 2012 @ In a ranking of the Top 30 Healthcare Blogs for 2012, Top Masters in Healthcare also rated Abby’s blog in the top three in Physical Therapy! Abby is the founder of Fit-Screen and she welcomes your comments and questions!