Hi, I’m Will Riddick, and as a physical therapist one question I get all the time
is, “Should I be using a cane?”
So, in this Walk Talk, I’m going to discuss when you should use an assistive device, like
this cane, and how you might benefit from using one.
Assistive devices are tools that enable people with walking difficulties to walk safely and
more efficiently.
When used correctly and when the right one is matched up with the right person, they
can make a world of a difference in getting around.
However, when used incorrectly or an improper device is chosen, they can actually hinder
people’s ability to get around.
So, how do I know if I need anything to help me walk?
Often times, this is a conversation with your physician or physical therapist, who might
see a potential need based on safety or the mechanics or manner in which you walk.
They are generally the first to alert you, but I always suggest that if you sense any
instability in your walk or any risk for falling during your daily activities, you should consider
some sort of assistive device.
Particularly when you are out in unfamiliar areas, crowded community settings, or on uneven
terrain.
So let’s say you don’t currently use anything to help you walk, but you feel uneasy in your
balance.
It’s likely that your walking impairment is minor.
For you, we want to try to add some support only on one side.
If you have some kind of pain, injury, or history of injury on one side that continues
to impact your walking, we want to place the assistive device on the opposite side of the
body.
For example, if you have a painful left knee you would place the device in your right hand.
It seems counter-intuitive but placing the device on the same side can actually make
it harder for you to walk.
Why is that?
Well, part of this is because the purpose of the cane is to give you a wider base of
support.
The base of support refers to the area on the ground that your body has to balance on
top of to maintain balance control.
This area typically includes your feet and the space immediately between them.
Here’s mine.
When we walk, we only have one foot on the ground for most of the time.
So, during this time our base of support only consists of a single foot.
Our body has to then balance over that foot, otherwise, we lose our balance and begin to
fall.
When we have a cane, this gives another point of contact on the ground to increase our base
of support.
So, the point the cane touches on the floor, the space underneath our foot on the ground
and everything in between becomes our new base of support.
We gain a lot more stability because our area to balance over is now much wider.
If we have the cane on the same side that has an issue, we only increase our base of
support by a little bit, but if we place it on the other side, our base of support becomes
drastically larger.
This gives us stability in difficult situations and improves our balance.
So, again, the device goes on the opposite side.
There’s another reason for this as well, but we’ll leave the physics that explain
that for another time.
If you don’t have any one-sided injuries, pain, or impairments that impact your walking,
you can actually choose either hand for the assistive device.
In this case, most people choose their dominant hand.
Let’s look at the assistive devices that are utilized in one hand.
As I mentioned, if we are dealing with a minor walking impairment, it is likely that we only
need support on one side.
So, in this category we have several options available to us ranging from more to less
support.
If you feel slightly uncomfortable only when navigating terrain such as an outdoor walking
trail then a trekking, or hiking pole, may be sufficient.
Single point canes are the probably the most popular and are great for people who feel
uneasy when traveling outside of the home.
If you’re looking to buy a single point cane, we recommend that you get one with a
single solid point at the end.
Points that swivel, move, or have multiple contact points with the ground could result
in some unsteadiness.
Quad canes and hemi-canes are for people who need significant support as these devices
are able to bear a lot of weight, but they can really slow you down when walking.
These are really only for a certain population and would likely only be recommended by a
physical therapist or physician.
If you don’t feel comfortable with only a cane or a trekking pole, we highly recommend
you talk to a medical professional in order to get the appropriate device for you.
Next let’s look at the assistive devices for individuals who need support on both sides.
People in this category have difficulty walking in their home as well as in the community.
They might be unable to take a step without support or might need the support to alleviate
pain during walking.
Often times people are provided with these devices after a surgery or hospitalization.
They are able to offer a lot of support and safety and can help people with extreme difficulty
in walking to navigate their environment.
So, for assistive devices utilized on both sides, there is again a range of support available.
Once again trekking poles offer the least support, as they are unable to bear full weight,
but they maintain a great deal of flexibility.
For higher level patients, loftstrand crutches and underarm crutches can be very helpful
in order to bear considerable weight but still enable a good walking technique.
Rollators, rolling walkers, and standard walkers offer the most support and can be very helpful
for those with significant difficulty in getting around.
Rollators are typically for individuals who are still able to navigate their community
and are able to manage the brakes and can accommodate for ramps.
This is important as rollators can unfortunately roll away from you if care is not taken to
avoid this.
Rolling walkers and standard walkers are for people who only navigate their home environment
or need supervision with walking in the community.
For any of these devices, we again highly recommend you talk to a professional, such
as a physical therapist, to get the right tool for you.
Obviously, there are numerous factors to consider when choosing an assistive device that are
beyond the scope of our video, but hopefully this gives you a better understanding of what
is available and how an assistive device can be of help.
If you find yourself in the category of feeling unstable getting around, you would likely
benefit from a rehabilitation program to improve your balance and walking.
Working with a physical therapist can help to regain confidence, improve strength and
coordination to make you safer, and enables a physical therapist to match you up with
an appropriate assistive device.
So, again, if this is you reach out to your doctor today about participating in physical
therapy.
Thanks for watching this episode of Walk Talk.
We have a lot of fun breaking down different topics for you and we hope you enjoy our series.
In our next episode we are going to talk about basic strengthening exercises that can
help to improve almost anyone’s walking.
If you are new to Mission Gait, check out our website at MissionGait.org.
To see more of these videos, you can either click the link in the
corner to subscribe or you can visit our YouTube channel at YouTube.com/missiongait!