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How do we know when it's time to start using a cane or walker?
Balance problems or difficulty with weight bearing (you are unable to
carry all of your weight on your lower extremities) are significant
markers for need. Are you compensating in inappropriate or harmful ways
such as holding on to furniture or walls? Improper posture to compensate
for one-sided weakness, foot drop, etc. can cause back or hip pain due
to poor body alignment. Usually, canes are for balance and walkers are
for additional support. But there are no absolutes, so a walker may be
appropriate for more serious balance challenges or one-sided weakness. A
traditional cane can offer balance aid and a "quad" cane, one with a
little platform with 4 feet may offer even better balance support.
A lightweight, adjustable aluminum cane is recommended. It should be
fitted to you so that when you stand with your shoes on and your arms
hanging loosely at your sides, the top of the cane should be at the
crease where your hand and wrist join. When using the cane, your elbow
should be bent at an angle of about 15 to 30 degrees. Wooden canes are
fine but they are not as lightweight as aluminum. There are different
style handles, but usually you choose the type that is the most
comfortable for you.
In which hand should you hold the cane? If one leg is weaker than the
other or is injured, you should hold the cane with the opposite hand.
Biomechanically, you can take more weight off the weaker leg if you hold
the cane with the opposite hand. If you are using the cane only for
balance, then hold it on whichever side feels most comfortable.
In using a cane on the stairs, the rule is "up with the good, down with
the bad". So, in climbing the stairs step first with the cane and the
good foot and follow with the weaker side. When going down the stairs,
step first with the bad foot and follow with the cane and the good foot.
Additionally, keep your free hand on the railing.
If you have a slight problem with balance, a cane will work fine, but if
you have a more significant balance problem of need assistance with
supporting your weight, a walker is probably what you'll need. Walkers
can either be standard or rolling. The rolling walker decreases the
amount of energy you expend but still provides the stability you need.
The correct height should be determined by a professional but you can
estimate it by the same elbow angle as described in the previous
information on canes. There are many models of walkers including 3
wheeled, 4 wheeled, ones with seats, carrying baskets, and brakes. A
physiatrist or physical therapist can help you determine what is best
for you.
A final comment, but an important one, is a reminder to remove or secure
any loose rugs or runners in your home. This will reduce your risk of
slipping and falling while using your cane or walker.
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