Walking with a Cane: How to Safely Use and Prevent Falls

Can using a cane help individuals after an injury, living with chronic pain or balance issues, or post-surgery?

Walking With A Cane

A cane is an assistive device that can help individuals walk after injury or surgery and aids with balance and stability. It can be used for:

Balance or Stability Issues

• Canes can help with minor balance or stability issues, such as weakness in the leg or trunk, or after an injury.

Pain

• Canes can help reduce stress on painful joints or limbs.

Independence

• Canes can help people continue living independently, especially the elderly.

There are different types of canes, including single-point and quad canes. Single-point canes are generally the least expensive. Quad canes have four points and can provide more stability. It is important to use it correctly to prevent falls and injuries.

Post-surgery or Injury

A cane can help reduce pressure on the leg or back after surgery or injury. Healthcare providers may recommend a cane as a step-down device after using a walker or crutches. Before walking with the cane, ensure it is at the right height. Hold the cane in the hand on the opposite side of the injury. Hold the cane’s handle at the level of the bend in the wrist when standing with the elbow slightly bent. (American Academy of Orthopaedic Surgeons, 2020) If there are issues in both legs or a cane is used after back surgery, keep the cane in the hand with the most support.

Practicing Taking Steps

To practice taking steps with a cane, try the following (American Academy of Orthopaedic Surgeons, 2020)

• Place the cane firmly on the ground.
• Take a small step forward with the injured leg.
• Step the opposite foot forward to meet the injured leg.
• Continue this process until you can take multiple steps in a row with balance.

Progress to a step-to-walking pattern (Hirayama K. et al., 2022)

• Step forward with the cane and injured leg at the same time.
• Step the non-injured leg up with the cane firmly on the ground to meet the injured leg.
• The feet should be side by side.

Walking Normally

Once comfortable taking practice steps, try walking normally with the cane. Step forward with the cane and injured leg simultaneously. The cane should be off the ground when the wounded leg is in the air. Firmly plant the cane when stepping onto the injured leg. Step forward with the cane and the injured leg first, then step past the injured leg with the good leg.

Using The Stairs

When walking up and down stairs, it’s important to use proper technique to prevent losing balance. (American Academy of Orthopaedic Surgeons, 2020)

Walking Up the Stairs

• Step up with the good leg.
• Bring the injured leg and cane up to the step.

Walking Down the Stairs

• Step down with the injured leg while lowering the cane to the step below.
• Make sure the cane is firmly on the stairs.
• Bring the good leg down to the same step.

If a handrail is available, use it. Although doing so may require moving the cane to the other hand, even if it’s on the same side as the injured leg, it will improve stability and reduce the risk of falling. Once proficient on the stairs, individuals may alternate placing one foot on each step.

Walking With Chronic Pain

Walking with a cane with a chronic pain condition is similar to using it with an injury. The location of the pain will determine which hand the cane is held in. If the pain is on the right side of the body, keep the cane on the left side or vice versa. If chronic pain is not in the legs but, for example, back pain makes it difficult to walk, hold the cane on either side, whichever feels more supportive and comfortable. If there is weakness on one side of the body or decreased sensation/numbness in one of the legs or feet, hold the cane on the opposite side of the pain, weakness, or numbness. Walking with a cane can also benefit individuals with other medical conditions. For example, assistive devices may be recommended for those with balance issues. (National Library of Medicine, 2023)

Cane Types

There are two primary types of canes, characterized by their points, and choosing the right one depends on the reason it’s needed. (Arthritis Foundation, N.D.)

Single-point

• Single-point canes have one tip at the end.
• These are recommended for those who need to relieve some pressure off an injured leg or need support due to occasional difficulties with balance.

Quad

• Quad canes have four tips or feet to provide more stability.
• They provide more support and are recommended for those with significant weakness in one leg or difficulty maintaining their balance while walking.

The traditional cane has a rounded C handle. Other types have contoured handles for a more secure grip. Talk to a doctor, physical therapist, or other health care professional for suggestions on which cane is right for you.

Losing Balance

A potential risk of using a cane is losing balance. If unable to maintain balance with a cane, individuals may want to consider a different walking device, such as a walker or crutches. To reduce the risk of falls, consider the following tips (American Academy of Orthopaedic Surgeons, 2020)

• Wear shoes with nonskid soles.
• Add lighting so you can see where you are walking.
• Remove throw rugs or objects that can cause tripping.
• Arrange furniture to allow for wide walking paths throughout the home.
• Carry objects in a backpack or fanny pack rather than holding them.

Injury Medical Chiropractic and Functional Medicine Clinic

Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

Osteoporosis

References

American Academy of Orthopaedic Surgeons. (2020). How to use crutches, canes, and walkers. orthoinfo.aaos.org/en/recovery/how-to-use-crutches-canes-and-walkers/

Hirayama, K., Otaka, Y., Kurayama, T., Takahashi, T., Tomita, Y., Inoue, S., Honaga, K., Kondo, K., & Osu, R. (2022). Efficiency and Stability of Step-To Gait in Slow Walking. Frontiers in human neuroscience, 15, 779920. doi.org/10.3389/fnhum.2021.779920

National Library of Medicine. (2023). Using a cane. Retrieved from medlineplus.gov/ency/patientinstructions/000343.htm

Arthritis Foundation. (N.D.). How to choose the right cane. www.arthritis.org/health-wellness/healthy-living/managing-pain/joint-protection/how-to-choose-the-right-cane