Canes and crutches

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VOL 104 / NO 2 / AUGUST 1998 / POSTGRADUATE MEDICINE

Many people who need a cane or crutches discover these devices are not easy to manage. Your doctor or physical therapist will help you, but be sure to speak up if something is uncomfortable. A cane that is too short or crutches that hit a little too high under the arms can cause problems. If you or someone you know is learning to use these walking aids, here are some tips that may help.

Choosing a cane

Canes come in many styles, sizes, and models, from glass to steel. For most people, aluminum canes work well because they are lightweight. Many canes have vinyl handgrips and push-button adjustments that lock in place. For greater stability, canes with four legs set on either a large or a small steel base are a good choice. These are called quad canes.

Any cane must have a sturdy rubber tip or tips that prevent slipping. Worn tips should be replaced. (New tips can usually be found in a hardware store, but you might have to ask for rubber tips for chairs or tables.) Never glue a rubber tip onto your cane.

The length of the cane you need depends on your height. To find the correct length, measure the distance from the wrist crease to the floor. If you are over 70 years of age or if you prefer, you can add 2 to 3 inches to this measurement.

Contrary to what you might think, a cane is used in the hand opposite the side that needs support. This is because we walk with the opposite arm and leg moving in unison.

Adjusting to crutches

Crutches should be fitted so that when you are standing, your shoulders are slightly forward and your wrists and elbows are bent. Improperly fitted crutches can cause back and shoulder fatigue and pain.

For walking, put both crutches about a foot in front of you. Then shift your weight forward over the crutches and bring your strong leg forward. Keep
your steps about 12 inches long and never longer than 18 inches.

If you get tired and need to rest, sit down or lean against a wall. Do not rest by shifting your weight to the armrests on the crutches. Prolonged pressure on the armpits can pinch nerves and cause pain and numbness in your arms.

Some tips for using crutches

Avoid long stairways and choose a ramp instead of the stairs whenever possible. Call ahead and ask about handicap access if you are concerned. When stairs are the only option, head for the handrail. Then follow these steps:

• Hold the railing with one hand and put both crutches under the other arm.
• Lift your body by pushing on the crutches and railing so you can raise your strong leg to the step above.
• Then lift the injured leg and the crutches.
• Repeat this, slowly, one step at a time.
• To move down stairs, reverse the process:
• Again, hold the railing and place both crutches under the opposite arm.
• Lower the crutches to the step below, and bend your strong knee, shifting your weight to the crutches and railing.
• Then step down with your strong foot and bring the crutches down.
• When no handrail is available, stairs can be very difficult. Here are some guidelines for going up:
• Place the crutches close to the first step. Then push on the crutches, straightening your elbows and ducking your head.
• Move your strong leg to the first step.
• Then straighten your back and lift the weak leg.
• Finally, bring the crutches up.
• Always move slowly, one step at a time. Be sure you have your balance before going to the next step. Do not lean backward.

For moving down stairs with no railings, follow these directons:

• Stand with the toes of the stronger leg close to the edge of the step.
• Lower both crutches, then the weaker leg onto the step below, bending the knee of the stronger leg as much as possible to help keep your balance.
• Then lean on the crutches and lower the stronger leg. Take your time.

Learning to open doors

To go through a door on crutches, stand facing the door and slightly at an angle to it so the door will clear your feet as it opens. Turn the doorknob with one hand while supporting yourself on the crutch with the other hand. Keep the crutch under the arm of the hand on the doorknob.

As the door opens, quickly grasp the crutch with the hand you used to open the door and place the crutch tip against the door to keep it open. Do not move until the door is stopped by the crutch. Move through the door. You may have to repeat these steps if the door is heavy.

Getting in and out of chairs

Choose a chair with arms if you can. To sit down, turn and slowly back up to the chair, until the backs of your legs are flat against the chair's edge. Keep the weak leg forward. Then take the crutches from under your arms. Hold them by the hand grips, and bring them in front of your body. Move the crutches to one hand so you can push down on them. Reach the other hand back to the chair for support, and bend the knee of the stronger leg until you are in a sitting position. Keep the weak leg forward.

To get up from the chair, reverse the procedure. Keep your head well forward and the stronger leg under the chair as you get up. Push with one hand on the crutches and with the other on the arm of the chair.

This information is not a substitute for medical treatment.

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