While those approaching retirement years are, in general, healthier than some of the generations before them, there are those who eventually may have to use some kind of assisted walking device to get around. It may be just temporary because of an injury or it might be long-term due to an ongoing deterioration, such as arthritis, or a chronic disorder such as multiple sclerosis, amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease) or Parkinson’s disease.
Proper Use of Canes, Crutches and Walkers
Canes and other assisted walking devices, such as crutches and walkers, are used for various disorders – not just leg or hip injuries. They are also used in helping individuals with balance problems caused by stroke, inner ear disorders, medication side effects and more.
These devices can be purchased without a prescription, and therefore used without an initial consultation or instruction on usage. There are some
- Size matters!
- Crutches:The top of the crutch should reach between 1 and 1.5 inches below your armpits when you are standing up straight.
- Canes:The top of the handle of the cane should be at the same height as the bone on the outside of the wrist (somewhere between the pisiform bone and the styloid process or head of the ulna). The cane should be comfortably held with the elbow bent at a 30 degree angle.
- Walkers: The height of the walker follows the same basic rule as the cane. The top of the walker should reach to about the top of your wrist crease when standing with arms down at the side of the body.
- Walkers and crutches are used with both arms, but a cane is used only on one side. It should be held in the hand opposite the injured or weak leg. When walking, the cane moves with the weaker leg – if the weak leg steps out in front, so does the cane. Both the cane and the weaker leg should hit the ground at the same time.
- Wear flat, sturdy, no-skid, comfortable shoes. No high heels, flip-flops or other flimsy footwear. You need a good base for balance.
- Make sure the rubber tips are in good shape. A worn or torn tip can catch on a rug or other item and cause a fall.
- Avoid entrances with revolving doors. They can catch the cane or other device and pull it away from the user.
- Don’t rush. Trying to move too quickly can cause an accident. Moving slowly allows the user to watch where he or she is going and avoid potential falls.
Exercises Using a Cane
Using a cane or other device can weaken some muscles. It may strengthen others and create an imbalance in the body. It is possible that clients using a cane or other device were not given any kind of exercises to do keep the body balanced.
Some of the simplest exercises to do include grasping the cane with both hands, palm down, and lifting over the head. Similarly this can be done with the palms facing up. Repeat this at least 12 times. Steps can be added by bending at the waist laterally, as well as twisting the torso to the left and right. These should be done slowly, taking about 10 seconds for each singular move.
Adding a resistance band can increase the number of exercises that can be done with a cane. Attaching the ends of a long band to the cane enables the user to do leg stretches, which may help to strengthen a weakened limb.
The crook of the cane, the part that is held by the hand, can also be used to ease muscle soreness, especially around the medial and lateral borders of the scapula. Grasping the middle of the cane, the end of the hook can be placed over the shoulder and against the back. By pulling the body of the cane, the hook can apply pressure to sore points. Pressure should be held for a few seconds and then released.
Massage for Discomfort Caused by Cane Use
Using walkers or crutches will usually result in bilateral weaknesses or soreness. Canes present with a different problem because they are unilateral and the user is using the muscles much more on one side than the other. The body also begins to rely on this “third leg” for strength, balance and proprioception. While this is not a big problem when first using a cane, the sudden abandonment of use can result in some minor disorientation until the brain reacquaints itself in the use of two healthy legs.
Massage on the back and shoulder muscles using basic Swedish massage techniques can help relieve the soreness and reduce spasms in areas that tend to get overused and tired. Adding stretches will help keep balance as well as give strength to the arms and shoulders.
An improper cane height may cause carpal tunnel syndrome. Massaging the hands and using mobilization techniques can help to maintain flexibility in the joints and lessen the effects of an over-extended wrist.
Advising clients to schedule a weekly massage while they are using a cane or other assisted walking device will help make them more comfortable and at ease with their bodies.