Mobility aids are necessary for recovery after injury or surgery, helping to maintain movement while protecting a healing limb. Many people look forward to transitioning from crutches to a less cumbersome cane. The decision to switch depends entirely on the current stage of healing and the body’s specific support needs. Understanding the functional differences between these devices determines the appropriate aid for recovery.
How Canes and Crutches Differ in Support
Crutches allow for non-weight bearing (NWB) or significant weight reduction on the lower extremity. When NWB is ordered, crutches enable the user to remove weight from the injured limb, transferring the load to the arms and upper body. They provide stability and support through two separate points of contact, typically the handgrips and the ground; axillary (underarm) crutches also use the chest wall for stability.
Canes are intended for minor balance assistance, not for offloading significant weight. A cane is capable of reducing the load on the opposite leg by approximately 20 to 25% of the user’s body weight. This limited support means they are unsuitable for injuries that require the foot, ankle, or knee to bear no weight at all. The single point of contact with the ground provides less overall stability compared to the dual-point support of crutches.
Criteria for Choosing a Cane Over Crutches
The primary factor governing a transition to a cane is the ability to tolerate partial weight bearing (PWB) on the injured limb. Crutches are mandatory when the injury requires full non-weight bearing (0% of the body’s weight). The switch to a cane is appropriate only after the patient is cleared for a higher level of weight bearing, often between 50% and 75% of body weight, which can be measured using a bathroom scale during physical therapy sessions.
The transition also requires sufficient balance and coordination, which is not necessary for crutch use. Because a cane offers significantly less stability, the user must be able to maintain their center of gravity with only minor assistance. If significant instability remains, even with PWB clearance, a single crutch or a walker may be a safer intermediate step than moving directly to a cane. A cane is well-suited for late-stage recovery from a minor fracture or for long-term issues causing minor weakness or joint pain.
The decision to change mobility aids must always be made in consultation with a physician or physical therapist. Attempting to switch prematurely risks disrupting the healing process and can cause further injury due to excessive load on the bone or joint. A healthcare provider will assess the stability of the injury, the level of pain, and overall physical readiness before recommending a change from crutches to a cane.
Essential Safety Considerations for Mobility Aids
Correct sizing is necessary for the safe use of both canes and crutches; improper fit can lead to secondary injuries. Crutches must be adjusted so the top pad sits about one to two inches (two to three finger-widths) below the armpit to avoid pressure on the nerves and blood vessels in the axilla. The handgrips on crutches should be level with the wrist crease, allowing the elbow to bend at roughly a 30-degree angle when gripping the aid.
A cane should be adjusted so the top of the handle aligns with the wrist crease when the user stands upright with their arm hanging at their side. This ensures the elbow is bent at a slight angle of 15 to 30 degrees when holding the cane, which minimizes wrist strain and optimizes weight transfer. Using a cane that is too low can cause the user to stoop, leading to back pain, while one that is too high can interfere with balance.
A common technique involves holding the cane on the side opposite the injured or weaker leg. When walking, the cane and the injured leg move forward together, followed by the stronger leg. Misusing a cane by attempting to bear too much weight on it when crutches are still required significantly increases the risk of a fall and can delay healing. Caution is required when navigating environments, particularly on stairs: the stronger leg should lead when going up, and the weaker leg and aid should lead when going down.