Recovery from a total hip replacement (THR) requires a careful and temporary reliance on an assistive device to ensure the new joint is protected and healing progresses. A cane provides a necessary balance point and helps reduce the forces transmitted through the operated hip, minimizing pain and preventing excessive strain on the surgical site during recovery. Using a cane correctly promotes a more natural walking pattern sooner than a walker, which is an important step in regaining independent mobility. This temporary tool allows for safe movement as the muscles surrounding the hip regain strength and control.
Selecting and Adjusting Your Cane
Choosing the right cane usually means selecting a single-point cane, which is the standard recommendation for most patients who have progressed past a walker. The quad-base cane offers greater stability but is typically reserved for individuals with significant balance deficits. Proper height adjustment is necessary for balance and comfort, measured while standing straight in walking shoes. The cane’s handle should align precisely with the crease of your wrist when your arm hangs relaxed at your side. This alignment ensures your elbow has a slight bend, optimally between 15 and 20 degrees, to absorb impact and prevent shoulder strain.
Safe Walking Technique on Level Ground
The fundamental rule for safe walking post-THR is to hold the cane in the hand opposite the operated hip, often called the “good” side. This placement allows the cane to work synergistically with the non-operated leg, effectively shifting the body’s center of gravity away from the surgical site. Placing the cane on the strong side reduces the load on the operated hip by 20% to 40%, significantly decreasing pain and supporting weakened abductor muscles.
The walking pattern follows a three-point gait, ensuring stability by keeping three points of contact on the floor. First, move the cane forward simultaneously with the operated leg, planting both slightly ahead of the body. Next, push down through the cane and the operated leg to bear weight. Finally, step through with the non-operated leg, moving it past the cane and the operated leg. This sequence ensures the cane absorbs a portion of the force that would otherwise be borne entirely by the new joint.
Managing Stairs and Curbs
Navigating vertical changes like stairs and curbs requires a distinct technique to prevent falls and protect the hip joint. The simple and effective rule to remember is “Up with the good, down with the bad,” which dictates which leg leads the movement. When ascending, lead with the non-operated, or “good,” leg, stepping up onto the next level first. The cane and the operated leg then follow onto the same step, allowing the stronger leg to bear the weight of pushing the body upward.
When descending, the cane is placed first onto the lower step, followed by the operated, or “bad,” leg. The non-operated leg is then brought down to join the cane and the operated leg, slowly lowering the body. This technique ensures the weaker leg is not required to generate lifting force or absorb the full impact of stepping down. Utilizing a handrail with the free hand, whenever one is available, provides additional support and stability.
Transitioning from Sitting to Standing
The transition between sitting and standing is a common point of instability where falls can occur, making a precise technique necessary. To prepare for standing, position the cane within easy reach but not yet bearing weight. Scoot toward the edge of the seat, place feet firmly beneath the knees, and use the chair’s armrests to push the body upward. The cane should never be used to pull oneself up, as it is designed for stabilization after standing, not for generating the initial lift.
Once fully upright and stable, the cane can be grasped for walking support. Moving from standing to sitting begins by backing up until the backs of the legs lightly touch the seat. The operated leg should be extended slightly forward to maintain hip precautions while reaching back for the armrests. Lowering the body slowly and in a controlled manner prevents a jarring impact on the new hip joint.