A cane is a mobility aid designed to improve stability and widen the base of support. Its primary purpose is to reduce the stress and weight placed upon a painful or weakened lower extremity joint. The correct side for holding the device is frequently misunderstood and often counter-intuitive. Understanding the proper technique is necessary to gain the full benefit of this assistive device and ensure safe movement.
The Principle of Opposite Support
If your left leg is experiencing pain or weakness, the cane must be held in the opposite hand (the right hand). This practice, known as contralateral cane use, is the most effective way to alleviate strain on the affected limb. The cane acts as a temporary substitute for the natural arm swing that occurs on the opposite side during walking. By planting the cane at the same time as the painful left leg, you create a stable, tripod-like base of support.
This biomechanical technique shifts the body’s center of gravity away from the injured side. Contralateral use allows the strong arm to exert downward pressure, reducing the required force from the abductor muscles in the painful hip or knee. This method can reduce the load on the affected joint by 20 to 40% during the gait cycle. Placing the cane on the painful side (ipsilateral use) does not provide this mechanical advantage and may increase joint strain.
Ensuring Proper Cane Fit and Height
For a cane to function correctly, it must be adjusted to the user’s height. An improperly sized cane can lead to discomfort, poor posture, and ineffective weight distribution. To check the fit, stand upright in your walking shoes with your arms relaxed at your sides.
The top of the cane handle should align precisely with the crease of your wrist. When you grip the cane, your elbow should have a slight, comfortable bend, ideally between 15 and 20 degrees. If the cane is too tall, it can force your shoulder up, causing strain in your neck and shoulder muscles. Conversely, a cane that is too short will cause you to stoop over, compromising your balance and posture.
Techniques for Safe Movement
When walking, the cane moves forward simultaneously with the injured or painful leg, not the strong leg. If your left leg is the affected limb, advance the cane and your left leg together, followed by a step-through with your right leg. This coordinated movement pattern maintains a smooth and rhythmic gait, simulating the body’s natural walking rhythm.
Navigating Stairs
Navigating stairs requires a specific sequence, often summarized by the phrase “Up with the good, down with the bad.” When ascending, lead with your strong leg first, followed by the cane and the painful leg moving up to meet it. When descending, the cane and the painful leg should move down to the next step together, with the strong leg following last.
Sit-to-Stand Transitions
To safely move from a seated to a standing position, or vice versa, hold the cane in the hand on your strong side. Push off from the armrests of the chair using your free hand and rely on the cane and your strong leg for support. This technique ensures maximum support is available during the transition, which is a common time for balance to be compromised.