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When Should I Progress from the Walker to the Cane?

Jay Kudronowicz

So you’re pushing your walker showing off your Funski walker glides and you're contemplating the progression to a cane.

After all, your injury/surgery is healing well and you feel as though you’re walking pretty normal, right?

For those individuals using walkers for short term rehab, remember this key piece of advice from someone who has been in the field for 20 years and has seen both sides of the spectrum.

YOU CAN NEVER PROGRESS FROM THE WALKER TOO LATE, BUT YOU CAN GET RID OF IT TOO EARLY!

Especially after a major surgery such as a hip or knee replacement. Weight bearing, no matter how you slice it, is an irritant to your healing joint and frankly, too much too soon may lead to a fierce setback.

The walker’s purpose is to provide a solid stable wheeled base to allow your strong, healthy upper extremities to assist in bearing weight to remove/minimize joint compression from your affected extremity while rolling at your acceptable walking speed and developing that rhythmic, symmetrical phenomenon we therapists call the ‘gait cycle’.

Think about it, when your healthy leg is swinging through the air in preparation for your next step, all of your weight is on the unhealthy leg – unless you're bearing weight through your arms with the help of that sturdy cage on wheels.

The more you weight bear, the more compression force, the more irritation, the more stiffness, the more swelling, etc. (you get the picture).

When you leave the hospital you're more than likely told to “weight bear as tolerated”. Pay attention to those last 2 words “as tolerated”.

If you place too much weight on the joint (or do it too often) and it becomes sore and swollen then you didn’t tolerate it and you violated your weight bearing restriction.

Now think about this: If you walk with a normal, acceptable gait pattern with your wheeled walker yet with the cane you resemble Quasimodo or a peg legged pirate – what is that doing to your muscle memory?

My golf instructor in college often told me this:

In order to create a habit it must be repeated 50 times per day for 21 straight days!

In my years teaching people how to walk again, I have found this to be more truth than “coachspeak”.

With that in mind, my advice would be to keep up your stretches/strengthening and keep grooving your gait pattern into normalcy until you are able to walk as well with the cane as you are able to with the walker.

If this is not possible (due to strength or range of motion restrictions) and you are reproducing that God awful gait pattern with a cane more than 3 weeks, good luck trying to break those bad habits!

Just like a golfer grooves their swing to perfection, the walker allows you to “groove your gait” so that when your strength and normal motion return, you are not frustrated at your pain free, walker free, cane free, … LIMP!


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