Walkers, Canes, Crutches & Wheelchairs

Walkers, Canes, Crutches & Wheelchairs

 

Using Crutches: Non-Weight-Bearing

A healthy leg can bear your body weight. But when you have an injured leg or foot, you need to keep weight off it. The "swing to" gait is easy to learn and takes less arm strength and balance. The "swing through" gait takes more practice, but it moves you farther with each step and is less tiring in the long run. Start with "swing to," and progress to "swing through" when instructed.

Balanced Standing (Tripod) Position

Use this position when you start or end a movement. Also, use it whenever you're standing for any length of time. Move your crutches in front of you about 12 inches. Hold the affected foot off the floor. Find your balance. Be sure not to rest your armpits on the pads.

Walking with Crutches

Swing To

  • Start in a balanced standing (tripod) position.

  • Squeeze the pads against the sides of your chest.

  • The tips should be wide enough apart for you to move easily between them.

  • Support your weight on your hands.

  • Press down on the handgrips.

  • Lift your unaffected foot and swing your body up to the crutches.

  • Land on your unaffected foot, between your crutches.

  • Keep the unaffected knee slightly bent.

  • Reach forward and out with the crutches to begin the next step.

Swing Through

  • Start in a balanced standing (tripod) position.

  • Squeeze the pads against the sides of your chest.

  • The tips should be wide enough apart for you to move easily between them.

  • Support your weight on your hands.

  • Press down on the handgrips.

  • Lift your unaffected foot and swing your body through the crutches.

  • Land on your unaffected foot, about 12 inches in front of the crutches.

  • Keep the unaffected knee slightly bent.

  • Reach forward and out with the crutches to begin the next step.

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Using Crutches: Up and Down Steps

Tip: Ask a friend to carry one of your crutches while you climb or descend stairs.

When climbing up and down steps, remember this rule: Up with the good(unaffected leg) and down with the bad (affected leg). Note: If you're supposed to keep all weight off your leg (non-weight-bearing), ask your healthcare provider for special instructions.

Up Stairs

  • Hold the handrail with one hand.

  • Put both crutches in your other hand.

  • Support your weight evenly between the handrail and your crutches.

  • Put some weight on the crutches.

  • Step up with your unaffected foot.

  • Get your balance.

  • Straighten your unaffected knee and lift your body weight.

  • Bring your crutches and affected leg up.

Down Stairs

  • Hold the handrail with one hand.

  • Put both crutches in your other hand.

  • Bend your unaffected knee, moving your crutches and affected leg down.

  • Support your weight evenly between the handrail and your crutches.

  • Slowly bring your unaffected leg down.

  • Don't hop.

Precautions for Using Stairs

  • Always use an elevator if one is available.

  • Have someone guard you as you learn to use stairs. A guard stands below you. He or she holds your belt (or a special "gait belt" you can borrow or buy) to assist you if you lose your balance.

  • When there is no handrail, keep one crutch under each arm. Follow the instructions above.

  • If the stairs are slippery or steep, it may be safer to lift or lower yourself from step to step while sitting. Hold both your crutches in one hand as you do so.

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Using Crutches: Weight-Bearing

Use a weight-bearing gait when you are told that you can put some weight on your leg as it heals. Depending on your arm strength and balance, you can either "step to" or "step through." 

Balanced Standing (Tripod) Position

Use this position when you start or end a movement. or when you're standing for any length of time. Move your crutches in front of you about 12 inches. Find your balance. Don't rest your armpits on the pads.

 Weight-Bearing: Step To

  • Start in a balanced standing (tripod) position.

  • Step forward with your affected foot.

  • Land lightly between your crutches.

  • Squeeze the pads against the sides of your chest.

  • Support your weight with your hands and your affected leg.

  • Press down on the handgrips.

  • Lift your unaffected foot and step to the crutches.

  • Land on your unaffected foot, between your crutches. Keep the knee slightly bent.

  • Reach forward and out with the crutches to begin the next step.

 A Weight-Bearing: Step Through

  • Start in a balanced standing (tripod) position.

  • Step forward with your affected foot.

  • Land lightly between your crutches.

  • Squeeze the pads against the sides of your chest.

  • Support your weight with your hands and your affected leg.

  • Press down on the handgrips.

  • Lift the unaffected foot and step forward through the crutches.

  • Land on the unaffected foot slightly in front of the toe of the other foot. Keep the knee slightly bent.

  • Reach forward and out with the crutches to begin the next step.

You may be told to use one of the gaits listed below.

  • Toe-touch or touch-down gait: Lightly touch your affected foot to the floor, and let your crutches bear most of the weight. Imagine that you're stepping on a ripe tomato: Step lightly, so it won't be squashed.

  • Partial weight-bearing gait: Put some weight on your affected foot as you walk. Your healthcare provider will tell you how much.

  • Full weight-bearing gait: Put most of your weight on your affected foot. Place only a little weight on your crutches.

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Using a Walker

To use your walker, you will need to learn a new gait, or way to walk. Your healthcare provider will tell you to use either anon-weight-bearing gait (which puts no weight on one leg and foot) or a weight-bearing gait (which puts weight on both legs and feet).

Non-Weight-Bearing Gait

  1. Hold the affected (injured or weaker) foot off the floor.
  2.  Lift the walker (roll it if you're using a wheeled walker). Move it forward about 12 inches.
  3. Support your weight on your hands. Swing the unaffected (uninjured or stronger) foot forward to the center of the walker.

Weight-Bearing Gait

  1. Roll the walker (lift it if you're using an unwheeled walker). Move it forward about 12  inches.
  2. If you have an injured leg, a new joint, or a weaker side, step forward with that foot first. Use the walker to help you keep your balance as you take the step.
  3. Bring your other foot forward to the center of the walker.

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Walkers: Bathing

Note: Try to make sure surfaces are dry before you walk on them. Non-skid mats can help prevent falls.

Special shower chairs and tub benches are available for use while bathing. These chairs help you bathe safely. Ask your health care provider where you can get one.

Getting Into a Shower Stall

  1. Back up over the lip of the shower stall with your good leg until you feel the shower chair behind you. Reach back for the shower chair first with one hand, then the other, as you begin to sit down.
  2. Lower yourself onto the chair. Lift each foot and turn to face the faucet.

Getting Into a Tub

  1. Back up until you feel the tub bench behind you. Reach back for the bench first with one hand, then the other, as you begin to sit down.
  2. Lower yourself onto the bench and turn to face the faucet. Use your hands to help lift each leg over the side of the tub. A hand-held shower nozzle can make bathing on a bench easier.

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Walkers: Stairs and Steps

Always use an elevator if one is available. Ask for different instructions if your walker has wheels. At first, always have someone below to guard you. A guard can stop you from falling if you lose your balance. "Up with the good and down with the bad" is an easy way to remember which leg to use first.

Up Stairs

1. Turn the walker sideways so the crossbar is next to you. Place the first 2 legs on the step above you. Hold the walker with one hand and the handrail with the other.

2. Support your weight evenly between the handrail and walker. Step up with your good leg.

3. Bring your injured leg up. Then lift the walker to the next step.

Down Stairs

1. Turn the walker sideways so the crossbar is next to you. Place the back 2 legs on the step beside you. Hold the walker with one hand and the handrail with the other.

2. Support your weight on your good leg. Step down with your injured leg.

3. Support your weight evenly between the handrail and your walker. Slowly bring your good leg down. Then move the walker down to the next step.

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Walkers: Cars

A walker can help you when you get in and out of a car. Note: If you have had your hip replaced, you may need special instructions. Ask your health care provider to show you the best way to move safely. The steps below help you get into a car. Reverse them to get out of a car.

Sit Down

  1. Back up to the car seat.

  2. Hold on to the side of the car or the dashboard for support.

  3. Lower yourself slowly onto the seat edge. Watch your head.

Bring Your Legs into the Car

  1. Slide back to the center of the seat.

  2. Lift your legs one at a time into the car.

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Walkers: Chairs

A walker can also help you when you sit down and get up. Note: If you have had your hip replaced, you may need special instructions. Ask your health care provider to show you the best way to move safely.

To Sit Down

  1. Back up until you feel the chair behind you. If you have an injured leg, knee, or hip, extend that leg out in front of you.

  2. Bend forward at your hip. Reach behind you with one hand and grab the armrest or the side of the chair. Do the same with the other hand.

  3. Lower yourself onto the center of the chair, then slide back.

Tip: Find sturdy, high-seated chairs with arms. If you must use a chair that swivels or has wheels, back it up against something stable before you sit down.

To get up

  1. To get up, do the reverse of the 3 steps above.

  2. Hold the crossbar of the walker with one hand, and the arm of the chair with the other.

  3. Don't try to use only the walker to stand-it could tip over.

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Walkers: Going Through Doors

These instructions will help you get through doors with your walker. Avoid revolving doors. Look for nearby disabled entrances instead. Follow any other instructions given to you by your healthcare provider.

Pushing Doors Open

  1. Push the door hard so it swings open. Move the walker into the doorway to keep the door from closing.
  2. Walk forward through the doorway, using the walker to hold the door open as you pass through.

Pulling Doors Open

  1. Stand to the side. Use your hand to pull the door so it swings open. Move the walker into the doorway and hold it firmly. The walker will stop the door from closing completely.
  2. Walk forward through the doorway. The walker will hold the door open until you're through.

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Using a Cane

A cane helps you get around on your own. Many different canes are available. The most common type has a single tip. But if you have balance problems, your healthcare provider may recommend that you use a quad (four-point) cane. Always use your cane on the stronger (uninjured or unaffected) side, unless told otherwise.

Use the cane on the side opposite your weaker leg.

Walking

  • Put all your weight on your stronger leg.

  • Find your balance.

  • Move the cane and your weaker leg forward.

  • Support your weight on both the cane and the affected leg.

  • Then step through with your stronger leg.

  • Put your weight on the weaker leg and start the next step.

  • When using a quad cane, place the cane so that all of the tips touch the ground.

Up Stairs and Curbs

  • If there is a railing, hold on to it with your free hand.

  • Step up with your stronger leg first.

  • Then move the cane and weaker leg together as a unit.

Down Stairs and Curbs

  • To walk down, step down with your weaker leg and the cane first.

  • Then follow with your stronger leg.

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Fitting Your Cane

Proper fitting helps you use your cane safely and effectively. When fitting the cane, stand up straight and wear the shoes you will normally use to walk. If your cane doesn't feel right, ask your doctor, nurse, or physical therapist (PT) to check the fit.

To check fit: Place the tip 2 inches in front and 6 inches to the side.

Getting to Know Your Cane

A cane is often used after crutches or a walker. It helps with balance as you regain strength and mobility. Many different kinds of canes are available. Some have only one tip. Others have four tips to aid balance. Hold the cane on theunaffected (stronger or uninjured) side unless told otherwise.

The Cane Fits If:

  • Your wrist is even with the handgrip when your arms hang at your sides.

  • Your arm bends slightly at the elbow when you hold the handgrip.

Press the buttons to lengthen or shorten an adjustable metal cane. A wooden cane must be cut to the right height.

Precautions

  • The cane should have nonskid rubber tip(s) to prevent slipping. Change tip(s) that look worn.

  • Keep the cane away from your feet so you don't trip.

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Fitting Your Walker

Proper fitting helps you use your walker safely and effectively. When fitting your walker, stand up straight and wear the shoes you will normally use to walk. If your walker doesn't feel right, ask your doctor, nurse, or physical therapist (PT) to check the fit.

To check fit: Stand in the center of the walker. Make sure that the walker is locked open and that all four legs are on a level floor.

Getting to Know Your Walker

A walker is often used for injuries involving the leg or hip. It may also be used for nerve or muscle problems that affect balance. A walker gives more stability than crutches. Some walkers have wheels, others do not. Your healthcare provider will help you choose the best type of walker for your needs. Follow any special instructions you are given.

A Walker Fits If:

  • Your wrists are even with the handgrips when your arms hang at your sides.

  • Your arms are slightly bent at the elbows when your hands are on the grips.

Precautions

  • If your walker does not have wheels, it should have nonskid rubber tips to prevent slipping. Change tips that look worn.

  • If you're using a folding walker, be sure you know how to lock it open. Check that it's locked open before use.

  • Keep all four legs of the walker at the same length.

  • Keep your back straight. Don't hunch over the walker.

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Walkers: Up and Down Curbs

Use these instructions to help you get around when using your walker. Remember to step up with your unaffected (uninjured) leg and down with your affected (injured) leg.

Up with the unaffected leg.

Up Curbs

  1. Move your feet and the walker as close to the curb as possible.

  2. Put your weight on both your legs, then lift the walker onto the sidewalk.

  3. Step onto the sidewalk with the unaffected foot. Using the walker to support your weight, bring up the affected foot.

Down with the affected leg.

Down Curbs

  1. Move your feet and the walker as close to the edge of the curb as you safely can.

  2. Lower the walker onto the street, keeping its back legs against the curb.

  3. Using the walker to support your weight, lower the affected foot. Then step down with the other foot.

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Fitting Your Crutches

Proper fitting helps you use your crutches safely and effectively. When fitting crutches, stand up straight and wear the shoes you will normally use to walk. If the crutches don't feel right, ask your doctor, nurse, or physical therapist (PT) to check the fit.

To check fit: Place the tips 2 inches in front and 6 inches to the side.

Getting to Know Your Crutches

Crutches are often used for injuries to the knee, ankle, foot, or hip. Using crutches requires good coordination, balance, and upper body strength. If you're using only one crutch, keep it on the unaffected (uninjured) side unless told otherwise.

The Crutches Fit If:

  • You can put 2 to 3 fingers between your armpit and the top of the axillary pad.

  • Your arms are slightly bent at the elbows when your hands are on the handgrips.

  • Your wrists are even with the handgrips when your arms hang at your sides.

Precautions

  • Crutches should have nonskid rubber tips to prevent slipping. Change tips that look worn.

  • Don't let armpits rest on the pads-this can cause tingling, numbness, and loss of muscle strength.

  • Don't use crutches that are too short or mismatched. They can cause back pain and falls.

  • In wet weather, dry crutch tips when coming indoors.

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Using a Cane with Your Prosthesis

Learning to walk with your prosthesis takes practice. To prevent falls, you may need a cane for balance and support. Work with your physical therapist and prosthetist (an expert who makes and fits your prosthesis). They'll teach you how to use the cane properly. Follow all instructions from the physical therapist and prosthetist closely.

Walking with a Cane

  • Hold the cane on the side of your intact limb (unless told otherwise by your healthcare team).

  • Put your weight on your intact limb and find your balance.

  • Move the cane and the prosthetic limb forward at the same time.

  • Support your weight on both the cane and your prosthesis.

  • Step through with your intact limb.

  • Put your weight on your intact limb and take the next step, using the cane and your prosthesis.

    When climbing stairs, always lead with your intact limb.

Using Steps

  • If there is a railing, hold on to it with your free hand.

  • Step up with your intact limb first.

  • Then move the cane and prosthetic limb together to the same step as your intact limb.

  • To walk down steps, hold the railing with your free hand.

  • Step down with your prosthetic limb and the cane first.

  • Then follow with your intact limb to the same step.

Note: Consult with your physical therapist and prosthetist to learn how to handle steps without railings.

Home Safety Tips

Making a few changes at home can reduce hazards and help prevent falls. Ask a family member or friend to make these changes before you go home.

  • Remove objects that could cause you to trip, such as area rugs.

  • Store supplies between waist and shoulder level. This will help you maintain balance as you reach for things.

  • Make sure all rooms are well lit.

  • Move all electrical cords out of the way or tape them securely to the floor.

  • Pick up clutter. Keep floors clear at all times.

  • Reduce stair use by making the most of each trip (do more than one task per trip).

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Preventing Falls: Moving Safely Out of a Chair and Bed

You can move safely, whether you're at home, in a hospital, or out and about. Plan your movements. Don't rush. The phone or doorbell can wait. And learn how to perform daily tasks safely, like getting in and out of a chair or bed. The more careful you are, the less likely you are to fall.

Find sturdy, high-seated chairs with arms. If you must use a chair that swivels or has wheels, back it against something stable before you sit down.

Getting In and Out of a Chair

When you can, choose chairs with long armrests.

To sit down:

  • Back up until you feel the chair against the backs of your legs.

  • Grasp the armrests with both hands and sit down.

To stand up:

  • Scoot to the edge of the chair. Place both feet firmly on the floor.

  • Grasp the armrests or put both hands on your thighs and slowly push yourself up.

If you use a walker, place it close to the side of the bed before you lean on it.

Getting Out of Bed

If you're using a hospital bed, make sure it's locked and in a low position. Put the head of the bed up.

To get up:

  • Move to the edge of the bed and roll onto your side. Push yourself up with your hand. At the same time, swing your legs over the side of the bed.

  • Sit on the edge of the bed for at least 30 seconds before standing up.

  • With both feet firmly on the floor, put your hands beside you on the bed and slowly push yourself up.

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Preventing Falls: Moving Safely Using a Cane or Walker

Keep the cane away from your feet so you don't trip.

A walking aid, such as a cane or walker, can help you stay more independent and avoid falls. Remember to keep your walking aid within easy reach when you're in a chair or in bed. And learn how to use it safely so you don't injure yourself.

Using a Cane

If you have a stronger side, hold the cane on that side.

1. Get your balance.

2. Move the cane and your weaker leg forward.

3. Support your weight on both the cane and your weaker side.

4. Step with your stronger leg.

5. Start again from step 1.

If you're using a folding walker, be sure you know how to lock it open. Check that it's locked open before each use.

Using a Walker

1. Roll the walker (or lift it, if you're using one without wheels) forward about 12  inches.

2. Step forward with your weaker leg first.

3. Use the walker to help keep your balance.

4. Bring your other foot forward to the center of the walker.

5. Start again from step 1.

Helpful Tips

  • Check with your healthcare provider about the right walking aid to use. Ask about a walker with a seat attached.

  • Check the tips of your cane or walker to make sure they have nonskid covers.

  • Move slowly from room to room. Don't rush.

  • Sit down to get dressed.

  • Use a fanny pack or backpack to keep your hands free.

  • Get help for jobs that mean climbing, even on a stepstool.

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Preventing Falls: Moving Safely Outside

Moving safely outside your home can be a challenge. Take care when walking up and down stairs and curbs. And be sure to wear sturdy, comfortable shoes and pay attention to where you step. Here are more tips to keep you from falling.

 

When stepping off a curb with a walker, lower the walker onto the street first, then step off the curb.

Using Curbs and Stairs

Curbs, steps, or uneven pavement can trip you. Take care when near them.

  • Check the height of a curb before stepping up or down. Be careful with uneven and cut-out sections of curbs.

  • Don't rush when crossing the street. Watch for changes in pavement height.

  • On stairs, grasp the handrail and take one step at a time. If you ever feel dizzy on stairs, sit down until you feel better.

Wearing Shoes That Keep You Safe

When you shop for shoes, keep these things in mind:

  • Choose shoes with rubber or nonskid soles. Athletic shoes are a good choice.

  • Choose flats or shoes with low heels. Avoid high heels or platforms.

  • All footwear should be sturdy and well-fitting. Don't wear flip-flops or backless shoes or slippers.

  • Don't walk around in stocking feet. Shoes are your safest bet, even when indoors. If you like, keep one pair of shoes just for indoors.

Moving Objects from Place to Place

Carrying objects can be hard, especially if you use a cane or walker. These tips can make it easier:

  • Use a rolling cart to carry things like groceries.

  • Wear clothes with large pockets for carrying small objects.

  • Divide large loads into smaller loads. That way, you can always keep one hand free for grasping railings.

  • Don't carry objects that block your view. That's a sure way to trip.