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How To Use A Cane

by Norman Smith |

Before we can describe how to use a cane, we first have to understand that there are three primary kinds of canes.  There are also several unique designs/styles which are not discussed in this blog.

  1. Single Point Cane
  2. Three Point Cane
  3. Quad (four) Point Cane

With any of the above canes, your Physical Therapist will justifiably tell you that the cane should be used beside the leg/hip/knee with the impairment.  But there has to be an exception if the hand/arm on that side is weak.  If so, use the hand with the strongest grip.

The stability of any cane is achieved when the body weight is channeled through the arm, directly onto the perpendicular shaft of the cane.  Therefore if the handle is offset 90 degrees to the perpendicular shaft, such a cane should be avoided because it offsets your downward pressure causing the hand to be out of alignment with the shaft, which can lead to unexpected falls of the user. The best cane handle design is one in which the perpendicular shaft is bent into an arc leading to the handle being directly over the shaft.  Because the person using a cane is already unstable (or they wouldn't need a cane) they automatically become susceptible to falls. Canes have great perpendicular stability, but very little lateral (non-perpendicular) stability. Therefore, when using any cane, the user must be careful to use the cane as directed by the manufacturer. Note, there are on average, over 40,000 injuries per year (requiring medical treatment) in the USA using mobility products.

To achieve the proper height of a cane, the cane handle should be adjusted to be at the wrist of the user, while the arm is dangled downward.

Canes can be used to help the user sit onto a chair or couch or toilet and to arise from the same.

Note:  The user can also use two canes (one in each hand) for added stability.

  1. Single Point Cane:
  • The conventional single point cane (perpendicular shaft with crooked   handle) has been in use for thousands of years.
  • The cane can be held against the leg and moved in conjunction with the leg's forward movement.
  • The cane can be held away from the leg and picked up and moved forward and placed on the ground, with each step.
  • The cane can be swung forward, prior to the step, the user steps forward while rotating the cane in motion with the body, until the cane tip is slightly behind the user. Repeat the process.
  • Three Point Cane:
    • In recent years, three point canes have become very popular
    • Three point canes have a triangular shaped "foot", comprising three contact points, with a single perpendicular shaft and handle.
    • This provides a larger footprint (approximately _______square inches), adding more stability than a single point cane.
    • Some three point canes have a somewhat flexible "ankle" which does provide very limited lateral stability/support
    • A three point cane is more stable than a single point cane.
    • Note:  three and four point rubber cane tips can be purchased which can be placed on single point canes.
    • A three point cane will stand alone on relatively smooth surfaces (but it is easily knocked over).
      • Therefore, the cane can be left beside the bed or other place within easy reach of the user.
    • The cane can be held against the leg and moved in conjunction with the leg's forward movement.
    • The cane can be held away from the leg and picked up and moved forward and placed on the ground, with each step.
    • The cane can be swung forward, prior to the step, the user steps forward while rotating the cane in motion with the body, until the cane tip is slightly behind the user. Repeat the process.
  • Quad Cane - Four Points
    • Quad canes are constructed with four points of contact with the floor. 
    • Quad canes come with various size foot prints. But in all cases, the quad footprint is larger than a 3 point footprint.
      • Therefore, Quad Canes are very stable and will usually stand alone on a wide variety of rough or uneven surfaces. Quad canes can be left standing next to the bed or chair ready to be used.
    • Quad canes usually have short feet on one side, that are to be pointed toward the user. This reduced trip hazards of the user kicking the cane feet.
    • Most quad canes will have a single perpendicular shaft extending from the quad feet.  But some will have two perpendicular shafts, connected by a handle between the shafts.  These units have a much larger footprint, therefore they have greater stability.
    • The  quad cane can be held away from the leg and picked up and moved forward and placed on the ground, with each step.
    • The quad cane can be swung forward, landing on the rear two feet prior to the step, the user steps forward while rotating the quad cane in motion with the body, placing all four feet on the ground, the user continues to rotate the quad cane onto the front two feet until the feet are slightly behind the user. Repeat the process.