Injury, arthritis, surgery are all times when you may need to use a walking stick, a walker or a pair of crutches. But using these isn’t instinctive. “It is important to understand that mobility is a highly complex and coordinated body function, and when we add a mobility device, the coordination has to be learned again. When mobility aids are advised and people are not thoroughly trained for their usage, there is the associated risk of injuries. The most common injuries occur due to falling, as people fail to coordinate the mobility aid in their walking,” says Dr Gagan Kapoor, head, physiotherapy services, HealthCare atHOME, Delhi.
The correct use of walking aids is not always as straightforward as it seems, and can in fact delay recovery and rehab. “They may improve your mobility, but if an inappropriate walking device is used, or if an incorrect technique is adopted, or if the device is not suitable for a particular environment, your independence and safety may be at risk, and there may be chances of falls,” says Dr Maninder Shah Singh, Chief, Foot and Ankle unit, coordinator, Sports Injury unit, Indian Spinal Injuries Centre, Delhi. Doctors tell us the right way to…
Use a walking stick
If you’re a senior, it’s best to use a stick when you’re out, because pavements are uneven and roads potholed. Even if you don’t have mobility issues, a stick will make you more conscious about where you’re putting your foot. If you have minor aches and pains, think of the device as a way to reduce dependence on oral painkillers.
While wood looks better, steel or aluminium can be height-adjusted, ideally upto hip-level. “The stick must be held in the hand opposite to the injured or painful leg. The elbow should be bent 20-30 degrees while holding it, and 15 cm away from the toes is the correct distance,” says Dr Kapoor. It’s not a good idea to use a walking stick as a support to rise from a chair. “They are not stable enough. Instead, push up with your hands on the arms of the chair and only take hold of the stick once standing,” says Chitra Kataria, a physiotherapist who is Chief of Rehabilitation Services, Indian Spinal Injuries Centre, Delhi. Make sure that your stick always has its rubber tip on, to prevent slipping.
Support yourself on crutches
There are three types of crutches: axillary, elbow, and gutter or platform crutches. Any injury to the lower limbs would mean a period of non-weight-bearing, while the limb heals. If you have good body balance, a physiotherapist may recommend axillary crutches. They allow a person to walk on one leg, or if the condition warrants, to put weight on both feet. Ensure the rubber tips at the bottom are not worn out, the hand rest position gives the elbow only a slight bend, and that the pad is not pressed into the armpit (there should be a 1-2-inch gap and no weight put on the pad). Any pressure in the armpit can put stress on the major nerves and may result in complications. The complete weight of the body must be borne on the hands, and the good leg. This requires good upper body strength. The length of the crutches should also be measured individually for each person. If you’re extremely confident, with time and use, try the ‘swing through’ gait; when you’re new to it, take short steps.
You can use elbow crutches if you can bear weight on both lower limbs. There is a trough on which the fore arms rest, and the body weight is borne on this. Gutter crutches are advised to those with a weak hand grip. “The weight of the body should be borne by the hand grip in the case of the axillary and elbow crutches, and by the platform in the case of gutter crutches,” says Dr Kapoor.
Take to a walker
Walkers are advised to patients with limited body and arm strength. They are three-sided, and can be adjusted to the person’s height. “The user’s elbow should be slightly bent while holding the walker. Make sure that all legs of the walker are touching the ground before taking a step. Move the weaker leg first,” says Dr Kapoor. Folding devices are also available. However, they require that the patient should be able to use both upper limbs and they are impossible to use on stairs. They are very useful for older patients with hip fractures. The ones with two front wheels do not need to be lifted with each step.
Post-op
After a surgery, check with your doctor what device to use and how you should use it. “A mobility aid helps in offloading pressure over the joint. For example, after a knee surgery, we advise stick support on the same side. However, for a hip surgery, we advise patients to use stick support on the normal side,” says Dr Anurag Awasthi, an orthopaedic specialist in Delhi. Lot of people don’t use their device properly.
Maintaining mobility equipment
“All walking equipment should be checked regularly for signs of wear and tear. Particularly vulnerable parts include the ferrules, hand grips and underarm pads. Replacement ferrules are usually available from the department that issued the equipment or the store you purchased it from,” says Kataria. Equipment used outdoors is susceptible to weather damage, especially rusting, rendering the frame dangerous to use.
Also, do ensure there’s no clutter on the floor, especially from children’s toys. Avoid using equipment on wet floors. Your footwear should be well-fitted, secure and supportive.
