Walking with a walker

Walking with a Walker (3 Point Gait)

If assistance is needed, the caregiver should stand behind the individual using the walker and on the same side as the injured or weak leg.

Steps for Using a Walker

To walk with a walker using a three point gait, follow these steps:

  1. Move the walker. Lift or roll the walker so that it is placed at a comfortable distance in front of you, about an arm’s length away. Make sure all four legs are firmly placed on the floor. The back legs of the walker should be about even with your toes.
  2. Move your weak leg. Moving your injured or weak leg first, step towards the walker.
  3. Move your good leg. Next, step forward with your good leg, bringing it slightly ahead of the injured or weak leg. As you step with your good leg, support some of your weight with the walker to avoid placing too much weight on your weak or injured leg.
  4. Repeat steps 1 through 3: move the walker, then the weaker leg, then the stronger leg.

Safety Tips for Using a Walker

  • Be careful not to step too close to the walker or lean forward over the walker, or you may lose your balance. Keep a comfortable distance between you and the walker at all times.
  • Do not place the walker too far in front of you. Keep the walker’s back legs even with your toes.
  • Look straight ahead as you are walking. Keep your head up and avoid watching your feet. Looking down at your feet while you walk is more tiring and may cause you to run into something.
  • Only move as fast as you feel comfortable. Take your time and don’t rush.

How to Use Crutches, Canes, and Walkers

All the assistive devices are meant to help you walk and assist you in various ways. It is a of paramount importance though that use them correctly.
We hold special sessions and training on use of these assistive devices. Here is a snapshot of the same.
Please note that this is just a snap shot to give you general idea, however contact us to discuss your detail case.
If you ever break a bone in your leg or foot, have a surgical procedure on your lower limb, or suffer a stroke, you may need to use crutches, a cane, or a walker.

In the beginning, everything you do may seem difficult. But, with a few tips and some practice, you will gain confidence and learn to use your walking aid safely.

General Guidelines
  • Remove scatter rugs, electrical cords, spills, and anything else that may cause you to fall.
  • In the bathroom, use nonslip bath mats, grab bars, a raised toilet seat, and a shower tub seat.
  • Simplify your household to keep the items you need handy and everything else out of the way.
  • Use a backpack, fanny pack, apron, or briefcase to help you carry things around.
Crutches

If an injury or surgical procedure requires you to keep your weight off your leg or foot, you may have to use crutches.

Proper Positioning

The top of your crutches should reach between 1 and 1.5 inches below your armpits while you stand up straight.

The handgrips of the crutches should be even with the top of your hip line.

Your elbows should bend a bit when you use the handgrips.

Hold the top of the crutches tightly to your sides, and use your hands to absorb the weight. Don’t let the tops of the crutches press into your armpits.

Walking

Lean forward slightly and put your crutches about one foot ahead of you. Begin your step as if you were going to use the injured foot or leg, but shift your weight to the crutches instead of the injured foot. Your body swings forward between the crutches. Finish the step normally with your non-injured leg. When the non-injured leg is on the ground, move your crutches ahead in preparation for the next step. Keep focused on where you are walking, not on your feet.

Sitting

Back up to a sturdy chair. Put your injured foot in front of you and both crutches in one hand. Use the other hand to feel for the seat of your chair. Slowly lower yourself into it. Lean your crutches upside down in a handy location. (Crutches tend to fall over when they are stood on their tips.) To stand up, inch yourself to the front of the chair. Hold both crutches in the hand on your good leg side. Push yourself up and stand on the good leg.

Stairs

To walk up and down stairs with crutches, you need to be both strong and flexible. Facing the stairway, hold the handrail with one hand and tuck both crutches under your armpit on the other side. When you’re going up, lead with your good foot, keeping the injured foot raised behind you. When you’re going down, hold your injured foot up in front, and hop down each stair on your good foot. Take it one step at a time. You may want someone to help you, at least at first. If you’re facing a stairway with no handrails, use the crutches under both arms and hop up or down each step on your good leg, using more strength. An easier way is to sit on the stairs and inch yourself up and down each step. Start by sitting on the lowest stair with your injured leg out in front. Hold both crutches flat against the stairs in your opposite hand. Scoot your bottom up to the next step, using your free hand and good leg for support. Face the same direction when you go down the stairs this way.

Canes

You may find it helpful to use a cane if you have a small problem with balance or instability, some weakness in your leg or trunk, an injury, or pain. If you are elderly, a single point cane may also help you to keep living independently.

Proper Positioning

The top of your cane should reach to the crease in your wrist when you stand up straight. Your elbow should bend a bit when you hold your cane. Hold the cane in the hand opposite the side that needs support.

Walking

When you walk, the cane and your injured leg swing and strike the ground at the same time. To start, position your cane about one small stride ahead and step off on your injured leg. Finish the step with your normal leg.

Stairs

To climb stairs, grasp the handrail (if possible) and step up on your good leg first, with your cane in the hand opposite the injured leg. Then step up on the injured leg. To come down stairs, put your cane on the step first, then your injured leg, and finally the good leg, which carries your body weight.

Walkers

If you have had total knee or hip joint replacement surgery, or you have another significant problem, you may need more help with balance and walking than you can get with crutches or a cane. A pickup walker with four solid prongs on the bottom may give you the most stability. The walker lets you keep all or some of your weight off of your lower body as you take your steps. You use your arms to support some of the weight. The top of your walker should match the crease in your wrist when you stand up straight. Do not hurry when you use a walker. As your strength and endurance get better, you may gradually be able to carry more weight in your legs.

Walking

First, put your walker about one step ahead of you, making sure the legs of your walker are level to the ground. With both hands, grip the top of the walker for support and walk into it, stepping off on your injured leg. Touch the heel of this foot to the ground first, then flatten the foot and finally lift the toes off the ground as you complete your step with your good leg. Don’t step all the way to the front bar of your walker. Take small steps when you turn.

Sitting

To sit, back up until your legs touch the chair. Reach back to feel the seat before you sit. To get up from a chair, push yourself up and grasp the walker’s grips. Make sure the rubber tips on your walker’s legs stay in good shape.

Stairs

Never try to climb stairs or use an escalator with your walker.

We do special sessions to teach clients on how to do different activities using these different devices. Talk to us now and get started.

Arthritis Myths

7 Common Arthritis Myths Busted

When a person is in pain due a bone or joint problems it can be hard to get moving and keep moving. Arthritis is a group of conditions that affect 4.6 Million Canadians over the age of 15, causing joint pain and swelling.1 Arthritis is the leading cause of disability in Canada and its impact on society is increasing.2

 

Seven common myths about arthritis

Myth 1: Arthritis is an old person’s disease.
Three of every 1,000 Canadian children live with a form of Arthritis.1 Three in five Canadians diagnosed with arthritis are working age.1 Arthritic conditions cost the Canadian economy $33 billion in lost productivity as well as health-care costs each year.1

Myth 2: Arthritis is a normal part of the aging process.
Arthritis is common among older Canadians, but it is not a normal part of aging. In fact, rheumatoid arthritis (RA) and other types of inflammatory arthritis are autoimmune disorders,1,3 while osteoarthritis (OA) is associated with joint trauma and obesity.1 By dismissing arthritis as a normal part of aging many Canadians do not access the treatment and resources they need to help them manage their condition.2

Myth 3: My parents both had arthritis, so I’m bound to get it.
Genetics does play a role in whether someone is at risk for arthritis,3,4 but other factors such as trauma and obesity are more closely related to whether or not you develop arthritis.2

Myth 4: The amount of joint damage on an x-ray directly relates to the pain and disability a person has.
Bone or joint damage on an x-ray is not necessarily related to pain or loss of function.4 Many factors contribute to the degree of disability a person experiences. In the late stages of RA, there is a relationship between joint damage and disability,5 but in the early stages of RA5 and throughout the course of OA4 the link between joint change and disability is much weaker.

Myth 5: Running causes arthritis.
A 2013 study of 90,000 runners found that there was no evidence that running increases a person’s risk of developing arthritis. In fact, those who ran 12.4 km/wk or more were at a lower risk for developing OA.6

Myth 6: If you crack your knuckles you will get arthritis.
Although it is true that when joints have significant arthritic changes they may make a considerable amount of noise; cracking and clunking when moved. However, there is no evidence that intentionally cracking your knuckles or other joints causes or is even associated with arthritis.7

Myth 7: Only a medical specialist can treat arthritis.
Physiotherapists can help you to manage the pain and inflammation of arthritis and provide you with exercises to minimize joint stiffness and maintain muscle strength which will help limit the disabling effects of arthritis.3 If you do need to see a surgeon for joint replacement, physiotherapists will be involved in your care both before and after your surgery to ensure that you regain your strength and maximize use of your new joint.

Arthritis FAQs

What is arthritis?
Arthritic conditions are divided into OA and inflammatory arthritis. OA is a “progressive joint disease that occurs when damaged joint tissues lose their normal ability to repair themselves, leading to a breakdown of cartilage and bone”2 RA is the most common of the inflammatory types of arthritis, which are associated with joint inflammation, pain and stiffness, as well as chronic systemic inflammation, fatigue and an increased risk of mortality.2

What causes arthritis?
There is no single cause of arthritis. Typically a combination of risk factors lead to joint changes and impairment. Risk factors for OA include injuries, obesity, age and family history.2,4 RA is an autoimmune disease that only occurs in those with both a genetic predisposition and a trigger to activate the autoimmune response that leads to  joint inflammation, pain and dysfunction.3 The ‘trigger’ that activates RA is unknown.3

Can I avoid arthritis?
When it comes to RA, the best thing you can do is to see your doctor if you develop joint pain and follow up diligently with any treatment recommendations or specialist referrals.2,3,5 Early diagnosis and treatment are especially important for inflammatory arthritis such as RA. Some research indicates modest healing of bone damage can occur with treatment using anti-rheumatic drugs5 and treatment “has important effects on disability. Patients who delay seeking specialist advice often develop severe disability.”5

Whether you have OA or RA, maintaining a healthy body weight will decrease the stress placed on your joints and help to manage your symptoms.2,3 Becoming active can help to control body weight and moving joints through their available range of movement can help to keep them healthy and prevent stiffness.3 Increasing muscle strength can decrease the disability often faced by those with RA.3

Use common sense to avoid injury while being active to help you to avoid OA2 and help limit the joint damage of RA.3

 

References:

  1. The Arthritis Society. Arthritis in Canada: Facts & Figures. Available at: http://www.arthritis.ca/facts.  Accessed August 5, 2014.
  2. Arthritis Alliance of Canada. Joint action on Arthritis: A framework to improve arthritis prevention and care in Canada. Available at: http://www.arthritisalliance.ca/en/. Accessed August 5, 2014.
  3. The Arthritis Society. Rheumatoid Arthritis: Know your options. Available at: http://www.arthritis.ca/document.doc?id=336. Accessed  August 5, 2014.
  4. Dieppe PA, Lohmander LS. Pathogenesis and management of pain in osteoarthritis. Lancet 2005; 365: 965-973
  5. Scott DL, Pugner K, Kaarela K, Doyle DV, Woolf A, Holmes J, Hieke K. The links between joint damage and disability in rheumatoid arthritis. Rheumatology 2000; 39:122-132.
  6. Williams PT. Effects of running and walking on osteoarthritis and hip replacement risk. Med Sci Sports Exerc 2013; 45(7): 1292-1297.
  7. deWeber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis. J AM Board Fam Med 2011; 24: 169-174.

– See more at: http://www.physiotherapyalberta.ca/public_and_patients/the_you_movement_blog/7_common_arthritis_myths_busted#sthash.PK8dlsYh.