How to Walk with a Cane

Author: G.Guido Rodriguez PT, RT, about this author..⟩⟩

As a physical therapist sometimes you find yourself assessing the way people walk in the street, it is inevitable,  particularly when they are utilizing an assistive device.

The most common mistake that I have observed, is people using a wrong gait pattern with a regular cane.

So, let me tell you details about to how to properly walk with a cane., but let me start by explaining…

What canes are for?

Canes are designed to facilitate a wider base of support for people with balance problems.

They also provide limited stability,  by unweighting up to 30% in people with an affected extremity.

There are different types, single point cane, quad cane, etc.

Well,  canes have not always been used for balance problems, in the past, they were also used for fashion, in the XVII century canes were used by men as part of their daily attire, and they were designed with a fashion intention in mind not necessarily to help with balance problems.

These canes were made out of wood, or wood with metal, with no rubber caps on end, providing little traction, you still see them around, but they should be considered for decoration purposes, technically they are not considered medical devices.

Today’s canes have evolved significantly, and unlike the past, the main objective is to provide stability to its user, they are now versatile,  made of different material, including, aluminum, steel, and carbon fiber with adjustable length, foldable, lightweight, and multiple end cap or tips options.

Adjusting it to the Right Length

The first thing you want to address when getting a new cane is adjusting it to the right height

 Walking with a cane with the wrong length will affect the way you walk defeating the reason you decided to get one for.

A cane that is too short will provoke you to bend forward with each step, increasing muscle strain and falling risk.

When the can is too tall will make it difficult to control decreasing its unweighing capabilities.

An easy way to adjust cane’s length to fit your body is:

  • Wear your regular walking shoes
  • Stand tall in your regular posture on a flat surface,
  • Hold the cane with the hand you are going to use it,
  • Place the tip of the cane 6 inches to the side of the toes
  • Adjust the cane’s length until you have 20-30 degrees of elbow flexion


What is a proper way to walk with it

Ok, when you utilize a cane, it should be an extension of your hand, so if you have a problem in the arm, you are going to be holding the cane with, please talk to your physical therapist to find the best device or technique for your problem.

The general idea of a cane is to support your weaker leg

In general, a cane should be held in the hand opposite to the lower limb with neuromuscular weakness or joint pathology

How to stand up/sit down with a cane

  • Standard cane / Quad cane: If the chair has armrest; hold the cane’s handle with one hand and push up from the armrest with your other hand.

Now, if the chair has no armrests, place both hands (one on top of the other) on the handle of the cane, spread your legs shoulder width.

Place tip of the cane in the middle at the heel level, stretch out your arms, lean forward and stand, pushing down on the cane. Once standing, make sure you are steady before walking.

To sit down in a chair:

  • Stand close to the chair, feel it against your legs. With your free hand reach down for the armrest or the side of the chair and lower yourself as you lean forward (ask your therapist how to do this if you have “hip precautions”).
  • With a quad cane, you can reach down with your free hand first, then the other hand leaving the quad cane upright and sit as described above.

How to sequence steps with a cane

Most canes are held similarly, however, depending on its type it may provide you with a different gait, for example, a quad cane will make you walk slower, the same sequencing, but with paused stepping, opposed to the continuous stepping seen with a regular cane.

  • Advance cane with the affected limb ( bad leg) together in what is called a three-point gait pattern.                                                                                           
  • Start shifting your body weight gradually onto the cane and bad leg simultaneously.
  • Now take a step forward with your stronger leg, shift your weight and balance to it.
  • Look up to see where you are going.

To deal stairs there is a common technique (“Up with the good and down with the bad), in practice, however,  there are no strict rules, and each condition and situation should be assessed independently.

Stairs are usually ascended leading with the stronger leg first,  then the cane along with the affected limb.

To descend, the affected leg and cane should go down first, then the stronger leg.

I need to say, that even though it seems a simple task, some people struggle to learn the proper sequence, so you may want to consult a physical therapist for skilled gait training if you present difficulties with it.

Thanks for taking the time to read this “How to Walk with a Cane” article. I hope you found it educational, if you have any comment or question, please write the comment section, thank you.


Leave A Comment