Posts Tagged ‘force couple’

Why is my cane on the other hand?

Thursday, April 28th, 2011

By Paul Kochoa, PT, DPT, CGFI

If you’ve ever had a leg or foot problem and you’ve been to a physiotherapist, you’ve probably been told that you should use the cane or crutch in the opposite hand … Well, let’s break it down and find out why it works better this way.

Let’s say you sprained your left ankle, you have one cane to use. Which hand do you use it in? If you’re Dr. House, you’d pop a Vicoden and use it in the left arm. And you’d be wrong. It’s better if you use it in the right arm, the side opposite to the injury. This works because of the force couple that happens between the muscles of the left hip and the right torso that decrease the stress on the left ankle.

If you take a step with your left foot, it swings forward and there’s no weight on it, all your weight is on the right foot. If you take a step with your right foot, all your weight goes on the left foot, and that’s what probably cranks up the pain levels. Ouch. You need a system to decrease the weight on that left side while you’re walking around. Holding the cane in the opposite side, does just that.

When you step with your right leg, your left leg has to do all the work to support the body’s weight. Putting the cane in the right hand allows the right arm and left leg to work together to support your weight. The right arm is supported by the cane, which works with the right-sided back muscle (latissimus dorsi), which in turn work with the pelvis, which connects to the left side hip muscles (gluteus medius). See the connections? A force-couple conga line.

What happens when you put the cane in the left hand? The cane supports the left arm, connected to the left back muscle, which connects to the left pelvis, which is already connected to the left hip … see the connections here? All the left side is working, which means more weight stays on that left side, and you have a less efficient weight shift to the right (away from the painful left side).

Just look at the way you walk normally. When you take a step with your left foot, your right arm swings forward. When you step with your right foot, your left arm swings forward. The body already moves in that pattern, using the cane correctly reinforces this pattern. Using it incorrectly results in a “Dr. House” gait pattern, you hobble around being really cynical. Nobody wants that.

Next time you see someone with a cane or a crutch, check to see if they’re using it correctly. Listen to your physiotherapist.