Assistive Devices

If your doctor recommends you use crutches to get around after your joint replacement, you will be taught to use them by a trained healthcare professional.

Follow these tips to use your crutches safely:

Walking (nonweight bearing):

• Put the crutches forward about one step's length.
• Push down on the crutches with the hands, hold the "bad" leg up from the floor, and squeeze the top of the crutches between the chest and arm.
• Swing the "good" leg forward. Be careful not to go too far
• Now step on the "good" leg.

Walking (partial-weight bearing):

• Put the crutches forward about one step's length.
• Put the "bad" leg forward, level with the crutch tips.
• Take most of the weight by pushing down on the handgrips, squeezing the top of the crutches between the chest and arm.
• Take a step with the "good" leg.
• Make steps of equal length.

Sit to stand:

• Make sure to keep the crutches nearby so they can be reached when needed
• Hold the hand grips of both crutches in one hand. Use the crutches with one hand and the side of the chair with the other hand. Make sure the chair is stable. If necessary, have someone stand behind you.
• Stretch the "bad" leg out straight.
• Push on chair, crutches, and the "good" leg; stand up.
• Keep the weight off the "bad" leg. Balance. Place the crutches in place for walking.

Stand to sit:

• Walk straight up to the chair.
• When a step away from the chair, turn until your back is toward the chair using the "good" leg and the crutches. (Move the crutches, then step, crutches, step...a little at a time.) Never pivot.
• Move backward until the chair touches the back of the "good" leg.
• Remove the crutches from under the arms.
• Hold both crutches in one hand and reach for the chair with the other hand.
• Stretch the "bad" leg out in front.
• Sit down slowly.

Stairs:

• Use one crutch and the stair rail if present (only if the railing is stable and there is someone to carry the other crutch). Use two crutches if there is no stair rail.
• It does not matter which side the stair rail is on.
• If both crutches can be held in one hand safely, you can use both crutches on one side and the railing on the other.

Up stairs:

• Walk close to the first stair and hold onto the stair rail.
• Hold onto the rail with one hand and the crutch with the other hand.
• Push down on the stair rail and the crutch and step up with the "good" leg.
• If not allowed to place weight on the "bad" leg, hop up with the "good" leg.
• Bring the "bad" leg and the crutches up beside the "good" leg.
• Remember, the "good" leg goes up first and the crutches move with the "bad" leg.

Down stairs:

• Walk to the edge of the stairs in the same way.
• Place the "bad" leg and the crutches down on the step below; support weight by leaning on the crutches and the stair rail.
• Bring the "good" leg down.
• Remember the "bad" leg goes down first and the crutches move with the "bad" leg.
• Use the same rules when going up and down curbs or doorsteps.

Precautions:

• Take care on slick or wet surfaces (for example, the kitchen and bathroom).
• Be careful of throw rugs; they should be taken up.
• Never hop around holding on to furniture; it may slide or fall.
• Keep the crutches near you so they are always in reach.
• Wear low-heeled shoes that will not slip off (for example, sneakers).
• For the first few days, a strong belt may be worn to allow someone to assist you.
• Be careful of ramps or slopes, as it is a little harder to walk.
• If falling, throw the crutches out to the side and use your arms to break your fall. To get up, get into a sitting position. Back up to a stool or low chair. Put your hands backwards on to the chair. Bend the "good" leg up. Pull with your hands and push with the "good" leg to get up onto the chair.
• If not allowed to take weight on the "bad" leg, hop up with the "good" leg.
• Do not remove any parts from your crutches, including the rubber tips.

Helpful hints:

• A bedside toilet may be used.
• Keep the "bad" leg up on a stool when sitting.
• Avoid leaning on the underarm pieces.

Your doctor will likely recommend you use a walker if you need to keep the majority of your weight off one leg. Walkers with four legs are the most stable walking aids.

Using a walker

To ensure your walker fits you, stand in your regular posture and rest your hands on the grips. If the walker is the right size, your hands will be even with the tops of your legs and your elbows should be slightly bent.

Walking

• Place the walker at arm's length in front of you
• Grip the handles as you move your "bad" leg forward to the middle part of the walker; don't take long strides
• Bring your "good" leg up, holding the handles securely

Curbs

• Move your walker to the edge of the curb
• Bring your walker up to the curb
• Using the handles for balance, step up with your "good" leg, followed by the "bad" leg
• If you are stepping down, step with the "bad" leg first, followed by the "good" leg

Stairs

For most people, walkers are not safe to use on stairs. Your physical therapist will determine whether it is appropriate for you, and if so, will show you how to use it safely.

Safety tips

To avoid injuring yourself or others, always follow these safety precautions when using your walker:

• Look straight ahead when walking
• Remove tripping hazards from the home, including throw rugs and electrical cords
• Avoid wet floors and icy sidewalks
• Do not use the walker to pull yourself up into a standing position; instead, use your hand to push off from your chair while resting the other hand on the walker
• Use your "good" leg to take the first step when going up stairs or a curb
• Use caution around children and pets; their movements can be sudden and unpredictable

Canes are an excellent walking aid to use if you need minimal help with stability and balance. They are also an option if your leg is not too weak or painful.

Canes come in two types: single tip and four-prong. Your surgeon will recommend one or the other, depending on how much assistance you need.

Getting a cane

To use a cane safely, it needs to fit you properly:

• The handle should be at wrist level
• When holding the handle, your elbow should be slightly bent
• Choose a cane with a handle that's comfortable to hold

Walking

To get around safely with your cane, follow these steps:

• Grip the handle of your cane firmly
• Step forward with your "bad" leg, simultaneously bringing the cane forward the same distance; the tip of the cane and your foot should be even
• Step forward with your "good" leg
• Repeat, going slowly at first until you get comfortable with the cane
• To turn, pivot on your "good" leg

Stairs and curbs

• To go up, step up with your "good" leg
• Bring your cane and "bad" leg up to meet the "good" leg
• To go down, place your cane below the step
• Bring down your "bad" leg to meet the cane, using it for balance
• Bring your "good" leg down to meet the cane
• When climbing or descending stairs, take one step at a time

Safety tips

• Hold your cane in the hand that is opposite the "bad" leg
• Never put your weight on the cane when the tip or prongs are not fully on the ground
• Look ahead when you walk, never down at your feet
• Avoid tripping or slipping hazards such as wet floors, icy sidewalks, throw rugs and electrical cords
• Ensure the tip of your cane is in good condition; if not, replacement tips can be bought at a medical supply or drug store