October 31, 2020
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Never Let Mom use Crutches

As our parents age, a decline in balance is natural. Often this can be reversed with physical therapy, but eventually an assistive device is likely to be required for safety.

How do you know when mom needs a cane or walker? Are there different types and which would be best for mom? Below is a description of common assistive devices and who they would be a good fit for. An evaluation by a licensed Physical Therapist may be needed for specific recommendations for your loved one. 


It is NEVER a good idea to let mom use crutches. They are unnatural to use, increase fall risk in all but the most athletic 20 year olds, and can cause upper extremity nerve damage if her arms are not strong enough for them to be used correctly. I have seen way too many significant injuries (broken bones, traumatic brain injuries etc.) from someone given crutches who does not have the strength, balance and coordination to safely use them. Use a cane instead of 1 crutch or a walker instead of 2 crutches.


Before I was a physical therapist, I thought of canes as 3 foot long shepherd’s hooks intended for shaking and the neighbors kids (often me) while telling them to get out of the flower bed. While cane’s can be used to make your point from across the yard, they also serve another purpose, to assist with balance. There are many different types and styles of canes. Each with their own pro’s and con’s. 

Single point cane: The traditional wooden, hooked handled cane mentioned above or some of the newer adjustable, aluminum canes with a single rubber stopper on the end. This device is for someone with a slight unsteadiness to their walk. The small single point of contact is just enough to provide increased stability and positional awareness to improve balance. Single point canes may be a good idea on an uneven (outdoor) surface who has no difficulty getting around their home. Someone who cruises (touching walls or furniture as they walk in the home) may benefit from the assistive device within the home.

Quad Cane: There are 2 sizes of bases for quad canes. Large base (approximately 12” x 6”) and small base (approximately 7”x4”). This assistive device is for someone who needs much more stability than a single point cane can provide. Often they are unable to walk short distances safely without it.  The size of the recommended base would depend on the amount of stability required. A quad cane can allow you to weight bear through it, but is not as cumbersome as a walker. This cane is often appropriate for someone who has had a stroke affecting one side of their body.

Hurry Cane: This unique device is most similar to a single point cane, but has a larger base and a joint between the base and the shaft which allows it to adjust to uneven surfaces and provide more stability than a single point cane but is much lighter and more convenient than a quad cane.


Much like canes, there are different types of walkers. Each with varying degrees of stability vs. mobility.

Standard Walker: The traditional four legged assistive device with Rubber stoppers on each leg. This is the most stable of the walker when it is on the ground, but the least mobile. To walk with this device, it has to be picked up, moved forward and then stepped into. This process repeats itself until the destination is reached. It is slow and methodical. This is rarely recommended for home use as it has to be lifted off the ground to be advanced thus eliminating the benefit of 4 stable legs on the ground. 

Rolling Walker or Two-Wheeled Walker: This is the most stable device when walking. The two wheels on the front eliminate the need for it to be lifted off the ground as it slides forward with little difficulty improving balance by increasing the base of support. The two legs on the back allow for your entire body weight to safely be put on the walker if needed. This can be required after an amputation or while non-weight bearing on one lower extremity following a fracture. 

Rollator or Four-wheeled walker: This assistive device is the most mobile of the walkers and the least stable. Its four wheels make it a breeze to glide around and it will provide some balance assistance. That being said, you need to have pretty good balance to safely use a rollator. It is often best for people with minimal balance difficulty who have trouble with activity tolerance and need to take seated rest breaks every so often. Make sure the brakes are locked prior to sitting. Also this is not a wheelchair. It is not safe to scoot around sitting on a rollator or to push mom while she sits on this four-wheeled walker. A light weight transport wheelchair would be the safe option for moving about while seated.

It is important to have an assistive device that is the right size and type for the person using it. In other words, it’s not a good idea to let mom use dad’s old walker just because it's still in the attic. While it's a good idea to reuse some durable medical equipment, make sure to have it evaluated and fitted by a licensed physical therapist to make sure it is right for mom. 

That’s all for today.

Take care, keep mom safe and have a great day!

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