Enter: The Cane

Last Friday at physical therapy, Christa picked up a cane, adjusted it to the right height, and gave it to Mary Ann to try.  There's a correct way to use a cane, which Christa showed her.  You hold the cane in the hand opposite the hip bring rehabbed.  In Mary Ann's case, her right hip was replaced, so she held the cane in her left hand.  You advance the cane when you advance the foot of the leg being rehabbed.  So for Mary Ann, right leg and left arm (with cane in hand) come forward at the same time. 

It seems odd at first, but not after some thought.  The cane shares the load with the affected foot.  In normal walking, there's an instant when we put full body weight on the foot being advanced.  By advancing the cane and leaning on it, the affected foot is only being asked to support half of the body weight. 

There is a rhythm required, and one learns it by counting seconds for each step and walking slowly.  Oh yes, and by practicing!  Mary Ann took a brief walk out of the gym and into the hallway, going a little distance in the hallway, and then returning to the gym.  This was shortly before the session ended, and Christa asked Mary Ann to be thinking about the internal counting and the step rhythm over the weekend.

Yesterday after 30 minutes of a pretty rigorous set of exercises, some with weights on her ankles, Mary Ann was once again given the cane.  This time the practice walks went longer, and the patient improved.  At several points along the walk, Christa lagged behind Mary Ann by maybe six feet or so in order to observe her hip aligment.  This made me very nervous, because Mary Ann was actually walking without any support except that cane. 

After observing many P.T. sessions, I have come to realize that re-learning how to walk properly is much more involved that I first thought.  Balance, muscle development, hip alignment, correct posture, coordination, and more need to be relearned and practiced.  Fortunately, Mary Ann is a motivated patient and Christa is a very good physical therapist.  They make a good team.