Mobility Aids and MS: Canes

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Walking difficulties are awkward, but people with MS are often hesitant to use a cane.   MS is often a hidden condition and carrying a walking aid simply exposes it to the world.   But why is it so embarrassing?   Canes first came into play when humble shepherds used their staffs to guide and protect their sheep. However, as the years passed, the cane became a symbol of social prestige and privilege. Marie Antoinette made them fashionable and American presidents often carried them. With such a rich history progressing from a lowly tool to a status symbol, a cane is embarrassing no more.

You sway when you walk, you fall down, people think you look drunk and then finally you believe it is time to consider a cane. Karen Zielinski, a person living with MS and author of Hope and Help for Living with Illness. gives advice about trying to walk when it's difficult.

She emphasizes that it does not increase your ability to walk, but it does tire you out. Still you think you can maintain your independence if you just try a little harder. Zielinski tells us not to let pride or fear interfere with mobility, and continues by saying, "These walking aids stretch what I can do each day, conserve my energy, and keep me safe and less anxious about getting around. They literally widen my world." It seems truly maintaining your independence means adopting a walking aid.

When you know you're walking is not as sturdy as it once was, when you find yourself working harder than you think you should have to in order to walk across a room or to cross the street, it is time to select a cane. It is better to have it before you need it, than to wait until you are desperate. Flailing about and falling are more embarrassing and less productive than employing a walking aid.

Once the decision is made to buy a cane, it's time to choose one - not as easy as it seems. When I decided to buy a cane I walked into a shop and picked a pretty one. Generally, it is not a good idea to select a cane just because it is pretty. I did not know any better. The cane is the tool to ensure your safety and "pretty" does not balance you. A cane reduces the energy needed to walk and decreases the chances of falling - it is your new balance. Take care and time to get the solution that is right for you.

First, talk to your doctor and physical therapist to see exactly what you might need from a cane. Are you looking for a simple balance correction or do you have weakness so you need to lean on the cane for support? If you get a prescription, insurance might even help you pay for it and perhaps even pay for a physical therapist to train you to walk with it.

When selecting your cane, evaluate these characteristics:

Your Weight - The cane is of no use if it cannot hold your weight. Give it a try-lean on it. If it feels sturdy and you feel comfortable with it, the came is a workable candidate. The dealer can tell you how much weight the cane is capable of balancing.
Cane Weight - If you are weak, the cane should be light weight. Otherwise, this tool meant to ensure your balance can actually interfere with it. Be careful. A cane made of light material may not be sturdy enough to hold your weight. Get the lightest cane you can that still supports you.

Cane Height - You want to be able to stand up straight rather than stooping over. Likewise, it is awkward to hold the cane too high when trying to balance comfortably. The cane should be about half your height so it can be held with your elbow slightly bent and still allow you to stand straight. A tall cane can often be cut to order.

Handle or Holder - The handle must be sturdy and comfortable for you to easily hold and lean on when balance is required. If the handle is too big or too small for your hand, and you lean on your cane, you may lose your balance or twist and hurt your wrist. There are several standard handle types, including: 1) Crook, J, or Tourist, the most common; 2) Derby, by far the most popular, shaped for comfort, placing the weight directly over the shaft; and 3) Fritz, designed in Germany especially for arthritics.

Tip Point - Consider the type of surface you normally walk over before selecting a tip type. For example, a metal tip is fine for carpet or outdoors, but it may slide over floors creating a serious challenge for your balance. During winter, an icy surface may require an ice pick accessory. The standard rubber tip satisfies most needs.

I didn't know much about canes when one became part of my life. I decided as long as I had to walk with a cane it was going to be fun; it can be a fashion accessory and a prop to play with. The first one I chose had a sleek black shaft with a silver derby handle. It has a classic look, very sophisticated. That would do-and it did for a long time. But my wardrobe was varied and this beautiful cane did not go with every outfit. Here was a new opportunity to build a wardrobe of canes.

Of the many varieties, I found canes that act as flasks and with swords hidden in the shafts. Shafts made of glass, wood, steel, aluminum, and animal products. There are canes with dog handles, horse handles, dragon handles, ball handles, handles made of ivory, brass, mahogany. They come in all shapes and sizes, in many colors and designs. My uncle had a crook-handled cane made for me with pink fishing line meticulously wrapped around the shaft and my name painted on it. It was beautifully designed, and I was touched by his thoughtfulness. But there is more to the cane than just a shaft, handle, and tip.

Accessories and special features expand the cane value.

  • A small wrist strap helps ensure the cane does not fall outside of the reach of an unsteady MSer.
  • A tripod tip broadens the base to supplement balance.
  • A quad cane which provides extra stability when required has a tip that actually has four separate prongs.
  • A cane can have a built in light for walking in dark places or at night.
  • A convertible folding cane is convenient when only small storage areas are available such as an airplane.
  • Built-in seats provide a rest for the walker who tires along the way.
  • Other devices used along with a cane enhance the safety aspect; for example, an ankle-foot orthotic (AFO), reduces the chances of tripping.

There are many items and features that make a cane a personal solution for each individual condition. It seems so simple, just a walking stick, but actually a cane may be the key to your enhanced mobility.

You have your cane, you know how to use it, but you're not through yet. There are just a few loose ends left. Be careful with long or loose clothing to ensure your clothes do not trip you up. Ensure your family knows that you and your cane should not be separated too far. Children are likely to play with it and leave it across the room, so when you're ready to go, your cane is not within reaching distance.

Now look around. It's time for some minor interior redesign. Be wary of area rugs, furniture placement that may be awkward, and potential tripping things such as cords. Get in the habit of looking around each time you enter a new room.

Next time I'll talk about other walking aids such as braces, walkers, and even some creative personal solutions.

Notes and Links:

  • Some of these links are for companies.   I include them here for reference only; I am not endorsing any company. Walking instructions -- simple cane
    Walking instructions -- quad cane
    Specialized tripod tip

Article on mobility aids
Cane specifications  
Article on walking aids