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Strain Injury from Cane Use

strain injuryMillions of people in the United States use a cane to increase mobility, whether due to an injury or just to improve balance and strength.  In addition to this, a cane can aid an individual in reducing weight on a lower-limb, thereby alleviating pain or compensating for a weak limb or injury.  The cane can be beneficial and improve mobility, however, some research has shown that mobility aids can increase the chance for falls and additional injury.  In order for one to properly use a cane, other parts of the body are demanded and constantly in use; this may adversely cause loss of balance control, or causing strain to the body, particularly the upper extremity.

Strain Injury

Clinical evidence for injury or other problems has indicated a high association with disuse of the cane or mobility aid among many older adults.  This raises the question of the device effectiveness among various users.  Injuries have been reported from repetitive strain or cumulative trauma disorder due to improper use and fit of canes.  Each year, nearly 40 percent of older adults in the United States will fall at least once and the medical costs associated with the falls are estimated around $26 billion a year.  Risks of strain injury are on the rise, raising questions as to how the mobility devices could be redesigned and configured.  Researchers are currently seeking means to further reduce these risks for adults who utilize canes, innovating and solving design issues.

Cane Design

Evidence suggests the outdated design of the canes available are to blame for soft tissues in the upper extremity from repetitive motion strain injuries from falls due to incorrect height of cane, slippery handles and/or the base of the cane, and poorly balanced weight of the walking device.  Other issues such as inappropriate cane prescription, inadequate training provided to the user, or the use of cane devices that were not suggested may be leading causes of such problems.

Many patients who experience strain issues have reported discomfort, pain or a strain injury.  The repetitive stresses on the upper-extremity joints can result from chronic cane use.  Tendonitis, osteoarthritis and carpal tunnel syndrome are three major upper-extremity issues associated with cane use.  Individuals with previous arthritis issues who often use canes are at a higher risk of developing joint inflammation from repetitive use.  It is also assumed that the selection of an improper cane for an individual could result in a disability to the body.

Using the wrist to balance is a natural and evolutionary concept.  As infants, we crawl with arms extended and wrists out, mainly applying weight through the wrists rather than the hands.  This is how we as humans maintain neutral alignment and continuous weight bearing.  Similarly, a human who utilizes a cane, hyperextends the wrist when bearing weight on it.  This in turn causes misalignment through the hand and creates torque in the wrist joint.


The solution to this issue is as follows:

Fitting the Cane to the Individual

Providing the correct cane length will help to alleviate these issues.  The two most commonly used cane lengths are either 33” or 36” length.  Many cane related injuries are associated with incorrect cane fitting in relation to the user’s size.  Canes that allow the user to adjust the size and then lock it into place are ideal and an up and coming design.  For example, the aPallo Cane can be adjusted in 3 easy steps:

  1. Loosen locking ring located at bottom of cane by rotating counterclockwise.
  2. Depress the push button and slide the leg to the desired height, up or down.  Make sure the push button is fully engaged in the desired hole.
  3. Rotate the locking ring by turning clockwise until completely secure.

It is very important to consider appropriate height for the cane being used by an individual.  Not only will mobility be much more accessible, but it will also reduce risks of falls and upper-extremity strain injuries.

Features of the aPallo Cane

The up and coming cane design of the aPallo Cane allow the user much more freedom, desired mobility and features that aid in reducing strain to the body.  Dr. Palo designed this particular cane after he recognized the great need for improvement in the design of canes.  Chronic muscle strain injuries is one of his main concerns when it comes to assisted mobility devices, which is why he was inspired to design and evolve the technology associated with the aPallo Cane.  Below are some features that were created with the consumer in mind:

  • The locking ring – can be loosened to allow height adjustment of the cane
  • Adjustable pivoting arm, which allows the handles to be placed in the desired position for taller or smaller users.
  • Non-skid rubber tip made to keep users from slipping

Not only were these features added to help decrease the chances of a strain injury, but they also allow mobility to be more easy, fun and exciting.

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