When Can You Stop Using a Walker After Hip Replacement?

How Long To Use Walker With New Hip —

Most hip replacement patients return home from the hospital using either a standard walker or wheeled walker.  I prefer a wheeled walker in a majority of hip replacement cases to both provide safety and mobility.

Wheeled walkers promote normal walking steps around the house that a standard walker cannot.  So when can you stop using a walker after hip replacement?  

When Can You Stop Using a Walker After Hip Replacement?

After hip replacement, your home care physical therapist will transition you from a walker to cane in the first 2-3 weeks. Barring any setbacks you will likely be allowed to stop using a walker after 3 weeks.

Other factors will determine how quickly you can stop using a walker include any weight-bearing limitations or other mobility issues. Both of these can lengthen your need for walker usage.  You must demonstrate normal independent walking with a walker to ensure no falls or safety issues.

While using a walker can carry a negative stigma for many hip replacement patients, it is a necessary tool. You need to properly recover in the early phase of rehabilitation after return home.  In these first few weeks home your new hip is simply not ready to take full body weight activity. This includes normal walking and prolonged standing.

In fact, even after you are ready to make the transition to a cane inside the home, I recommend continuing wheeled walker use outside of the home. This includes any amount of distance walking such as a physician follow up appointments .  There is no reason to push away from the walker too quickly in your recovery and its always better to be safe than sorry.

Current and Past Medical History and Walker Usage

How long to use a walker after hip replacement depends on many factors related to your current status. This takes into account you current health record and prior medical history.  For example, those with additional orthopedic issues such arthritis on the opposite hip or knees would benefit from additional walker usage

knee arthritis

Realistically any other medical condition affecting your endurance would warrant a delay from stopping walker usage after hip replacement.  Your doctor would agree with this decision to avoid any possible re-injury and re-hospitalization.  

Medical conditions including cardiac (Congestive Heart Failure), breathing (COPD) and neuropathy deficits would place a fall risk on you.  In these cases most I would recommend a delay in transition from walker to cane. You would need to regain strength and endurance after your return home from surgery to transition safely. 

In order to transition from walker to cane, a few things would need to be in place from the patient side of things.  

One additional factor to consider is that some surgeons do place weight bearing restrictions on the surgery leg. This occurs if there were any complications or extra work performed on the hip during the surgery. 

You are only allowed full weight bearing through that leg once your PT confirms this with your surgeon .  You must use your walker until this point. Using a cane is contraindicated with any weight bearing restrictions with no exceptions.  

Requirements For Transition From Walker to Cane After Hip Replacement

First, you should have been walking with either no device or sparingly using a cane prior to the surgery.  If you were using a walker prior to surgery, the transition away from a walker after surgery will likely take between 4-6 weeks and sometimes much longer. 

walking normal after hip replacement

In some circumstances such as those with severe arthritis pain or stenosis, a transition away from using the walker may not ever be realistic but a move to a rollator walker or more mobile walker might be doable.

Don’t forget, one of the major reasons you got the surgery performed was to remove the pain in your hip joint. If you cannot transition away from a walker most likely your surgery was still a success.

Second, you need to be mentally ready to move on from a walker.  You may be fearful of giving up that walker support and relying solely on your own legs.  Until you gain some strength and confidence there’s no shame in staying with the walker for a longer timeframe.

Once mentally ready it would be beneficial to work away from the walker to avoid becoming too dependent.   Safety is priority number one. When one of my patients is not mentally prepared to use a cane then we will wait.  Make your own decisions, don’t let family or friends pressure you into actions you can’t handle.  

Lately, be sure your pain level is under control before using a cane after hip replacement.  I would advise to continue using the walker if you are still having consistent pain ranging above 4-5/10. In this case your body is still in the acute phase of healing. 

Transitioning to a cane places increased weight through your new hip. This extra weight can increase pain symptoms for those dealing with soreness.   You had the surgery performed to remove the pain in your hip. Make sure to let that pain subside before you transition into cane usage.

Best Cane After Hip Replacement

cane after total hip replacement

For most of my patients after hip replacement the best transition is to a standard single point cane.  Standard canes are much easier to manage and use properly during this transition. 

I suggest using an adjustable metal cane with a large curved handle rather than a wooden cane or small handled canes. You can find this type of cane in your local drug store or big box retailer. 

A large handled cane provides greater grip and easer weight bearing vs. the more decorative smaller handed canes.  The chances a wooden cane you own fits you properly is likely very low.  

Should I Use a Quad Cane After Hip Replacement?

4 point quad canes are often the shiny object that new hip patients feel they need. Often times this is because they look steadier or maybe a friend or neighbor said to get one.  In most cases a quad cane is not the cane of choice in using a cane after hip replacement.  While a quad cane does have a wider base of support, it can be difficult to coordinate during the walking motion. 

quad cane after hip replacement

You must place all 4 legs of the cane down and hit the ground simultaneously to give proper balance and support.  Improper leg placement can cause the cane to rock and actually increase the fall risk during walking.  

Only those who have additional mobility issues should consider using a quad cane. These are cases where a standard single point cane doesn’t provide enough support yet they are too mobile for a walker. 

Instead of using a quad cane, an alternative option is placing a small base support on the bottom of a standard cane. This will provide a wider support base but not so much as a quad cane to cause coordination issues. 

Add on bases are widely available online and in stores and are used daily by many cane users. Even those without orthopedic or hip issues commonly use a wider add on base for their cane.

Why do You Use a Cane on the Opposite Side of the injury

While this is not a training piece on the proper use of a cane after surgery, this question is such a common one that it needs a quick explanation.  The simple explanation is that the cane should be viewed as an extra leg. 

When you are lifting your ‘good’ or non-surgical leg off the ground during walking, the cane being on that ‘good’ side acts as a leg for support and balance while the ‘good’ leg is in the air.  If the cane was placed on the same side as the hip replacement your body weight would actually be shifted over that leg placing more weight on the weaker surgery leg.  

One potential issue arises when right hand dominant patients have their right hip replaced (or left/left) forcing the cane into their non-dominant hand.  Many times right handed persons have difficulty coordinating the cane in the left hand (and vice versa) and unfortunately this can make the transition to the cane from the walker more difficult. 

In these circumstances the PT will sometimes allow the patient to place the cane in the ‘incorrect’ dominant hand as long as they can demonstrate balance and proper cadence during walking.  Each patient must be evaluated independently to determine if this can be safely performed.

Final Thoughts on When You Can Stop Using a Walker After Hip Replacement

  • A Majority of Patients Can Transition Away From Walker Usage 2-3 Weeks After Surgery
  • Additional Medical Issues Will Prolong Your Walker Usage After Surgery

The bottom line regarding walker to cane transition after hip replacement surgery is that you the patient need to be ready both physically and mentally in order to do so safely.  Too early transition can be detrimental to one’s recovery and cause additional issues early on in your rehabilitation. 

Trust your home care physical therapist and ask questions to make sure you are both on the same page when this cane transition occurs.  Don’t let the walker usage be a stigma but rather view it as a necessary tool in your recovery after hip replacement surgery.  

About Jeffrey Roth MPT

Owner and operator of Roth Therapy Services in Pittsburgh, PA focusing on in home rehabilitation physical therapy services.


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