Use your cane on the opposite side of your hip surgery. If your left hip was operated on, hold the cane in your right hand. If your right hip was replaced, hold it in your left hand. This feels counterintuitive to most people, but it’s the standard recommendation from orthopedic surgeons and physical therapists for good reason.
Why the Opposite Side Works Better
When you walk without a cane, muscles on the outside of your hip (the abductors) work hard to keep your pelvis level each time you step forward on the surgical leg. After hip surgery, those muscles are weakened and the joint is still healing, so every step puts significant strain on that side.
Placing the cane in the opposite hand creates a counterbalance across your body. Research measuring muscle activity around the hip found that using a cane on the opposite side reduced hip abductor activity to about 66% of normal. Using it on the same side as the surgical hip actually increased that activity to over 400% of normal, meaning the healing joint would be working harder than it would with no cane at all. The opposite-side placement also mimics how your arms naturally swing when you walk, which helps you maintain a smoother, more normal gait instead of an awkward side-to-side lurch.
A cane can support roughly 25% of your body weight when used correctly, which is enough to meaningfully reduce the load on your recovering hip with each step.
How to Walk With the Cane
There are two common patterns your physical therapist may teach you. The simpler version, called a three-point gait, works like this:
- Step 1: Stand with your weight on your non-surgical leg. Move the cane forward about 12 to 18 inches, keeping it close to your body.
- Step 2: Step forward with your surgical leg so it lands even with the cane.
- Step 3: Transfer your weight onto the cane and surgical leg together, then bring your stronger leg forward to meet them.
As you get stronger, you’ll likely progress to a two-point gait, where the cane and your surgical leg move forward at the same time in one fluid motion, followed by your non-surgical leg. This is faster and feels more like normal walking. Your physical therapist will tell you when you’re ready to make that switch.
Navigating Stairs
Stairs after hip surgery can feel intimidating, but one simple phrase covers it: “up with the good, down with the bad.”
When going up stairs, lead with your stronger (non-surgical) leg onto the next step, then follow with the cane and your surgical leg. When coming down, reverse it: place the cane on the lower step first, then your surgical leg, then bring your strong leg down last. Your stronger leg does the heavy lifting in both directions, either pushing you up or controlling your descent.
If a handrail is available, use it. Hold the cane on the side opposite the handrail and follow the same sequence. If there’s no handrail, keep the cane on the side you normally use it (opposite the surgery) and take it one step at a time.
Getting the Right Cane Height
A cane that’s too tall or too short changes how you distribute weight and can cause you to lean awkwardly, increasing your fall risk. To check the fit, stand up straight with your arm relaxed at your side. The top of the cane should line up with the crease of your wrist. When you grip the handle and place the cane tip on the ground, your elbow should have a comfortable bend of about 15 to 20 degrees. Most adjustable canes have push-button height settings that make this easy to dial in.
When You’re Ready for a Cane
Most people don’t go straight from surgery to a cane. You’ll typically start with a walker or two crutches, which provide more stability when your weight-bearing ability is still limited. A single cane doesn’t offer enough support for someone who’s been told to keep partial weight off their surgical leg. Once your surgeon clears you for full or near-full weight bearing, usually a few weeks after surgery, you can transition to a cane. Many people use a cane for several weeks after that before walking independently.
Common Mistakes to Avoid
The most frequent error is simply holding the cane on the wrong side. It feels logical to support the surgical hip directly, but as the muscle activity research shows, this actually makes things worse. If you catch yourself switching hands out of habit, move it back to the opposite side.
Reaching the cane too far ahead is another common problem. Keeping it within 12 to 18 inches of your body prevents you from leaning forward or sideways, which is when falls happen. Make sure the rubber tip on the bottom of your cane is in good condition and replace it if it looks worn or cracked, especially on wet or smooth floors. And resist the temptation to ditch the cane too early. Even if you feel steady at home, uneven surfaces, crowds, and longer distances outside can reveal that you’re not quite ready to go without it.