I just had a confusion in regards as to where to put the cane on walking. Is it on the strong side, or the weak side? Why some people will say its better on the weak side? Please advice. Thank you

The selection and use of assistive devices is quite a wide area in Physical Therapy practice. Strong side or weak side cane placement (or alternatively, contralateral / ipsilateral cane placement) significantly depends on a variety of factors – chiefly, the patient’s presentation. For example, is the cane being prescribed for a case of abnormal gait correction (e.g. Trendelenburg gait), non-weight bearing ambulation (e.g. sprains, strains, fractures, joint – hip or knee replacement surgeries) or musculoskeletal pathology (scoliosis) etc.

Two other very important factors (among others) to consider when selecting a side to use an assistive device for patient rehabilitation is patient safety and the patient’s functional ability. Safety considerations prevent additional injuries (such as falls or palsies) to the patient. In consideration of patient’s safety, assistive devices which require a high degree of coordination are not selected for patients with neurological deficits. Devices that have a narrow base of support are not selected for patients with balance issues (in these instances, walkers are preferred to crutches or canes) and lastly, devices such as crutches and canes are calibrated to match, for instance, a patient’s height to avoid exposing the patient to unintended injury (e.g. axillary crutches that are too long causing radial nerve palsy).

From my research, the available literature is not unanimous as to which side – either weak side or strong side hip, a cane can be used to correct Trendelenburg gait. (i.e. both sides can be used for effective rehabilitation). For example, in this ref, the authors present a case for both ipsilateral and contralateral hip side cane placement).

However, for total hip replacement surgery and other similar non-weight bearing ambulation rehabilitation, ipsilateral (same side as the surgery) or weak side cane placement is recommended in order to reduce the compression forces at the affected or surgically repaired joint and to offer more support to the affected or weakened limb during stance.

Ref; Levangie PK, Norkin CC. Joint Structure and Function: A Comprehensive Analysis. 2005. 4th Edition. FA Davis Company Publishers. Chapter 10: The Hip Complex. Pg 382.