When a physical therapist takes a holiday, they keep observing

I don’t stop being me when it’s a holiday.

I identify as a physical therapist. It’s something that I strove for when I was in college. I’ve now been practicing for thirty-four years. It’s not a job. It’s not a career. It’s who I am. 

This holiday season, let’s look through the eyes of a physical therapist who is at an airport, with time to spare before their flight departs.

The first part of every assessment that you make is observation. Today it comes in the form of “people watching.” Holiday crowds and gatherings give us plenty to observe.

Holiday people-watching

Your eyes notice a person walking with a cane. Your head slightly turns side to side as if to say “No.” The cane is too high. It’s a common mistake. A cane is used to take weight off a leg that is unable to bear it fully. A downward force is directed from the arm and through the cane. When a cane is at its proper height, that force is generated primarily at the shoulder. The elbow will be only slightly bent. If the cane is too high, then the elbow will be bent too far to have good leverage.

The next thing you notice is perhaps the most common mistake. The cane is in the wrong hand. A cane should (almost) always be in the hand opposite the leg it is aiding. This not only mimics our natural arm swing but also provides a wider base of support. Just like you wouldn’t build a table with all the feet close together, you are better balanced when the cane and supported leg are separated.

There is one exception to the rule of which hand to use. If the opposite arm is unable to operate a cane, then it goes into the “same side” arm.

You see plenty more people. A person who when walking “waddles” to one side, bringing their shoulders outside of the foot that’s on the ground. Your inner voice says, “Most likely a hip problem.” A mother with her infant, sitting with her weight shifted onto one butt cheek. “Most likely post-partum back pain.” An older, otherwise healthy-appearing person being taken to their gate in a motorized cart. A quick observation finds their hands misshapen in the characteristic form of a person with rheumatoid arthritis.

Some people are doing great

Then, we see this person: Older. Walking tall. Legs gliding forward seemingly effortlessly. A gait that is brisker than people half their age with a lengthy stride marked by the heel distinctly touching the ground before the ball of the foot. There’s a narrow-based walking pattern, indicating assured balance.

To paraphrase Dave Grohl of the band, The Foo Fighters: There goes our hero.