February 10, 2020
Sprained ankle? Broken foot? Other injury or permanent disability? Crutches are a great option to help patients regain their mobility. Share this guide with your patients to advise them on how to choose and use crutches for the forearm or underarm.
Patient’s Guide to Selecting and Using Crutches
Types of Crutches: Choosing the Right Crutches for You
Crutch Accessories
How to Fit Crutches
How to Walk With Crutches
Sitting Down and Standing Up With Crutches
Using Crutches on the Stairs
Other Tips for Using Crutches
What Injuries Require Crutches?
Crutches can be used to help support your weight as you recover from a variety of short-term injuries and long-term conditions. Underarm and forearm crutches are often used for patients recovering from:
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Types of Crutches: Choosing the Right Crutches for You
Underarm Crutches
Standard underarm crutches are also called axillary crutches (‘axillary’ meaning they relate to the armpit). These crutches are typically used in the United States while recovering from leg injuries, like a sprained ankle.
Some people consider axillary crutches best for short-term users because they are easy to learn how to use and readily available. Compared to forearm crutches, axillary crutches require less upper body strength.
However, not everyone finds walking on crutches under the arm comfortable. They can make your hands, wrists, and underarms sore due to the pressure exerted during use. Patients find that they can combat this discomfort when walking on crutches by adding grips and using proper form.
Improper use, such as drooping your body weight onto your armpits when fatigued, compresses your axillary nerve and can lead to axillary nerve dysfunction (shoulder numbness or weakness). Learning how to properly fit and use your crutches can help you avoid this damaging condition.
Forearm Crutches
Forearm crutches, sometimes referred to as elbow crutches, have a cuff that goes around your forearm (and sometimes elbow or wrist) to offer support. These are more commonly used in Canada and Europe. In the U.S., forearm crutches are typically recommended for long-term or permanent disabilities, but more people are starting to use them for short-term injuries as well.
These crutches typically require more practice before users master how to use them. They also require more upper body strength, compared to axillary crutches. The good news is that once you master forearm crutches stairs and uneven terrain are much more manageable.
If you’re looking for comfortable crutches, many people find forearm crutches are the easier solution. They help you maintain proper posture, reducing your chances of back pain. This crutch style also doesn’t allow you to rest your weight on your armpits, so they don’t get sore. Your hands and arms may still get a little tired, though.
Alternatives to Crutches
Both versions of crutches can have their drawbacks, including the fact that you can’t use your arms to carry things while you’re walking. If crutches don’t sound like the right fit, maybe a knee scooter or wheelchair would be a better option. Find out about the pros and cons of other mobility aids for a broken ankle or foot to help you make the right decision.
Crutch Accessories
If you’ve decided to stick with crutches, you may also be wondering about how to make crutches more comfortable. Consider adding one of these crutch accessories too.
To stop the mobility aids from hurting your hands or underarms, try adding more comfortable grips or pads to increase your support. Choose between soft fleece covers, wipe clean non-latex pads, or cushy gel covers.
If you’ve chosen forearm crutches, you can add a gel cover to the forearm cuff to make them more comfortable.
As you use your crutches, the tips may get worn down. Ensure you have good traction while walking by replacing the tips with latex free crutch tips.
If you’re using your crutches during the winter, you might want an ice crutch attachment. The pronged cleat gives you more traction on icy areas.
Once you’ve selected the accessories, it’s time to fit your crutches to the size of the person using them.
How to Fit Crutches
Ensuring that the crutches are at the proper height before use will make mobility easier and reduce your likelihood of soreness. Follow these simple steps to ensure your crutches are adjusted correctly.
How to Properly Fit Underarm Crutches
When standing up straight:
- Adjust the crutches’ length so the underarm supports are 1-½ to 2 inches below your armpits
- The hand grips should be parallel with your hips, so your elbows are slightly bent and can be fully extended when taking a step
- Be sure to rest your weight on your hands and not your underarm supports during use
How to Properly Fit Forearm Crutches
When standing up straight:
- Adjust the crutches’ length so the forearm cuff is 1 to 2 inches below where your elbow bends
- The hand grips should be close to where your wrist bends
Your crutches are now fit for YOU! Time to start walking!
How to Walk With Crutches
- Begin in the tripod position: standing on your good leg with your crutches about one foot in front of you and 4-6” to the side of either foot
- Lean on your crutch handles and move your body forward, including your affected leg (without letting it touch the ground)
- Step forward with your good/weight-bearing foot
- Move your crutches out in front of you to the tripod position and repeat
- Practice will make a smooth, even gait easier
Talk to your doctor about how much weight you can put on your affected, weak leg.
- Non-weight-bearing
- You must keep your weak leg off the ground
- Touch-down weight-bearing
- You can touch the ground lightly for balance, but do not place any weight on your leg
- Partial weight-bearing
- Your doctor will tell you how much weight you can put on your leg
- Weight-bearing as tolerated
- You can put over half of your body weight on your weak leg as long as it isn’t painful
Sitting Down and Standing Up With Crutches
How to sit down with crutches:
- Move into position so the back of your legs touch the chair, bed, etc. (something that will not move or roll)
- Balance on your weight-bearing leg
- Hold both crutches in one hand on your weak side
- With your other hand, hold onto the armrest (bed, toilet, etc.) for balance and stability
- Slowly ease yourself down into a sitting position
How to stand up with crutches:
- Move to the front of your chair and move your weak leg forward
- Hold both crutches in one hand on your weak side
- Use your free hand to push yourself up to a standing position
- Balance on your strong leg and place a crutch in each hand
Using Crutches on the Stairs
Walking on crutches and navigating up and down the stairs can be challenging. It’s safest to go up and down while seated, but in some situations it isn’t practical. Once you’re ready, you can also practice going up and down while standing with someone next to you to support you as needed.
How to go up the stairs with crutches (seated):
- Sit on a low step (back to the top of the staircase)
- Place your crutches as far up the stairs as you can reach
- Reach behind you with both arms
- Use your arms and weight-bearing leg to move up one step
- Repeat until you make it to the top of the stairs, pausing to move your crutches up the stairs as needed
How to go up the stairs with crutches (standing):
- Step up with your weight-bearing leg
- Move your crutches up to the next stair, one in each hand
- Place your weight on your weight-bearing leg
- Move your weak/affected leg up
How to go down the stairs with crutches (seated):
- Sit on the top step (back facing the top of the staircase)
- Slide your crutches down the stairs as far as possible
- Reach behind you with both arms
- Use your arms and weight-bearing leg to move down one step
- Repeat until you reach the bottom of the stairs, pausing to slide your crutches further down the stairs as needed
How to go down the stairs with crutches (standing):
- Place your crutches one step down, holding one in each hand
- Move your weak leg forward, followed by your strong leg
- If there is a handrail, you can hold your crutches in one hand and the rail in the other, but this may feel awkward
Other Tips for Using Crutches
It may take some time for you to learn how to use a crutch properly. Here are some tips to keep in mind when using crutches in your home or outside:
- Remove rugs around your home or make sure they are secured so you don’t trip
- Remove other clutter and make sure all cords are coiled up so you have clear pathways
- Wear shoes with non-slip soles, don’t wear heels or shoes with slippery soles
- Keep your floors clean and dry to avoid falls
- Inspect your crutch tips daily and replace them when they become worn down
References
Intermountain Healthcare. (2016). How to Use Crutches. Retrieved from https://bit.ly/2m43VAF
Minager, A. (2019). Axillary Nerve Dysfunction. PennState Hershey. Milton S. Hershey Medical Center. Retrieved from https://bit.ly/2k3U6lv
Vorvick, L. (2019). Using Crutches. MedlinePlus. Retrieved from https://bit.ly/2m50GJn
Medical Disclaimer: The information provided on this site, including text, graphics, images and other material, are for informational purposes only and are not intended to substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other healthcare professional with any questions or concerns you may have regarding your condition.
by Morgan Callard