Crutches are mobility aids that allow individuals to bear weight without stressing an injured limb. Achieving the correct fit is critical for ensuring stability and safety during movement. An improperly fitted crutch increases the energy required for walking and places undue stress on joints. Correct adjustment helps prevent secondary issues like nerve compression under the armpit or excessive strain on the wrist and shoulder joints.
Setting the Overall Crutch Height
Before setting the hand grip, the total length of the crutch must be calibrated to the user’s height. The crutch tip should be placed on the ground approximately six inches away from the side of the foot and six inches in front of the toes. When the user stands straight, the top of the axillary pad should sit about one to one-and-a-half inches below the axilla. This space, roughly equivalent to two finger-widths, ensures the user does not lean their body weight directly onto the pads. Bearing weight on the axillary pads can lead to compression of the nerves and blood vessels in the armpit, a condition sometimes called crutch paralysis.
Determining the Ideal Hand Grip Position
The hand grip is the point where the user’s body weight is intended to be transferred, making its placement highly specific. The goal is to channel the primary weight-bearing force through the hands, wrists, and arms. To find the target height, the user should stand upright with their arms relaxed and hanging naturally at their sides. The top of the hand grip should align precisely with the crease of the wrist closest to the hand, or alternatively, with the greater trochanter (the bony prominence felt on the side of the hip). This height establishes the foundation for the correct elbow bend; positioning the grip too low forces the user to stoop, while setting it too high causes shoulder shrugging and wrist strain.
Step-by-Step Hand Grip Adjustment
Once the overall crutch height has been set, the physical adjustment of the hand grip can begin. The user should stand next to the crutch, using the wrist crease or greater trochanter as the visual guide for the desired grip level. Most modern crutches utilize a push-button mechanism or a wingnut and bolt system to secure the hand grip to the main shaft. To adjust, release the securing mechanism, slide the grip to the ideal height, and ensure the locking pin fully engages and snaps into the nearest adjustment hole. Both crutches must be adjusted to the exact same numerical setting on the shaft to ensure symmetry and balance during use, as failure to fully engage the locking pin presents a significant fall risk.
Verification and Troubleshooting
Verification involves assessing the angle of the elbow joint while the user grasps the hand grips and bears a small amount of weight. When the hand is placed on the grip, the elbow should exhibit a slight bend, ideally falling within a range of 20 to 30 degrees. This arc allows the arm muscles to effectively absorb shock and generate the necessary force for forward movement. If the grip is set too high, the elbow will be nearly straight, causing the user to shrug shoulders and potentially leading to wrist pain. Conversely, if the grip is too low, the elbow will be bent at an angle greater than 30 degrees, forcing the user to lean forward excessively and leading to increased wrist strain and poor posture.