Crutches are a common mobility aid designed to help individuals move while keeping weight off an injured leg. Their effectiveness and safety depend entirely on a proper fit, as incorrectly sized crutches can lead to secondary injuries, increased risk of falling, and discomfort. Crutches are meant to bear weight through the hands and arms, not by resting on the armpit. Fitting your crutches correctly involves two primary adjustments: setting the overall vertical height and positioning the handgrips.
Establishing the Correct Crutch Height
The first step in fitting standard axillary crutches is setting the total vertical height, which requires the user to stand straight and wear the shoes they will typically use while walking. This initial measurement is crucial for preventing a severe condition known as “crutch palsy.” Crutch palsy is a compressive neuropathy caused by pressure on the brachial plexus, a network of nerves located in the armpit. The axillary pad, or the top of the crutch, must not press directly into the armpit. To ensure proper clearance, the crutch’s height should be adjusted so the top pad sits approximately 1.5 to 2 inches below the armpit (two to three finger widths of space). This space must be maintained, ensuring that the body weight is never supported by the armpit.
Adjusting the Handgrip Position
Once the overall crutch height is set, the handgrip position requires a separate adjustment to ensure the arms are in the correct posture for weight bearing. The handgrip must be positioned so that when the user stands upright with their arms relaxed at their sides, the grip aligns with the crease of their wrist. This measurement establishes the ideal height for the user to comfortably grasp the handle. When the user grips the handle, their elbow should exhibit a slight bend, specifically between 20 and 30 degrees. This minor bend in the elbow is necessary to allow for full extension of the arm during the walking cycle, which is how the hands and arms absorb and transfer the body’s weight to the floor. Achieving this angle is important because a straight arm would lock the elbow joint, while too great a bend would strain the shoulder and back muscles.
Confirming the Fit and Avoiding Common Errors
After setting both the height and the handgrip, the user must confirm the fit by walking a few steps to ensure stability and comfort. During this test, the user must actively push their weight down through the handgrips, using their hands and arms to support their body. The axillary pads are intended only to stabilize the crutches against the side of the chest wall, not to bear body weight. A common mistake is using crutches that are too tall, which eliminates the necessary two-inch gap below the armpit and increases the risk of nerve damage or “crutch palsy.” Conversely, crutches that are too short force the user to stoop over, which can lead to back pain and compromised balance. The crutch tips should be placed about six inches to the side and six inches in front of the foot to create a stable base, known as the “tripod position.”