Crutches are mobility aids designed to assist individuals recovering from lower extremity injuries by transferring body weight to the upper body and arms. Properly acquiring and fitting these devices is paramount for a safe recovery and ensuring effective movement. Understanding the different types of crutches and how to use them correctly is the foundation for regaining independent mobility.
Where to Get Crutches
The most immediate source for crutches is often the hospital or clinic where the injury is treated. Patients are frequently discharged with a pair of standard underarm crutches, providing instant, temporary support. These are often generic, one-size-fits-all options and may not be the ideal long-term fit.
Retail pharmacies and medical supply stores offer a wider selection of crutches for purchase or rental. These locations stock various sizes, materials, and specialized accessories like upgraded handgrips or cushioned pads. Purchasing from a dedicated medical supply store can provide professional guidance in fitting and adjusting mobility equipment.
For short-term needs, some community organizations, fire departments, or thrift stores may operate loan closets where crutches can be borrowed for free or a minimal fee. When exploring these options, inspect the equipment carefully, ensuring all height adjustment mechanisms are functional and the rubber tips, or ferrules, are not worn smooth.
Understanding Crutch Types and Sizing
Two types of crutches exist: axillary (underarm) and forearm (Lofstrand or Canadian). Axillary crutches are the most common for short-term injuries, as they are simple to learn and widely available. Forearm crutches, which feature a cuff that encircles the forearm, are preferred for long-term use or for individuals with chronic conditions because they allow more freedom of movement and are more ergonomic.
Correct sizing prevents complications like “crutch palsy,” which is nerve damage caused by pressure on the axillary nerve bundle. When standing with the crutch tips placed about six inches to the side of the feet, the top of an axillary crutch pad should rest 1.5 to 2 inches (about two finger-widths) below the armpit. The handgrip must be positioned so the elbow is bent at a slight angle, ideally between 15 and 30 degrees.
For forearm crutches, the handgrip is also set to allow a slight elbow bend. The cuff should be situated one to two inches below the elbow joint, holding the forearm without restricting movement or circulation. Proper fit ensures the user’s weight is borne entirely by the hands and not by the soft tissues of the armpit.
Navigating Insurance and Costs
Crutches are classified as Durable Medical Equipment (DME), meaning they are designed to withstand repeated use and are medically necessary. For coverage through Medicare Part B, a physician must provide a formal prescription, and the equipment must be obtained from a Medicare-approved supplier. Coverage applies only if the equipment is intended for use in the home.
Most insurance plans, including Medicare, cover crutches, often paying 80% of the approved cost after the annual deductible is met, leaving the patient responsible for the remaining 20% co-insurance. Private insurance policies may vary, sometimes requiring a higher co-pay or limiting coverage to rental instead of purchase. Contact the insurance provider directly to confirm out-of-pocket costs and to verify if the supplier participates in the plan’s network.
Safe Setup and Initial Use
Initial setup requires a final check of the device’s height and handgrip position to confirm fitting parameters. The height-adjustment mechanism (often a push-button system) and the handgrip adjustment must be firmly locked before use. This verification ensures the user maintains the 15-to-30-degree elbow bend, which is optimal for weight-bearing.
The most common walking technique for non-weight-bearing injuries is the three-point gait. This involves moving both crutches and the injured leg forward simultaneously, followed by the strong, uninjured leg. The crutch base should be placed about 12 to 18 inches in front of the body, forming a stable “tripod” stance. When standing up, hold both crutches in the hand on the side of the injured leg, using the chair and handgrips to push up with the strong leg.
To navigate stairs safely, the rule is “up with the good, down with the bad.” The strong leg steps up first, followed by the crutches and the injured leg. Going down, the crutches are lowered to the next step with the injured leg, and the strong leg follows. Use a handrail if one is available, placing both crutches under the opposite arm to free the hand for grasping the rail.