Crutches are a common tool for restoring mobility following a lower body injury or surgery. Their effectiveness and safety depend entirely on achieving a proper fit. An incorrectly adjusted crutch can lead to poor posture, increased strain on upper body joints, and, in severe cases, nerve damage. Precisely fitting the device is paramount for ensuring comfort, facilitating recovery, and preventing secondary injuries such as falls. This guide focuses on fitting standard axillary (underarm) crutches, the type most often provided for temporary mobility assistance.
Understanding Crutch Components and Types
Standard axillary crutches are composed of several adjustable parts. Primary components include the axillary pad, which sits just below the armpit, and the handgrip, which bears the body’s weight. These crutches also feature a telescoping lower section for overall height adjustment, typically secured with a push-pin mechanism, and a non-slip rubber tip at the base for traction.
The handgrip height is independently adjustable using a separate set of pins or a bolt and wingnut system. While axillary crutches are suitable for short-term use, forearm (Lofstrand) crutches are often preferred for long-term mobility. Forearm crutches feature a cuff around the forearm instead of an underarm pad. The following instructions pertain specifically to fitting the axillary style of crutch.
Setting the Total Crutch Height
The first adjustment sets the crutch’s overall length, measured from the floor to the axillary pad. To start, the user should stand upright with relaxed shoulders. Place the crutch tips on the floor about six inches out to the side and slightly forward of the feet, mimicking the stable “tripod” stance used during walking.
The top of the axillary pad must be positioned approximately 1 to 1.5 inches below the armpit crease, providing two to three finger widths of clearance. This space prevents the crutch from pressing directly into the armpit, which can compress the brachial plexus nerves. Compression of the radial nerve can cause “crutch paralysis,” resulting in temporary weakness or “wrist drop.” The overall height adjustment is typically made using the lower push-pin mechanism on the crutch’s leg.
Adjusting the Handgrip Position
Once the total crutch height is set, adjust the handgrip position. The handgrip bears the majority of the user’s body weight, making its position critical for comfort and function. With arms relaxed and hanging straight down, the top of the handgrip should align precisely with the wrist crease closest to the hand.
This alignment ensures the elbow is flexed at a slight angle, optimally between 20 and 30 degrees, when grasping the grip. This elbow bend is necessary for effective shock absorption and generating the leverage needed to advance the body during walking. The handgrip height is adjusted independently of the crutch’s overall height, usually via a separate set of pins or bolts on the upright poles.
Final Fit Verification and Safety Checks
After setting both the total height and the handgrip position, a final verification confirms the fit is secure and safe. The user should stand in the tripod position and apply weight to the handgrips to check standing posture. The body must remain upright and balanced, without hunched shoulders or excessive leaning.
It is necessary to confirm the axillary pad is not making firm contact with the armpit. Body weight must be supported entirely by the hands pushing down on the handgrips, not by resting weight on the pads under the arms. Users should wear the footwear they intend to use regularly, as changes in heel height require readjustment. Regular inspection of the rubber tips for wear and tear is also required, as worn-down tips significantly increase the risk of slipping.