Crutches function as temporary mobility aids, redistributing a user’s weight to the upper body to allow an injured limb to heal. The effectiveness and safety of this device depend on a precise fit to the user’s body. Incorrectly sized crutches can lead to poor balance, increased fatigue, and a serious risk of secondary injuries. Proper adjustment is a simple but essential step in ensuring a safe recovery process, allowing the hands and arms to bear weight correctly instead of the delicate structures near the armpit.
Adjusting Underarm Crutch Height and Handgrips
Setting the overall crutch height is the first step, performed while the user stands straight and wears the shoes they intend to use daily. The primary measurement focuses on the gap beneath the armpit, where the top of the crutch pad should rest. This gap must be approximately 1.5 to 2 inches, which is typically the width of two or three fingers.
The overall height of the crutch is adjusted at the bottom section, ensuring the crutch tips are properly positioned on the floor during this measurement. This space is intentionally left to prevent the user from leaning on the pad, which would compress the nerves and blood vessels. Once the total height is established, the next adjustment involves setting the handgrip position.
To find the correct handgrip height, let your arms hang naturally at your sides. The top of the handgrip should align with the crease of your wrist or the top of your hip joint. Once the hand is on the grip, the elbow should exhibit a slight bend, specifically between 20 and 30 degrees. This elbow flexion allows for the muscle engagement needed to push down on the grips and absorb impact during movement.
Confirming the Final Fit and Posture
After setting both the overall height and the handgrip position, the user must perform a practical assessment to confirm the fit. The most important safety check is ensuring that all body weight is transferred through the hands and wrists, not the armpits. If the user leans heavily on the underarm pads, it can lead to a condition known as crutch paralysis, caused by sustained pressure on the axillary nerve bundle.
While standing with the crutches in the walking position, the shoulders should remain relaxed and level, and the user should not have to hunch over or lean forward excessively. An observer can visually confirm the desired 20 to 30-degree elbow bend when the hand is resting on the grip. This correct posture ensures that the crutches work as an extension of the arms, maintaining balance and stability.
If the user feels any upward pressure in the armpit area when walking or standing, the crutches are too long and need to be shortened by one adjustment hole at the base. Conversely, if the user must visibly bend forward to reach the handgrips, the crutches are too short. Making these final, subtle adjustments is necessary to achieve a comfortable and safe gait.
Sizing Forearm Crutches
Forearm crutches, sometimes called Lofstrand or Canadian crutches, require a different sizing approach as they do not have an underarm pad. The process begins similarly to underarm crutches by first setting the handgrip height. This handgrip must be adjusted so that when the arm hangs at the side, the grip aligns with the wrist crease, resulting in a 20 to 30-degree bend at the elbow when held.
The unique adjustment for forearm crutches is the placement of the cuff, the ring that wraps around the forearm. This cuff should sit approximately 1 to 2 inches below the bend of the elbow. The cuff must be secure enough to hold the crutch to the forearm when the hand is released, but it should not restrict the elbow’s movement.