When a lower-body injury requires support, crutches become a temporary necessity for maintaining mobility. Crutches redistribute your body weight from the injured leg to your arms and upper body. Learning the correct technique prevents falls, avoids nerve damage, and allows the injury to heal properly. Mastering proper crutch use ensures safety and maximizes independence while you recover.
Ensuring Proper Crutch Fit
Proper crutch adjustment is the first step to prevent secondary injury and ensure stable movement. The crutch height must be set so the top pad rests approximately two to three finger widths below the armpit (axilla) when standing straight. Resting full body weight on the axillary pads can compress the brachial plexus, potentially leading to crutch palsy. Weight must be supported primarily by your hands, not your armpits.
The hand grip placement is the second crucial adjustment, as this is where body weight should be transferred. With arms hanging loosely, the grips should align with your wrist crease. When grasping the handles, your elbows should have a slight bend, ideally between 15 to 30 degrees. This bend ensures maximum leverage and comfort for stable and efficient movement.
Walking and Moving Safely
The three-point gait is the most common method for moving with a lower-body injury, used when the leg is non-weight bearing or tolerates partial weight. To begin, establish a stable tripod stance, positioning the crutch tips slightly out to the sides and forward of your feet. Look straight ahead, not down at your feet, for better balance when moving.
The walking sequence starts by advancing both crutches forward a comfortable distance, typically about 12 inches. Next, transfer your weight through your hands and the crutch grips, keeping your injured leg elevated and bent at the knee. Finally, swing or step your uninjured leg forward, landing your foot in line with or slightly past the crutch tips. The crutches and injured leg count as one point of contact, and the uninjured leg is the third point, completing the three-point gait cycle.
To initiate movement from a seated position, scoot forward to the edge of the chair. Hold both crutches together in the hand on the injured side, and place your free hand on the armrest for stability. Use your uninjured leg to push off the floor while using your arms to push up from the chair and crutch grips simultaneously. Once standing and balanced, quickly move one crutch to the opposite side to resume the standard walking position.
Mastering Stairs and Transitions
Navigating stairs safely requires a distinct sequence of movements. Remember the phrase: “Up with the good, down with the bad,” indicating which leg leads. When ascending, if a handrail is available, hold it with one hand and consolidate both crutches in the other. Step up onto the next step with your uninjured leg, followed by bringing the crutches and injured leg up to meet it.
When descending stairs, the sequence is reversed; the crutches and injured leg lead the movement. Place both crutches down onto the lower step, ensuring stability. Bearing weight through your hands on the crutch grips and the handrail, slowly lower your injured leg down. The uninjured leg then steps down to join the crutches.
To sit down safely, back up until your uninjured leg touches the chair. Hold both crutches in the hand opposite the armrest, and use your free hand to stabilize yourself on the chair. Maintaining the injured leg extended, slowly lower yourself into the seat using your uninjured leg and arms for a controlled descent.