When an injury or surgery requires you to keep all pressure off a limb, a doctor will prescribe a non-weight bearing (NWB) status. This means the affected foot or leg cannot touch the ground, demanding zero weight be placed upon it to allow for proper healing. Crutches become the primary tool for mobility, acting as temporary legs to support your entire body weight. Understanding the specific techniques for safe and effective NWB crutch use is necessary for protecting your injury and maintaining stability during recovery.
Proper Crutch Sizing and Fit
The correct fit is mandatory for both comfort and injury prevention, as improperly sized crutches can cause serious nerve damage. When standing straight with your arms relaxed, the top of the crutch pad must be adjusted to rest approximately two to three finger widths below your armpit. This small space prevents the crutch from pressing directly into the axilla, which houses nerves and blood vessels that can be damaged.
The handgrip placement is equally important, as this is where you must bear all of your weight, not on the armpit pads. The grip should be positioned so that when you grasp it, your elbow is flexed at a slight angle, typically between 15 and 30 degrees. This angle allows your arms to absorb shock and support your body mass efficiently with each step. For stability during measurement, the crutch tips should rest on the floor about six inches in front and slightly to the side of your feet.
Mastering the Non-Weight Bearing Gait
Walking on a flat surface with a non-weight bearing restriction requires mastering the three-point gait, which uses the crutches and the uninjured leg as the three points of contact. You begin by moving both crutches forward together, placing their tips about 12 inches in front of you. Maintaining your body weight on your hands, swing your uninjured leg forward, landing your foot between the crutch tips.
Your injured leg must be held off the ground throughout the process, often slightly bent at the knee, to ensure no pressure is applied. The sequence involves the crutches moving first, followed by the uninjured foot landing. It is helpful to look straight ahead rather than down at your feet, which aids in maintaining balance and posture.
Navigating Daily Obstacles
Navigating elevation changes like stairs demands a precise, modified technique for safety. When ascending stairs, the guiding rule is “Up with the good,” meaning you lead with your uninjured leg. Step up onto the next step with the uninjured foot, push down on the handgrips to lift your body, and finally bring the crutches up to the same step.
Conversely, when descending, you follow the rule “Down with the bad.” This requires you to place the crutches and your injured leg down onto the lower step first. Bear your weight through the crutch handgrips and gently bring your uninjured foot down to meet them. If a sturdy handrail is available, use it for added stability, holding both crutches in the hand opposite the railing.
To safely sit down in a sturdy chair, back up slowly until the chair touches the back of your uninjured leg. Transfer both crutches into the hand on the side of your injured leg, holding them by the handgrips. Use your free hand to grasp the armrest or the seat, then slowly lower yourself down, keeping the injured leg extended in front of you. To stand up, reverse the process: push down with your arms and the uninjured leg, then secure the crutches under your arms once stable.
Essential Safety Practices and Injury Prevention
Routinely check the rubber tips at the base of the crutches for wear, as worn-down tips reduce traction and increase the risk of slipping. Replacing these rubber ferrules when they become smooth or cracked ensures maximum grip on walking surfaces.
Environmental awareness is necessary; you should avoid wet floors, ice, or loose gravel, which present fall hazards. Inside the home, tripping hazards like electrical cords and scatter rugs must be removed to create clear pathways. When walking, take shorter, controlled steps rather than long strides, especially when turning, to maintain balance.