Crutches function as essential aids to mobility, providing support following an injury or surgical procedure that limits a person’s ability to bear weight on a lower extremity. Mastering their use requires a specific technique to ensure stability, prevent secondary injury, and maintain an efficient walking pattern. By understanding the correct fit, gait mechanics, and strategies for navigating various environments, users can regain a degree of independent movement during recovery.
Proper Crutch Sizing and Adjustment
Correct crutch fitting is fundamental to safe usage and directly prevents nerve damage. The top of the crutch pad should be positioned approximately 1 to 2 inches, or about two finger-widths, below the armpit when standing upright with relaxed shoulders. The armpit pads are not meant to bear the user’s weight; they primarily serve to stabilize the crutch against the side of the ribcage.
The handgrip height must be adjusted so the elbow is slightly bent when grasping it, typically forming an angle of about 15 to 30 degrees. When the arms hang naturally by the sides, the handgrips should align with the wrist crease. Proper positioning ensures that the user’s body weight is transferred through the hands, allowing the arms to fully straighten during the push-off phase of walking.
Mastering Basic Movement and Gait
The standard method for walking when one leg cannot bear full weight is the three-point gait. This pattern involves the crutches and the injured leg moving forward simultaneously, followed by the uninjured leg. To begin, the user establishes a stable “tripod” position by placing both crutch tips about 6 to 12 inches ahead and slightly to the sides of the feet.
Once stable, the user leans forward slightly and transfers weight onto the handgrips, ensuring the injured leg is held off the ground or toe-touching, as prescribed by a healthcare provider. Both crutches and the injured leg move forward together as a single unit, landing a comfortable distance ahead. The sequence concludes by swinging the uninjured, or “good,” leg forward to land even with or slightly past the crutches. Focus on taking small, deliberate steps rather than large, sweeping strides, as this maintains better balance and control.
Navigating Common Obstacles
Moving beyond level ground requires specialized techniques, particularly when encountering stairs. The general rule of thumb for stair climbing is “up with the good, down with the bad.” When ascending, the uninjured leg steps up to the next stair first, lifting the body’s weight. The crutches and the injured leg then follow, moving up to the same step.
When descending a staircase, the crutches and the injured leg must be lowered to the step below first. The user bears their weight through the crutch handgrips and then carefully brings the uninjured leg down to meet them. If a handrail is available, it should be used for extra stability, with both crutches held in the opposite hand for support.
Transitions between standing and sitting also require careful coordination to prevent falls. To sit, the user backs up until the uninjured leg touches the chair, confirming its stability. Both crutches are then gathered into the hand on the side of the injured leg. The free hand reaches for a stable surface, such as the chair’s armrest, before the user slowly lowers themselves into the seat, keeping the injured leg extended.
Avoiding Injury and Common Mistakes
Resting the body’s weight on the armpit pads can compress the nerves and blood vessels running through the axilla. Pressure on this area, particularly the axillary nerve, can lead to a condition known as “crutch palsy,” resulting in numbness, tingling, or even temporary paralysis in the arm. Weight must always be supported by the hands pressing down on the handgrips, not by the armpits.
Maintaining a stable and upright posture is important to prevent secondary issues like back or shoulder strain. Users should keep their gaze focused forward, scanning the area ahead rather than looking down at their feet, which helps with balance and obstacle detection. Before each use, the rubber tips at the base of the crutches should be checked for wear, as worn tips significantly increase the risk of slipping, especially on wet or smooth surfaces.