Elbow crutches, also known as forearm crutches, are mobility aids that offer support and stability while allowing greater freedom of movement than traditional underarm crutches. These devices secure to the forearm with a cuff, transferring the user’s weight through the hands and forearms, rather than relying on pressure in the armpit area. This design significantly reduces the risk of nerve damage, such as “crutch palsy.” For many users, elbow crutches provide a more comfortable, secure, and manageable solution for maintaining mobility. Learning the proper technique for fitting, walking, and maneuvering is necessary to ensure safety and to maximize the benefits of this support tool.
Ensuring Proper Fit and Adjustment
Correctly adjusting elbow crutches is the first step toward safe and efficient use, as improper sizing can lead to poor posture and joint strain. To set the handgrip height, stand upright with your shoulders relaxed and arms hanging naturally. The top of the handgrip should align with the crease of your wrist bone.
When you grasp the handgrip, your elbow should be bent slightly, aiming for an angle between 15 and 30 degrees. This slight bend is necessary to absorb shock and allow you to push down effectively to support your weight without locking your elbow joint. The forearm cuff height should be set so it rests approximately 1 to 2 inches below the bend of your elbow.
The cuff’s position is important because it provides stability and control. The open end of the cuff, typically shaped like a “U,” should face forward, away from your body, to allow you to easily release the crutch if you fall. Always ensure that any locking mechanisms are fully engaged and secure after making height adjustments.
Mastering the Basic Walking Gaits
Movement on level ground requires adopting a specific walking pattern, or gait, based on the amount of weight your injured leg can bear. For users who are non-weight bearing, meaning the injured foot cannot touch the floor, the three-point gait is the standard method. This gait involves moving both crutches forward first, creating a stable triangular base approximately a foot in front of you.
Once the crutches are planted, you swing or hop your unaffected leg forward, landing it between the crutches or slightly ahead of them. The entire sequence is crutches, then the good leg, keeping the injured leg elevated and off the ground. It is necessary to push down through your hands on the crutch handles, using your arms and shoulders to support your weight.
If your injury allows for partial weight bearing, you may use a more fluid two-point gait. This pattern mimics normal walking more closely, moving the left crutch and the right foot forward simultaneously, followed by the right crutch and the left foot. This alternating motion requires more coordination but provides a smoother, more continuous rhythm for walking.
Navigating Stairs and Seating Transitions
Moving vertically or transitioning between sitting and standing presents challenges that require a specific sequence of movements to maintain balance. When ascending stairs, the general rule is “Up with the good,” meaning you should lead with your unaffected leg. If a handrail is available, hold both crutches in the hand opposite the rail, using the rail for additional support.
First, step up onto the next step with your unaffected leg, bearing your weight through your hands on the crutch handles and the handrail. Next, bring the crutches and your injured leg up to the same step. If no handrail is present, use both crutches for support, hopping up with your good leg while pushing down on the crutches.
Descending stairs requires reversing this sequence, following the guideline “Down with the bad.” Place the crutches down onto the step below first, followed by your injured leg. Finally, bring your unaffected leg down to the same step, controlling the movement with your arms and the crutches.
For sitting down, back up to the chair until the back of your unaffected leg touches the seat. Remove your arms from the cuffs and gather both crutches into one hand, holding them by the handgrips on your injured side. Place your free hand on the armrest of the chair for stability, then lower yourself slowly, keeping your injured leg extended. To stand up, reverse the process: push up with your unaffected leg and free hand on the armrest, find your balance, and then secure your arms back into the crutch cuffs.
Maintaining Stability and Preventing Falls
Ongoing safety involves continuous awareness of your environment and the condition of your equipment. Always check the rubber tips, or ferrules, on the bottom of your crutches, as they can wear smooth or split, significantly reducing traction. Regularly inspect the crutch tubing and hardware for any signs of bending, cracks, or loose handles that could compromise their structural integrity.
Environmental hazards must be actively avoided; this includes loose rugs, wet floors, and uneven surfaces. When moving, avoid looking down at your feet, instead focusing your gaze slightly ahead to anticipate obstacles.
To manage carrying items, use a backpack or similar hands-free method, since carrying objects can disrupt your balance and compromise your grip on the crutch handles. If you feel yourself losing balance and a fall seems unavoidable, quickly release the crutches away from your body. This allows you to use your arms to break the fall and prevent the crutches from causing additional injury.