Forearm crutches, also known as Lofstrand or Canadian crutches, are mobility aids designed to provide support while walking. These crutches feature a cuff that encircles the forearm and a handgrip for support. This design transfers weight from the legs to the upper body, reducing pressure on lower extremities and offering greater stability. Forearm crutches are often used for long-term mobility needs or during recovery from lower limb injuries and surgeries. This guide provides practical instructions for safely and effectively using forearm crutches.
Preparing and Getting Started
Proper fitting is fundamental for comfort and safety. To determine the correct handgrip height, stand upright with your shoulders relaxed and arms hanging loosely at your sides, wearing your typical shoes. The handgrip should align with the crease of your wrist. When you grasp the handgrips, your elbows should exhibit a slight bend, approximately 15 to 30 degrees, which allows for effective weight support without straining your joints.
The forearm cuff also requires careful adjustment. This cuff should sit around your forearm, ideally 1 to 2 inches below the bend of your elbow. This ensures stability without restricting elbow movement or causing discomfort. Once both the handgrip and cuff are adjusted, ensure all spring buttons are fully engaged and secured, as loose components can compromise stability.
Before walking, practice standing up safely. Place both crutches firmly on the ground, slightly in front and to the sides of your feet. Use your arms and the crutches to push yourself up, distributing your weight evenly and pushing through your hands, not your armpits. Establish balance before moving, and begin practicing in a clear area to build confidence.
Walking Techniques
Understanding your prescribed weight-bearing status is important before walking with forearm crutches. This status, determined by a healthcare provider, dictates how much pressure you can place on your injured leg. “Non-weight-bearing” means no weight should be placed on the injured leg, requiring the crutches and your other leg to support your full body weight. “Partial weight-bearing” allows for some controlled weight, while “weight-bearing as tolerated” permits as much weight as comfort allows.
The three-point gait is commonly used when one leg is non-weight-bearing. Begin by moving both crutches forward simultaneously with your injured leg, keeping no weight on the injured limb. Next, transfer your weight through your arms and crutches, then step forward with your uninjured leg, landing it even with or slightly past the crutches. This keeps the injured leg off the ground throughout the movement.
For individuals with partial weight-bearing status or those needing increased stability, the four-point gait provides a slower, more deliberate progression. This gait involves a sequential pattern: first, advance one crutch, then the opposite foot, followed by the second crutch, and finally the remaining foot. For instance, move the right crutch, then the left foot, then the left crutch, and finally the right foot, ensuring three points of contact for maximum stability.
The swing-through gait is an advanced technique often employed when both legs can bear weight, but additional support or increased speed is desired. In this gait, both crutches are advanced forward, and then both legs swing through past the crutches. This method requires substantial upper body strength and coordination to maintain balance, as it involves a moment of controlled imbalance.
Maintaining proper posture is important for any gait pattern. Keep your head looking forward, not down at your feet, and maintain an upright torso. Avoid leaning excessively forward or hunching your shoulders, as this can lead to discomfort and strain. Pacing yourself with small, controlled steps can also enhance balance and reduce fatigue, particularly when first learning to use the crutches.
Navigating Stairs and Seating
Navigating stairs with forearm crutches requires a specific technique to ensure stability and safety. When ascending stairs, always lead with your uninjured leg. Place your uninjured foot firmly on the next step, then push through your crutches and uninjured leg to bring your injured leg and the crutches up to the same step. If a handrail is available, use it for added support by holding it with one hand while holding both crutches in your other hand.
Descending stairs involves a reversed sequence. Start by placing your crutches and injured leg down onto the step below. Then, transfer your weight through your crutches and slowly bring your uninjured leg down to meet them on the same step. Maintain a controlled descent and avoid rushing. Remember the mnemonic “up with the good, down with the bad” to recall which leg leads.
Sitting down safely with forearm crutches begins by backing up to the chair until you feel its edge against the back of your uninjured leg. Keep your injured leg extended slightly forward to avoid putting weight on it. Hold both crutches in one hand, typically on the side of your injured leg, and use your free hand to reach for the chair’s armrest or seat for support. Slowly lower yourself onto the chair, ensuring a controlled movement.
To stand up from a seated position, scoot forward to the edge of the chair, placing your uninjured foot flat on the floor. Hold both crutches in one hand, and use your other hand to push off the armrest or seat. Push up with your uninjured leg, keeping your injured leg extended. Once you are stable and upright, reposition one crutch to each arm.
Safety and Crutch Care
Maintaining safety while using forearm crutches involves several considerations beyond proper walking technique. Keep walking pathways clear of obstacles like loose rugs to prevent trips. Avoid navigating slippery surfaces, such as wet floors, as these increase fall risk. Wearing supportive footwear with non-slip soles and low heels is important for stability.
Regular maintenance of your crutches is important for ongoing safety. Periodically inspect the rubber tips for wear and tear, replacing them if cracked or excessively worn, as damaged tips reduce traction. Ensure all adjustment buttons and collars are securely engaged to prevent height shifts during use.
If you experience persistent pain, numbness, or instability, consult a healthcare professional or physical therapist. These symptoms could indicate an incorrect fit, improper technique, or an underlying issue.