A broken ankle requires non-weight bearing, making crutches a temporary necessity for mobility. Learning the correct technique is paramount for safety and promotes proper healing of the fracture. Following clear instructions for fitting and movement will help you navigate your recovery securely and with confidence.
Ensuring Proper Crutch Fit
A correct fit is essential for comfortable and safe crutch use, preventing secondary injuries like nerve damage. The top pad must sit approximately one to two inches, or roughly two finger-widths, below the armpit when standing upright. This clearance is important because leaning on the underarm pads can compress the radial nerve, potentially causing crutch paralysis, characterized by tingling or numbness in the arm.
The hand grip height must be positioned to transfer your body weight effectively. When standing, the grip should align with your wrist crease, allowing for a slight elbow bend between 15 and 30 degrees. This flexion enables your triceps and shoulder muscles to support your weight through your hands, which are the primary weight-bearing points. Adjusting the crutch height first, followed by the hand grip, ensures proper alignment.
Mastering the Non-Weight Bearing Gait
The three-point non-weight bearing gait requires the uninjured leg and both crutches to support the body weight. To begin, establish the tripod position by placing the crutch tips four to six inches to the side and slightly in front of your uninjured foot, providing a stable base. Ensure your injured leg is held up, bent at the knee, to prevent accidental contact with the floor.
The movement sequence involves advancing both crutches and the injured leg simultaneously forward a comfortable distance. Push down firmly on the hand grips, transferring your weight entirely to your arms and shoulders. This allows your uninjured foot to swing through past the crutches, landing between them or slightly ahead.
After placing your uninjured foot, redistribute your weight and regain your balance before repeating the sequence. Maintaining this rhythm creates a fluid, stable forward motion. When changing direction, take small, incremental steps and pivot slowly on the uninjured foot, rather than twisting your body, to maintain stability.
Techniques for Navigating Obstacles
Moving beyond flat surfaces requires specific maneuvers to maintain stability and protect your healing ankle. When approaching stairs, remember the rule: “up with the good, down with the bad.” The uninjured leg always leads when ascending, and the crutches and injured leg lead when descending.
To ascend, stand close to the bottom step. Bearing weight through the crutch grips, step up onto the first step with your uninjured leg. Once stable, bring the crutches and your injured leg up to meet the uninjured foot. When a sturdy handrail is available, use it for support on one side, holding both crutches in the hand opposite the railing.
Descending reverses the sequence: place the crutches and the injured leg down onto the lower step first, keeping the injured foot suspended. Transfer your weight to the hand grips and slowly bring your uninjured leg down to join them. This technique ensures the full weight-bearing leg is always in a position to stabilize the body.
Sitting Down
For safely sitting down, back up slowly until your uninjured leg touches the chair seat. Hold both crutches in the hand on the side of your injured leg, freeing the other hand to grasp the armrest or seat for support. Leaning forward and pushing down on the hand grips and the chair, slowly lower yourself, keeping the injured foot extended forward to prevent weight bearing.
Standing Up
To stand up, reverse the process by sliding to the edge of the seat. Push down on the chair and the crutch grips with your arms to propel yourself upward onto your uninjured leg.
Preventing Injury and Common Mistakes
A safety consideration is the environment, as crutch tips can easily slip on wet or icy pavement, loose gravel, and highly polished floors. Avoid these surfaces completely, but if unavoidable, proceed with caution and take very small steps. Within the home, secure or remove any throw rugs or loose cords that could snag the crutch tips and cause a loss of balance.
Maintaining an upright posture is important; look straight ahead rather than down at your feet, which helps maintain your center of gravity and balance. Slouching or looking down can shift your weight improperly and increase the risk of a fall. Using a backpack is highly recommended for carrying personal items, as your hands must remain free to grip the crutch handles.
A common error is resting on the axillary pads under the armpits, especially when tired, which risks nerve damage. If you feel any tingling, numbness, or weakness in your hands or arms, it is a sign that you are leaning on the pads and must immediately shift your weight to your hands. Taking frequent breaks and performing gentle upper body stretches can help manage the fatigue that often leads to this incorrect posture.