A crutch allows an individual to move by transferring body weight from the lower limbs to the upper body and torso. This device is used when a person cannot bear full weight on one or both legs due to injury, surgery, or disability. Healthcare professionals select the appropriate design based on the user’s condition, required duration of use, and physical strength. The three main categories of crutches are the axillary, the forearm, and the platform designs.
The Axillary (Underarm) Crutch
The axillary crutch is characterized by its tall, padded top that fits beneath the armpit and a separate adjustable hand grip. These crutches are frequently provided in hospital settings for immediate use, often for temporary needs such as recovery from a broken bone or joint surgery. They are a common choice for short-term use lasting between one to three months.
Proper fitting is necessary to prevent crutch paralysis, or axillary nerve damage. The padded top must sit one to two inches (two finger widths) below the armpit when the user is standing upright. The user must put all body weight through the hand grip, not by leaning on the underarm pad. The hand grip should be adjusted to allow about 30 degrees of elbow flexion, ensuring a stable weight-bearing position.
The Forearm (Lofstrand) Crutch
Forearm crutches, also known as Canadian or Lofstrand crutches, eliminate the padded underarm support. They consist of a shaft with a hand grip and a cuff that encircles the user’s forearm, typically positioned just below the elbow. This design allows the user to maintain contact with the crutch even when briefly needing to use their hands, such as to open a door.
These crutches are used for long-term independence and are prescribed to individuals with chronic conditions like multiple sclerosis or cerebral palsy. While they offer superior maneuverability, they demand greater upper body strength, balance, and coordination than axillary crutches. Fitting requires the hand grip to be set to a height that allows a 30-degree bend in the elbow, with the forearm cuff positioned about 1.5 inches below the elbow joint.
The Platform (Forearm Support) Crutch
Platform crutches are designed for highly specialized applications. The design incorporates a horizontal trough where the entire forearm rests, with a vertical hand grip positioned near the elbow. This structure transfers the user’s weight primarily to the forearms, bypassing the hands and wrists entirely.
This specialized weight distribution makes them the primary choice for users who cannot bear weight through their hands or wrists due to severe arthritis, weakness, or nerve damage. Platform crutches provide enhanced stability compared to the other types, but this often comes at the cost of reduced maneuverability. They are intended for long-term use, especially for individuals with significant neurological impairment affecting stability.