Crutches are common mobility aids designed to help individuals move by shifting body weight from the legs to the upper body and torso. They are routinely prescribed when a person cannot put full weight on a lower extremity due to an injury, surgery, or a neurological condition. A variety of designs exist to cater to a person’s specific medical needs and the expected duration of use. The choice of crutch is usually guided by a healthcare professional, considering factors like the user’s upper body strength and coordination.
Defining the Most Common Crutch Type
The most frequently encountered crutch in many healthcare settings is the axillary crutch, often simply called the underarm crutch. This design features a padded top that rests near the armpit, an adjustable handgrip, and a foot piece connecting to the ground. Axillary crutches are widely popular because they are generally considered easy for new users to master and are readily available for immediate use after an injury or surgery. They are typically recommended for short-term use, such as recovery from a sprain, fracture, or minor surgery, usually lasting between one and three months. It is important that users bear their weight on the handgrips, not the underarm pads, to prevent a condition called crutch palsy, which is nerve damage that occurs when excessive pressure is placed on the brachial plexus.
Specialized Alternatives and Their Uses
While axillary crutches are the standard for temporary injuries, other designs offer advantages for different types of mobility challenges. Forearm crutches, also known as Lofstrand or elbow crutches, are a specialized alternative. These crutches feature a cuff that encircles the forearm and a handgrip, eliminating the underarm pad entirely. Forearm crutches are preferred for individuals requiring long-term mobility assistance, such as those with permanent disabilities like cerebral palsy or paraplegia. They allow for greater mobility and require less energy expenditure over time than axillary crutches, making them more suitable for active users.
Another alternative is the platform crutch, sometimes called a gutter crutch or forearm support crutch. These are the least common type and are specifically designed for users who cannot grip the handles of traditional crutches due to conditions like severe arthritis or wrist injuries. Platform crutches feature a horizontal, padded trough where the forearm rests, often secured with straps, which distributes weight across the entire forearm.
Ensuring Proper Fit and Safe Movement
Regardless of the crutch type, proper sizing is necessary to ensure safety and prevent secondary injury. For axillary crutches, the top pad should sit approximately one to two inches, or two finger-widths, below the armpit when the user is standing upright. The handgrip height is also adjusted so that the user’s elbow is slightly bent, typically at an angle of about 30 degrees, when grasping the handle. This slight bend maximizes the ability of the arm muscles to bear weight and propel the body.
The primary method for walking with crutches, especially when the injured leg cannot bear weight, is the three-point gait. The three-point gait involves advancing both crutches and the injured leg forward simultaneously, followed by stepping through with the uninjured, stronger leg. Users should always look ahead, not down at their feet, and maintain a stable base by keeping the crutch tips about six inches to the side of the feet. Safety on stairs requires leading with the stronger leg when going up and leading with the crutches and injured leg when going down.