Why use crutches?
Crutches are a mobility aid used to help patients ambulate if they have injured one or both of their legs. They do so by using your upper body to support/reduce the amount of weight placed throughout your legs. By reducing the amount of weight being placed throughout the affected leg(s), it can help facilitate injury recovery. They are commonly used for conditions including:
- Severe ligament sprains of the pelvis, hip, knee or ankle
- Severe muscle/tendon tears of the lower limb
- Most lower limb fractures (from the pelvis to the toes)
- Post operative injuries/conditions of the lower limb
- Lower limb amputation
Less common conditions where crutches may be used includes injuries affecting the lower back that causes pain and/or weakness in the legs. Generally if people require a mobility aid to balance, they likely require equipment that is more stable such as a four wheeled walker. Very rarely are crutches prescribed to assist with balance.
Types of crutches
There are three main types of cutches, including:
- Axillary Crutches
- The most commonly prescribed crutches and are generally the easiest and most stable to use.
- These crutches have an axilla bar that sits about three finger widths below your armpit (aka axilla).
- The handles sit well below the axilla bar where the heel of your hand should sit comfortably with a slight bend in your elbow.
- To ensure your handles are at the appropriate height, stand with your arms relaxed by your side. The handles should be inline with the crease of your wrist.
- Issues that may arise when using these crutches can include a nerve palsy, or wrist joint irritation due to ill fitting crutches – ALWAYS ensure your crutches are adjusted appropriately to your fit. You can always seek advice from your physiotherapist if you have any concerns.
2. Canadian Crutches
- Are designed with a forearm cuff and a handles below.
- The forearm cuff should sit comfortably about two finger widths below your elbow.
- The handles are measured in the same way to that of the axillary crutches.
- To ensure your handles are at the appropriate height, stand with your arms relaxed by your side. The handles should be inline with the crease of your wrist.
- Canadian crutches allow you to move and use your arms more easily while standing without having to hold the crutches themselves.
- Issues that may arise when using these crutches can include wrist joint irritation due to ill fitting crutches.
3. Gutter Crutches:
- Are designed with a cushioned forearm support pad, strap and adjustable handle.
- These crutches are used in scenarios when a patient is unable to tolerate the amount of load going through their wrist that would be required when using axillary or Canadian crutches.
- These are the least commonly prescribed crutches as they can be difficult to use.
How do I use the crutches?
Your doctor or physiotherapist will advise you when and how to use your crutches. The amount of weight you can put through your injured leg(s) will depend on your injury, and can vary from completely non-weight-bearing to partial weight-bearing.
A full physiotherapy review will include an adjustment of the crutches to ensure an appropriate fit, as well as a mobility assessment on both stairs and flat surfaces to ensure you are safe and comfortable to use them.
Going UP stairs – think GOOD LEG TO HEAVEN!
- Approach the bottom step
- Press your weight through the handles and lift your UNINJURED leg to the step and accept the weight on your UNINJURED leg
- While supporting your weight on your uninjured leg, straighten your knee and lift the crutches to the same step along with your INJURED leg
- DO NOT put any weight through your injured leg if you have been prescribed a non-weight-bearing status
- If a railing is available you can place one hand on the rail and both crutches under your other arm or have someone hold the second crutch while near the bottom step
- Press your weight through both the crutch handles AND the railing and lift your UNINJURED leg to the step and accept the weight on your UNINJURED leg
- While supporting your weight on your uninjured leg, straighten your knee and lift the crutch(es) to the same step along with your INJURED leg
Going DOWN stairs – think BAD LEG TO HELL!
- Approach the top step
- First place the crutches down to the first step below
- Have your INJURED leg out in front of you
- If you have a partial weight-bearing status, you can have your foot gently resting on the step below but not with all of your weight going through it
- If you have a non-weight-bearing status, hover your foot above the step
- Ensure that you are well balanced and secure before pressing your weight through the crutches and bringing your UNINJURED leg to the step below
- If a railing is available you can place one hand on the rail and both crutches under your other arm or have someone hold the second crutch while near the top step
- Lower the crutch(es) to the step below and your hand slightly lower down the rail so it is inline with your crutches
- Have your INJURED leg out in front of you
- If you have a partial weight-bearing status, you can have your foot gently resting on the step below but not with all of your weight going through it
- If you have a non-weight-bearing status, hover your foot above the step
- Ensure that you are well balanced and secure before pressing your weight through the crutches and bringing your UNINJURED leg to the step below
Sitting down
- Get close enough to the chair so you can feel the back of your legs on the seat cushion
- Hold both crutches in front of your by the handles in one hand
- Slowly lower yourself to the seat using your free hand to guide you down on the chair behind you
Sitting to standing
- Shuffle your bottom to the front edge of the seat
- Hold both crutches in one hand in front of you with the other hand on the chair/chair arms
- Lean forward and press through your uninjured leg and arms to stand up
- Once standing and balance, arrange the crutches appropriately to have support under both your arms
How long do I need to use the crutches?
This depends on your injury type and severity, and your speed of recovery. It is always important to follow up with your doctor or physiotherapist to determine whether it’s safe to progress you off the crutches.
My Crutches don’t fit right, what should I do?
If your crutches feel uncomfortable or awkward to use, it’s important that you contact your physiotherapist to ensure they have been fitted properly and that they are being used correctly.
This is paramount to your safety, as appropriate fitting can prevent the risk of secondary injuries such as radial nerve palsy or joint irritation. Additionally, correct use ensures that the crutches can be used safely without risking further injury to the affected limb or a secondary injury caused from a potential fall.
Safety Tips
- Wear enclosed footwear with adequate tread to prevent slipping
- Ensure screws are fully tightened on the crutches
- Ensure the rubber slip pads on the bottom of the crutches are not worn through
- Make sure the weight goes through your hands and not your armpits
- Do not walk in socks or thongs while using crutches as these may cause you to slip or trip
- Avoid wet or slippery surfaces
- Take you time, PARTICULARLY when using the stairs