How to use crutches

Overview

Crutches are widely used medical devices that aid in mobility during injury recovery or post-surgery. They help individuals stand, walk, and move while minimizing weight on a healing leg, knee, or ankle.

Your healthcare provider will determine the appropriate type of crutches for your needs and how long you should use them. When using crutches, it’s essential to move slowly and cautiously to avoid straining your leg or disrupting the surgery site. Your provider will show you the correct techniques for standing, moving, walking, and navigating stairs before you start using crutches at home.

Type

There are several types of crutches you might need to consider:

• Axillary crutches: These crutches are the most commonly used type. They have a padded top that rests beneath your arm, below the armpit, a straight frame, and a handgrip for support.
• Forearm crutches: These crutches are sometimes called elbow crutches and are typically shorter than underarm crutches. Forearm crutches feature a supportive cuff that fits around the back of your upper arm just above the elbow, along with a handgrip for support.
• Gutter crutches: Gutter crutches, less common than other types, consist of a straight pole with a padded pocket on top. You place your forearms in the pocket and grip the attached handgrip at the front of the gutter for support.

Reasons for undergoing the procedure

Crutches are frequently needed following an injury or surgery. Some of the most common reasons include:

• Sports injuries: Different injuries such as sprains, ACL tears, or torn meniscus may necessitate the use of crutches during recovery.
• Bone fractures: Crutches are often required after fracturing a bone in the leg, knee, ankle, or foot.
• Ligament or tendon injuries: Crutches may be prescribed by your healthcare provider following injuries such as Achilles tendon rupture or tendinitis.
• Surgery: Crutches are commonly needed after lower body surgeries, including procedures like arthroscopic surgery.

The amount of weight or pressure you can place on your leg, knee, ankle, or foot depends on the reason for using crutches and your stage of recovery. Your healthcare provider, surgeon, or physical therapist will determine your weight-bearing status. Some terms they might use include:

• Non-weight bearing: You are unable to put any weight on the recovering part of your body.
• Toe touch for balance: Use only your toe to lightly stabilize yourself and regain balance; do not apply any weight or pressure.
• Partial weight bearing or a specified percentage: Your healthcare provider allows you to use a specified percentage of your weight, such as 50% or 80%. This is a guideline rather than a strict limit, helping you gauge how much to use your recovering leg. Imagine placing that portion of your usual weight down as you stand, walk, and move.
• Weight bearing as tolerated: You can use your full weight as long as you can tolerate it without experiencing pain or other symptoms. Avoid exceeding your limits unless instructed otherwise by your healthcare provider.

Risk

The risks associated with not following the safety guidelines include:

• Increased risk of slipping or falling due to debris on the crutch bottoms.
• Home or workplace clutter could increase the likelihood of tripping over your home or workspace.
• Potential for reinjuring your leg or damaging the surgical site if crutches are discontinued early and against medical advice.

Procedure

Making adjustments to your crutches will enhance their comfort:

• Many crutches can be adjusted using a sliding mechanism. Seek assistance from your healthcare provider or physical therapist to ensure they are properly fitted to your body before use.
• Ensure your crutches are adjusted to your height. For underarm crutches, the tops should be a few inches below your armpits, and the handgrips should align with your hips.
• Always bear your weight on your arms using the handgrips. Avoid leaning on the tops of the crutches under your arms.

The following will provide you instruction on how to utilize crutches:

• Standing with crutches:
  • Stand upright with the crutches positioned slightly ahead of your body and spaced apart on either side.
  • Avoid placing your weight on the underarm supports; instead, use the handgrips to bear your weight.
  • Leaning on your armpits can reduce stability and potentially cause discomfort in your shoulder joints, as well as affect the nerves and blood vessels under your arms. Additionally, relying on your shoulders for support can make you tired quicker while using crutches.
• Sitting to standing with crutches: When you stand up from sitting, it’s important to ensure you maintain balance and control, preventing any unintended movement caused by momentum.
  • Slide forward until your buttocks are at the edge of the seat.
  • Hold both crutches in the hand opposite your recovering leg.
  • Place one hand on a crutch handgrip and the other on your seat, then push yourself up into a standing position, using your stronger leg as much as possible.
  • Avoid placing more weight on your recovering leg than your designated weight-bearing limit.
  • Achieve balance before moving away from your seat.
• Sitting down with crutches: Compared to many other crutch actions, sitting down is a simple movement. But be careful not to lean back into the seat too soon. To avoid sliding or falling, keep your movements slow and steady.
  • Position yourself close to the edge of the seat, ensuring you can feel the seat against the back of your legs.
  • Maintain balance on your stronger leg as you remove the crutches from under your arms.
  • Hold both crutches in one hand by the handgrips, while using your other hand to support yourself on the seat.
  • Gradually lower yourself into the seat with controlled movements.
• Walking with two crutches: Walking safely with crutches during your recovery is important. Following surgery, you may need to begin moving as early as the following day, as advised by your surgeon.
  If you have a boot or cast on your foot or ankle, follow these steps accordingly, ensuring you do not exceed the weight-bearing limit advised by your healthcare provider.
  • Ensure you are safely balanced before starting to move.
  • Move both your crutches and your recovering leg forward simultaneously.
  • Apply even pressure on both handgrips as you step through with your other leg.
  • Regain stability before taking the next step.
• Walking with one crutch: Following certain injuries or surgeries, your healthcare provider may advise using only one crutch.
  • Hold the crutch firmly on the side opposite your recovering leg.
  • Step forward with your stronger leg.
  • Coordinate the movement of your recovering leg and the crutch in your opposite hand together.
  • Use the crutch to effectively support your weight as you move, ensuring you adhere to the pressure limits set by your healthcare provider for your recovering leg.
• Walking up the stairs: Going up stairs can be risky if you rush. Take it slow, regain your balance before each step. If possible, have someone assist you, especially at first.
  If there is a handrail on the stairs, use it to help support yourself as you ascend.
  • Position yourself one shoe length away from the bottom step.
  • Balance on your stronger leg and grasp the handrail for support.
  • Secure your crutches under the arm opposite the handrail.
  • Step up with your stronger leg, keeping your recovering leg lifted slightly behind you.
  • Pause to regain your balance before proceeding further.

  Here are the steps to follow when going up stairs without a handrail:

  • Position yourself one shoe length away from the bottom step.
  • Hold the crutch on the same side as your recovering leg.
  • Start by advancing your stronger leg upward first.
  • Keep your recovering leg and crutch together on the step below.Then, simultaneously move the crutch and your recovering leg up to the next step to align with your stronger leg.

  If you find walking upstairs on crutches uncomfortable or unsafe, you can use a seated method to ascend by scooting or sliding on your buttocks.

  • Sit on the bottom step with your back to the stairs.
  • Extend your recovering leg away from the stairs.
  • Hold the crutches in the hand opposite your recovering leg.
  • Use your strong leg and the free hand to push yourself up from the ground.
  • Before proceeding to the following step, regain your strength and balance.
• Walking down the stairs: Descending stairs can pose greater challenges compared to ascending, particularly when adjusting to crutches. Take your time and ensure your stable leg is securely positioned on the step below before shifting your weight or proceeding downward.
  If there’s a handrail on the stairs, utilize it to assist you when going down:
  • Position yourself at the top of the stairs and stabilize your balance before initiating movement.
  • Lean on your sturdy leg and grasp the handrail for support.
  • Hold the crutches in your opposite hand.
  • Begin by descending with your crutches and recovering leg.
  • Also, lower your sturdy leg to align with your recovering leg.
  • Re-establish your balance before continuing your descent.

  Here are the steps when going down the stairs without a handrail:

  • Position yourself at the top of the stairs and ensure you’re balanced before starting to move.
  • Balance your weight on your strong leg.
  • Place both crutches on the next stair below.
  • Step down with your recovering leg to meet the crutches. Apply even pressure on the crutch handgrips for support, then bring your strong leg down to meet your recovering leg.
  • Regain your balance before proceeding to the next step.

  If you find walking down stairs with crutches uncomfortable or unsafe, you can sit and slide down them on your buttocks instead.

  • Seated facing downward, take the top step.
  • Stretch your recovering leg out of the way of the stairs.
  • With the hand across from the recovering leg, hold the crutches.
  • With your strong leg and the hand not holding the crutches for support, slide down.
  • Prior to proceeding to the following step, regain your strength and stability.

Outcome

Taking your time and prioritizing safety and stability while using crutches is essential. If you need help during your recovery, don’t hesitate to ask. Your healthcare provider or physical therapist can adjust your crutches for comfort and safety and offer guidance on their correct use.