Injuries happen. Sometimes, they require us to temporarily rely on assistive devices like crutches. Whether you’ve sprained an ankle, broken a leg, or undergone surgery, crutches can be a game-changer for mobility during recovery. However, using them incorrectly can lead to further pain, discomfort, and even secondary injuries. This comprehensive guide will walk you through everything you need to know about mastering crutch use, from initial fitting to navigating various terrains.
Understanding the Basics of Crutches
Before we delve into the specifics, let’s familiarize ourselves with the different types of crutches and their components:
- Axillary Crutches (Underarm Crutches): These are the most common type. They have a padded top that fits under your armpit, hand grips for support, and rubber tips on the bottom.
- Lofstrand Crutches (Forearm Crutches): These crutches have a cuff that goes around your forearm, a handgrip, and a rubber tip. They are generally preferred for long-term use as they provide more freedom and reduce underarm pressure.
- Platform Crutches: These are less common and used for individuals with limited hand or wrist strength. They feature a platform to rest the forearm, a handgrip, and a rubber tip.
For this guide, we’ll focus primarily on axillary crutches as they are the most frequently used.
Step-by-Step Guide to Using Axillary Crutches
Using crutches safely and effectively requires a proper setup and technique. Here’s a detailed breakdown of the process:
1. Getting the Right Fit:
A poorly fitted crutch is a recipe for discomfort and potential injury. Proper fitting ensures that your weight is distributed correctly and reduces stress on your upper body. Here’s how to fit axillary crutches:
- Standing Upright: Stand tall with your shoes on, the same type you’ll be wearing when using the crutches. Keep your arms relaxed at your sides.
- Crutch Height Adjustment: Position the crutch tips about 6 inches (15cm) in front of and to the side of each foot. The top of the crutch should be approximately 1-2 inches (2.5-5cm) below your armpit. Ideally, you should be able to fit two to three fingers between the top of the crutch and your armpit when standing straight with the crutches slightly in front of you. Don’t rest the top of the crutch directly into your armpit. This can cause nerve damage. The weight should be on your hands, not in your armpit.
- Handgrip Adjustment: Adjust the handgrips so that your wrists are straight (not bent) when holding them. Your elbows should be slightly bent about 20-30 degrees. Proper handgrip height helps maintain a natural posture. When you grab the handgrips, the top of the crutch should still maintain that 1-2 inch gap.
Important Note: It’s recommended to have a healthcare professional or physical therapist assist you with the initial fitting to ensure it’s done correctly.
2. Mastering the Tripod Stance:
The tripod stance is your foundation for safe crutch use. It’s a stable, three-point base of support. Here’s how to achieve it:
- Positioning: Stand with your weight on your good leg. Place the crutch tips 6 inches in front of and to the side of each foot, making a triangle shape.
- Weight Distribution: Ensure that your weight is supported by your hands on the handgrips, not your armpits.
3. The Four-Point Gait (Slow and Stable):
This is a slow but very stable gait, often used when learning to walk with crutches and is ideal for uneven or crowded areas. It requires moving each crutch and foot individually. Here’s how it works:
- Step 1: Move your right crutch forward about 6-12 inches.
- Step 2: Move your left foot forward even with or past the right crutch.
- Step 3: Move your left crutch forward about 6-12 inches.
- Step 4: Move your right foot forward even with or past the left crutch.
- Repeat: Continue alternating crutch and foot movements, maintaining the tripod stance each time before advancing.
4. The Two-Point Gait (Faster Pace):
This is a more efficient gait, allowing for faster movement. It involves moving one crutch and the opposite foot simultaneously. Here’s how to perform it:
- Step 1: Move your right crutch and your left foot forward simultaneously.
- Step 2: Move your left crutch and your right foot forward simultaneously.
- Repeat: Continue alternating movements of opposite crutch and foot.
5. The Three-Point Gait (Non-Weight Bearing):
This gait is used when you are not allowed to put any weight on your injured leg. It requires more upper body strength. Here’s how to perform it:
- Step 1: Move both crutches forward about 6-12 inches.
- Step 2: Swing or step through with your good leg, bringing it to or just beyond the crutches. Make sure you are not putting any weight on the injured leg.
- Repeat: Continue the crutch-forward-swing-through pattern.
6. Going Up and Down Stairs:
Stairs can be challenging with crutches. Proceed slowly and cautiously and, when possible, have another person assist you. Here’s how to manage them:
Going Up Stairs:
- Positioning: Face the stairs. Place your hands firmly on the handrails if available, or hold both crutches in one hand. Keep the hand holding the crutches to the outside, meaning if the handrail is on the left side, hold the crutches in your right hand.
- Lead with Good Leg: Step up onto the first step with your good leg, bringing your body weight onto it.
- Bring Up Crutches/Injured Leg: Bring your crutches and injured leg up to the step you’re standing on.
- Repeat: Continue the process, always leading with your good leg.
Going Down Stairs:
- Positioning: Face the stairs. Place your hands firmly on the handrails if available, or hold both crutches in one hand. Keep the hand holding the crutches to the outside, meaning if the handrail is on the left side, hold the crutches in your right hand.
- Crutches First: Lower both crutches down to the next step.
- Injured Leg Second: Lower your injured leg to the same step as your crutches.
- Good Leg Last: Lower your good leg down to the same step as your crutches and injured leg.
- Repeat: Continue the process, lowering crutches, injured leg, good leg to each new step.
Important Note: If no handrails are available, use the crutches for support and carefully move them to each step as you go. Go slowly and be sure of your balance before moving on to the next step.
7. Sitting Down and Standing Up:
These transitions can be tricky. Here’s how to do them safely:
Sitting Down:
- Positioning: Back up to the chair until you feel it against the back of your legs.
- Hold Crutches: Hold both crutches in one hand (the hand on the side opposite to where you’ll be placing your injured leg).
- Lower Yourself: Slowly lower yourself onto the chair, using your good leg and the arm holding the crutches for support.
Standing Up:
- Positioning: Move to the edge of the chair, keeping your good foot flat on the floor.
- Hold Crutches: Hold both crutches in one hand, placing the tips firmly on the ground on the side of your good leg.
- Push Up: Push yourself up to a standing position using your good leg and the hand holding the crutches for support. Shift crutches back into the standard positioning.
8. Turning Around:
Avoid sharp, sudden turns while using crutches. Instead, take small, controlled steps while pivoting on your good leg.
Important Tips for Safe and Effective Crutch Use
- Proper Posture: Stand upright with your head up and shoulders back. Avoid slouching, as this can lead to back pain and increase the chance of injury.
- Maintain a Slow Pace: Don’t try to rush. Take your time to establish balance and maintain control, especially on uneven surfaces.
- Clear Your Path: Make sure your path is clear of obstacles like rugs, cords, and toys. This will help avoid trips and falls.
- Wear Appropriate Shoes: Wear shoes with good traction. Avoid wearing slippery shoes, heels, or flip-flops.
- Inspect Your Crutches Regularly: Check the crutch tips for wear and tear and replace them as needed. Make sure all screws are tightened.
- Take Breaks: Don’t overdo it. Take frequent breaks to rest and avoid overexertion.
- Consult Your Healthcare Provider: Follow your healthcare provider’s instructions regarding weight bearing and crutch use.
- Padding: Consider adding padding or cushions to your crutch handles or tops if you find that it is causing discomfort.
- Avoid Armpit Pressure: Remember, the weight should be on your hands, not in your armpits. Excessive pressure can cause nerve damage.
- Practice: The more you practice, the more comfortable and confident you’ll become. Find a safe place to practice and don’t be discouraged by initial difficulties.
Troubleshooting Common Issues
- Pain in Armpits: Adjust the height of your crutches so the top of the crutch is a couple of inches below your armpit. Focus on putting the weight on your hands rather than your armpits. Consider padding on the crutch tops and handgrips for added comfort.
- Hand and Wrist Pain: Ensure your handgrips are at the correct height to keep your wrists straight. You may also need a thicker or softer handgrip. If the pain persists, consult your doctor.
- Loss of Balance: Practice your balance in a controlled environment. Make sure you are using the proper gait techniques for different situations.
- Difficulty With Stairs: Take extra care and assistance going up and down stairs. Take breaks if needed. If you have severe difficulty, consider using ramps or elevators instead.
Beyond the Basics: When to Seek Professional Help
While this guide offers comprehensive information, it’s essential to consult a healthcare professional or physical therapist if you experience any of the following:
- Unexplained pain or discomfort.
- Persistent difficulties with balance or mobility.
- Skin irritation or breakdown around the armpits or hands.
- Any other concerns regarding your recovery process.
Conclusion
Mastering crutch use is essential for a successful and safe recovery. By following the steps outlined in this guide, you can regain your mobility while minimizing the risk of secondary injuries. Remember to take it slow, prioritize proper technique, and listen to your body. With patience and practice, you’ll be navigating with confidence in no time. This temporary reliance on crutches is a stepping stone to getting back on your feet, so embrace the process and be kind to yourself along the way!