Mastering Your Mobility: A Comprehensive Guide to Adjusting Forearm Crutches for Optimal Support

Forearm crutches, also known as Lofstrand or elbow crutches, are essential mobility aids for individuals with temporary or long-term lower limb injuries or conditions. Unlike underarm crutches, they distribute weight through the forearms, providing a more natural gait and reducing pressure on the armpits. However, improperly adjusted crutches can lead to discomfort, pain, and even secondary injuries. This comprehensive guide will walk you through the detailed steps of adjusting your forearm crutches for optimal comfort, stability, and support.

Why Proper Adjustment Matters

Before we dive into the adjustment process, it’s crucial to understand why proper crutch fit is so important:

• Reduced Pain and Discomfort: Incorrectly adjusted crutches can cause pain in the hands, wrists, elbows, shoulders, and back. Proper adjustment ensures weight is distributed evenly, minimizing strain on these joints and muscles.
• Improved Stability: Crutches that are too short or too long can make it difficult to maintain balance and increase the risk of falls. A proper fit provides a stable base of support for confident movement.
• Enhanced Efficiency: When crutches are adjusted correctly, you can move with greater ease and efficiency, conserving energy and reducing fatigue.
• Prevention of Secondary Injuries: Using crutches that don’t fit well can lead to secondary issues like nerve compression, carpal tunnel syndrome, or repetitive strain injuries.

Understanding the Components of a Forearm Crutch

Before you begin adjusting your crutches, it’s helpful to familiarize yourself with their key components:

• Handgrips: These are the handles you grip while using the crutches. They may be straight or contoured.
• Forearm Cuff: This is the cuff that wraps around your forearm, usually made of plastic or padded material.
• Upper Shaft: The portion of the crutch between the handgrip and the forearm cuff.
• Lower Shaft: The portion of the crutch below the handgrip.
• Ferrule (Tip): The rubber or plastic tip at the bottom of the crutch, providing traction.
• Height Adjustment Mechanisms: Usually push buttons, clips, or screw mechanisms to adjust the length of the crutch.

Step-by-Step Guide to Adjusting Forearm Crutches

Now, let’s walk through the detailed steps of adjusting your forearm crutches. Ideally, you should have someone assist you for the initial adjustments, especially if you are new to using crutches. Here’s a breakdown:

Step 1: Initial Assessment – Stand Tall

Before making any adjustments, stand upright in your normal posture, wearing the shoes you’ll typically wear when using the crutches. Keep your arms relaxed at your sides. This will help you determine the necessary height adjustments.

Step 2: Adjusting the Overall Height

The first critical adjustment is the overall height of the crutch. Here’s how to adjust the height of forearm crutches:

Method 1: The ‘Wrist-to-Handle’ Technique

1. Positioning: Let your arms hang naturally at your sides. The top of the handgrip should align with the crease of your wrist when your arm is relaxed. This ensures that your elbow will be bent at a slight angle of around 15-20 degrees while using the crutches.
2. Adjust the Lower Shaft: Using the adjustment mechanism (push button, clip, or screw), adjust the lower shaft of the crutch to achieve this height. You may need to shorten or lengthen the shaft by extending or retracting it. Ensure both crutches are adjusted to the same height.
3. Confirm Measurement: Check that the handgrips are at the level of your wrist crease. It might help to have someone place their hand across your wrist to check alignment.
4. Fine Tune: Once the rough adjustment is done, place both crutches on the ground with the handles and ferrules aligned as if you are standing. Stand beside the crutches with your arms at your sides, looking forward. The handles of the crutches should come up to where the crease of your wrist is.

Method 2: The ‘Standing Upright’ Method

1. Stand Straight: Stand as straight as you can.
2. Handgrips Measurement: The handgrips of the crutches should sit up to the level of your wrist crease, as mentioned above. Use the same process and make sure that both handles are the same height.
3. Walking Test Take a few steps with the crutches and watch the way you are walking and the way the crutches are moving. You should be able to walk upright without having to bend to reach the handgrips. The top of the handle should line up to the crease of your wrist. If you are hunching over or the crutches seem to be too high or too low, readjust them.

Important Note: The height adjustment may feel slightly different depending on whether you’re wearing shoes or not. Ensure that you are wearing your most commonly worn shoes when adjusting the height. If you have to frequently switch shoes you may need to do this adjustment more than once.

Step 3: Adjusting the Forearm Cuff Height

The next step involves adjusting the height of the forearm cuff. The cuff should allow your forearm to rest comfortably inside without being too tight or too loose. The cuff height affects how effectively you can distribute your weight and use the crutches.

1. Cuff Placement: The cuff should sit approximately 1-1.5 inches (2.5-4cm) below your elbow. This provides a secure and comfortable placement.
2. Adjust the Cuff: Using the adjustment mechanisms, position the cuff in the correct spot on your forearm and ensure both crutches are set to the same height.
3. Check for Comfort and Fit: Place your forearm into the cuff. It should fit snugly, but not so tight that it restricts circulation. The cuff should not press into your elbow, nor should it slide down too far on your forearm.
4. Adjust as Necessary: If the cuff feels too high or too low, readjust by using the adjustment points on the crutch until it is snug and comfortable.
5. Movement Test: Now move around with the crutches and check that the forearm cuff stays secure on your arm without impeding movement.

Step 4: Fine-Tuning the Handgrip Angle

Some forearm crutches allow you to adjust the angle of the handgrip. This customization can further improve comfort, especially if you have wrist issues.

1. Check if Adjustable: Determine if your crutches allow for handgrip angle adjustment.
2. Experiment with Angles: Slightly adjust the angle to find the most natural and comfortable position for your wrist.
3. Test and Adjust: Test the crutches with the new angle and readjust as required to get the perfect grip.

Step 5: Test and Refine

Once you’ve made these adjustments, it’s essential to test the crutches thoroughly. Here’s what to do:

1. Walk Slowly: Start by walking slowly and carefully in an open area.
2. Observe Posture: Pay attention to your posture. Are you hunching over? Do you feel any strain or discomfort in your wrists, elbows, shoulders, or back? If so, readjust the crutches and test them again.
3. Check Stability: Ensure you feel stable and balanced while walking. If not, re-check the height adjustments and forearm cuff positions.
4. Check for Rubbing or Pinching: If any point of the crutches is rubbing or pinching against your skin, try readjusting that specific point.
5. Repeat Adjustments: If you experience any pain or discomfort during this initial walk, make any necessary adjustments and retest.

Tips for Using Forearm Crutches

After proper adjustment, here are some additional tips for using your forearm crutches effectively:

• Keep Your Head Up: Look forward, not down, while walking. This helps maintain proper posture and balance.
• Take Small Steps: Avoid taking large steps, especially when starting. This provides a stable base.
• Use Your Hands: Engage your hands to maintain your grip and weight distribution.
• Avoid Uneven Surfaces: Be cautious on uneven ground, stairs, and inclines.
• Regularly Check Ferrule: Ensure the rubber tips (ferrules) on your crutches are in good condition and not worn, to prevent slipping.
• Rest When Needed: If you experience pain, or are feeling tired, take breaks as needed.
• Consult Your Therapist: If you’re unsure about how to use or adjust your crutches, consult with a physical therapist or healthcare professional. They can provide personalized advice and guidance.

Maintaining Your Crutches

Regular maintenance of your crutches can ensure their longevity and your safety. Here are some key maintenance tips:

• Clean Regularly: Wipe down the crutches regularly with a damp cloth and mild soap. This helps prevent dirt and bacteria build-up.
• Inspect Regularly: Check for any loose screws, cracks, or damage to the frame, handgrips, or forearm cuffs. If you notice any damage, get them repaired or replaced immediately.
• Replace Worn Ferrules: If the rubber tips at the bottom of the crutches are worn, replace them immediately. This is essential for maintaining good grip and preventing falls.
• Storage: When not in use, store your crutches in a dry and safe place, away from extreme temperatures or direct sunlight.

Common Mistakes to Avoid

Avoid these common mistakes when adjusting or using forearm crutches:

• Ignoring Pain: Don’t ignore any pain or discomfort while using the crutches. These could be signs of incorrect adjustment or misuse.
• Using Incorrect Height: Using crutches that are too short or too long can lead to various issues.
• Not Adjusting to Different Shoes: The crutch height should be adjusted if you regularly change the type of shoes you wear.
• Over-Reliance on Crutches: It is easy to over rely on the crutches. Be mindful and use them for the purpose that they are intended for.
• Forgetting to Check Ferrules: Regularly check that the ferrules are in good working condition as this is a safety measure.

When to Seek Professional Help

If you are having trouble adjusting or using your crutches, do not hesitate to reach out for professional guidance. It’s essential to consult with a healthcare professional or a physical therapist if:

• You’re unsure about how to adjust the crutches properly.
• You continue to experience pain or discomfort, despite making adjustments.
• You’re having trouble walking safely with your crutches.
• You have a specific medical condition affecting your mobility.
• You are feeling that the crutches are not working well for you.

Conclusion

Adjusting your forearm crutches correctly is a vital step in ensuring your comfort, safety, and mobility. By following the step-by-step guide outlined in this article, you can achieve an optimal fit, distribute weight evenly, and move with greater confidence. Remember to test and refine the adjustments, pay attention to your body, and seek professional help if needed. With proper use and maintenance, your forearm crutches can be a valuable tool in your recovery or daily mobility.