Crutches: How to Use Correctly

Physiotherapist

During clinical practice, I found that most patients who come to me with walking aids – specifically crutches – do not use them in the right way and confirm that they have not been properly shown how to.

With the patient’s assessment in consideration, during the physiotherapy session we evaluate the actual need for crutches or any other walking aids.  We consider alternative options based on how the patient walks.  We will ask the patient to perform one or two types of adjustment in their walking style and consider other types of aids. We take also into consideration the following:

  • Risk of falling ¹
  • Symptoms
  • Degree of patient confidence and ease ¹
  • Acceptance of the use of the equipment by the user ¹

The information provided in this document may not be right for all circumstances; but it does provide information on some of the better ways to use crutches.  For the purpose of this document, the information is based on crutches that have a hand grip and forearm support.

Quality assessment of crutches

  • The hand area should be covered and feel comfortable during use;
  • The rubber ferrules (“tips” which rest on the floor) should be in good condition and with a good grip. If the grips are damaged, you can change them – usually from where you purchased the equipment or similar

 

Crutch height adjustment

Place the crutch about 10 cm from the front of the foot slightly out to avoid tripping. With the arm extended, the hand support should be at the same height as the greater trochanter (bone prominent near the end of the thighbone [femur]) ².  If this is not at the same height, then it needs to be adjusted.

If you feel as though you are using too much strength in your arms and/or shoulders, then this is an indication that you may have the wrong height adjustment.  If so, re-adjust the height and try again.

 

How do I walk with crutches?

In progressing through the options below – starting with option 1 which protects the area of injury the most, you can work towards the final option 3 which is the most independent and closer to usual day to day life.


Walking with two crutches:

  1. Bending the “bad” leg (so that it isn’t on the floor), move both crutches at the same time forwards and then bring the other leg forwards ³
  2. Move the two crutches and the “bad” leg forward at the same time (supporting it lightly on the ground) and then step the other leg forward ³
  3. Move the “bad” leg at the same time as the opposite crutch and then the “good” leg with the opposite crutch ³

 

Walking with one crutch:

Move the “bad” leg at the same time as the opposite crutch and then the “good” leg ³


How to manage the stairs?

Golden rule: always go up with the “good” leg, go down with the “bad” leg and the crutches always follow the latter.

If you have a handrail and you are stable, you can use that and use only the opposite crutch as an aid.

Climbing stairs:

Move the “good” leg first and then the other leg at the same time as the crutches ³

Downstairs:

Move the “bad” leg first with the crutches and then the other leg ³

 

In conclusion

During a time when face-to-face physiotherapy sessions have been reduced to a minimum and advice is being provided remotely, understanding our clients becomes even more important.

Therefore, the advice and examples of using crutches in this document are purely for information and should be personalised according to the client’s needs in terms of convenience, circumstances or medical requirements.

You may be advised by your Doctor or Physiotherapist to use another walking aid or style which may be the most appropriate for your clinical condition, which you should seriously consider.

If you have any doubt, please do not hesitate to contact the CMM – Medical Centres and Rehabilitation or your Physiotherapist for further clarification.


Adapted from the original: https://www.cmm.com.pt/canadianas-como-usar-corretamente/
Author: Catarina Lourenço CMM Physiotherapist, Portugal

1.Bertrand K, Raymond MH, Miller WC, Martin Ginis KA, Demers L. Walking Aids for Enabling Activity and Participation: A Systematic Review. Am J Phys Med Rehabil. 2017;96(12):894‐903. doi:10.1097/PHM.0000000000000836

2.Esposito F, Freddolini M, Marcucci M, Latella L, Corvi A. Unassisted quiet standing and walking after crutch usage in patients with total hip replacements: Does crutch length matter?. Gait Posture. 2018;64:95‐100. doi:10.1016/j.gaitpost.2018.06.004

Rasouli F, Reed KB. Walking assistance using crutches: A state of the art review. J Biomech. 2020;98:109489. doi:10.1016/j.jbiomech.2019.109489

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