Crutch Walking

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Crutch Walking

Walking (Touch-down weight bearing):

• Put the crutches forward about one step’s length.

• Put the injured leg forward; level with the crutch tips.

• Touch the front of the foot of the involved limb to the floor. Do not bear weight into the foot, but bear the weight of the body on your crutches.

• Take a step through with the uninjured leg

Walking (partial-weight bearing):

• Put the crutches forward about one step’s length.

• Put the injured leg forward; level with the crutch tips.

• Bear some of the weight on the injured leg according to your instructions, and bear the remainder of your weight on crutches.

• Take a step through with the uninjured leg

Walking (full-weight bearing and weight-bearing as tolerated):

Walking with one crutch

• Put the injured leg forward with the crutch held on the uninjured side (opposite)

• Bear weight on the injured leg and assisted with the crutch as needed.

• Step through with the uninjured leg.

Stairs:

• Use one crutch and the stair rail if present (only if the railing is stable and there is someone to carry the other crutch).

• Use two crutches if there is no stair rail.

• It does not matter which side the stair rail is on.

• If both crutches can be held in one hand safely, you can use both crutches on one side and the railing on the other.

Up stairs:

• Hold onto the rail with one hand and the crutch with the other hand (or both crutches if no rail).

• Push down on the stair rail and the crutch(es) and step up with the uninjured leg

• Bring the injured leg and the crutches up beside the uninjured leg.

• Remember, the uninjured leg goes up first and the crutches move with the injured leg.

Down stairs:

• Walk to the edge of the stairs.

• Place the injured leg and the crutches down on the step below; support weight by leaning on the crutch(es) and the stair rail.

• Bring the uninjured leg down.

• With your weight supported by the crutches and injured leg, step down with the uninjured leg.

• Remember the injured leg goes down first and the crutches move with the injured leg.

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Crutch Training | Instructions on How to Use Crutches

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5. How to Fit and Use Crutches

Weight Bearing Restrictions

Your doctor may have given you weight bearing restrictions on your leg which tells you how much weight you can put through your leg.

Weight Bearing as Tolerated
If you are weight-bearing as tolerated, that means you can put as much weight through your leg as is comfortable. Putting weight through your legs should not significantly increase or cause you pain.

Partial Weight Bearing
If you are partial weight bearing then you can put some weight but not all through your leg. You should push through your hands on the crutches to keep the full weight off of your leg. 

Toe Touch Weight Bearing 
If you are toe touch or foot flat weight-bearing, then you may simply rest your foot on the floor. Imagine there is an egg or a cracker under your foot that you don’t want to crush. It’s important to know that toe touch weight bearing does not mean that only your toe can touch the ground. It is important to allow your entire foot to rest flat on the ground.

Non Weight Bearing
If you are non-weight-bearing then you can’t put any weight through your foot. You should push through your hands on the crutches to keep the weight off of your foot. As you walk, you should be able to walk without your foot touching the ground.

No matter what your weight-bearing restrictions are, make sure that you never lean on the tops of your crutches. You can hurt a nerve causing numbness and tingling in your arm. Put all of your weight through your hands, not your armpits.

How to fit your crutches:

1. Stand tall with your shoes on. Make sure your shoes have low heels and good support. 
2. Put the crutches under your arms. Relax your arms and let them hang down over the crutches. There should be a two inch space between your armpit and the top of the crutch with your hands hanging relaxed.
3. The hand grips should be at the level of your wrist when holding the hand grips.
4. Your elbows should be bent slightly to about thirty degrees.

Standing Up 
To stand up, hold both crutches by the hand grips in one hand and push up with the other hand on the chair. Then put one crutch under each arm. 

Sitting Down 
To sit down, place both crutches in one hand holding the hand grips together and reach for the chair with your other hand to lower yourself slowly. 

Walking

1. To take a step, squeeze the crutches between your upper arms and ribs put the weight through your hands not your armpits. 
2. Move the crutches forward. Move your injured leg forward and put your foot even with the crutches. Put as much weight as you are allowed on the injured leg, taking the rest of the weight through your arms and hands. 
3. Step past with your stronger leg. 
4. In summary, move the crutches first, your injured leg next, and then your stronger leg.

Going Up Stairs

1. To go upstairs with a handrail, place one crutch under one arm and use the handrail with the other arm for support. 
2. Step up with the stronger leg, then the injured leg, and lastly bring up the crutch. Always make sure the crutch tip is completely on the stair. If you do not have a handrail be very careful as you could lose your balance. Have someone help you or avoid the stairs until you are stronger. 
3. Place one crutch under each arm. Step up with the stronger leg then, then bring the injured leg and your crutches up together.

Going Down Stairs

1. To go down stairs with a handrail, place one crutch under one arm and use the handrail with the other arm. 
2. For support, lower the crutch down to the step below and move your injured leg down and then bring your stronger leg down. Always make sure the crutch tip is completely on the stair. If you do not have a handrail, be very careful as you can lose your balance. Have someone help you or avoid the stairs until you are stronger. 
3. Place one crutch under each arm. Step down with your crutches and your injured leg. Together then bring your stronger leg down. 

If you do not feel steady on crutches, a walker is another option. The walker does offer more stability. If you need to go up one step with a walker you should do this backwards. Going down one step you should go forwards, leading with your walker and your injured leg. More than one step is not safe with a walker. Be sure to sit for a few minutes before standing while sitting. Review the process for the safe use of crutches. Once you are standing, be sure that you are stable before you start moving. If at any time you do not feel stable, you should stop and sit down on a safe surface. 

In conclusion, be sure to check with your healthcare team to determine whether or not crutches are the safest choice for your situation. Be sure that your environment is also safe for the use of crutches. This means that your environment should be free of clutter. There should be no throw rugs or loose edges on carpeting and absolutely do not use crutches on wet surfaces. If you have any questions or you have any difficulty using crutches, please discuss these with your health care team.

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How to Walk with One Crutch: 6 Steps (with Pictures)

If you have injured your ankle or knee, or broken a bone in your leg, your doctor will likely recommend using crutches during your recovery. Crutches are supports that allow you to keep your weight on your injured leg while you stand and walk. They provide balance and allow you to perform daily activities more safely while the injury heals. Switching to one crutch can be more convenient at times because it allows you to move around your environment a little more easily and frees up your hand for other activities, like carrying groceries. Using a single crutch can also be easier when climbing stairs if there is a railing for support. Keep in mind that switching to a single crutch puts some pressure on your injured leg and may increase your risk of falling. So check with your doctor if you prefer to use a single crutch.

Steps

Part one of 2: Walking on a flat surface

1. one Place the crutch under the armpit against the injured leg. When using one crutch, you will need to decide on which side to use it. Health professionals recommend placing the crutch under the armpit on the side of the healthy leg – or, in other words, on the opposite side of the injured leg. Squeeze the crutch under your armpit and grasp the handle, which is located approximately in the middle of the crutch.

   • By resting the crutch on your uninjured side, you can lean away from your injured side and put less weight on it. However, in order to walk with one crutch, you will have to put a little weight on the injured side with each step.
   • Depending on the injury, your doctor may decide that putting weight on the injured side is not a good idea, so you may need to stick with two crutches or use a wheelchair. You should always listen to your doctor’s advice to ensure the best possible outcome of your rehabilitation.
   • Adjust the length of the crutch so that at least three fingers can fit between your armpit and the padding at the top of the crutch when you are standing straight. Adjust the handle so that it is at wrist level and your arm hangs straight.

2. 2 Properly position and balance the crutch. Once the crutch is properly adjusted and placed under the arm opposite the injured side, position it about 3-4 inches (laterally) from the midpoint on the outside of the foot for better stability. Most, if not all, of your body weight should be supported by the arm and the extended arm, because too much stress on the armpit can lead to soreness and potential nerve damage.

   • Both the handle and the axillary support of the crutch must have padding. Padding provides better grip and cushioning.
   • Avoid wearing bulky shirts or jackets when walking with one crutch, as this may result in decreased mobility and stability.
   • If your foot or leg is in a cast or walking boot, consider wearing thick heeled shoes on your good foot so that there is no such difference in height between the two feet. Equal leg length provides greater stability and reduces the risk of hip or lower back pain.

3. 3 Get ready to take a step. As you prepare to walk, move the crutch forward about 12 inches and simultaneously step forward with the injured leg. Then step over the crutch with your good leg, firmly grasp the handle with your outstretched hand. To move forward, keep repeating the same sequence: step with the crutch and injured leg, then step over the crutch with your good leg.

   • Remember to balance by keeping most of your weight on the crutch when stepping on the injured foot.
   • Be careful not to rush when walking with one crutch. Make sure you’re on a firm footing and there’s nothing in your way to confuse you – make sure there’s no clutter around and rugs rolled up. Take extra time to move from one place to another.
   • Do not support your weight under your armpit to prevent soreness, nerve damage, and/or shoulder injury.

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Part 2 of 2: Walking up and down stairs

1. one Determine if there is a rail. Going up and down stairs with two crutches is actually much more difficult than with one. However, you should only use a single crutch to move up stairs if you have a stair handrail or support. Even if there is a railing, make sure it is stable and securely attached to the wall and can support your weight.

   • If there is no railing, use both crutches, take the elevator, or seek help.
   • If there is a handrail, you can grab it with one hand and carry one (or both) crutches with the other as you go up stairs – this may be easier and/or faster without crutches.

2. 2 Grasp the handrail on the injured side. As you begin to climb the stairs, keep the crutch at hand on the uninjured side and grasp the railing with the hand on the injured side. Press down on the railing and the crutch at the same time from the opposite side, and then step forward with an uninjured leg. Then raise the injured leg and the crutch next to the uninjured leg on the same step. Repeat this pattern until you get to the top of the stairs, but be careful and take your time.

   • If possible, practice this skill with a physical therapist first.
   • If there is no railing, no elevator and no one around to help you and you absolutely must take the stairs, try using the wall next to the stairs for support in the same way you would use a railing.
   • Make more time for steep stairs and narrow steps, especially if you have big feet or wear walking boots.

3. 3 Take extra care when descending stairs. Going down stairs with two crutches or one crutch is potentially more dangerous than going up because of the distance you can fall if you lose your balance. Thus, firmly grasp the railing and first place the injured leg on the bottom step, then the crutch on the opposite side and the uninjured leg. However, do not put too much pressure on the injured leg, because the sharp pain can cause nausea or dizziness. Always keep your balance and take your time. Follow the pattern of the injured leg, then the healthy leg, all the way to the bottom of the stairs.

   • Remember that when going down stairs is opposite to walking up the stairs.
   • Pay attention to any objects on the stairs that might get in your way.
   • It is always best to have someone help you down the stairs if at all possible or convenient.

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Community Q&A

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• Question: What should I do if my back and legs are hurting because of using one crutch? You should consult your doctor about using a walker, a wheelchair, or two crutches.
• Question: Can a crutch break due to too much weight? This is possible, depending on the type of crutch and the person’s height. Obviously, a large adult should not use baby crutches solely in terms of size. Aluminum crutches usually do not break. However, most aluminum crutches are adjustable, and the little piece that pops out of the holes is easily bent or broken by too much weight. Wooden crutches tend to be stronger, even if they are adjustable, since that adjustable piece is a clip or pin, not a flexible button.
• Question. Which side should the crutch be placed on after a right hip replacement? On the left side of your body. If you are unstable, you should consult your doctor about using a walker.
• Question: How can I walk with one crutch when I have only one leg? I am a single amputee above the knee. Place the crutch on the side where the amputation was and use it as a leg. It will be awkward at first, but you’ll get used to it. If you have problems, talk to your doctor or physical therapist.
• Question: How can I climb stairs using my injured leg if I can’t put pressure on it? While supporting the weight of the injured foot with the crutch, take a step with your good leg, pull the crutch and injured leg with you to this step, and repeat for each step until you reach the top. Alternatively, you can look for a ramp for people with disabilities, an elevator or a wheelchair lift.
• Question: What should I do if my palm hurts? You can buy soft tubes to help. Just place it on the handle, or if it’s a wooden crutch, you may have to cut it lengthwise and wrap it around.

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Tips

• Carry any personal items in a backpack. This will free your hands and improve your balance when walking with one crutch.
• Maintain good posture when walking. If you don’t, hip or back pain may develop, making it difficult to use the crutch.
• Wear comfortable shoes with rubber soles for better traction. Avoid flip-flops, sandals, or slippery dress shoes.
• Take extra time to move from place to place on crutches.
• If you lose your balance, try to fall on your side with your undamaged side, as it will be able to absorb the impact better.

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Warnings

• Take extra care when walking on wet or uneven surfaces or on snowy or icy surfaces.
• Make sure your crutch is not too low under your armpit/arm. It can slip out of your armpit, which can cause you to lose balance or fall.
• If you are ever unsure about something, such as whether you can safely go down stairs, always be careful and ask for help.

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How to walk on crutches

Crutches are one of the widely used medical devices used to support a person’s weight while standing and moving. They are used for acute or chronic lesions of the legs, such as various physiological diseases and lesions of the lower extremities of a different nature, the consequences of injuries, disorders of the musculoskeletal system, and some others.

Types of crutches

As a result of these disorders, often the patient is faced with a serious limitation of physical activity and a complete or partial loss of mobility. To compensate for the lost ability to move, crutches are also used – a simple medical device that makes it possible to transfer body weight from foot to hand, which improves the patient’s dynamics, facilitates movement and unloads the affected lower limbs, placing them in optimal conditions for a speedy and complete recovery.

Crutches have been known to mankind for several thousand years, and since their appearance, their design has never seriously changed. Today, there are two main types of these medical devices – with support under the elbow and with support under the armpit. The choice of one or another type depends on the physical condition of the patient and the body weight that is planned to be transferred from the legs to the upper part of the body.

If it is impossible to keep the body straight on your own, axillary crutches are preferable, which completely transfer the body weight to the body. Elbow crutches (the so-called canadian crutches) support only part of the body weight and are more suitable for patients who are in rehabilitation or who cannot use the axillary version.

Choosing and adjusting crutches

Today, crutches are most often made of wood or aluminum. Seriously, these two types do not differ – wooden ones are only slightly heavier. Both of them have a load capacity of about 150 kg, and the reinforced aluminum version can withstand a patient weighing more than 200 kg.

The final decision on the choice of the type and size of the crutch is made by the doctor. But there are several patterns that determine the appropriateness and correctness of the chosen design in a particular case.

Crutch adjustments should be done with normal shoes, the one you plan to wear most often.

Elbow crutches are adjusted as follows. Standing straight, you should slightly bend the arm of the affected side. For a crutch located parallel to the leg, the distance from the fixing cuff to the elbow should not exceed 10 cm. With a normal physique of the patient, lightweight models are most often used, weighing no more than 2 kg. With excess weight, reinforced models with a weight of 4 kg or more are used.

The size of axillary crutches is determined by the formula “Height of the patient minus 40 cm.”

After adjustment, you should try to walk with crutches. The general principle of this walking is as follows – a healthy limb begins to move, and only then the injured leg moves. While walking, the device should be functional and as comfortable as possible.

Let’s take a closer look at the features of the choice and operation of crutches of the armpit and axillary types.

Axillary crutches

They have an adjustable height, which is calculated based on the height of the patient. With the right choice of the height of such crutches, two main calculation points are taken into account: at the level of the wrist of the vertically lowered arm on the affected side, there should be a crossbar for the hand, and two fingers (4-5 cm) below the armpit should be located under it.

After fitting the crutches, you can begin to teach the patient how to use them. Attention! At all stages of learning to walk on crutches, a safety net is required.

One crutch is used. The patient is located on a healthy limb. It is held by the support with one hand, and rests on the crutch with the other. The crutch is carried forward, at a step distance. The weight of the body is transferred to the crutch, then a step forward is also taken with the healthy leg. Then the procedure is repeated. Training lasts until the patient can do it without using additional support.

Two crutches are used. The patient holds crutches, holds crutches in both hands, stands on a healthy leg. Both crutches are taken forward in turn, at a step distance. The weight of the patient is transferred to them, and the healthy leg moves forward. The operation is then repeated over and over again. After mastering this technique, both crutches can be tried to move forward at the same time.

Elbow crutches (Canadian)

An elbow crutch is similar to an elbow-high cane and has a flexible cuff. Most often made of aluminum. Its design consists of a handle, an emphasis and a rack. It has an adjustable height, which is calculated based on the height of the patient. For the correct choice of the arm crutch, it is necessary to adjust its height so that the distance from the elbow of the standing patient, with the arm bent at a slight angle, to the fixation cuff of the crutch, placed parallel to the lower limb, is in the range of 5-10 cm.

After fitting the crutch, you can begin training. Attention! At all stages of learning to walk on crutches, a safety net is required.

One crutch is used. The patient stands on a healthy leg, holding the crutch with one hand and the support with the other. The crutch is carried forward, at a step distance. The weight of the body is transferred to it. Then the second leg is transferred to the length of the step. Then this sequence is repeated over and over until the patient can do without additional support.

Two crutches are used. The patient holds crutches in both hands, leaning on a healthy leg. First, one crutch is transferred to a step distance, then another. The weight of the body is transferred to the supports and then the healthy leg is transferred forward, at a step distance. The procedure is repeated again and again. Subsequently, you can walk while moving both crutches to a walking distance.

General recommendations for the use of crutches

Depending on the nature of the lesion, the duration of the use of crutches can vary greatly. But, no matter how much the patient has to use them, it is necessary to take into account a number of patterns that can minimize the inconvenience associated with this.

When walking or standing on crutches, they should be positioned so as to provide a wide support base even during rest – this ensures the stability of the patient.

When walking, the head should be straight and the body should remain level.

The crutches should be positioned slightly in front of the leg at a distance of about 10 cm.

Body weight should be applied to the arms, not the armpits – this will help avoid injury and rubbing of the armpits.

When using axillary crutches, their support posts should be placed as close to the chest as possible to maintain balance and stability.

The distance between the upper stop of the crutch and the armpit should be 5-10 cm.

Elbows bent at an angle of about 30°.

The final suitability of the chosen crutches is revealed during a walk.

When standing up, the crutches are placed on the injured side and, holding them from the inside, are thrown over the seat and the healthy leg is straightened.

In order to sit down, the manipulations with crutches are repeated, after which the patient straightens his back and sits down.

When walking, crutches are placed approximately 30 cm in front and 20 cm to the sides of the lower extremities. The weight of the body is transferred forward, leaning on the handles of the crutches, landing on the heels, leaving the crutches behind the patient.

For novice users, the “shuttle” gait is optimal – taking the crutches forward, moving the weight of the body on them, and then sliding the healthy leg in the direction of travel.

Climbing the stairs is carried out as follows. Both crutches are held with one hand, while the other rests on the railing. When climbing, the crutches remain at the level of the user, the body weight is evenly distributed between the hand with crutches and the hand on the railing, the healthy leg is lifted up the stairs, straightened and moved the crutches up.

When descending, the crutches are placed on the lower step, one hand rests on them, the other on the railing, the body weight is evenly distributed on the hands, the sore leg is extended and the healthy limb is moved to the lower step.

Rules for moving on crutches

In order to properly learn to walk on crutches, in addition to the above techniques, it is important to follow the following rules.

Shoes should not have a heel and have a ribbed surface to improve traction.

You must carefully monitor the road, always be careful and try to avoid even small obstacles along the way.

On rugged, slippery or muddy surfaces, steps should be at least halved.

One should never rush, it is better to prioritize caution. You should regularly take breaks in walking and rest – otherwise, it is easy to damage or overstrain the muscles.

After a long walk, it is advisable to do at least the simplest massage – to relax and restore tissues.