Crutches

After almost any injury to the leg or foot, resting the injured area plays an important role in proper healing. Each time we take a step the entire weight of our bodies is placed on one foot and leg. In many situations, the injured area cannot tolerate these pressures and it becomes essential to keep all or most of the weight off of the foot and leg. The use of crutches may be essential for ambulation to allow an injured leg or foot to heal.

CRUTCH DESCRIPTION

Crutches usually come in wood or aluminum.
The part of the crutch that goes under the armpit is called the ‘axillary pad’ (the medical term for armpit is ‘axilla’). The axillary pad is usually cushioned with foam rubber.
The ‘toe’ is the part that touches the ground and usually has a rubber bottom. The toe is connected to the crutch by a ‘leg’ or center post that is often adjustable in height.
The hand grip is used to support the weight of the body and is often padded and adjustable.

TO BE FITTED FOR CRUTCHES

Crutch selection:

Your crutches should be adjustable including the leg and hand grip.
The axillary pad and the hand grip should be cushioned.
A non-skidding tip on the toe is essential.

Crutch adjustment:

To adequately fit your crutch:

Wear a shoe or shoes with which you normally walk.

Standing up straight you should place the crutches about 2 inches in front of your foot and about 6 inches to the side of each foot.

The crutch should be raised or lowered so that the underarm pad is about 1 1/2 to 2 inches under the armpit.

The hand grips should then be lowered so that the arms bend at the elbow about 15°.

WALKING WITH YOUR CRUTCHES

After many injuries it may be essential to keep all weight off of the injured foot or leg. Your good leg will be used as it would normally, and the crutches will be used to act as the injured extremity.

Keeping your injured leg up in the air, the crutches are moved forward with the weight being placed on your hands.
Do not let the weight of the crutches fall into the armpits as this can cause nerve damage to your arms if done repeatedly. The weight should be borne by the hands with the axillary pads (arm pit area) of the crutches being pressed against your rib cage.
By alternating the good foot and the crutches, you should be able to walk without putting any weight on the injured extremity.
As time goes on, you may want to bear some weight on the injured foot. Your physician or his staff or the physical therapist can work with you in giving you some idea when weight bearing can be done safely.

HOW DO I GO UP AND DOWN STAIRS WITH CRUTCHES?

Going up and down stairs can often present a challenge and care must be taken. Each step must be taken individually and special precautions should be taken when no hand rails are available to help you on your way up or down.

DOWN STAIRS

Going down stairs with a hand rail:

You should put both crutches under the armpit opposite the injured extremity and keep the injured leg on the side of the handrail.

Using the hand rail and the crutches together, you should go down with your crutches, keeping the weight off of the extremity with your hands on the crutches and handrail.

You should then follow the stair down with your uninjured leg, carrying the injured leg, until both feet are on the same step.

You should keep doing this repeatedly. Do not try to go two steps at a time as you would when you are normally walking.

Going down stairs without a hand rail:

If there are no handrails, then you should put both crutches down on the lower step and come down with the injured foot first followed by the normal foot.

UPSTAIRS

Going up stairs with a hand rail:

Going up the stairs with a handrail you should, again, support your weight with both crutches under the arm opposite your injured extremity and put the injured extremity next to the handrail.

Using the hand on the handrail and both crutches under the armpit, step up the next step with the uninjured leg, and then bring your crutches and the injured leg up to the next successive step.

Going up stairs without a hand rail:

If there are no handrails, then the crutches should be used to keep the weight off your injured extremity as you go up the stairs with your good foot one step at a time.

TIPS FOR CRUTCH USERS

To sit in a chair, it is always best to back up to the chair and use the arm rest of the chair for assistance much like you would use a crutch. Lay the crutches down and stand on one foot and put one hand on each arm of the chair and lower yourself slowly. If there are no arms, use the crutches for support.
If the stairs are uneven, slippery, or you are just not sure of yourself, it is better to sit down and drag yourself up or down on your buttocks one step at a time. A fall down stairs could be devastating to your injury or recent surgery. Although sitting down might be embarrassing and cumbersome, it is still the safest.
Revolving doors are very difficult for a patient using crutches and should be avoided if at all possible. Use handicap entrances when possible. Escalators are dangerous and should also be avoided. Elevators are always preferable.
Make certain that the tips on the end of the crutches are nonskid and have not worn out.
If the crutches are too long, undue pressure will be placed under the armpit on the nerves going to the arms causing nerve damage. If you have any numbness or tingling sensation in your hands or arms, you should probably have the crutches refitted immediately and bring these symptoms to the attention of your doctor or physical therapist.
In the beginning, you may develop blisters or calluses on your hands from the pressure of the hand grip. If this occurs have the hand grip padded. Wrapping wash cloths with tape around the hand grip can give you added protection.
Until you are comfortable with your crutches don't try to walk long distances. On inclines or slippery surfaces be particularly careful. Wear flat nonskid shoes that provide good support for your good leg.
Consider getting a disabled or handicapped parking permit while you are using crutches to keep the distances that you need to walk at a minimum. You can do this by asking your physician for a signed release form, which is usually available from the Department of Motor Vehicles.

In summary, crutches are often a temporary solution to allow your injured leg or foot to heal. By adhering to these few suggestions, you can make your crutch experience a positive one.