Adjusting Crutches

Although crutches have been fitted, they may need to be adjusted to compensate for bulky clothing. To adjust crutches properly, stand with good posture, and wear supportive, low-heeled shoes (e.g., athletic shoes). Adjust the crutch length so that two or three fingers can fit between the underarm area and the top of the crutch. Then, adjust the handgrip so that the hand piece is at wrist level when the arm is hanging down. All weight should be carried on the hands. Carrying weight on the underarm area can cause permanent nerve damage. Hand rests should be padded.

Precautions

  1. Have someone nearby for assistance until accustomed to the crutches.
  2. Frequently check that all pads are securely in place and all hardware is tight.
  3. Check screws at least once per week.
  4. Clean out crutch tips to ensure they are free of dirt and stones.
  5. Remove small, loose rugs from walking paths.
  6. Beware of ice, snow, wet or waxed floors, and telephone and extension cords.
  7. Avoid crowds; leave class early.
  8. Never carry anything in your hands; use a backpack.
  9. Watch for pets.

How to use crutches

Walking

"Swing-through Gait"
Keep head and posture upright to maintain balance and the correct center of gravity. Do not slouch.

  1. Place both crutches forward at the same time, about 12 inches in front, and 6 to 8 inches to the sides of the toes.
  2. Push against the handles and straighten the elbows while shifting weight forward.
  3. Let the body swing through, placing the uninjured foot heel first, slightly in front of the crutches.

Swing-to Gait” This gait is similar to the “swing-through” but more cautious. Step one and two are the same. In step three, swing to a point between the crutches.

“Three-point Gait” The three-point gait can be used when the treating clinician says that some weight can be placed on the injured leg or foot.

  1. Place both crutches and the injured foot about one step’s length forward, at the same time, positioning the injured foot between the crutches.
  2. Push against the handles while shifting weight forward.
  3. Lean the body forward on the hands and the injured foot.
  4. End with the uninjured foot ahead of the crutches.

Stairs

To begin, place both crutches under the arm of the injured side, holding the inside handle with the thumb. Hold onto the railing with the other hand. When using stairs, remember, “up with the good, down with the bad.”

To Ascend

  1. Leave crutches on the same level where standing.
  2. Support weight evenly on the crutch hand and railing.
  3. Raise the uninjured foot to the higher step, letting the injured foot trail behind.
  4. Straighten the uninjured leg and advance the crutches.

To Descend

  1. Place the crutches on the lower step, while extending the injured foot forward. Place the crutches on both sides of the body if no railing is present.
  2. Support weight evenly on the crutch hand and railing.
  3. Move the uninjured foot to the lower step.
  4. Narrow steps without a railing might require sitting on each step.
  5. Apply the same techniques when going up and down curbs.

Sitting down

  1. Keeping the injured leg forward, turn and back into the chair until the edge of it is against the back of the legs.
  2. Put both crutches in the hand of the injured side.
  3. Grasp the chair arm with the other hand.
  4. Lean forward and sit down slowly, keeping weight on the uninjured foot.

Standing up

  1. Move to the edge of the chair.
  2. Place both crutches in the hand of the injured side.
  3. Grasp the chair arm with the other hand.
  4. Lean forward and push up, keeping weight on the uninjured foot.

Falling

If falling, throw crutches to the side and use arms to break the fall.

  1. To get up, get into a sitting position.
  2. Back up to a stool or low chair.
  3. Put hands backwards on to the chair.
  4. Bend the uninjured leg up.
  5. Pull with hands and push with the uninjured leg to get up on to the chair.

Doors

Allow someone else to open doors whenever possible. If required to open doors, the following are ways to do so more safely.

To Pull

  1. Stand close to the door and face the hinges.
  2. Pull the door with the hand farthest from the door.
  3. Shift the hand to push and give the door a shove.
  4. Place the tip of the crutch closest to the door in path of the door and let the door rest against the crutch tip.
  5. Walk through.

To Push

  1. Stand close to the door and face away from the hinges.
  2. Push against the door with the hip.
  3. As the door moves, follow the bottom edge with the crutch tip.
  4. Hold the door open with the crutch tip when the door is open far enough.
  5. Side step part way in and push further, or turn and walk through.

Using one crutch

Use one crutch to keep some weight off the injured leg or foot. Place the crutch on the opposite side of the body from the injured leg. When taking a step with the injured leg, the crutch will provide extra support.