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Understanding Crutch Basics and Types

Crutches come in several different styles, and knowing which type works best for your situation is the first step toward moving safely. The three main categories are axillary crutches (also called underarm crutches), forearm crutches (also called Lofstrand or Canadian crutches), and platform crutches. Each type distributes your weight differently and requires different techniques.

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Axillary crutches are the most common type people picture. These crutches have a padded underarm piece and a handgrip lower down the shaft. They work well for short-term injuries because they're straightforward to use, though they can cause shoulder and underarm discomfort if used incorrectly. Forearm crutches have a cuff that wraps around your forearm above the wrist and a handgrip below. These crutches let your hands stay free more easily when you're not moving, making them popular for people who use mobility aids long-term. Platform crutches feature a forearm trough and platform where your hand rests, which can be useful if you have weak wrists or arthritis in your hands.

The right crutch height matters significantly. Crutches that are too tall put pressure on your underarms and can affect your circulation. Crutches that are too short force you to hunch over and strain your back. When standing upright with crutches at your sides, the grip should be at about wrist height, and the top should sit about two finger-widths below your armpit. Many people rent or borrow crutches without checking the height, which can slow recovery and create new problems.

Your healthcare provider, physical therapist, or medical equipment specialist can measure you properly. If you're purchasing crutches, look for adjustable models. Some crutches adjust at the hand grip, others adjust along the entire shaft, and the best ones allow both adjustments. This flexibility matters because your needs may change as you heal or if you use crutches in different settings.

Practical takeaway: Before using crutches, confirm the type recommended for your situation and verify the height is correct. Improper height causes unnecessary strain that can slow your recovery and create additional injuries.

Preparing Your Living Space for Crutch Use

Your home environment has a huge impact on how safely and confidently you'll move on crutches. Walking on crutches requires space, stability, and clear pathways. Taking time to prepare your living space prevents falls and frustration, particularly in the first weeks when you're still learning to use crutches.

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Start by clearing your main pathways of clutter, loose rugs, and items that could catch your crutch tips. Crutch tips are the rubber or plastic pieces at the bottom of the crutches that grip the floor—they're essential for traction, but they can catch on edges or loose carpet. Remove throw rugs or secure them with non-slip tape. Coiled cords from electronics, pet toys, and stacks of books or boxes in walkways are hazards. Even small items on the floor can trip you or get tangled in crutches. Walk through your home and think about what could cause you to lose balance or where a crutch might slip.

Lighting is critical. Ensure hallways, stairways, and bathrooms are well-lit. Falls on crutches often happen in dim areas where you can't see the floor clearly. Install nightlights in hallways and bathrooms if you move around at night. Keep a flashlight near your bed for nighttime trips to the bathroom.

Arrange the things you use frequently at waist height or slightly below. Reaching high requires balance you may not have on crutches. Store plates, glasses, medications, and toiletries in accessible cabinets. If you spend time in a chair or on a bed, set up a small table within arm's reach that can hold water, a phone, remote control, and other items you'll need without having to stand and walk.

Furniture placement affects your ability to move safely. Make sure chairs are sturdy enough to support your weight if you need to grab one for balance. Soft or wheeled chairs can move unexpectedly and cause a fall. Consider temporarily removing low tables or furniture that sticks into walkways. Handrails or grab bars on stairs and in bathrooms provide crucial support points if you'll need to use these areas on crutches.

Practical takeaway: Spend an hour preparing your home by removing tripping hazards, improving lighting, and positioning frequently-used items within easy reach. This preparation reduces the physical strain of moving on crutches and significantly lowers fall risk.

Proper Crutch Walking Techniques and Gait Patterns

How you walk on crutches depends on your injury and what movements cause pain or instability. Different injuries require different gait patterns. Your physical therapist or healthcare provider will recommend the pattern that's right for your situation, but understanding how these patterns work helps you use crutches more safely and efficiently.

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The four-point gait involves moving one crutch forward, then the opposite leg forward, then the other crutch forward, then the other leg forward—creating an alternating pattern. This pattern mimics normal walking closely and provides the most stability because you always have multiple points of contact with the ground. People recovering from minor injuries or those still learning to use crutches often start with this pattern. It's slower but safer when balance is uncertain.

The three-point gait works when one leg cannot bear weight at all. You move both crutches forward together, then bring your injured leg forward (without putting weight on it), then move your good leg forward. This pattern requires more upper body strength but moves faster than four-point gait. People with broken legs or significant knee injuries often use this pattern during early recovery.

The two-point gait is faster than both previous patterns. You move one crutch and the opposite leg forward together, then move the other crutch and other leg forward together. This pattern requires more balance and coordination, so it works better once you've recovered enough that you can bear some weight on your injured leg, or once you've built strength and confidence with crutches.

Several mistakes can cause falls or injuries. Leaning too much weight onto the underarm piece of axillary crutches can cut off circulation and cause nerve damage. Your crutches should support your weight through your hands and arms, not your underarms. Looking down at your feet rather than ahead creates balance problems because you lose your sense of the space in front of you. Starting to hurry before your body is ready is also a common mistake—using crutches requires coordination that takes time to develop.

Stair use on crutches follows a specific pattern. Going up stairs, you lead with your good leg: step up with the good leg, then bring both crutches and the injured leg up together. Going down stairs, you lead with the injured leg: place both crutches down a step, then the injured leg, then bring the good leg down. The saying to remember this is "up with the good, down with the bad." Many people skip using crutches on stairs and hop, which is actually riskier and can re-injure the healing leg.

Practical takeaway: Follow the gait pattern your healthcare provider recommends, keep weight in your hands and arms (not your underarms), and practice on stairs using the correct pattern before you need to rush down them.

Building Strength and Managing Fatigue While Using Crutches

Using crutches is physically demanding. Walking on crutches engages your arms, shoulders, chest, and core in ways they may not be used to, and this creates muscle fatigue even when you're not walking very far. Understanding how your body responds to crutch use helps you pace yourself and avoid overuse injuries that could delay your recovery.

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Your upper body does significantly more work when you're on crutches. Your arms and shoulders move your entire body weight with each step instead of sharing the work with your legs. Your grip strength is also taxed because you're holding your body weight on handles all day. People often underestimate this demand and use crutches far more than their body can safely handle early in recovery. This leads to sore shoulders, aching hands, and fatigue that slows your healing.

Start by limiting your time on crutches to short periods spread throughout the day. If your doctor or therapist hasn't given you specific guidance,