Crutches are typically used to aid in ambulation when one or both of the lower extremities is injured or when recovering from a surgical procedure. Read on to learn how to be sure your crutches are properly sized, and how they are to be used depending upon the nature of the injury.
Knowing what your injury or surgical procedure is/was is critical because this information will have a direct bearing on how you will be able to mobilise for the short term. For example, if you have suffered a mild-to-moderate ankle sprain, you may be allowed to bear as much weight as tolerable, provided you are protected by using crutches. However, if the ankle is badly broken and you are either in need of surgery or are recovering from it, you may be in a situation where complete absence of any weight on the foot and ankle may be required for several weeks to promote proper healing. Each scenario dictates a different way of ambulating, and consequently dictates the manner in which the crutches will be used. There is wide variation in the amount of weight that can be placed on a lower extremity, and the use of the crutches is dependent on that weight-bearing limit.
Get the right height. Once you know your limitations, it is critical that the crutches be sized correctly to avoid sustaining any injuries from misuse. The proper way to ascertain whether or not your crutches are adjusted correctly is to stand up as erect as possible while placing one crutch under one arm. Hold the arm out to the side of the body at a 90-degree angle. If the very top of the crutch, where the underarm pad is located, lies 1 to 2 inches below the armpit, it should be in an acceptable position to avoid unnecessary pressure on the nerves and blood vessels located in the armpit. If, however, the crutch feels "jammed" up into the armpit, or if pressure is exerted there even before the hands reach the hand grip, the crutches are too high and should be lowered.
Once the correct height of the crutches has been determined, it is equally important to correctly adjust the distance between the top of the crutch and the hand grip. If the distance between these two points is too long, the arm will end up in a state of constant full extension, forcing the elbow to lock out, which places excessive stresses on the elbow. If the distance is too short, the elbow must bend too much, causing extreme stress and fatigue of the upper arm and excessive pressure on the wrist. The correct distance between these points should have the elbow slightly flexed, but allow the person to maintain maximum control of the crutches with the majority of the weight being distributed in the hands.
Make sure all necessary pads are present and in good condition. The upper arm portion of the crutches should come with foam rubber pads. If not, get some. Many people use washcloths or towels, but these can be too bulky and cause potential problems. The hand grips should also be padded to avoid any injury to the nerve and tendon structures that pass through the palms of the hand.
Be certain that the tips of the crutches have pads. This is absolutely critical! Failure to have appropriate padding on the tips of crutches is a prescription for disaster. The crutches can, and will, slip on smooth surfaces, almost certainly causing a dangerous fall.
Get instruction on how to navigate with the crutches. Typically, the pattern for ambulation involves placing the crutches out in front of you, and stepping up to them with the good leg, and touch-weight-bearing the bad one if allowed. Oftentimes this is not terribly easy to learn, and feels uncoordinated at first. Frequently it is necessary to "lead" with the "bad" leg, while gently touching it to the floor for balance purposes only. If at all possible, try to avoid, or at least minimise, the one-legged "swinging" motion frequently seen on crutches. This is a most unstable means of getting around, and increases the risk of falling.
Always be sure your crutches are properly sized. Get instruction on the safest way to ambulate with crutches. Know your situation, and what your weight-bearing limitations are.
Never use crutches that are without proper padding. Never put full weight on you armpits--this is risky activity and can injure nerves and blood vessels in the armpit. Try to avoid "swinging" on crutches. Do not use broken or severely worn crutches.