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How to Choose Crutches

Life Mobility – How to correctly size and use Crutches

Underarm (axilla) crutches are commonly used following an acute, short-term injury and may be recommended for those who are only able to bear weight on one leg.

Forearm (or elbow) crutches may not be quite as stable with a full load and are commonly recommended in situations of long-term use for those who can bear weight on both legs, but who require the additional support.

Incorrectly fitted crutches or poor posture can cause a disorder called crutch palsy in which the nerves under the arm are temporarily or permanently damaged, causing weakened hand, wrist and forearm muscles. Correct measurements can minimize complications and promote safe use of the crutches. To ensure correct measurements, it is easier if someone else measures you.

Adjusting the height/length:

Underarm Crutch Measurements & Set-up:

  1. Place the person's regular walking shoes on and assist them to a standing position.
  2. Place the top axilla pad approximately 5cm (2–3 finger widths) under the armpit and extend the crutch to a point on the ground approximately 15cm out from the side of the foot.
  3. In this position the handgrip should then be adjusted to sit approximately at the height of the wrist crease. This should allow for around 15–30 degrees of bend at the elbow. 
  4. Check the final fit of the crutches. The top of each crutch should be about two finger widths from the underarm and his wrists should be even with the hand grips when the user’s arms hang at their side.

See below:

Description: http://kidshealth.schn.health.nsw.gov.au/sites/kidshealth.schn.health.nsw.gov.au/files/fact-sheets/images/509/crutches.gif

Forearm: For forearm or elbow crutches, measure the handle height as with underarm crutches. To set the height of the forearm cuff, measure from a clenched fist to 2.5cm below the elbow crease. The forearm cuff should not impede upon elbow movement but should stop the crutch from slipping off the arm.

Forearm Crutch Measurements & Set-up

  1. Place the person's regular walking shoes on and assist them to a standing position.
  2. Instruct them to flex their elbow so the crease of his wrist is level with his hip joint.
  3. Measure the forearm from 3 inches below the elbow and then add the distance between the wrist and floor.
  4. Measure around the largest part of the forearm for the cuff size.
  5. Select a pair of crutches based on the person's measurements. Adjust the length of the crutches up or down to match the measurements.

 

How to use crutches:

When using crutches, weight should be taken through the hands via the hand pads. For underarm (or “axilla”) crutches, the top pad of the crutch should be pressed against the side of the chest wall (approximately 5cm under the armpit). It is important that the crutches are not positioned high against the armpit as this can cause damage to nerves and blood vessels located close to the skin and can also affect posture, balance and stability. Crutches should be positioned slightly to the side and forward of the body for a stable base of support.

  1. Some weight bearing: There are many different ways to use crutches depending on balance and the ability to place weight on one or both legs. If the affected leg can hold some body weight, then it is recommended that the crutches and the affected leg be placed forward together approximately one step length (sharing the load between them) followed by the unaffected leg. As per below:

Description: http://images.ddccdn.com/cg/images/en2384020.jpg

Four point walking pattern: Another option is to use a four point walking pattern, which is slower but may assist with safety for general weakness.

This involves putting one crutch forward, then the opposite leg, and then the next crutch forward, followed by the final leg and continue with this pattern.

  1. No weight bearing: If balance is poor and no weight can be taken on the affected leg, then it is suggested that both crutches be put forward first, followed by a hop forwards of the unaffected leg, stopping just behind the crutches and keeping the affected leg clear of the ground. If balance is good then the hop can swing past the level of the crutches, which will increase speed and fluency.
  2. Stair climbing: To climb up stairs and steps, lift the unaffected leg up to the step first while taking weight on the crutches, and then bring the crutches and the affected leg onto the step second. To go down, lower the affected leg and the crutches down the step first followed by the unaffected leg second.

Description: http://images.ddccdn.com/cg/images/en2383974.jpg

 

 

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