Introduction
Crutches are medical devices designed to aid in ambulation, by transferring body weight from the legs to the torso and arms. They are mainly used to assist individuals with lower extremity injuries and/or neurological impairment. This activity describes the types of crutches, their indications, and contraindications and highlights the role of the interprofessional team in proper evaluation and training of patients needing ambulatory devices.
Technique
Patients can receive training for different gait patterns depending on their current injury and coordination level.
One crutch gait: This pattern utilizes only one crutch. Crutch positioning is on the side of the uninjured lower extremity. The crutch and the injured leg are advanced forward. Then the uninjured leg proceeds while the crutch supports the user’s weight.
Two-point gait: The left crutch and right leg move forward followed by the right crutch and left leg.
Three-point gait: This is the most used technique. The left and right crutch along with the injured leg are both advanced while the uninjured leg supports the body weight. Next, the uninjured leg is advanced.
Four-point gait: This technique provides the most support. The left crutch is advanced followed by the right leg, right crutch and at last the left leg.
Swing-to gait: The left and right crutch are advanced. Then the left and right legs are advanced.
What are the different types of crutches?
There are a few types of crutches you might need:
- Underarm (axillary) crutches: Underarm crutches are the most common type of crutch. They have a padded top that fits under your arm below your armpit, a straight frame and a handgrip.
- Forearm crutches: You might see these crutches referred to as elbow crutches. They’re usually shorter than underarm crutches. Forearm crutches have a supportive cuff that fits around the back of your upper arm just above your elbow and a handgrip.
- Gutter crutches: Gutter crutches are less common than the other types. They have a padded pocket on top of a straight pole. You rest your forearms in the pocket and hold onto the attached handgrip at the front of the gutter.
How do I stand with crutches?
Follow these tips for standing up with crutches:
- Stand up straight with the crutches placed slightly in front of your body and slightly apart on either side.
- Don’t lean your weight on the underarm supports. Use the handgrips to support your weight.
- Leaning your weight on your armpits can make you less stable. It can also hurt your shoulder joints and the nerves and blood vessels under your arms. Putting weight on your shoulders will also tire you faster while using your crutches.
