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Understanding Crutches: Types and Basic Differences

Crutches are mobility tools that help people move around when they cannot put full weight on one or both legs. They come in several types, and knowing the differences matters because each type works better for different situations and body types.

Axillary crutches, sometimes called underarm crutches, are the most common type. These crutches have a padded piece that fits under your armpit, with handles you grip with your hands. The U.S. National Institutes of Health notes that axillary crutches work well for short-term injuries because they are straightforward to use. However, they can cause nerve damage in your armpit if you lean your body weight directly on the padded part instead of using your hands and arms to support yourself.

Forearm crutches, also called Lofstrand crutches or Canadian crutches, have a cuff that wraps around your forearm and a handle you grip below. Many physical therapists recommend these for long-term use because you can distribute your weight more evenly and have more freedom to move your arms. People recovering from serious injuries or managing permanent mobility challenges often use forearm crutches.

Platform crutches have a flat surface where you rest your forearm and hand, rather than gripping a handle. These work well for people with arthritis, carpal tunnel syndrome, or weakness in their hands and wrists. The platform design reduces strain on joints.

Crutch size matters significantly. Crutches that are too long or too short can cause back pain, shoulder pain, and muscle strain. When standing upright with your arms at your sides, the top of an axillary crutch should be about two inches below your armpit. Your elbow should bend at about a 20 to 30-degree angle when you hold the handle.

• Axillary crutches: temporary injuries, easier to learn, risk of nerve damage if misused
• Forearm crutches: long-term use, better weight distribution, requires more coordination
• Platform crutches: hand and wrist problems, reduces joint stress
• Proper sizing: crucial for preventing injury and pain

Practical Takeaway: Understanding which crutch type matches your specific situation helps you move more safely and comfortably. Ask your doctor or physical therapist which type suits your injury or condition best.

How to Measure and Fit Crutches Correctly

Wearing incorrectly sized crutches is one of the most common mistakes people make. Poor fit leads to pain, slower healing, and increased risk of falls. Learning to measure crutches yourself means you can check the fit regularly as you progress in your recovery.

For axillary crutches, the measurement process is straightforward. Stand barefoot with your shoes off, as you will actually be using the crutches. Your feet should be about six inches apart, which is a comfortable walking stance. Have someone help you measure, or use a mirror to check alignment. The crutch should reach to a point about two finger-widths below your armpit—roughly one to one-and-a-half inches. If the crutch sits directly in your armpit, it is too long. If it is more than two inches below your armpit, it is too short.

Next, check your elbow bend. Grip the handle of the crutch with your arm hanging naturally at your side. Your elbow should bend at approximately 20 to 30 degrees. You should be able to fit about one to two fingers between your palm and the handle. This positioning lets your arm and shoulder muscles do most of the work, not the padded part under your arm.

For forearm crutches, the cuff should sit about one to one-and-a-half inches below your elbow crease when your arm hangs at your side. The handle should allow the same 20 to 30-degree elbow bend. The cuff should be snug enough to support your arm but loose enough that you can slide one finger between the cuff and your skin.

Adjustable crutches are helpful because you can modify the height as your injury heals or if you are growing (important for young people). Most crutches adjust by moving clips or pushing buttons to change the length. Write down your correct measurements so you can reset them if they shift.

Your shoes affect crutch fit. You will be wearing shoes when you use crutches, so wear the shoes you plan to use most often when you measure. Thick-soled shoes or high heels change your body's angle slightly.

• Axillary crutches: top should be 1-2 inches below armpit
• Elbow bend: aim for 20-30 degrees when gripping the handle
• Hand position: one to two fingers of space between palm and handle
• Forearm crutches: cuff 1-1.5 inches below elbow crease
• Measure while wearing the shoes you will normally wear
• Recheck fit regularly, especially during healing

Practical Takeaway: Proper fit takes five minutes but prevents weeks of pain and injury. Measure once, document your numbers, and recheck every two to three weeks during recovery.

Safe Walking Techniques and Posture

How you walk on crutches matters as much as the crutches themselves. Poor technique can slow healing, cause pain in unexpected places, and increase your risk of falling. The good news is that safe walking patterns are learnable skills that become automatic with practice.

Before you start walking, understand weight-bearing status. Your doctor will tell you whether you can put weight on your injured leg. "Non-weight-bearing" means you cannot put any weight on that leg at all. "Partial weight-bearing" means you can put some weight on it. "Weight-bearing as tolerated" means you can put weight on it as much as pain allows. This determines which walking pattern you will use.

The basic three-point gait works for non-weight-bearing injuries. This pattern goes: crutch-crutch-good leg, pause, crutch-crutch-good leg. You move both crutches forward together, then swing your good leg forward while your crutches support your weight. This pattern is slower but safe when your injured leg cannot bear weight.

For partial weight-bearing, the four-point gait is safer for beginners. The pattern is: right crutch, left leg, left crutch, right leg. You move one crutch and the opposite leg forward at the same time. This pattern is slower than normal walking but safer because you have more points of contact with the ground at any moment.

Posture matters significantly. Keep your head up and look ahead, not down at your feet. Your shoulders should stay level—do not lean to one side or hunch forward. Let your arms do the work. Your arms and shoulders should support about 25 percent of your body weight when using crutches; your good leg and core muscles support the rest. Leaning on the crutch pads under your arms causes nerve damage and shoulder problems.

Your hand position affects safety. Grip the handles firmly but not so tight that your hands cramp. Keep your wrists straight, not bent forward or backward. Bent wrists can lead to carpal tunnel problems. Your elbows should stay slightly bent throughout your stride.

Practice on level ground first, then progress to slight slopes, stairs, and uneven surfaces. Always use railings when available. Falls from crutches can cause serious injury, so move slowly until the motion feels natural.

• Three-point gait: both crutches, then good leg (non-weight-bearing injuries)
• Four-point gait: right crutch, left leg, left crutch, right leg (partial weight-bearing)
• Look ahead, not down at your feet
• Keep shoulders level and do not hunch
• Let arms support about 25 percent of body weight
• Keep wrists straight and elbows slightly bent
• Practice on level