Many conditions and injuries to the lower extremities make it necessary for a person to walk with some level of limitation to weight-bearing, or simply with additional support. Major benefits of crutches include broadening the base of support and balance for better mobility, to lessen the discomfort from weight-bearing and to improve mobility during times of difficulty. According to the American Academy of Orthotists and Prosthetists, crutches have been seen in ancient artwork, validating that they were in use as far back as 5,000 years ago. How crutches are used depends upon many factors, including weight-bearing restrictions that may be in place; however, there are some basics that apply in most instances.
Proper Instruction
Learn the gait pattern, or how you initiate the first step with crutches by placing the crutch tips out in front of your body and stepping up to meet them. In instances where there is partial weight-bearing, it may help to extend the affected leg at the same time as extending the crutch tips out in front, then step up to meet the crutches while placing partial weight on the bad leg.
Identify Purpose
There are essentially three types of crutches: the axillary, forearm and platform. The most common type is the axillary. Crutches typically are used in pairs unless specifically directed otherwise. Use the axillary crutch by placing the top, padded portion of the crutch under your armpit, properly fitted so that the top rests approximately two to three finger breadths below the armpit. Then grasp the handle to provide stability.
The forearm crutch is typically shorter and used in the United States more for people with long-term or permanent disabilities. This crutch type requires you to place your arms into special C-shaped cuffs. You then grip the respective hand grips, creating stability.
The platform crutch is frequently used in instances where pressure cannot be placed on the forearm or wrist, such as in cases of fractures. Platform crutches can be a modification of the traditional axillary crutch simply by attaching the predetermined platform attachment directly onto the crutch and fitting it to the person's height and arm dimensions. The forearm is usually in a horizontal, or flat, resting position and the majority of the pressure is placed on the upper arm and elbow. Platform attachments can be used on one or both crutches, depending upon the specific injuries or conditions of the upper extremities. These crutches are also called Canadian crutches.
Weight Bearing Limitations
How a person uses crutches crutches is directly dependent upon the amount of weight, if any, that will be allowed on one or both lower extremities. In cases where one lower extremity must be absent of any weight-bearing, the body will spend a fraction of time completely off the floor or ground while the good leg swings through the gait and planted ahead of the crutches in preparation for the next step sequence. In this scenario, it is critical that the crutches be sized properly to avoid unnecessary pressure in the armpit, as there are major blood vessels and nerves that can be injured.
In instances where partial weight-bearing is allowed, the bad leg typically advances with the forward placement of the crutches and, while light weight is placed on the affected leg, the good leg moves forward to meet with the other leg and crutches respectively.
Adequate Padding
The critical parts of a crutch that should be padded properly are under the armpits, the hand grips and the tip of the crutch that meets the floor. Proper padding reduces the risk of nerve or artery damage from repetitive pressure on the congregation of vessels and nerves called the brachial plexus under the axilla, or armpit, and the median nerve; the one that causes carpal tunnel syndrome, from pressure on the hand grips. Rubber tips on the ends help lessen the possibility of the crutches slipping.
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