What are the instructions for a patient using crutches?

Instructions for Proper Crutch Use

Patients should be properly fitted for crutches and taught the correct technique to reduce risk of falls, prevent secondary injuries, and optimize mobility during recovery. 1

Proper Crutch Fitting

• Height adjustment: Crutches should reach to about two finger widths (approximately 2-3 cm) below the armpit 2
• Handgrip adjustment: Position handgrips so the elbow is flexed 25-30° with the wrist straight 2
• Weight distribution: Weight should be supported through the palms on the handgrips, NOT through the armpits 2, 3
• Consider slightly shorter crutches: Research suggests crutches adjusted 2.5 cm below conventional height may reduce energy expenditure 4

Safe Crutch Walking Technique

Basic Standing Position

• Stand with feet slightly apart for stability
• Place crutches approximately 15 cm to the side and in front of each foot
• Distribute weight through the hands, not the armpits

Three-Point Gait (for single leg injury)

1. Move both crutches forward approximately 15-20 cm
2. Swing the uninjured leg forward between the crutches while supporting weight on hands
3. Repeat the sequence, maintaining proper posture with head up and shoulders back

Weight-Bearing Instructions

• Non-weight bearing: Keep injured leg completely off the ground
• Partial weight-bearing: Apply only the prescribed amount of weight to the injured leg
• Weight-bearing as tolerated: Apply as much weight as comfortable while using crutches for support

Navigating Stairs

Going Up Stairs

1. Step up with the uninjured leg first ("up with the good")
2. Bring crutches and injured leg up together afterward

Going Down Stairs

1. Place crutches on the step below first
2. Lower the injured leg down
3. Step down with the uninjured leg last ("down with the good")

Common Pitfalls and Safety Precautions

• Avoid axillary pressure: Never rest weight on armpits as this can cause nerve damage and vascular complications 3
• Check crutch tips regularly: Ensure rubber tips are intact to prevent slipping
• Clear walking paths: Remove obstacles, loose rugs, and cords to prevent tripping
• Use appropriate footwear: Wear supportive, non-slip shoes
• Inspect crutches periodically: Check for cracks, loose parts, or worn tips
• Maintain proper posture: Keep head up and shoulders back to prevent back strain

Special Considerations

• Fatigue management: Take regular rest breaks during longer walking periods
• Surface awareness: Exercise extra caution on wet, slippery, or uneven surfaces
• Doorways: Open doors toward the uninjured side when possible
• Sitting down: Back up to the chair, hold both crutches in one hand, and use the other hand to support yourself as you lower into the chair

By following these instructions, patients can minimize the risk of falls and secondary injuries while optimizing mobility during recovery with crutches.