Overview of Crutches
Crutches are tools used to help people walk by shifting the body’s weight from the legs to the upper body and arms. They’re mainly used to help people who have injuries to their lower body or problems with their nerves that affect how they move. The three main types of crutches you might see are axilla crutches (which you tuck under your armpits), forearm crutches (which you grip and rest your forearm on), and platform crutches (where you rest your forearm on a flat platform).
Why do People Need Crutches
Crutches are needed when a person has a temporary or permanent problem that affects their ability to balance or bear weight on their lower body. However, to use crutches, the person must have enough strength and coordination in their upper body to support and move their own weight.
When a Person Should Avoid Crutches
Some people may not be able to use crutches due to their age. Very young children and elderly individuals might lack the required core strength and coordination to use crutches successfully. If a person has a condition, either related to muscles and bones (musculoskeletal) or the nervous system (neurological), that affects their movement, strength or sensation, using crutches might not be recommended. It could be a short-term or long-term concern depending on the condition.
Equipment used for Crutches
Axilla crutches, which are the most commonly used crutches, are chosen due to their straightforward usage. They are usually suitable for short-term use. These crutches function by moving most of the user’s body weight onto their arms and upper body. However, they may not be the best choice for individuals with weak wrist or arm strength, or those who have difficulty in coordinating their movements. When patients are discharged from health care facilities, they are typically given these crutches for immediate use.
On the other hand, forearm crutches are more suitable for long-term use. They operate by shifting the user’s weight onto their upper arms. To use these crutches effectively, the individual must have strong upper body strength. They are typically chosen by individuals with long-term disabilities who wish to maintain an active lifestyle or participate in sports.
Platform crutches are less common. They function by transferring the weight of the user mainly onto their forearms. Even though they provide more stability than axilla and forearm crutches, they allow less movement. These crutches are designed for long-term use. They are often the crutch of choice for individuals with severe neurological impairments affecting their lower body, resulting in decreased stability.
Preparing for Crutches
It’s very important that crutches are adjusted to fit the individual user correctly. If they’re not, it could result in serious injuries. Since there are various types of crutches available, let’s look at how to adjust each one for a good fit:
First, let’s talk about axilla or underarm crutches. The top of the crutch, also known as the shoulder pad, should be about 2 inches (around the width of two fingers) below your armpit when your shoulder is relaxed. The handle of the crutch should be positioned so that your elbow bends slightly, at about 30 degrees. Also, the crutch should be about 6 inches outside of your feet. Remember, you should never rest your armpit directly on the shoulder pad; this could lead to nerve damage.
Next, we have the forearm crutches. The handle on these crutches should also be adjusted so your elbow is bent about 30 degrees.The cuff of the crutch, which wraps around your forearm, should be about 1.5 inches below your elbow. Just like the axilla crutches, the bottom of the forearm crutch should rest about 4 inches outside of your feet.
Lastly, we have platform crutches. These have a design that can vary from a flat surface where you rest your forearm, to a fully adjustable one with elbow guards and hand holds. During the fitting, your elbow should not rub against anything and the overall position should promote your stability.
In any case, always make sure that crutches are fitted correctly to ensure your safety and comfort!
How is Crutches performed
Patients can learn different ways to walk based on their particular injury and how well they can move around.
One crutch walk: This way of walking uses only one crutch. The crutch is placed on the side of the person’s uninjured leg. The crutch and the injured leg are moved forward together. Then, the uninjured leg is moved forward while the crutch is used to support the person’s weight.
Two-point walk: This style of walking alternates movement between the left crutch and right leg and then the right crutch and left leg.
Three-point walk: This is the most commonly used method. The left and right crutches and the injured leg are all moved forward at the same time. The person’s weight is supported by the uninjured leg. After that, the uninjured leg is moved forward.
Four-point walk: This technique offers the most support. The steps are taken in this order: left crutch, right leg, right crutch, and then left leg.
Swing-to walk: In this method, both the left and right crutches are moved forward. Following that, the left and right legs move forward.
Possible Complications of Crutches
Before a pair of crutches can be given to someone, it’s really important to check on their strength and coordination. If wrongly matched, crutches can potentially cause harm rather than assist. Most injuries occur because the person loses balance and falls.
One common problem is “crutch palsy”, which happens when someone puts their weight on the top or shoulder rest of underarm crutches. This pressure could affect the nerves in the armpit region, known as the brachial plexus, and lead to weakness or loss of feeling in the area. This could then affect the arm and hand nerves, leading to issues in movement or sensation. Cushioning the shoulder rest with extra padding might be helpful in preventing these complications.
Patients need to be educated not to prop their weight on the shoulder rest to avoid the possibility of crutch palsy. The good news is this condition usually reverses with the right treatment.
What Else Should I Know About Crutches?
Crutches are essential tools for managing injuries related to bones and nervous system, both temporarily and permanently. By transferring the body’s weight away from the injured limb, crutches help create the best possible conditions for quick healing of sudden injuries. Moreover, for people with chronic bone injuries or injuries related to the nervous system, crutches provide support for walking, allowing them to move around and stay active. They are very helpful, especially for those dealing with sudden or long-standing injuries, as they help to keep mobile and independent.
