What should the nurse teach a patient about safe axillary crutch walking?

Physiotherapy

How to use crutches

This information has been translated into other languages – see the links at the bottom of this page.

Make Sure the Crutches Fit

1. Stand straight.
2. Place the top of the crutches under your arms.
3. Put the ends 12 to 20 cm (5 to 8 inches) to the side of your feet.

The crutches are the correct length if there is a 2 to 3 finger space between the top of the crutch pad and your armpit.

The hand grip should be at wrist level when your arm is hanging by your side. Your elbows are slightly bent as you push down on the handgrips.

Remember:

Support your weight with the hand grips, not the crutch pads under your armpits.

Your weight bearing order is:

Use the method you were shown with the instructions below.

Walking

1. Put the crutches ahead and to the sides of your feet for the best balance.
2. Move both crutches forward at the same time.
3. Move the injured leg forward between the crutches.
4. Gently squeeze each crutch into your ribs. Put weight through your hands and keep your elbows straight.
5. Move your uninjured (good) leg ahead of the crutches, or to between the crutches for better balance.

Repeat these steps to keep walking—crutches, injured leg, good leg.

Note: Don’t lean on the crutch top

Sitting

1. Step backwards until the back of your good leg touches the front of the chair. Keep your injured leg forward
2. Keeping your weight on the good leg, take the crutches from under your arms. Transfer 1 crutch and hold both crutches by the hand grips in 1 hand.
3. Lean forward and bend your good knee. Hold the armrest of the chair (or chair seat) with the other hand.
4. Sit down slowly. Keep your crutches next to the chair.

Standing

1. Make sure the chair is steady before you try to stand.
2. Move forward to the edge of the chair so your good foot is flat on the floor. Slide your injured leg forward and follow the weight bearing order.
3. Hold the crutches by the handgrips in one hand. Hold the armrest of the chair (or chair seat) with the other hand.
4. Stand up, taking weight through your good leg. Transfer the crutches under your arms after you get your balance.

Steps and Stairs

• Use the handrail if there is one. Put both crutches under the arm away from the railing (or hold as in the diagram below) and use both crutches as one.
• Hold the railing with your free hand and stand close to the rail.
• On stairs without a railing: follow the instructions for going up and down stairs, except leave one crutch under each arm (as for walking).

Going Up Stairs

1. Stand close to the bottom step.
2. Put your good leg up first.
3. Lean forward taking your weight on your good leg.
4. Lift your injured leg and crutches up.
5. Climb one stair at a time. If someone is helping you, have them stand behind and to the side of you.

Going Down Stairs

1. Stand close to the edge of the top step.
2. Move your hand down the railing.
3. Lower your crutches, then your injured leg, to the next step.
4. Step down with your good leg.
5. Step down one step at a time. If someone is helping you, have them stand in front and to the side of you.

Using One Crutch

Use the crutch in the hand opposite to the injured leg. This gives you better support and helps you walk with more normal movements.

Using a 4-Point Gait-Style

Only use this method if your therapist has shown you. You’ll be shown either partial weight bearing or weight-bearing as tolerated.

Follow these steps to walk:

1. Move your right crutch forward
2. Move your left foot forward so it’s even with the right crutch.
3. Move your left crutch forward.
4. Move your right leg forward so it’s even with the left crutch.

Repeat these steps to keep walking.

Note: If you start with your left crutch, reverse the above order.

Follow the same instructions for crutch walking to:

• sit down
• stand up
• go up and down stairs

Safety Tips

• Make sure that your crutches have rubber tips, padded shoulder pieces and hand grips. These should be checked regularly, kept in good condition, and replaced as needed.
• It’s important to use your crutches correctly. If you feel any numbness or tingling below your armpits or in your upper arms, you’re probably not using the crutches as you were shown.
• Never stand on your injured leg unless your doctor says you can. Always follow your doctor’s order about the weight-bearing status of the injured leg.
• Always wear good supportive shoes or bare feet rather than slippers.
• Use a waist pouch or a backpack as a purse.
• Watch for wet surfaces. Use small steps if you must walk on a wet or slippery surface.
• Be careful when walking on uneven ground. Ask for help if you need it.
• Remove loose mats and rugs, electric cords, and cables—these could cause you to trip or slip.

Your doctor or physiotherapist will tell you when you can stop using your crutches.

To see this information online and learn more, visit MyHealth.Alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_physio_crutches_inst.

Other languages

Physiotherapy: How to use crutches

For 24/7 nurse advice and general health information call Health Link at 811.

Current as of: Oct 21, 2020

Author: Allied Health (Physiotherapy), Alberta Health Services

This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.

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