How to Use Elbow Crutches Correctly
Key insights: 60-second read
- Crutches absorb force for your injured leg – How you use them depends entirely on your weight-bearing status (non-weight bearing to full weight bearing).
- Proper fitting prevents secondary issues – Handgrips should align with your wrist, cuffs sit below your elbow, and you should maintain upright posture.
- "Up with the good, down with the bad" – Your good leg leads going up stairs; your injured leg leads going down.
- Single crutch goes on the opposite side – This provides better stability and promotes a more natural walking pattern.
Learning to use elbow crutches (also called forearm crutches) properly is essential for a safe and efficient recovery. Whether you're recovering from surgery, a fracture, or a soft tissue injury, this comprehensive guide will help you master proper crutch technique, avoid common mistakes, and optimise your healing process.
Table of Contents
1. Understanding Elbow Crutches and Weight Bearing Status
Elbow crutches are designed to help you maintain mobility while protecting an injured leg. Unlike underarm crutches, they support your weight through your arms and wrists rather than your armpits, reducing the risk of nerve damage and allowing better maneuverability.
The single most important concept to understand is that crutches exist to absorb the force that your injured leg cannot currently tolerate. How you use your crutches depends entirely on your weight-bearing status, which your healthcare provider will determine based on your specific injury.
Weight Bearing Classifications
| Classification | Description |
|---|---|
| Non-Weight Bearing (NWB) | No weight allowed on the injured leg. Keep foot off the floor at all times. |
| Toe-Touch Weight Bearing (TTWB) | Only toes may touch the floor for balance with no actual weight placed on the leg. |
| Partial Weight Bearing (PWB) | A specific percentage of body weight (usually 30-50%) is allowed on the injured leg. |
| Weight Bearing as Tolerated (WBAT) | You can put as much weight on the leg as comfort allows, using crutches primarily for balance and support. |
| Full Weight Bearing (FWB) | Full weight is allowed, with crutches providing minimal support and stability. |
Professional Insight: Understanding that crutches absorb unwanted force helps you progress appropriately. As your injury heals, you'll naturally put more weight on your leg, signaling when you're ready to reduce crutch dependency.
2. Proper Crutch Fitting and Adjustment
Correctly fitted crutches are essential for safety, comfort, and maintaining proper posture during your recovery. Ill-fitting crutches can cause secondary issues in your back, shoulders, and neck.
Step-by-Step Fitting Guide
1. Handgrip Height: When standing straight with arms relaxed at your sides, the handgrip should align with the bump on the outside of your wrist. Your elbows should be slightly bent at about 15-30 degrees when holding the grips.
2. Cuff Position: The forearm cuff should sit 2.5-5 cm (1-2 inches) below the bend of your elbow, allowing full range of motion without restriction.
3. Posture Check: With properly fitted crutches, you should be able to maintain an upright, comfortable posture without hunching your shoulders or leaning forward excessively.
Safety Note: Never lean on the tops of your crutches with your armpits. This may irritate the nerves in your armpit leading to numbness and tingling in your hands. Always support your weight through your hands on the grips.
3. Walking Techniques Based on Weight Bearing Status
The walking pattern you use will depend on how much weight your healthcare provider has cleared you to put on your injured leg.
Non-Weight Bearing Gait
- Move both crutches forward together about a step's length
- Push down on the handgrips and swing your body forward
- Land your good leg either even with or slightly past the crutches
- Keep your injured leg elevated throughout the movement
Partial Weight Bearing Gait
- Move both crutches and your injured leg forward simultaneously
- Place the permitted amount of weight through your injured leg
- Step through with your good leg, which can go level with or past the crutches
Weight Bearing As Tolerated Gait
- Use a more natural walking pattern while still using crutches for support
- Focus on walking without a limp, using the crutches to facilitate normal movement
- Gradually increase weight on the injured leg as comfort allows
4. Sitting and Standing with Crutches
How to Sit Down Safely
- Back up until you feel the chair against the back of your legs
- Remove your arms from the cuffs and hold both crutches by the handgrips in one hand
- Reach back with your free hand to grasp the chair arm or seat
- Lower yourself slowly into the chair, keeping your injured leg slightly forward
How to Stand Up Safely
- Scoot forward to the edge of the chair
- Place your strong foot slightly back and your injured leg slightly forward
- Hold both crutches by the handgrips in the hand on your injured side
- Push up using the chair arm and your strong leg
- Once standing balanced, place the crutches under your arms
5. Navigating Stairs Safely with Elbow Crutches
Going Up Stairs
With a handrail:
- Hold the handrail with one hand and both crutches (or just one) in the other hand
- Step up with your good leg first
- Bring your injured leg and crutches up to the same step
- Repeat for each step
Without a handrail:
- Place both crutches on the step you're standing on
- Step up with your good leg
- Bring the crutches and your injured leg up together
Going Down Stairs
With a handrail:
- Hold the handrail with one hand and crutches in the other
- Lower the crutches and your injured leg to the step below
- Step down with your good leg
- Repeat for each step
Without a handrail:
- Lower both crutches to the step below
- Step down with your injured leg, maintaining appropriate weight bearing
- Follow with your good leg
Helpful Mnemonic: "Up with the good, down with the bad" - when going upstairs, your good leg leads; when going downstairs, your injured leg leads.
6. Transitioning to a Single Crutch
Correct Single Crutch Placement
Contrary to what many people assume, a single crutch or cane should be used on the opposite side of your injured leg. This provides better stability and allows for a more normal walking pattern.
- It creates a wider base of support
- It helps maintain an upright posture
- It balances forces at the hip, reducing strain on your joints
- It prevents the "penguin walk" where you shift your weight excessively to one side
Walking with One Crutch
- Hold the crutch in the hand opposite your injured leg
- Move the crutch and your injured leg forward together
- Step through with your good leg
- Maintain as normal a walking pattern as possible
7. Essential Safety Tips for Crutch Users
Home Environment Safety
- Remove trip hazards: Clear clutter, secure loose rugs, and keep electric cords out of walkways
- Ensure good lighting: Make sure all areas are well-lit, especially hallways and stairs
- Create clear paths: Rearrange furniture to create wide pathways for movement
- Use non-slip surfaces: Place non-slip mats in bathrooms and kitchens
Crutch Maintenance
- Check rubber tips regularly: Replace worn, smooth, or split ferrules immediately
- Inspect for damage: Look for bends, loose handles, or other signs of wear
- Verify adjustment mechanisms: Ensure all buttons and clips are secure
Personal Safety
- Wear proper footwear: Choose flat, supportive shoes with non-slip soles
- Use a backpack: Carry items in a backpack to keep your hands free
- Be cautious on wet surfaces: Take small steps and avoid wet leaves, ice, or slippery floors
- Take your time: Move slowly and don't rush your movements
Master Your Mobility With Confidence
Learning to use elbow crutches properly empowers you to navigate your recovery safely and efficiently. Remember that the ultimate goal is to gradually reintroduce weight to your injured leg as it heals, using the crutches to support only what your body cannot currently tolerate.
Always follow the specific weight-bearing instructions provided by your healthcare provider, and listen to your body's signals as you progress. With proper technique and patience, you'll build confidence in your mobility while optimising your healing process.
For visual demonstrations of these techniques, watch our detailed video guide above.
I genuinely hope this article offers a fresh perspective - or at least one useful takeaway. If you have a different issue, or simply want to learn more about how your body moves, head over to the Your Wellness Nerd YouTube channel. Subscribe if you feel inclined, and let me know in the comments what you'd like me to cover next.
– Grant
Frequently Asked Questions
How do I know if my crutches are the right height?
When standing straight with arms relaxed at your sides, the handgrip should align with the bump on the outside of your wrist. Your elbows should be slightly bent (15-30 degrees) when holding the grips, and you should be able to maintain upright posture without hunching.
Which leg goes first when going up stairs with crutches?
Remember the mnemonic: "Up with the good, down with the bad." When going up stairs, your good (uninjured) leg leads first. When going down stairs, your injured leg and crutches go first, followed by your good leg.
Should I use one crutch on the same side as my injury?
No. When transitioning to a single crutch, it should be used on the opposite side of your injured leg. This provides better stability, promotes a more natural walking pattern, and balances forces at the hip.
How often should I replace the rubber tips on my crutches?
Inspect the rubber tips (ferrules) regularly. Replace them immediately if they become worn, smooth, or split, as this compromises traction and safety. Many healthcare providers recommend replacing them every 6-12 months with regular use.
One profound insight from this post
"A single crutch should be used on the opposite side of your injured leg. This creates a wider base of support, balances forces at the hip, and prevents the 'penguin walk' - shifting weight excessively to one side."
Medical Disclaimer: This content is for informational purposes only and does not replace professional medical advice. Always follow the specific instructions provided by your healthcare provider.
Living With Persistent Pain?
If your pain has lasted longer than expected, feels disproportionate to injury, or hasn't responded to standard treatment, you may benefit from a broader approach. Learn more about our physiotherapy services in Port Macquarie.
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