How to Use Crutches

How to Use Crutches

use CrutchesAlmost all of us have used crutches or another type of weight bearing aid such as a walker or cane at some point. These helpful devices aid in walking when a limb is too weak, painful, or unstable for normal walking to be possible. They also increase safety by preventing falls, which can be quite damaging to a healing or newly healed joint.

Using Crutches Correctly:

You should begin walking again after your surgery as soon as possible. This is because bearing weight on the injured limb is a vital part of post-surgical recovery. As you might imagine, crutches provide patients with the support they need to get on their feet quicker. In simple terms, they work by letting the patient bear less weight on the affected leg while walking. This is known as offloading. These helpful devices also grant added stability and balance. This reduces the chance of a slip and fall, which could lead to re-injury.

Best Method for walking with Aid

The best method isn’t immediately obvious, however. This is because the “simple” act of using them is a fairly complex motor skill. Using them correctly is easier, more comfortable, and less fatiguing. It’s also safer. The following tips and tricks will help you get the most from your crutches.

  • Use your hands to support your weight—not your armpits.
  • Look forward and in the direction you are moving—not at your feet.
  • Adjust your crutches properly. The handles should be even with the hips. The tops should be about 1 ½ inch below the armpit while standing.
  • Bend your elbows slightly when using.
  • Maintain approximately 3 inches of space between the tips of the crutches and the sides of your feet. As you might guess, this prevents your feet from becoming tangled in the crutches.
  • Rest your crutches upside down—not on their tips. This makes them less likely to fall.
  • Some patients have trouble rising from a seated position after surgery. Chairs with sturdy arms can make standing (and sitting) much easier.

Also note that every patient (including you!) is different. A walker is usually the better option if a higher degree of stability and support is required. Obviously this can occur with more severe injuries or disorders. Patients with balance problems, muscle weakness, or both also benefit more from a walker.

Using Crutches Correctly (Pt. 2)

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Camwalker and Cast of Foot

Crutches are incredibly helpful for anyone recovering from a Lower-Extremity (leg) injury. Such injuries include fractures (breaks) of the ankle bones, lower leg, and even the large bone of the thigh (femur). Patients who’ve had leg surgery also frequently walk with crutches. Often times this includes hip and knee replacements. Ankle surgery is becoming incredibly complex as well. We haven’t discovered how to replace an ankle yet, but orthopedic specialists are developing this technology as we speak.

Yet crutches will always have their place, no matter how sophisticated or minimally invasive surgery becomes. In fact, you yourself have probably used them at some point in your life. Were you using them correctly?

The instructions below are more advanced tips and tricks for crutch walking. This advice holds doubly true if you plan on needing crutches for an extended period.

Walking forwards and turning:

You’ll soon learn to walk with crutches effortlessly. Start by standing up and placing your crutches approximately 1 foot in front of your weak or injured leg, then:

1. Simply lean forward, transferring your weight to the crutches.The crutches are for support only at this point. Avoid putting weight on the affected limb.

2. Step through your crutches by swinging your strong or un-injured leg forward.

3. Repeat the cycle. Until you develop confidence be sure to go slowly.

4. Turning is simple. Pivot on your strong or un-injured leg. Then continue forward as above.

sports injury cranberryProceed carefully. If you can bear any weight at all on your strong or un-injured leg it’s possible to ambulate with crutches. Partial weight bearing on the affected limb is also possible. Providers of all types prescribe the following protocols:

  • Non-weight bearing (non-load). The patient puts no weight on the injured or post-surgical limb. It shouldn’t touch the ground while walking.
  • “Touch-off” weight bearing (semi or pre-loading). The patient uses the injured or post-surgical limb to gently push off during the walking cycle.Fractional weight-bearing (partial load). Less severe injuries or surgical recoveries let patients transfer more weight to the affected limb. As you might imagine, this is much more preferable as it allows patients to return to unassisted walking faster.Weight bearing (loading) as tolerated. Patients will (ideally) become less and less dependent on crutches as healing progresses.
  • Walking is a central Activity of Daily Living (ADL). In very rare cases a patient will not regain the ability to walk without the added support of crutches.
  • Treatment must then continue under the direction of physical and orthopedic medical specialists.

 

Standing up and sitting down:

The following advice describes sitting and standing while on crutches. These tips and tricks help you maximize safety and effectiveness. Most of the same rules apply when sitting on or rising from a bed or toilet.

To stand from the seated position:

  •         First, move your body to the front of the seat.
  •         Your weak leg should be positioned in front of your strong or uninjured leg.
  •         You should hold both crutches in the hand of your “weak leg” side.
  •         Also be sure to push up using your “strong leg” arm. Using both arms together helps you to stand smoothly and efficiently.
  •         Finally, balance on your strong or uninjured leg while transferring a crutch to your “strong side” hand. You are now ready to move forward as normal.

To sit from the standing position:

    • To start, move backwards slowly and carefully to the chair.
    • You should then position your weak leg in front of your strong or uninjured leg.
    • Balance on your strong leg as you move your weak or injured leg forward.
    • Use the hand on your “weak leg” side to hold both crutches. Use them for support as you lower yourself.
    • Finally, use your free hand to steady yourself on the seat of the chair, side of the toilet, or bed. Slowly and carefully assume a seated position.

Standing up and sitting down on crutches:

The following advice describes sitting and standing while on crutches. These tips and tricks help you maximize safety and effectiveness. Most of the same rules apply when sitting on or rising from a bed or toilet.

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To stand from the seated position:

·         First, move your body to the front of the seat.

·         Your weak leg should be positioned in front of your strong or uninjured leg.

·         You should hold both crutches in the hand of your “weak leg” side.

·         Also be sure to push up using your “strong leg” arm. Using both arms together helps you to stand smoothly and efficiently.

·         Finally, balance on your strong or uninjured leg while transferring a crutch to your “strong side” hand. You are now ready to move forward as normal.

To sit from the standing position:

Climbing stars is one of the most difficult Activities of Daily Living (ADLs) you’ll need to perform while on crutches. It is also potentially the riskiest. As you might guess, falling while ascending and descending stairs is a pressing concern. This can lead to re-injury—the polar opposite of any physician’s treatment goals.

Put simply, it’s often best to avoid stairs until you know you’re ready. Fortunately, it isn’t always necessary to actually use your crutches. Many patients simply sit down and scoot up or down the steps, one step at a time. It’s slow (and somewhat undignified) yet it’s very safe. The patient is naturally very low to the ground, essentially eliminating the risk of falling.

Yet this safer, easier method isn’t always an option. Additionally, it isn’t exactly quick and efficient. Fortunately, there’s a better way. Using stairs while on crutches can be done relatively easily. The following tips can help you ascend and descend safely.

To go up:

1. Lead with your strong (uninjured) leg.

2. Now position a crutch under each arm. Transfer your weight to the crutches and place the uninjured limb on the next stair up.

3. Simply maintain balance while bringing the weak (injured) leg even with the strong one. You’ll be climbing the stairs in “half-steps,” leading with the strong leg.

4. Repeat until you’ve reached the top of the stairs.

To go down:

1. First, place each crutch on the step immediately below you.

2. Using similar “half-steps” as detailed above, lead with your weak (injured) leg. Follow up with the strong leg.

3. Note: be sure and use handrails if they’re available. This simple step can help you position yourself properly to both ascend and descend steps while on crutches.

Crutch safety and fall avoidance:

fall preventionWhat’s the number one risk associated with using crutches? As you can probably guess, the answer is accidental falls. This can result in one of two potential outcomes. The first is re-injuring the affected limb. The second is developing a new injury. Fortunately, however, most falls are completely avoidable. The following tips will help:

  • Your living space should be prepared before you set foot (crutch) inside. All loose rug corners, electrical cords, and other tripping hazards should be remedied. A simple piece of tape is often all that’s needed.
  • Clutter and other debris should be removed from the floor. All walking areas should be kept completely free of obstructions.
  • Shoes with soft, textured rubberized soles provide the best traction. Dress shoes or footwear with high heels should be avoided.
  • The soft rubber tips at the “floor” end of each crutch wear out quite easily. These should be checked periodically to make sure they’re intact. Replacements can be found easily at any medical supply store.
  • Don’t overload yourself. A small book bag or fanny pack will hold all of your items, allowing your hands to remain free.