Walking with crutches – A step-by-step guide
The correct way of walking with crutches can make a big difference to how quickly your injury heals and help you avoid other injuries like shoulder pain. This article provides guidance on the correct height of crutches, how to walk with crutches non-weightbearing and partially weightbearing, and how to walk with one crutch. It also has advice on how to mimic your normal walking pattern to speed up your recovery. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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This article is about forearm crutches (also called elbow crutches), which have largely replaced the ones that go into your armpit.
We’ve also made a video about this:
The height of your crutches
If you experience shoulder pain from walking with your crutches, chances are they are too high for you.
You want your crutches to be set to a height that doesn’t make you stand and walk awkwardly. Too high, and they will force your shoulders to hunch upwards. Too low, and you’ll have to stoop.
When you’re adjusting the height of your crutches, make sure you’re wearing the footwear you’re going to have on when using them. If your foot is in a cast or an orthopaedic boot, consider getting a shoe leveller for the other foot so that your feet are equally high off the floor. This will help you to simulate a normal walking gait while using your crutches (more about that further down).
Forearm crutches should have two adjustments: How high the handle is off the floor, and how far the arm support clip is below your elbow. It helps to have someone to adjust the settings for you as you follow the guidelines below. (I use the word “guidelines”, because a bit of trial-and-error may be necessary before your crutches feel comfortable for you.)
It’s better to adjust the handle first: Stand up nice and straight with your crutch next to you. The foot of the crutch should be next to your heel and the handle should be facing forward. Put your arm through the arm support clip and then let your arm hang free. The handle height should be where your hand and your wrist meet.
Once you’ve set the handle height, grip the handle, and check where the arm support clip is. If it touches your elbow, it’s too high. Many people feel comfortable when the clip is about two-thirds up on their forearm, where there’s a nice bit of fleshy cushioning.
When you’re satisfied with these two settings, apply them to the second crutch (if you’re using two) and try them out to see whether they feel comfortable. If you can support your weight on them without hunching or stooping while your feet are flat on the floor, they should be fine, but adjust them if necessary until you feel comfortable.
How to walk with crutches non-weightbearing
It’s easy to walk with crutches in a non-weightbearing way – you just hoist up the injured leg, and off you go. However, many people who do it this way find it difficult to return to their normal way of walking when they get off the crutches, and this can complicate or delay your recovery from your injury. Also, it puts unnecessary strain on the hamstring and hip flexors of your injured leg while you’re using the crutches.
It is much better to mimic your normal walking gait pattern by doing “shadow walking” with your crutches (see video for demo) so that you can get back to walking normally much faster once you can cast them aside. However, there are some injuries where shadow walking is not allowed so do check with your doctor or physiotherapist before you try it.
Our normal walking gait pattern is to place the heel down first, then to roll forward with the weight on the foot, and then to roll further forward and finally push off with your toes. With crutches, you want to mimic that forward rolling movement of the injured foot but without actually placing weight on your foot.
So, just before you take a “step” with the injured side, you put your crutches down, slightly in front of you. Then, as you transfer your weight from your good leg to your crutches, you bring your injured side forward, pretend to place your heel down, and then let the foot roll through while touching the floor very lightly; ideally, an ant on the floor should survive an encounter with that foot.
How to walk with crutches partially weightbearing
You should use the same “shadow walking” with your crutches if you can walk partially weightbearing.
The only difference is that you can go a bit quicker by putting down the crutches and the injured side’s foot simultaneously, as opposed to leading with the crutches (see video for demo).
So, it’s really important to not hop around on your crutches unless your doctor told you to do so. If you can get your brain used to the normal walking pattern and use the injured side as normally as possible, your recovery will be much quicker.
How to walk with one crutch
For some injuries, you can get away with using only one crutch. And because there’s only one crutch, it means that you’ll be in a partially weightbearing situation.
When you’re walking with one crutch, which side is the best? It’s advisable to use the crutch on the opposite side to the injured side, because this is the normal way of walking, with our opposite legs and arms going forward at the same time.
So, you would place the crutch and the injured side on the floor at the same time and divide your weightbearing between the crutch and that leg (see video for demo). Try to maintain the “shadow walking” gait here as well.
However, I have had patients who just couldn't walk with the crutch on the opposite side. If you’re like that and you're really unstable, just do it the other way round, with the crutch on the injured side. It's not ideal, but it's better than risking falling over.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.