Crutches: Definition, Uses, and Clinical Overview

Crutches Introduction (What it is)

Crutches are mobility aids that help a person walk when one or both legs cannot fully bear weight.
They are commonly used after injury, surgery, or during flare-ups of painful joint conditions.
Crutches shift some body weight from the legs to the arms and upper body.
They are widely used in orthopedics, sports medicine, emergency care, and rehabilitation.

Why Crutches used (Purpose / benefits)

Crutches are used to reduce how much force travels through the hip, knee, ankle, or foot during standing and walking. In orthopedic terms, they help modify weight-bearing status—how much body weight a limb is allowed or able to تحمل (bear). Put simply, they can “take pressure off” a painful or healing leg.

Common purposes and benefits include:

• Protection of healing tissue: After fractures, ligament injuries, tendon repairs, or joint procedures, limiting load can help protect healing bone and soft tissue. Exactly how much weight is permitted varies by clinician and case.
• Pain reduction during movement: Many hip and lower-limb conditions hurt more when the joint is loaded. Crutches can decrease pain by reducing compressive forces through the joint during walking.
• Improved mobility while limited: When walking normally is difficult or unsafe, Crutches can help a person move around the home, school, or workplace with less reliance on others.
• Improved gait safety: By widening the base of support and providing additional contact points with the ground, Crutches can improve balance for some users.
• Support during diagnostic periods: When clinicians are still determining the cause of symptoms (for example, acute hip pain), temporary offloading with Crutches may be used while evaluation is ongoing. This is informational and not a recommendation for self-management.

Crutches do not treat the underlying cause of hip or leg pain directly. Instead, they function as a mechanical strategy to manage loading and stability while recovery, rehabilitation, or further assessment occurs.

Indications (When orthopedic clinicians use it)

Orthopedic and rehabilitation clinicians commonly consider Crutches in scenarios such as:

• Acute lower-limb injury with pain or swelling that makes walking difficult (sprain/strain patterns, contusions)
• Suspected or confirmed fracture of the lower extremity or pelvis
• Post-operative protection after hip, knee, ankle, or foot surgery (weight-bearing restrictions vary by procedure)
• Significant hip pain where joint loading worsens symptoms (for example, painful osteoarthritis flare-ups)
• Tendon or ligament injuries where reducing stress may be part of the plan (varies by clinician and case)
• Neurologic or balance conditions where additional support improves stability (selection depends on deficits)
• Overuse injuries where temporary load reduction is part of a broader rehabilitation approach
• Short-term offloading during diagnostic workup of groin, hip, or thigh pain

Contraindications / when it’s NOT ideal

Crutches are not ideal for everyone. Situations where they may be unsuitable, less safe, or where another device may be preferred include:

• Limited upper-body strength or endurance, making it difficult to support body weight through the arms and shoulders
• Significant hand, wrist, elbow, or shoulder pain (for example, arthritis, recent injury, or nerve symptoms) that would be worsened by gripping and weight transfer
• Poor balance, impaired coordination, or cognitive barriers that reduce the ability to use Crutches safely
• High fall risk due to severe dizziness, fainting risk, or neurologic conditions not adequately supported by this device
• Narrow or cluttered living environments where maneuvering is difficult (device choice may depend on home layout)
• Stairs without railings or environments with frequent uneven terrain, ice, or loose surfaces (risk varies by setting)
• Body size or weight outside device specifications (varies by material and manufacturer)
• Need for hands-free function (for example, carrying items at work), where other mobility options may be considered

In some cases, a walker, cane, knee scooter (for certain lower-leg conditions), wheelchair, or supervised assistance may be more appropriate. Device selection typically depends on diagnosis, weight-bearing status, balance, and home/work demands.

How it works (Mechanism / physiology)

Crutches work through load redistribution and stability control. Biomechanically, they create additional points of ground contact so the body’s center of mass can be supported by both the lower limbs and the upper limbs. This reduces the ground reaction forces and joint loading transmitted through the painful or healing leg—especially at the hip, knee, and ankle.

Key biomechanical principles

• Offloading: When a user places weight through the crutch handles, some body weight is transferred through the arms into the crutch tips and then to the floor. Less force must be absorbed by the injured side.
• Widened base of support: Two Crutches can widen the support area compared with unassisted walking, which can improve stability for some people.
• Gait pattern modification: Different patterns (for example, step-to vs step-through) change how and when the injured limb contacts the ground. Specific patterns are typically taught by a clinician.

Relevant hip anatomy and tissues

Crutches are frequently used to manage conditions affecting structures such as:

• Femoral head and acetabulum: The ball-and-socket hip joint surfaces, where load-related pain can occur with arthritis or cartilage injury.
• Hip labrum and cartilage: Soft tissues that can be sensitive to compressive and shear forces during walking.
• Femoral neck and proximal femur: Areas involved in certain fractures or stress injuries where limiting load may be important.
• Hip muscles and tendons: Including gluteal muscles and hip flexors, which may be strained or recovering after surgery.
• Pelvis and sacroiliac region: Where pain may be aggravated by asymmetric gait or altered mechanics.

Onset, duration, and reversibility

Crutches have an immediate effect on how forces are distributed during walking once they are correctly fitted and used. Their effect is temporary and fully reversible—when Crutches are no longer used, walking mechanics return toward baseline (though the underlying condition may still influence gait). Crutches themselves do not create a lasting physiological change; they support mobility while tissues heal, symptoms settle, or rehabilitation progresses.

Crutches Procedure overview (How it’s applied)

Crutches are a device rather than a medical procedure. Clinically, their “application” usually follows a structured workflow to improve safety and function.

1. Evaluation / exam – A clinician assesses the reason for assisted walking, pain level, balance, and any weight-bearing limitations. – They may also consider the person’s environment (stairs, work demands) and upper-limb capacity.

2. Preparation – The appropriate type of Crutches is selected (commonly axillary or forearm). – Height and handle position are adjusted to the user’s body and posture. Fit details vary by device design and manufacturer.

3. Intervention / training – The user is taught a gait pattern matched to their allowed loading level and coordination. – Training often includes turning, sitting/standing transitions, and stairs if relevant.

4. Immediate checks – The clinician checks comfort, grip, tip contact with the ground, and overall stability. – Common early issues include poor fit, unsafe posture, and fatigue.

5. Follow-up – Follow-up may include reassessing fit, updating gait pattern as weight-bearing changes, and monitoring skin or nerve irritation risks. – Progression away from Crutches depends on healing status and clinician judgment; timelines vary by clinician and case.

Types / variations

Crutches come in several designs. The “best” choice depends on the clinical scenario, user strength, coordination, and environment.

• Axillary (underarm) Crutches
• The most commonly recognized style with an underarm pad and handgrip.
• Often used short-term after injury or surgery.

• Fit and technique matter because prolonged pressure in the underarm region can irritate soft tissues and nerves.

• Forearm (Lofstrand) Crutches

• Feature a cuff around the forearm and a handgrip.
• Often used for longer-term mobility needs or when users prefer more freedom of shoulder movement.

• Can be easier to maneuver for some people, but still require upper-limb strength.

• Platform Crutches

• Include a forearm platform to bear weight through the forearm rather than the hand.

• Sometimes used when gripping is painful or not possible (for example, certain wrist or hand conditions). Specific indications vary by clinician and case.

• Hands-free options (orthosis-style devices)

• Some devices allow partial hands-free mobility by supporting the lower leg. These are not traditional Crutches but are sometimes discussed as alternatives depending on injury location and balance demands.

• Suitability varies by clinician and case.

• Materials and tips

• Frames may be aluminum, composite, or other materials (varies by material and manufacturer).
• Rubber tips and shock-absorbing designs vary; tip condition is important for traction.

Pros and cons

Pros:

• Helps reduce loading through a painful or healing hip or leg
• Can improve mobility when normal walking is limited
• Adjustable and reusable across many short-term situations
• Portable compared with larger mobility devices
• Supports a range of gait patterns and weight-bearing levels (as prescribed)
• Can improve stability for some users on flat surfaces

Cons:

• Requires upper-body strength and coordination; fatigue is common early on
• Can aggravate wrist, elbow, shoulder, or neck symptoms in some users
• Incorrect fit or technique can increase discomfort and fall risk
• Challenging on stairs, uneven ground, wet surfaces, or in crowded spaces
• Limits the ability to carry items because hands are occupied
• May contribute to altered posture or asymmetric gait while in use
• Skin irritation or pressure issues can occur at contact points (pads, grips, cuffs)

Aftercare & longevity

Crutches are typically used for a defined period, but the duration depends on the underlying condition, tissue healing, pain levels, and clinical goals. There is no universal timeline.

Factors that commonly affect how long Crutches are needed and how well they work include:

• Condition severity and tissue involved: A minor soft-tissue injury may require brief assistance, while fractures or post-operative restrictions may require longer use. Duration varies by clinician and case.
• Weight-bearing status: Some plans allow full weight-bearing as tolerated, while others limit loading more strictly. The allowed amount is determined clinically and may change over time.
• Rehabilitation participation: Strength, balance, and gait training can influence how efficiently a person transitions off Crutches. The specifics depend on the rehab program.
• Fit and device condition: Worn tips reduce traction; loose adjustments reduce stability. Longevity varies by material and manufacturer.
• Comorbidities: Arthritis, neuropathy, vestibular disorders, cardiopulmonary limitations, and upper-limb conditions can affect tolerance and safety.
• Environment: Frequent stairs, long walking distances, and uneven terrain can increase demand and may influence whether another mobility aid is more practical.

From a device standpoint, ongoing usability is influenced by maintenance and wear (especially tips and grips). From a patient standpoint, outcomes are influenced by how well the device matches the person’s needs and how consistently safe technique is used.

Alternatives / comparisons

Crutches are one option among several ways to manage mobility limits. Alternatives are not universally “better”; selection depends on diagnosis, safety, and functional goals.

• Cane
• Typically provides less unloading than two Crutches.

• May be appropriate for mild pain, mild balance issues, or later-stage transition, depending on clinician guidance.

• Walker (standard or rolling)

• Often offers more stability than Crutches and can be easier for people with balance challenges.

• Can be bulky in tight spaces and may be slower for longer distances.

• Wheelchair

• Provides maximal unloading of the lower limbs.

• Useful when weight-bearing is highly restricted, pain is severe, or distances are long, but requires accessible environments and may reduce overall walking activity.

• Knee scooter (for certain lower-leg injuries)

• Commonly used for foot/ankle problems where kneeling support is acceptable.

• Not typically used for hip conditions and may not suit uneven terrain or stairs.

• Observation / activity modification

• In some cases, clinicians may recommend monitoring symptoms and adjusting activities rather than using a device. This depends heavily on diagnosis and risk factors.

• Physical therapy and rehabilitation

• Targets strength, range of motion, gait mechanics, and functional capacity.

• Often used alongside Crutches rather than as a direct substitute early on.

• Medications or injections

• May address inflammation or pain in certain diagnoses but do not provide mechanical unloading.

• Choice depends on condition, risks, and clinician assessment.

• Surgery

• For selected structural problems, surgery may be part of treatment; Crutches are commonly used around the surgical period to protect healing tissues and support mobility.

Crutches Common questions (FAQ)

Q: Are Crutches supposed to hurt under the arms or in the wrists?
Discomfort can occur if Crutches are poorly fitted or if technique places excessive pressure on sensitive areas. Underarm pressure is a common concern with axillary designs, and wrist or shoulder strain can occur with any type. Persistent or worsening pain is a sign that fit, technique, or device choice may need reassessment by a clinician.

Q: How long do people typically need Crutches?
The duration varies widely based on the injury or surgery, the tissues involved, and the prescribed weight-bearing status. Some people use Crutches briefly for symptom control, while others need them longer during bone or soft-tissue healing. Timelines vary by clinician and case.

Q: Can Crutches help with hip pain even if there is no fracture?
They can reduce hip joint loading during walking, which may lessen symptoms in some conditions where weight-bearing increases pain. However, Crutches do not diagnose or correct the underlying cause of hip pain. Whether they are appropriate depends on the clinical scenario and functional needs.

Q: Is it safe to use Crutches on stairs?
Stairs add complexity because balance demands are higher and hand placement matters. Many people can learn stair techniques with training and appropriate railings, but safety varies by person, device type, and environment. If stairs are a daily requirement, clinicians often factor that into device selection and instruction.

Q: Can I drive while using Crutches?
Driving considerations depend on which leg is affected, pain level, reaction time, medication effects, vehicle type, and local regulations. Crutches themselves are not used while driving, but the underlying condition may limit safe vehicle control. This is a situation commonly discussed with the treating clinician.

Q: What does “weight-bearing as tolerated” mean with Crutches?
It generally refers to placing as much weight through the leg as feels tolerable without excessive pain, while using Crutches as needed for support. The exact meaning can differ across clinicians and conditions, and it may be paired with specific gait instructions. Clarification is typically provided during clinical training.

Q: Are forearm Crutches better than underarm Crutches?
Not universally. Forearm Crutches can be preferred for longer-term use and may reduce underarm pressure, while underarm Crutches are common for short-term injuries and can feel more stable for beginners. The best match depends on strength, balance, diagnosis, and user preference.

Q: How much do Crutches cost?
Cost varies by device type, materials, adjustability, and whether they are purchased, rented, or provided through insurance or a clinic. Added features (special grips, shock absorption, platform attachments) can change pricing. Availability also varies by region and supplier.

Q: What are common mistakes people make with Crutches?
Frequent issues include incorrect height adjustment, leaning on the underarm pads, taking steps that are too long, and placing crutch tips too close together or too far ahead. Fatigue can also lead to poorer technique over time. Training and periodic reassessment can help reduce these problems.

Q: Do Crutches weaken the leg over time?
Crutches can reduce how much the leg is used, which may contribute to temporary deconditioning if used for extended periods. That said, they are often used to protect healing tissues or manage pain during a defined phase. Maintaining function typically involves a broader plan that may include rehabilitation, but specifics vary by clinician and case.