The Complete Crutch Guide
How to choose the ideal crutch for every rehabilitation need
Why does crutch choice matter?
Crutches are assistive walking devices designed to partially or completely reduce weight-bearing on one or both lower limbs, providing stability, safety, and independence during recovery from orthopedic injuries, surgical procedures, or neurological conditions that impair mobility.
Although they all share the same objective—assisting with walking—there are different models, construction materials, and support systems. Each is designed to meet specific needs related to duration of use, user weight, degree of mobility, and type of rehabilitation.
An inappropriate choice can reduce comfort, increase physical exertion, lead to pain in the hands, shoulders, and forearms, as well as compromise balance and increase the risk of falls.
Knowing the different types of crutches allows for the selection of the most suitable model for each clinical situation, contributing to a safer, more comfortable, and more efficient recovery.
How are crutches classified?
Crutches can be classified according to the support point used during walking.
CRUTCHES
├── AXILLARY CRUTCHES
│ │
│ ├── Aluminum
│ │ ├── Conventional
│ │ └── Bariatric
│ │
│ └── Wood
│ └── Temporary use
│
├── FOREARM CRUTCHES (LOFSTRAND CRUTCHES)
│ ├── Fixed Cuff
│ └── Articulated Cuff
│
└── PEDIATRIC CRUTCHES
├── Axillary
└── ForearmThis classification facilitates identifying the most appropriate model based on the user's needs.
General Comparison of Main Crutch Types
| Category | Main support | General indication |
|---|---|---|
| 🟦 Axillary Crutch | Armpits and hands | Temporary recovery, fractures, and post-surgery |
| 🟨 Forearm Crutch (Lofstrand) | Forearm and hands | Prolonged rehabilitation and greater mobility |
| 🟩 Pediatric Crutch | Adapted for pediatric use | Pediatric orthopedic recovery |
| 🟥 Bariatric Crutch | Reinforced axillary | Users with higher body weight |
General Comparison by Characteristics
| Characteristic | Axillary | Forearm | Pediatric | Bariatric |
|---|---|---|---|---|
| Stability | ⭐⭐⭐⭐⭐ | ⭐⭐⭐⭐ | ⭐⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
| Mobility | ⭐⭐⭐ | ⭐⭐⭐⭐⭐ | ⭐⭐⭐⭐ | ⭐⭐⭐ |
| Prolonged use | ⭐⭐ | ⭐⭐⭐⭐⭐ | ⭐⭐⭐⭐ | ⭐⭐⭐⭐ |
| Ease of adaptation | ⭐⭐⭐⭐⭐ | ⭐⭐⭐ | ⭐⭐⭐⭐ | ⭐⭐⭐ |
| Equipment weight | Medium | Low | Low | High |
| Load capacity | Medium | Medium | Low | Very High |
Axillary Crutches
The axillary crutch remains the most widely used model in hospitals, clinics, and orthopedic services due to the high stability it offers during ambulation.
Its support is primarily through the hands, with the upper structure serving only as a reference near the armpit.
Important: body weight should not be directly supported by the armpits, as this can compress nerves and blood vessels.
Axillary crutches can be classified according to their manufacturing material and load capacity.
Comparison: Wooden vs. Aluminum Axillary Crutch
| Characteristic | 🟧 Wood | 🦶 Aluminum |
|---|---|---|
| Weight | Heavier | Lighter |
| Height adjustment | Generally limited | Telescopic |
| Moisture resistance | Lower | Excellent |
| Transportation | Medium | Easy |
| Durability | Very high | Very high |
| Comfort | ⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
| Hospital use | Less frequent | Very frequent |
Wooden Crutch
Traditionally used for many years, it stands out for its robustness and high mechanical strength.
Advantages:
- Very sturdy structure.
- Excellent stability.
- High durability.
- Lower acquisition cost.
Limitations:
- Heavier.
- Limited adjustment.
- Less practical for transport.
Aluminum Crutch
It is currently the market standard. Its lightness and height adjustment provide greater comfort and adaptability to the user.
Advantages:
- Very light.
- Telescopic adjustment.
- Easy to transport.
- Excellent corrosion resistance.
Applications: hospitals, clinics, post-operative care, and home use.
Comparison: Conventional vs. Bariatric Axillary Crutch
Although visually similar, they have important structural differences.
| Characteristic | 🟦 Conventional | 🟥 Bariatric |
|---|---|---|
| Structure | Standard aluminum | Reinforced aluminum |
| Tubing | Conventional | Thicker |
| Handgrips | Conventional | Reinforced |
| Tips | Conventional | Reinforced |
| Crutch weight | Lighter | Heavier |
| Load capacity* | Conventional | High |
* According to manufacturer's specifications.
When to choose bariatric:
- Users with higher body weight.
- Greater mechanical demand.
- Need for greater structural safety.
Forearm Crutches (Lofstrand Crutches)
Forearm crutches use support on the forearm and hands, providing greater freedom of movement. They are widely used in prolonged rehabilitation programs and by patients who require greater functional independence. They are currently divided into two main models.
Comparison: Fixed Cuff vs. Articulated Cuff Forearm Crutch
| Characteristic | 🟦 Fixed Cuff | 🟨 Articulated Cuff |
|---|---|---|
| Cuff | Rigid injected | Articulated |
| Movement | Limited | Natural |
| Comfort | ⭐⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
| Ergonomics | ⭐⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
| Long walks | ⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
| Ease of sitting | ⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
| Prolonged use | ⭐⭐⭐⭐ | ⭐⭐⭐⭐⭐ |
Forearm Crutch with Fixed Cuff
This is the most widespread model. It offers excellent stability and great cost-benefit.
Applications: temporary recoveries, home use, and orthopedic rehabilitation.
Forearm Crutch with Articulated Cuff
Developed to provide greater comfort during prolonged use. The articulated cuff allows for natural forearm movement, reducing effort and improving ergonomics during long walks.
Advantages:
- Natural forearm movement.
- Greater comfort during prolonged use.
- Ease of sitting and standing.
- Superior ergonomics.
Pediatric Crutches
Pediatric crutches are versions adapted to the size and needs of children. Available in axillary and forearm models, they have reduced dimensions, height adjustment suitable for growth, and lighter materials.
Indications:
- Pediatric orthopedic recovery.
- Fractures and post-operative care in children.
- Conditions that temporarily impair walking.
How to choose the correct crutch?
The choice of the ideal model should consider the user's clinical profile and the rehabilitation objective.
| Situation | Recommended crutch |
|---|---|
| Temporary recovery (fracture, post-op) | 🟦 Aluminum axillary |
| Prolonged rehabilitation | 🟨 Articulated forearm |
| User with higher body weight | 🟥 Bariatric axillary |
| Child in orthopedic recovery | 🟩 Pediatric crutch |
| Greater mobility and independence | 🟨 Forearm (fixed or articulated) |
| Hospital/clinic environment | 🟦 Aluminum axillary |
Selection Flowchart
Final recommendation must be individualized according to the assessment of the responsible healthcare professional.
How to choose the correct crutch size
| Crutch type | How to measure | Correct fit | Height reference* |
|---|---|---|---|
| Axillary | Measure from the floor to approximately 2 to 5 cm below the armpit, with the user standing and wearing their usual footwear. | The handgrip should be at wrist height, with the elbow bent at about 20° to 30°. | S: up to 1.55 m M: 1.55 to 1.75 m L: above 1.75 m (according to the manufacturer's adjustment range). |
| Forearm (Canadian) | Adjust the handgrip to wrist height and position the cuff approximately 3 to 5 cm below the elbow. | The elbow should remain bent at about 20° to 30°, allowing for comfortable support and freedom of movement. | S: up to 1.55 m M: 1.55 to 1.75 m L: above 1.75 m or extra-long models, when available. |
* Height ranges are for reference only. The final choice should always consider the adjustment and specifications provided by the manufacturer.
Before buying your crutch
- ✔ Check the minimum and maximum height indicated by the manufacturer.
- ✔ Confirm that the adjustment range is compatible with your height.
- ✔ Adjust the handgrip to keep the elbow slightly bent (20° to 30°).
- ✔ For axillary crutches, keep the top support 2 to 5 cm below the armpit, avoiding direct weight bearing on this area.
- ✔ For forearm crutches, position the cuff about 3 to 5 cm below the elbow.
- ✔ Always follow the guidance of a healthcare professional to ensure correct adjustment and safe use.
Good Practices for Use
Important: Correct crutch height adjustment is essential to prevent strain on the shoulders, wrists, and spine. Always instruct the user with a qualified professional before use.
- Adjust the height according to the user's stature.
- Regularly check the condition of the non-slip tips.
- Do not bear body weight directly on the armpits (axillary crutch).
- Replace worn tips to prevent falls.
- Use appropriate footwear while using crutches.
Myths and Facts
| Statement | Myth or Fact? | Explanation |
|---|---|---|
| Axillary crutches are always the best option. | ❌ Myth | It depends on the user's profile and duration of use. Forearm crutches may be more suitable for prolonged rehabilitation. |
| Body weight should be supported by the armpits. | ❌ Myth | Support should be provided by the hands. Pressure on the armpits can compress nerves and blood vessels. |
| Forearm crutches offer more mobility. | ✅ Fact | Forearm support allows for more freedom of movement and is more suitable for prolonged use. |
| Bariatric crutches are just wider. | ❌ Myth | They have a reinforced structure, thicker tubing, and specific components for higher load capacity. |
Conclusion
The correct choice of crutch directly contributes to safety, comfort, and rehabilitation efficiency. Understanding the differences between models — axillary, forearm, pediatric, and bariatric — allows for the selection of the most appropriate device for each clinical situation.
More than selecting a model, it is crucial to ensure correct adjustment and instruct the user on the safe use of the equipment.
