Safety Principles for Crutch Walking
- Patient should regularly perform upper-body strengthening exercises in preparation for crutch use.
- Crutches should be adjusted to correctly fit the patient. (With the patient standing, position the crutches about 5 inches lateral on either side of the patient and about 5 inches in front of the client. The crutch pad
should fit approximately 2 inches below the axilla and the hands should rest on the hand grips in a position that allows 30 degrees of flexion in the elbows). - Patient should wear comfortable, firm, low-heeled walking shoes.
- Gait belt should be place around the waist if balance and stability are questionable. When assisting patient to ambulate with crutches, stand slightly behind and to the affected side of the patient with one hand positioned on the gait belt. Do not pull on the patient, as this can affect balance.
- Inspect tips of crutches for wear at frequent intervals.
- Always inspect nuts and bolts on crutches prior to use to ensure tightness.
- Caution patient not to lean on axilla crutch pad, as this can lead to brachial nerve plexus pressure.
- If patient complains of tingling in hands and arms, which is indicative of brachial nerve pressure, inspect
the crutches for appropriate fit and observe patient’s use of crutches. - When sitting in a chair, the patient advances to the chair, turns around, and carefully backs up to the chair until the unaffected leg touches the chair. Both crutches are then placed in the hand of the unaffected side, and the patient carefully reaches for the arm or seat of the chair with the hand on the affected side, and carefully lowers self to the chair, moving the affected leg forward. To get up from the chair, the crutches are positioned on the unaffected side of the patient and used to push the patient up, while the patient uses the hand on the affected side to help push up from the chair. The unaffected leg bears the weight while the patient assumes an upright position, and then the crutches are transferred to the correct standing position.
by
Dr. Judith A. Halstead