Elbow crutches (also called forearm crutches) support your weight through your hands and forearms rather than your armpits, which makes them safer for long-term use and easier on the nerves and blood vessels under your arms. Getting the most out of them comes down to proper fit, the right walking pattern for your injury, and a few key techniques for stairs and chairs.
How to Fit Elbow Crutches to Your Body
Two measurements matter: handle height and cuff position. Stand upright with your arms relaxed at your sides. The handgrip should sit at the crease of your wrist when your arm is fully extended. This lets you walk with a slight bend in your elbow, which is where your power and control come from. If the grip is too low, you’ll hunch forward. Too high, and your shoulders will ride up and fatigue quickly.
The forearm cuff should sit 1 to 2 inches below the bend of your elbow. This gives the cuff enough room to stabilize your forearm without restricting your elbow joint. Most elbow crutches have push-button or twist-lock adjustments for both the height and cuff position, so fine-tune both before you start walking.
Choosing the Right Walking Pattern
The walking pattern you use depends entirely on how much weight your injured or recovering leg can handle. Your physical therapist or surgeon will tell you whether you’re non-weight-bearing, partial weight-bearing, or full weight-bearing. Each status has a specific gait pattern designed to protect the injury while keeping you mobile.
Non-Weight-Bearing (Swing-Through Gait)
If your injured leg cannot touch the floor at all, keep that foot off the ground the entire time. Start by standing with all your weight on your healthy leg. Move both crutches forward about 6 to 12 inches. Shift your weight onto the crutches through the handgrips, straighten your elbows, and swing your healthy leg forward, landing on it ahead of (or level with) the crutches. As you build confidence, you can swing past the crutches for longer strides and faster movement. If you prefer more stability at first, you can move the crutches one at a time instead of together, though this slows you down.
Partial Weight-Bearing (3-Point Gait)
This pattern lets you put some weight through your recovering leg while the crutches absorb the rest. Move both crutches forward at the same time. Press down through both handgrips with your full weight. Then step forward with your injured leg, placing only as much weight on it as your provider has cleared. Finally, step your healthy leg through to complete the stride. The crutches and your injured leg essentially work as a team, sharing the load so your healing tissue isn’t overloaded.
Full Weight-Bearing (4-Point Gait)
When both legs can bear weight but you still need balance or support, the 4-point gait mimics a natural walking rhythm. Move your right crutch forward, then step with your left foot. Move your left crutch forward, then step with your right foot. It’s slow and deliberate, with three points of contact on the ground at all times, which makes it the most stable pattern.
Going Up and Down Stairs
Stairs are the most intimidating part of using crutches, but one simple rule keeps you safe: up with the good, down with the bad.
Going up, step onto the next stair with your unaffected (strong) leg first. Let that leg do the work of lifting your body. Then bring the crutches and your injured leg up to the same step. If a handrail is available, hold both crutches in one hand and grip the rail with the other. Without a handrail, keep one crutch in each hand and move your injured leg and crutches together as a single unit.
Going down, lead with your crutches and injured leg. Lower them to the next step first, then bend your strong knee and slowly bring your healthy leg down to meet them. Don’t hop. Hopping creates momentum that’s hard to control, especially if your arms are tired. Keep your movements deliberate and take one step at a time.
Sitting Down and Standing Up
To sit, back up until you feel the chair against the back of your legs. Transfer both crutches to the hand on the same side as your injured leg. Reach back with your free hand to find the armrest or seat edge. Lower yourself slowly, keeping your weight on your arms and healthy leg. Don’t tip backward into the seat too quickly, because the sudden shift can jar your injury or pull you off balance.
To stand, scoot to the front edge of the chair. Hold both crutches in one hand, press down on the armrest or seat with the other, and push up through your healthy leg. Once you’re upright and steady, separate the crutches back into both hands before you start walking. Rushing this transition is one of the most common causes of falls.
Posture and Weight Distribution
The single most important rule with elbow crutches: your weight goes through the handgrips, not the cuffs. The forearm cuff is there to keep the crutch attached to your arm when you open a door or reach for something. It is not a weight-bearing surface. Leaning into the cuffs shifts force into your shoulders and compresses nerves and blood vessels in your upper arm, which can cause numbness, tingling, and faster fatigue.
Keep your torso upright. It’s tempting to lean forward over the crutches, especially when you’re tired, but hunching changes your center of gravity and makes you less stable. Look ahead rather than down at your feet. Your peripheral vision is enough to monitor the ground in front of you, and keeping your head up helps with balance and prevents neck strain.
Keeping Your Crutches Safe to Use
The rubber tips at the bottom of each crutch (called ferrules) are the only thing between you and a slippery floor. Check them regularly for cracks, splits, or smooth spots. If the tread pattern is worn down or the rubber feels hard and glossy, replace them immediately. Replacement ferrules are inexpensive and available at most pharmacies or medical supply stores.
A few other practical points: avoid wet or polished floors when possible. If you can’t, shorten your stride and move more slowly. Keep the crutch tips about 4 to 6 inches out to the side of your foot rather than directly underneath you, which gives you a wider, more stable base. And check that all the adjustment pins or locks are fully engaged before each use. A crutch that telescopes under load is a fast path to a fall.
Why Elbow Crutches Over Underarm Crutches
If you’re wondering why you were given elbow crutches instead of the underarm (axillary) type, the reason is safety. Underarm crutches have been linked to artery compression and nerve damage in the armpit, a condition sometimes called crutch palsy. This risk led most of Europe to adopt forearm crutches almost exclusively decades ago, and they’ve become increasingly standard elsewhere for anyone who needs crutches for more than a few days. They’re lighter, less bulky, and let you use your hands without setting the crutches down, since the forearm cuff keeps them attached to your arms.