When recovering from a lower-body injury that permits partial weight bearing, using a single crutch offers support and improves mobility. This technique is often used in the later stages of recovery, such as after a minor ankle sprain or during post-surgical rehabilitation, when transitioning from two crutches. Proper application of the single crutch method maintains stability, ensures correct body alignment, and helps prevent re-injury. Using this aid reduces stress on the affected limb and encourages a more natural walking pattern.
Proper Sizing and Positioning of the Crutch
Correct adjustment of the crutch height ensures safe and comfortable use. To find the right length, stand upright with the arm relaxed at your side while wearing the shoes you use most often. The top of the handgrip should align with the crease of your wrist, allowing for a 15 to 30-degree bend in the elbow when gripping it. This angle provides optimal leverage for transferring weight efficiently through the hands.
The overall height of the crutch should be set so that the top pad rests approximately one to two inches below your armpit, allowing two to three finger-widths of space. This gap is necessary because the armpit is intended for balance only, not for bearing the body’s weight. Putting pressure directly on the armpit can compress nerves and blood vessels, potentially leading to nerve damage or discomfort in the arm.
The single crutch must always be held in the hand on the side of your uninjured leg. Placing the crutch opposite the affected limb mimics the natural cross-body motion of a typical human gait. This positioning provides a stable base of support precisely when the injured leg is bearing weight, reducing the load on the affected side and promoting an upright posture.
Walking Mechanics on Level Ground
The walking sequence with a single crutch follows a three-point gait pattern designed to shift the body’s center of gravity away from the injured area. Begin by simultaneously moving the crutch and the injured foot forward about one foot’s length. The crutch, held on the uninjured side, should be positioned slightly to the side to create a wide, stable base.
As you prepare to step, gently bear weight through the crutch’s handgrip and the foot of the injured leg, depending on your prescribed weight-bearing limit. All weight must be directed through the hand and down the shaft of the crutch, completely bypassing the armpit pad. This support takes the load off the healing limb.
Swing the uninjured leg forward, stepping past the crutch and the injured foot. This movement establishes the next stable point and encourages smooth, forward momentum, preventing an uneven or exaggerated limp. Aim for a rhythm that keeps your weight centered and your body balanced over the tripod formed by the uninjured foot and the crutch base.
Perform the sequence with a steady, controlled pace, focusing on maintaining an upright posture without leaning excessively to one side. Coordinating the crutch and the injured leg together effectively creates a balanced, three-point support system during each step. This technique allows for the continuous transfer of weight, minimizing the time the injured leg must bear load independently.
Techniques for Stairs and Seating
Navigating vertical changes like stairs presents a greater risk of falling and requires a specific, controlled approach. When ascending stairs, always lead with the uninjured leg, remembered as, “Up with the good.” The uninjured leg steps up first, followed by the crutch and the injured leg moving up to meet it on the same step.
When descending stairs, the sequence is reversed, leading with the crutch and the injured leg, summarized as, “Down with the bad.” The crutch is placed on the step below, followed by the injured foot, which bears minimal weight. The uninjured leg then steps down to the same level, taking the full body weight to stabilize the position before proceeding.
If a sturdy handrail is available, use it, holding the crutch in the opposite hand. For both sitting and standing, back up to the chair until the uninjured leg touches the seat, ensuring the chair is stable and will not roll or slide. Hold the crutch by the handgrip in the hand opposite the injured leg, and use the other hand to find the seat or armrest.
Push the injured leg forward, use the crutch and the chair for support, and slowly lower yourself onto the seat. To stand up, reverse the action by pushing off the chair and the crutch simultaneously, using the strength of the uninjured leg to rise. Maintain a firm grip and ensure you have full balance before attempting to walk away.
Essential Safety Guidelines
Maintaining the crutch and preparing your environment prevent accidents. Regularly inspect the rubber tip, or ferrule, at the base of the crutch for signs of wear, as a worn tip significantly reduces traction and increases the risk of slipping. Always wear flat, supportive shoes with non-slip soles, since high heels or loose-fitting slippers impair balance and stability.
Avoid walking on slick surfaces such as wet floors, ice, or loose rugs, which can easily catch the crutch tip and cause a fall. Clear pathways of electrical cords, loose clutter, and small obstacles. When carrying items, use a backpack or a shoulder bag to keep both hands free, as the hand holding the crutch is responsible for bearing weight and maintaining balance.
If you experience tingling, numbness, or pain in your hands or underarms, the crutch sizing is incorrect or you are improperly leaning on the armpit pads. Adjust the crutch immediately to ensure weight is transferred solely through the handgrips. If pain or instability persists, seek advice from a physical therapist or healthcare professional.