Crutches are essential mobility aids for individuals enduring lower limb injuries or surgeries. Choosing the right set of crutches is crucial for successful rehabilitation, comfort, and preserving energy. Users typically have two options when selecting crutches – forearm (or ‘elbow’) crutches and underarm (or ‘axillary’) crutches.
Both types have their pros and cons, and this comprehensive guide is intended to help you understand the contrast between them and make the right choice according to your needs. Since your mobility and successful recovery depend heavily on the crutches you choose, it’s critical to understand the functions, advantages, and disadvantages of each crutch type as well as the considerations relevant to your specific situation.
I. Understanding Forearm vs. Underarm Crutches
Forearm Crutches
Forearm crutches are known by several names such as elbow crutches, Canadian crutches, or Lofstrand crutches. Their design includes a cuff that fits around the forearm, securing the crutch to the user, and a handgrip positioned at a comfortable height for gripping and carrying the body’s weight.
The forearm crutch is often made of lightweight materials like aluminum, making it easier to maneuver. They are more ubiquitous in European countries but have gained popularity worldwide due to their ergonomic design that lessens stress on the wrists and hands.
Forearm crutches generally provide greater mobility due to their lighter weight and require a bit more upper body strength and coordination to use than underarm crutches.
Underarm Crutches
On the other hand, underarm crutches, also known as axillary crutches, are more commonly seen in the United States. They are constructed with a padded top that fits under the armpit and a handgrip for holding and moving forward.
Underarm crutches are beneficial for users who do not have a good sense of balance or those who need significant weight-bearing support. They are commonly used for temporary injuries and are easier for beginners to adjust to due to their straightforward design.
But a crucial factor to remember with underarm crutches is that the weight-bearing occurs mainly in the underarm area, and improper use could potentially lead to nerve damage. Hence, it is not the most suitable choice for long-term use.
II. Advantages of Forearm Crutches
While both forearm and underarm crutches serve the noble purpose of support and mobility, they each come with their unique benefits.
Improved Posture and Support
Forearm crutches significantly contribute to maintaining proper posture while walking due to their design. By placing your weight through your forearms or hands, the spine remains erect instead of being hunched over as often seen in underarm crutch users.
Greater Ease of Navigation
Forearm crutches are designed to provide better control which, in turn, makes navigation easier in tight spaces and on stairs, both up and down. Their shorter and more compact design allows for quick changes in direction and maneuverability.
Better Weight Distribution
One of the most considerable advantages of forearm crutches is the improved weight distribution when compared to underarm crutches. As users bear the weight through their hands and forearms rather than their underarms, forearm crutches eliminate the possibility of axillary nerve damage, a common issue with underarm crutches.
Forearm crutches, in essence, offer better stability, control, and strength to the user. They are most effective for individuals who need a walking aid for a prolonged period and can develop the strength and coordination needed to use them effectively.
Remember, the choice among forearm vs. underarm crutches is more about individual needs, comfort, and lifestyle rather than a standard answer based on factors such as appearance or popularity. Both types are instrumental in different scenarios catering to diverse needs and should be selected under the guidance of a healthcare professional to ensure the ideal match with the user’s specific situation.
III. Disadvantages of Forearm Crutches
Though forearm crutches provide several benefits, they are not without a few drawbacks. Recognizing these cons allows users to make an informed decision based on their unique situation and needs.
Increased Demand on Upper Body Strength
Forearm crutches require more upper body strength than their underarm counterparts. Moving with these crutches involves actively utilizing the arms, shoulders, and torso to support the body’s weight and propel it forward. While this builds muscle and improves coordination over time, it can initially be quite challenging — especially for those with limited arm strength or long-term disability.
More Difficult to Master
Using forearm crutches effectively involves a steeper learning curve compared to underarm crutches. Forearm crutches require more balance and control to use safely and efficiently — skills that often take time and practice to learn.
Potential Wrist and Hand Discomfort
The design of forearm crutches places a significant amount of pressure on the hands and wrists, potentially leading to discomfort or even injuries such as carpal tunnel syndrome. However, with the right fit, padding, and usage, this risk can significantly reduce, and the forearm crutches can provide an effective and comfortable mobility aid.
IV. Advantages of Underarm Crutches
While underarm crutches — or axillary crutches — have a few disadvantages, they provide several benefits that make them a popular choice for temporary support or those without strong upper body strength.
Ease of Use for Beginners
Underarm crutches are intuitive and straightforward to use, which makes them a common choice for first-time crutch users. They provide stability and support for walking without demanding too much from the upper body, making them accessible for nearly anyone.
Lower Demand on Upper Body Strength
As they allow the user’s body weight to rest significantly on the underarm padding, underarm crutches require less upper body strength than forearm crutches. This design makes them particularly appropriate for patients recovering from sudden injuries or surgeries who may not have the time or capability to build sufficient upper body strength quickly.
General Affordability and Availability
Underarm crutches are typically less expensive than forearm crutches, making them more accessible for many individuals. Plus, being the most common type of crutch used, they are readily available in pharmacies, medical supply stores, and online.
V. Disadvantages of Underarm Crutches
While underarm crutches are beneficial in many respects, understanding their limitations can help potential users make an informed decision.
Potential for Underarm Nerve Damage
Perhaps the most significant disadvantage of using underarm crutches is the potential for underarm nerve damage. Extended pressure on the axillary nerve located in the underarm can lead to damage and result in numbness, tingling, or reduced mobility in the arm or hand. To alleviate this, it’s paramount to ensure proper padding, fitting, and technique when using underarm crutches.
Issues with Navigation
Underarm crutches can be awkward and inconvenient to use in tight spaces. Their longer design makes turning and moving through narrow areas challenging, requiring more effort and practice. They’re also more difficult to use on stairs than forearm crutches, which are generally more agile and adaptable.
Bad Long-Term Posture
While effective for short-term use, underarm crutches are not the best choice for long-term use. They often promote a “hunched” posture, which puts strain on the neck, back, and wrists during extended use. It’s important to consider this factor if you anticipate using crutches for an extended period.
While both types of crutches have their unique set of pros and cons, the key to choosing the right one lies in understanding your specific needs, comfort, health status, and recovery goals. Consulting with healthcare professionals will provide the best guidance, helping you make the right selection.
VI. Tips for Adjusting to Your Chosen Crutches
Getting comfortable with your selected crutches, be it forearm or underarm, is vital for a successful healing period and increased mobility. Here’s a set of tips designed to help you adapt to your crutches:
Proper Adjustment of Crutch Height and Handgrip
For both crutch types, the correct fit is key to avoid discomfort and potential injury. In standing position, the top of the underarm crutches should be 1-2 inches below the armpit, and forearm crutch cuffs should be 1-1.5 inches below the bend of the elbow. The handgrips should be positioned at wrist height, allowing for a slight bend in the elbow when standing upright. If your crutches are not adjustable, consult a professional to help with choosing the correct size.
The Necessity of Proper Padding and Hand Care
Many crutch users might initially find the pressure and friction of the handgrips challenging. To prevent this, invest in quality padding for the crutch handles. Furthermore, care for your hands is key. Shea butter or another thick moisturizer can help keep the skin on your hands from cracking due to increased usage.
VII. Techniques for Walking, Stairs, and Navigating Obstacles
Remember that walking with crutches will initially feel slow and may be difficult. Patience and constant practice are key to developing the rhythm necessary for crutch walking. When you’re starting, let the injured foot touch the ground slightly for balance, but avoid putting weight on it.
Climbing stairs with crutches is also challenging and requires extra care. The best policy is “up with the good (leg), down with the bad (leg).” When starting upstairs, step up with your non-injured leg first, then bring the crutches and injured leg. When heading downstairs, lead with your crutches and injured leg, then step down with the non-injured leg. If there’s a sturdy handrail, you can use that for additional support while carrying the crutches in the other hand.
Navigating uneven ground needs caution. Remember to move slowly and pay attention to the placement of crutches. Seek assistance when necessary and don’t rush yourself.
VIII. Forearm vs. Underarm Crutches: Seeking Professional Guidance
Even with these tips, there’s a significant amount of nuance to using crutches, and improper use can result in discomfort or, worse, injury. That’s why consulting with a healthcare provider for personalized advice is utmost importance:
Personalized Advice from Healthcare Providers
Your treating physician or physical therapist should provide you with initial guidance on crutch usage, considering your unique situation. They’ll take into account your injury, your mobility, strength and balance levels, healing process, and your personal circumstances such as home layout and lifestyle.
Consulting Physical Therapists for Crutch Training
Physical therapists excel at crutch training. They are skilled at demonstrating and teaching how to use crutches safely and efficiently, both for walking and for navigating common obstacles like curbs, stairs, and uneven surfaces. If you feel uncomfortable with your crutches or experience pain or difficulty walking, don’t hesitate to consult a physical therapist.
You can also find support at local community health organizations or support groups for people dealing with similar mobility challenges. These can be a source of mastery tips on crutch usage, coping strategies, and emotional support.
Using crutches significantly alters your daily routine and mobility. But, with patience, professional guidance, training, and the right selection to suit your needs, they can remarkably assist in independence and contribute significantly to the healing process.
IX. Choosing Crutch Accessories for Enhanced Comfort and Frustration-Free Mobility
After selecting the right crutches for you, it’s helpful to think about accessories that can elevate the experience and enhance your mobility. High-quality crutch accessories can reduce discomfort, increase convenience, and improve your overall satisfaction with using crutches. Here are several essential crutch accessories and their benefits:
Forearm vs. Underarm Crutches: Crutch Pads for Comfort
Crutch pads play a significant role in providing comfort and support while using crutches, consequently minimizing the risk of calluses or blisters. It can be easily added to underarm crutches to ensure adequate padding for the armpits and protect nerves in the area. Forearm crutch users can also find cuff cover pads to add a cushioning layer between the cuff and forearm. When selecting crutch pads, prioritize softness, quality materials, durability, and easy cleaning.
Forearm vs. Underarm Crutches: Grips and Grip Covers
Crutch grip covers can be crucial for those experiencing soreness, blisters, or discomfort from the pressure on the hands. Look for grip covers made from materials with excellent shock absorption properties, such as gel or memory foam. Grip covers should be easy to install, clean, and durable.
Forearm vs. Underarm Crutches:
Crutch Tips for Traction
Safety is a top priority for crutch users. Investing in high-quality, non-slip crutch tips for your walking aids can provide better stability and balance on various surfaces, reducing the risk of unwanted slips and falls. Pick tips made of nonslip rubber, with a tread design for added grip. It’s also essential that the tip size matches your crutches. If you find yourself navigating muddy, snowy, or icy surfaces, exploring specialized ice grips and tips can be valuable.
Forearm vs. Underarm Crutches:
Crutch Bags and Pouches
Handling everyday essentials like phones, keys, or wallets can become challenging while using crutches. Crutch bags and pouches are practical accessories designed to remedy this inconvenience. Look for a crutch bag that can be easily fixed to your crutches and hold essential items securely. It should be lightweight, easy to access, and, ideally, made from a material that provides weather resistance.
Forearm vs. Underarm Crutches:
Reflective Safety Patches
Reflective safety patches can be a crucial add-on to your crutches for those who frequently use crutches during nighttime hours or in low visibility situations. These easy-to-apply patches increase your visibility to passing vehicles, cyclists, or pedestrians and minimize the possibility of accidents.
Forearm vs. Underarm Crutches:
Hands-Free Crutch Accessories
Hands-free crutch accessories, such as water bottle holders or umbrella mounts, offer practical solutions for managing common tasks while using crutches. Staying hydrated and keeping dry become significantly more manageable with these devices.
X. Forearm vs. Underarm Crutches:
Hand Hygiene Solutions
Since your hands will be in frequent contact with crutch handles, cleanliness is vital. Convenient pocket-sized hand sanitizers are essential to keep your hands clean regularly, and sanitizing wipes are perfect for giving your crutch handles a quick, thorough clean.
Before selecting any of these accessories, do thorough research about their compatibility with your crutch type and personal needs. Consulting with healthcare professionals can also be helpful for recommendations.
While using crutches can be frustrating at times, investing in well-designed and functional accessories can ultimately make the experience less stressful and more comfortable. By prioritizing comfort, convenience, and safety, you can maximize your mobility during the healing process and make the journey to recovery smoother and more enjoyable.
Also read
Unlock Mobility: Exploring Bariatric Crutches for the Modern World
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