Crutches are often seen as the in-between mobility aid, providing greater stability than a walking cane yet not being as restrictive as a medical walker. A crutch, however, as with any mobility aid should be used when the situation demands it as each type of device has distinctive pros and cons. It is ideally suited for the patient with weakness of one or both legs, who need greater support than that offered by a walking cane but the ability to move around quicker and with a greater degree of flexibility than is the case with a medical walker. For the elderly, it has a wide range of indications provided that a person has a significant degree of upper body stability.
It is important to understand the function of a crutch to differentiate between the two major types. Crutches bear the weight of the body when walking. It can therefore also reduce pressure on the legs which can aggravate pain even in the absence of muscle weakness. It should, however, by the nature of its design not be used for supporting the body weight when standing for long periods of time.There are broadly two types of crutches – one where most of the body weight is transferred to the crutch via the armpits and the other where this is achieved mainly through the forearm. These crutches are known as axillary and nonaxillary crutches respectively.
These crutches rest under the arm (armpit ~ axilla), hence the name axillary crutches or underarm crutches. The body weight is transferred from the armpit to the floor and in this manner it can bear up to 80% of the body weight. The hands should grasp on the handles during walking but can be freed momentarily when standing, only if the hands need to be used and the entire body weight will not be rested on a single crutch during this time. It is more restrictive than nonaxillary crutches but does not require the same upper body strength and stability as nonaxillary crutches. However, users need to be aware of the dangers of using these crutches as ongoing pressure on the armpit area can cause compression of the nerves running through it. Therefore, crutch users are discouraged from resting their entire weight on the crutch for long periods like when standing.
These crutches transfer the body weight through the foream and down to the floor. It is essentially a cane with a handle along its length, rather than at the top as is seen with a traditional walking stick. It may have a forearm cuff at the top which provides greater support. Nonaxillary crutches are suited for a person who needs slightly greater support than a walking cane. It is able to transfer up to 50% of the body weight down to the floor. The most popular type of nonaxillary crutch is the Lofstrand crutch, which is lightweight yet strong and durable. However, nonaxillary crutches require the user to have good upper body strength and stability. There are several other types of nonaxillary crutches each designed fo specific needs. This includes the wooden forearm crutch, platform forearm orthosis and triceps weakness orthosis.