Crutch Maneuvering Techniques
Walking with crutches is not an inherent skill. Thus, techniques on ambulating with crutches should be taught to the patient. However, since each patient has different learning needs all patient education should be individualized.
Before teaching the client how to ambulate with crutches, the following things should be instructed to the patient:
P – Patient is instructed to wear a sturdy and well-fitting shoe
R – Rationalize the intervention of teaching the client to support his or her weight on the hand pieces not the axilla. The pressure of the crutch can damage the brachial plexus nerves producing “crutch paralysis.”
E – Explain and demonstrate to the patient the techniques on how to manipulate the crutches before the patient attempts to do so.
P – Prepare the client for maintaining balance by asking him or her to stand on the unaffected leg by a chair. Holding the patient near the waist or using a transfer belt would be helpful in promoting balance.
Techniques for Independent Crutch Walking or Ambulation
Before a patient can ambulate using crutches alone, he or she needs to be instructed first on the different techniques. The following instructions should be given to the patient.
- To sit down, grasp the crutches at the hand pieces. This is to promote control while mobilizing.
- Slightly bend forward while assuming a sitting position.
- To prevent weight-bearing and flexion, place the affected leg forward.
- With the string leg slightly under the chair, move towards the edge of the seat.
- Place both crutches in the hand on the side of the affected extremity.
- While raising the body to a standing position, push down on the hand piece.
Going DOWN the stairs
- Walk forward as much as possible on the step.
- Advance the crutches to the lower step, and then slowly advance the weaker leg first followed by the stronger one. Using this technique, the stronger extremity shares with the arms the work of raising and lowering body weight.
Going UP the stairs
- Step the strong leg first to the next step.
- Advance the crutches with the weaker extremity. An important reminder is to keep in mind that the strong leg is the one that goes up first and comes down last. Memory device to avoid confusion is to remember this phrase, “up with the good and down with the bad.”