Basic guidelines for the use of crutches

Basic guidelines for the use of crutches

You should always get advice from a healthcare professional before choosing or using crutches. Crutches are designed to be used in pairs and you need good co-ordination to use them correctly (Ainslie 2012). Occasionally one crutch is used on its own, but this should only be done under the guidance of a physiotherapist.

Types of crutches

Elbow crutches
These are the most common type of crutch and may be single or double adjustable. Both floor-to-handgrip height and the distance between the cuff and the handgrip are adjustable on double adjustable elbow crutches. Single adjustable elbow crutches allow floor-to-handgrip height adjustment only. Standard and anatomically moulded handgrips are available.

Elbow crutches are available with two styles of cuff: open or closed. An open cuff is semi-circular in shape and provides a support to brace the forearm against in the step-through phase of walking. A closed cuff is an incomplete ring which prevents the forearm slipping forwards out of place and holds the crutch on the arm if, for example, you need to take your hand off the crutch to open a door.

Axilla or underarm crutches
These have a single or double shaft, the height and the distance between the handgrip and the axilla pad are adjustable.

If you are using axilla crutches, do not lean on the underarm pad as this may interrupt the blood flow and put pressure on important nerves that run through the armpit. The handgrips should be positioned so that the elbows are slightly flexed.

Forearm crutches with gutter armrest
These are designed for people who need to weight bear through the length of their forearm rather than their hand and wrist, for example those who experience pain in their hands. The height of these can be adjusted and they have a trough or gutter armrest that supports and spreads the user's weight through his/her forearms. The length and angle of the handgrip can also usually be adjusted.

Some crutches can have contoured handles, shaped to follow the contours of the hand and spreading the pressure over a wider area of the palm, for more comfortable use. A gel handgrip can also help to improve comfort.

Elbow crutches can be supplied with gutter armrests. These allow people to bear weight through their forearms rather than through their hands. They have padded, vinyl covered, trough-shaped supports with vertical handgrips. The length and angle of some handgrips can be adjusted to achieve the most comfortable position.


Most crutches are made of metal, either aluminium or steel-reinforced aluminium for heavy-duty use. You may find some underarm crutches are still made of wood. Some metal crutches can have a coloured paint finish. All crutches must be fitted with an appropriate ferrule. The ferrules of metal crutches must incorporate a metal ring to prevent the base of the crutch cutting into the rubber of the ferrule.

The correct height for crutches

Crutches must be at the correct height for use. Both axilla and elbow crutches usually have two adjustment points.

The overall height of axilla crutches can be adjusted. This should be measured by standing upright in appropriate and supportive footwear. The underarm pad should fit under the armpit with two finger widths of space above to ensure no pressure is applied through the armpit when the crutches are being used.

The handgrip adjusts along the upright side of the crutches and should be set at a height level with the protruding bone at the side of the wrist.

The overall height of elbow crutches can be adjusted. This is measured by lining up the handgrips with the wrist bone. Some elbow crutches also have an adjustment for the elbow cuff, which should cradle the forearm just below the elbow joint so that movement of the elbow is not impeded.

Advice last checked: 26 January 2018 Next check due: 26 January 2021

All advice is either supported by references (cited in the text) or is based upon peer reviewed professional opinion. Our advice is impartial and not influenced by sponsors or product suppliers listed on the site.
Conflict of interest statement