How to Walk Safely with Crutches

Using Crutches to Walk

Caregiver helping a man with crutches.
Your physical therapist can help you learn to walk with crutches.. Jose Luis Pelaez Inc./Getty Images

After lower extremity injury - like a fracture - or after hip, knee or ankle surgery, your doctor may have you walk with crutches to help your leg heal properly. Walking with crutches may be done if you are under specific weight bearing precautions to help ensure that your leg is not damaged further while it is healing.

Your physical therapist can help you learn how to walk properly with crutches. He or she can ensure that your crutches are sized properly and that you are using the device properly.

There are six different way to use crutches to assist with ambulation, or walking. Each of these has advantages, disadvantages, and appropriate indications. Review the six patterns of crutch usage below to determine what the safest pattern is for you and your condition. Be sure to check in with your doctor before changing anything about your crutch walking or lower extremity rehab protocol.

Four-Point Crutch Gait

The four point crutch gait uses 2 crutches and both legs to offer maximum stability while walking.

  • Indication: Weakness in both legs or poor coordination.
  • Pattern Sequence: Left crutch, right foot, right crutch, left foot. Then repeat.
  • Advantages: Provides excellent stability as there are always three points in contact with the ground
  • Disadvantages: Slow walking speed

Three-Point Crutch Gait

If you are unable to bear weight on one leg, you may benefit most from using the three-point crutch gait. This allows you maximum mobility while maintaining maximum protection on your injured leg.

  • Indication: Inability to bear weight on one leg. (fractures, pain, amputations)
  • Pattern Sequence: First move both crutches and the weaker lower limb forward. Then bear all your weight down through the cruthes, and move the stronger or unaffected lower limb forward. Repeat.
  • Advantages: Eliminates all weight bearing on the affected leg.
  • Disadvantages: Good balance is required.

Two-Point Crutch Gait

Indication: Weakness in both legs or poor coordination.

Pattern Sequence: Left crutch and right foot together, then the right crutch and left foot together. Repeat.

Advantages: Faster than the four point date.

Disadvantages: Can be difficult to learn the pattern.

The two-point crutch gait may disrupt your normal walking pattern. When people walk, they typically swing their opposite arm and leg - as the left leg moves forward, your right arm swings forward. The two-point crutch gait patten alters this, and it may make returning to normal ambulation challenging once you no longer require the use of crutches for ambulation.

Swing-Through Crutch Gait

Most people who are non-weight bearing and using crutches use the swing-through crutch pattern.

Indications: Inability to fully bear weight on both legs. (fractures, pain, amputations)

Pattern Sequence: Advance both crutches forward then, while bearing all weight down through your hands on both crutches, swing both legs forward at the same time past the crutches. Land on your unaffected (strong) leg while holding your injured leg up in the air.

Advantage: Fastest gait pattern of all six.

Disadvantage: Energy consuming and requires good upper extremity strength.

Swing-To Crutch Gait

The swing-to pattern is often used when you are first learning to walk with crutches.

Indications: Patients with weakness of both lower extremities.

Pattern Sequence: Advance both crutches forward then, while bearing all weight down through your hands on both crutches, swing both legs forward at the same time right to (not past) the crutches.

Advantage: Easy to learn.

Disadvantage: Requires good upper extremity strength.

Tripod Crutch Gait

Indications: Initial pattern for patients with paraplegia learning to do swing-to gait pattern.

Pattern Sequence: Advance the left crutch, then the right crutch, then drag both legs to the crutches

Advantage: Provides good stability.

Disadvantage: Very energy consuming.

A tripod crutch gait pattern may be used more frequently with Lofstrand crutches.

Walking with One Crutch

To use one crutch, hold the crutch on your strong side. Your injured leg, or the leg that had surgery, should be opposite the crutch.

Indications: Used for weaning from 2 crutches and when starting to gain full weight bearing after surgery or injury.

Pattern Sequence: Advance your weak leg with the crutch on the opposite side. Place your weight through your hand on the crutch, and advance your strong leg.

Advantage: The crutch helps support your body weight with your injured or weak leg. Easy to learn.

Disadvantage: May may you slightly unstable, especially immediately after coming off partial weight bearing status.

Using crutches may simply be a temporary inconvenience, or they may be a permanent part of your everyday life. Learning to use crutches properly and to use the best type of pattern for you is important to simultaneously maximize your functional mobility and your safety.

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