Tips for Using and Fitting Canes and Crutches
Note: The following guidelines are considered general, and as such, some situations may require subtle deviations from these guidelines. Please discuss with a doctor or physiotherapist for more information about using canes or crutches for specific condition.
Canes and crutches are some of the most common gait aids. They have applications with all age groups and can be used in a variety of ways to assist with certain conditions, but there are some general tips that are fairly applicable across the board. We will highlight these below, but we will also try to keep it brief, leaving you with the most important information. For more details or information about using gait aids for your particular condition, we encourage you to chat with a doctor or physiotherapist.
Axillary Crutches - When to Use Them
These are by far the most common types of crutches. They have the armpit pads, the wider upper portion with a horizontal bar for grip, and then narrow to a single point on the ground.
Crutches are usually used when a person cannot bear their full weight when standing under gravity. In this case, crutches can be used to offload some of that weight and can also provide some more stability.
Crutches and walkers are the only gait aids that you can use if you have a limb that needs to be completely offloaded. For example, if you have a broken or severely sprained ankle, or are recently post-op, and are considered to be of ‘non-weight-bearing’ status, then crutches will likely be the first option.
How to Fit Axillary Crutches
Forearm Crutches - When to Use Them
Forearm crutches are also relatively common, but not as common as axillary crutches. They are more slender and allow for more use of the hands, for example if you need to open a door, but they are a lot more difficult to learn, so they are usually reserved to people who will need them for a long time.
Children are often given forearm crutches because they can learn them so quickly, they allow them to get around faster than axillary crutches, and if they’re going to be using them for a long time they may as well have something more convenient.
Generally speaking, forearm crutches are much more difficult to learn and become natural with, so given that their advantages may take a little while to appear, they are usually reserved for long term conditions. For the short term, axillary crutches are often a better option.
How to Fit Forearm Crutches
Please follow the guidelines listed above for axillary crutches. There are only a couple additional points to consider, which we listed below.
Canes - When to Use One
While crutches can be really effective for unloading body weight without compromising stability too much, canes on the other hand are not meant to offload a lot of body weight. Generally speaking, canes have the ability to offload about 10-30% of body weight, but placing any more weight than that through the cane can be highly dangerous.
Canes cannot be used if you are told to be non-weight-bearing on one foot. Even if you use two canes in a similar manner to crutches, the design simply does not allow for total offloading of a limb, and are therefore best used in cases where you just need a bit of extra balance. They can increase the base of support in order to enhance balance, but a cane will also improve proprioception, which is the ability to detect all body part positions in space, which is similarly crucial for balance.
There are a variety of cane styles, but the most common are standard canes and quad canes, where quad canes simply have four “feet”, as opposed to one single point. A quad cane will offer more stability, but it’s a little bigger.
Overall, canes are great for those who need a little help with their balance, but otherwise have suitable muscle strength to allow them to get around. Also, given they don't offload too much bodyweight, they are more reliable for those who do not have an injury requiring off-loading. these factors combined make them popular options among older individuals who need a little extra balance support and confidence when getting around.
How to Fit a Cane
Performance and Safety Tips for Using a Cane or Crutches
All the information about the different gait aids is fairly general, but nevertheless, is often misunderstood. For example, most people would not realize that they should not place the armpit pads of axillary crutches directly under the armpits, even though this can save a lot of trouble in the long run. Additionally, our tips on how to fit a cane or crutches are also quite brief, but in reality, that information should really cover everything you need to know about fitting these devices.
If there is one take-away message from this article, it is that gait aids can be extremely helpful, but need to be fitted properly and used with caution. The latter point is especially important, as you may be completely confident in your ability to use a gait aid in a certain situation, but may be surprised when the situation changes unexpectedly. Just be careful, listen to advice from your doctor or physiotherapist, listen to your body, and you should be well on your way to mobility!