By Dr. Haris, Board-Certified Medical Practitioner
Walking is no less than a challenge for people having chronic disabilities, injury or neuromuscular diseases affecting their legs. Forearm crutches can serve as a great equalizer for individuals grappling with these mobility challenges.
The unmatched stability, the self-confidence – forearm crutches have a lot more to offer than a simple cane or even trekking poles. However, given the array of options available out there, choosing the right crutches can be quite overwhelming.
We have compiled everything you need to know about the forearm crutches, how they differ from the traditional aids and what to consider while choosing one for yourself. Happy reading!
Health Conditions Compelling the Use of Mobility Aids
Crutches are medical devices designed to assist in ambulation by shifting the body weight from the legs to the upper torso. They are indicated in circumstances when the weight-bearing or balancing capabilities of the lower limbs are compromised but the person has sufficient upper body strength and coordination to support and move his body. [1]
Several medical conditions are there which affect the mobility of the legs. These may include;
- Muscle strains
- Orthopedic injuries, like sprains or leg fractures
- Joint disorders, e.g., arthritis where walking and movement of the joints are quite painful
- Neurological conditions, including cerebral palsy, paralysis, and multiple sclerosis
- Muscular dystrophies
- Balance disorders – etc
Doctors also advise the use of crutches during the post-surgery recovery period especially those involving the lower limbs and joints.
What are Forearm Crutches?
Also known as Lofstrand or elbow crutches, forearm crutches are mobility aids having a cuff which goes around your forearm while handles are there to grip with your hands.
Forearm crutches are often recommended to those who need long-term support for their walking disability. These crutches took the load off from the legs and shifted the body weight to the arms. It helps in relieving some pressure from your lower torso while allowing you to roam around independently.
Forearm Crutches vs. Traditional Underarm Crutches – Which one is better?
Generally, you will find two types of crutches in the market. One, we have just discussed, is forearm crutches. They are short, light-weight having a hand grip and elbow cuff for support. The second type is underarm crutches, also known as axillary crutches. They are longer and come with an axilla bar or you can say an underarm rest.
So, which one is better? Here is a comparison of the two types of crutches based on various characteristics.
Ø Level of Comfort
In comparison to an elbow crutch, the pivot point of underarm crutches is on average 62% higher, requiring more energy and effort to move the sticks while walking. Besides, being longer and more cumbersome, the person gets easily exhausted by using underarm crutches.
This is supported by the findings of a 2016 study, published in the American Journal of Engineering Research. It found that the percentage increase in heart rate was 20% higher in individuals walking with underarm crutches as compared to those who were using forearm crutches for ambulation. Researchers concluded that the elbow crutches were more suitable for the majority of the subjects.[2]
Ø Freedom of Movement
Forearm crutches also render a greater freedom of mobility to the users. Being short and light-weighted, they are easier to handle than the weighty axillary crutches, and therefore, allow you to easily move in different terrains, including the stairs.
Ø Risks of Compression Injuries
Forearm crutches have a larger and more padded area which distributes the weight more evenly to the upper body and forearms. Unlike axillary crutches, they exert less pressure on the underarm area where important neurovascular structures are present. That’s the reason why the majority of the studies have reported a higher incidence of arterial complications and compressive neuropathies, termed as crutch palsy, with the use of underarm crutches. [3]
Ø Body Posture
Forearm crutches allow for maintaining a more upright posture while walking. This not only prevents various posture-related problems like backaches but also allows better navigation through the obstacles with lower risks of falling.
Ø Balance and Stability
Talking about stability and equilibrium, underarm crutches have a superior hand. In a recently published cohort study, 90% of the participants subjectively reported a better learning curve, ease of ambulation, superior balance and stability with the use of axillary crutches. [4] This property warrants the use of underarm crutches for people suffering from balancing issues or having a weak upper torso, thus, requiring better support and equilibrium.
In short, both types of mobility aids have their unique benefits and characteristics. The right type of crutch depends upon the individual body’s needs and personal preferences.
Things to Consider While Choosing the Right Forearm Crutches
While buying the forearm crutches, you should consider the following factors;
Size Selection
Selecting the right size for your crutch is probably the most crucial thing when purchasing a mobility aid. The crutch length should be perfectly tailored to your height ensuring that the body weight is comfortably supported by the arms without putting strain on the shoulders. It shouldn’t be too short to stoop you over, or too long to impede your mobility.
However, if you want to do some crazy stuff like going on adventures, walking up or down hills, etc., buy those which offer the customization or adjustability option. Otherwise, the fixed ones are just fine to go with.
Material
Elbow crutches come in a variety of materials, i.e. aluminum, plastic, titanium, carbon fibre, etc. Which one to choose, mainly depends upon your pocket or the insurance plan you have. Those made of titanium and carbon fibre are strong, lightweight and have impressive shock-absorbing properties – that’s why they will cost you more. However, if you are running low on budget, you can buy inexpensive ones made of aluminum or steel.
Tips
If you really want to put money, invest in the tips of the crutches. A high-quality pair with extra cushioning, wet-slip resistance and shock-absorbing features will render you a mountain-goat footing which will not only reduce the risks of fatigue or injury but also make walking comfy for you. The Fetterman crutch tip technology is the industry standard in this regard.
Cuff
Regarding the cuffs, you will be scratching your head for the size, opening and material selection. The cuffs should be comfortably fitting to your forearm. As far as the cuff material is concerned, it’s totally up to you. You can choose the inexpensive vinyl-coated stuff or the custom-molded plastic with leather padding.
Talking about the cuff opening, several options are there, i.e. 3/4, front and side ones. 3/4 are usually not recommended as they don’t provide enough support. Front openers are good for stealthiness and more side-to-side stability; however, side openers are preferred for daily use as they won’t slip with lifting the arms.
Hand Grip
Lastly, the grips! The standard narrow grips put the entire load on the pressure points between your thumb and forefinger, which eventually becomes painful even if the grips are padded. Therefore, hand grips with flat and wider bases are recommended as they distribute the weight more effectively to the heels of your palms.
Forearm Crutches are not for you!
You might have figured out now that using forearm crutches requires strong wrist and arm stability along with good upper-body strength. So, they are not recommended if you have an arm or wrist injury, lack upper body strength, or are suffering from a condition which requires full-weight-bearing support as in the case of severe leg injury and surgery. Besides, forearm crutches will also not be a great fit for people having balance problems. Axillary crutches will be a better choice in these circumstances.
Bottom Line
Forearm crutches can be a great equalizer for individuals having leg-related mobility issues, offering stability, freedom of movement and better weight distribution. However, you need good upper body strength to use these aids. For choosing the right forearm crutches tailored to your individual needs, careful consideration of size, material, cuffs, tips, and hand grips is vital. Seek advice from your doctor while selecting mobility aids to have the most comfy experience.
Other articles written by Dr. Haris:
References
- Warees, W.M., L. Clayton, and M. Slane, Crutches, in StatPearls [Internet]. 2022, StatPearls Publishing.
- Miski, A., Design Evaluation of crutches from an engineering perspective. American Journal of Engineering Reseach (AJER), 2016. 5(9): p. 33-38.
- Manocha, R.H., et al., Injuries associated with crutch use: a narrative review. PM&R, 2021. 13(10): p. 1176-1192.
- Yap, W., Z. Hairodin, and E. Kwek, Axillary versus forearm crutches: A prospective cohort comparing which is superior for 3-point crutch gait. Malaysian Orthopaedic Journal, 2021. 15(2): p. 36.
