When Are Crutches Prescribed?

Your podiatrist may prescribe crutches after:

  • Foot or ankle surgery requiring non-weight-bearing or partial weight-bearing recovery
  • Fractures of the foot, ankle, metatarsals, or toe bones
  • Severe ankle sprains requiring protected rest
  • Tendon repairs (Achilles, peroneal tendons)
  • Significant wounds or ulcers requiring complete offloading

Your weight-bearing status will be specified as part of your post-operative or injury instructions:

  • Non-weight-bearing (NWB) — the affected foot must not touch the ground at all
  • Touch-down weight-bearing (TDWB) — the foot may rest lightly on the ground for balance only, with no significant load through it
  • Partial weight-bearing (PWB) — some weight through the foot is permitted, typically 25%–50% of body weight as directed

Follow your prescribed weight-bearing status precisely. Putting too much weight through a healing bone or surgical repair can cause it to fail.

Proper Crutch Fitting

An improperly fitted crutch is uncomfortable, inefficient, and potentially dangerous. Take the time to fit your crutches correctly before you use them.

Axillary Pad Height

Stand upright with the crutch tips placed approximately 6 inches (15 cm) in front of and 6 inches to the side of each foot. The axillary pad (the top padded piece that fits under your arm) should sit 2–3 finger-widths (about 1.5 inches) below your armpit. If the pad is touching your armpit, the crutch is too tall.

Axillary nerve palsy warning: Never lean your body weight directly onto the axillary pad under your armpit. The axillary nerve and brachial plexus pass through this area, and sustained pressure causes "crutch palsy" — numbness, tingling, and weakness in the arm and hand. All your weight must be supported through your hands and wrists, not through your armpits.

Handgrip Position

With the crutch tip on the floor and the axillary pad correctly positioned, your elbow should be bent approximately 15–30 degrees when your hand is on the grip. Your wrist should be straight. If your arm is fully straight or your elbow is bent more than 30 degrees, adjust the handgrip height.

A quick check: stand with arms relaxed at your sides. The handgrip should align with your wrist crease.

Crutch Tips and Padding

Inspect the rubber tips on the bottom of your crutches before each use. Worn, cracked, or missing tips significantly increase the risk of slipping. Replace them at a pharmacy or medical supply store if worn. Add extra padding to the handgrips if your palms become sore — padded gloves or foam wrap can help.

How to Walk on Crutches

Non-Weight-Bearing Gait (Three-Point Gait)

This is the standard walking pattern when no weight is allowed through the affected foot.

  1. Stand upright with both crutches slightly in front of you. Keep your weight on your good leg. Hold the affected foot up — slightly bent at the knee — so it does not contact the floor.
  2. Swing the crutches forward together, about one comfortable step-length ahead of you. Do not reach too far forward; shorter, controlled steps are safer.
  3. Transfer your weight to your hands by pressing down firmly on the handgrips — not the axillary pads. Your elbows should straighten slightly as you push down.
  4. Swing your good leg forward, landing it between or just past the crutch tips.
  5. Repeat. The rhythm is: crutches forward → swing through → land on good leg.

Keep your head up and look forward — not down at your feet. Looking forward helps you maintain balance and scan for obstacles.

Partial Weight-Bearing Gait

When your doctor clears you for partial weight-bearing, you may gently place the affected foot on the ground during your swing-through, taking only the prescribed portion of your body weight through it. Move the crutches and affected foot forward together, then step through with the good leg. The rhythm is similar to three-point gait but with light foot contact on the affected side.

How to Navigate Stairs

Stairs require special technique. The rule to remember is: "Up with the good, down with the bad."

Going Up Stairs

  1. Position yourself at the bottom of the stairs. Hold both crutches on the same side as your affected foot (or hold onto the railing with one hand and tuck both crutches under the opposite arm if a railing is available).
  2. Step up with your good (uninjured) leg first, onto the first step.
  3. Bring the crutches and your affected foot up to meet the same step.
  4. Repeat — good leg leads up each step.

Going Down Stairs

  1. Position yourself at the top of the stairs.
  2. Move the crutches and your affected (bad) foot down to the next step first.
  3. Follow with your good leg, stepping down to meet them on the same step.
  4. Repeat — affected foot and crutches lead down each step.
Whenever possible, use the stair railing for stability. If the railing is on your affected side, hold it with one hand and tuck both crutches under your other arm. Take stairs slowly — there is no rush.

Sitting Down and Standing Up

To Sit Down

  1. Back up to the chair until you feel its edge against the back of your good leg.
  2. Hold both crutches in one hand on your affected side. Reach back with your other hand to grip the armrest or seat.
  3. Lower yourself slowly onto the seat, keeping the affected foot forward and off the floor.

To Stand Up

  1. Move forward to the edge of the seat.
  2. Hold both crutches in one hand on the affected side, gripping the handgrips together.
  3. Push up from the armrest with your other hand and your good leg.
  4. Once standing and balanced, position each crutch under the appropriate arm before moving.

Do not use the crutch handgrips as your only support when standing from a low chair — they are not designed to bear the sudden upward load without the crutches properly positioned on the floor.

Safety Tips

  • Slippery surfaces: Be extremely cautious on wet floors, ice, loose rugs, and polished tile. Take very short steps and slow down significantly. Consider rubber-soled footwear or crutch tip covers designed for wet conditions.
  • Narrow spaces: Turn by pivoting on your good foot in small increments rather than stepping sideways.
  • Carrying items: You cannot carry objects in your hands while on crutches. Use a backpack, fanny pack, or bag with a long strap across your body. Avoid holding a cup of liquid.
  • Fatigue: Crutch walking uses significant upper body energy. Rest frequently. Fatigue leads to accidents.
  • Clothing: Wear sturdy, flat-soled footwear on your good foot. Avoid flip-flops, sandals, or shoes with slick soles. Keep long robes or loose pants from dragging on the floor.
  • Pets and children: Use extra caution around pets or small children who may move unpredictably underfoot.
  • Door thresholds and uneven surfaces: Pause and look before crossing doorway thresholds, transitions between floor types, or slightly raised surfaces.

When to Call Our Office

Contact Big Sky Foot & Ankle if you experience:

  • Pain in the healing foot or ankle that is increasing — especially after a misstep or fall
  • Numbness, tingling, or weakness in your hand or arm (possible axillary nerve compression — adjust your crutch fit immediately)
  • Skin breakdown, sores, or blisters under the arms or on the hands
  • Increased swelling, redness, or warmth in the surgical or injured area
  • Any fall resulting in impact to the healing foot or ankle

If you are struggling significantly with crutch mobility or live alone, ask your care team about alternatives such as a knee scooter or hands-free crutch (iWALK), which some patients find more practical depending on the location of their injury.