An Overview of Crutches
by Madeleine Anderson
Everyone who has been confronted with a lower-extremity amputation has had to make decisions regarding mobility options. Many amputees opt for a prosthesis as their primary mode, wearing it (or them) full-time. Some prefer wearing their prosthesis part-time or for specific activities. In either scenario, the “must-have” equipment, the most important aid that a single-leg amputee could ever invest in, is a pair of appropriate crutches.
Crutches are an absolute necessity, especially for a single-leg amputee because they provide the most efficient means of transportation. Aside from the axilla crutches, which fit under the arm, the forearm, or “Canadian,” crutches have been most commonly used and are ergonomic in design. From among that general field of devices, many niche market products like Ed’s Legs®, One Crutch® and Walk Easy® have entered the market, and, in some cases, have already disappeared.
Crutches Have Evolved
Aside from the drugstore variety of crutches, typically made by Guardian® or Lumex® in North America, over the years vast arrays of European-designed crutches have appeared. They vary in style and size with open or hinged cuffs, shock absorbers, anatomically shaped hand grips and wide-based tips and pads. Today’s crutches are lighter in weight and free from the traditional “shake and rattle” alerting everyone of your arrival. There are also a fantastic variety of colors available.
Consider traveling with folding crutches in your suitcase, carry-on bag, backpack, or even strapped to your bicycle. Hopping is not safe, especially when you are older, and for some it is not even possible. Basic actions like going to the bathroom at night or walking around the pool or beach demonstrates that having a comfortable, reliable pair of crutches can make or break the trip. Even being able to walk in the sand with a prosthesis can be challenging at times. So, instead of having your prosthesis act as a liability or “limbibility,” a leg amputee’s best allies are crutches. The investment in a good pair of crutches will pay for itself in dividends for many years, and, in many cases, the purchase would be covered by insurance.
Not all crutches are created equal. The quality, design, materials and workmanship vary as widely as in any other manufacturing industry. Generally speaking, “you get what you pay for.”
Not all crutches are created equal. The quality, design, materials and workmanship vary as widely as in any other manufacturing industry. Generally speaking, “you get what you pay for.” Price is a good measuring stick to give an indication of quality. Standard crutches that some people buy at garage sales or thrift stores are definitely a cheap alternative, but most certainly do not have the features that customized crutches have. When you are an amputee, the requirements for crutches are vastly different than if you have a sprained ankle and only need crutches for a week or so. There are many examples of both on the market, and an educated, discerning consumer will quickly recognize the critical elements prior to making a decision to purchase. When in doubt, ask questions about materials, specifications and references.
The primary “pitfalls” of using under-arm crutches for long periods of time are many. No matter how conscientious you are, leaning with your whole weight on the crutch tops will result in peripheral nerve damage. They are also harder on the shoulders and inclined to make you hunch over, creating bad posture and sore backs. The type of grips on that style of crutch can eventually produce carpal tunnel syndrome. Sometimes this damage will not show up for years. In general, they are also much more awkward to use when navigating stairs or walking over uneven terrain. The forearm style of crutch enables the user to more easily go up and down stairs, curbs, logs or rocks.
Why Go Custom?
Why is a custom-fitted crutch important, especially for a full-time crutch user? In many cases they are the only means of mobility. Proper sizing of the overall length and proportions above and below the handle grips is critical. Accessories are important, too.
Especially after prolonged use, many individuals experience carpal tunnel syndrome in their palms, tendonitis in their elbows and bursitis in their shoulders. All of these conditions eventually turn into early osteoarthritis or a variety of other bone or tendon ailments. Prevention is the key goal here.
Several universities have attempted to create new products made from carbon composite materials used in prosthetic feet, pylons, struts, orthotic frames, etc. In most cases these were monolithic devices where, aside from cutting them shorter at the bottom end, no other adjustments were possible.
The expense involved in creating such designs made it prohibitive to sell them commercially. Crutches made from titanium tubing, however, have made some impact for the serious heavy-duty crutch user. Companies like Enabling Technologies and Thomas Fetterman produce several models of them. Currently, the international price of raw titanium has driven the price up significantly. These also are only available in custom sizes, cut and/ or welded to a specific user. However, they are extremely durable and with the right combination of cuffs, grips and tips, they are the “Rolls Royce” of crutches.
In the tip category, the choices are virtually limitless: round, square, big, small, flat, wide, narrow, cushioned, articulated, ice-worthy and more. Then there is the choice of colors! The primary thing to remember is whether the tubes will fit the inside of the tips you have chosen. Tube diameters come in inch sizes from a half inch to 1 inch. Sometimes a filler sleeve is required to match these properly. Winter tips, beach tips and suction tips are specialty items that also merit consideration depending on your local environment or your destination when on vacation.
The Bottom Line
If you are in the market for mobility products, there is no one-type-fits-all solution. Check out the Internet and, if you can, find a local facility to view and test some products prior to making your purchase. If this is not possible, ask around, check references and communicate with satisfied customers. An informed consumer is a wise purchaser. Try to select a provider or manufacturer that has been around for a while. Make sure that you can get expert advice from a professional, not just a sales person. Keep in mind that although the cost of mobility aids is often lower than a leg prosthesis, the importance of what they mean to you as the end consumer is no less important.
Once you have made your decision on which crutches to purchase, you can consider crutch clothes for those special occasions like weddings. You can also use them to spruce up an older pair of crutches to hide imperfections or to coordinate with your wardrobe, giving the impression that you have many pairs of crutches, like the shoes in your closet.
The main goal is to be kind to your body. Whatever your choice, make sure you are aware of the consequences of your decision and enjoy your particular mobility aid.
Erwin Kowsky GmbH & Co. KG
(Now brand of Medline Industries, Inc.)
(Now brand of Graham-Field Health Products)
Disclaimer: The following information is provided and owned by the Amputation Coalition of America and was previously published on the website http://www.amputee-coalition.org or the Coalitions Newsletter, inMotion.