Crutch Walking and Crutch Gait Training

Crutches reduce loading on an injured or weakened lower limb by transferring force through the hands and upper extremities. That transfer is protective only when the device is fitted correctly, the patient has enough strength and balance, and the gait matches the prescribed weight-bearing order. The first thing an experienced nurse notices is not whether the patient can recite a gait pattern. It is whether the patient is safe before taking the first step. A patient who rests on the axillary pads, locks the elbows, or walks on a limb ordered to remain non-weight-bearing can be injured despite appearing confident. Sustained axillary pressure can injure the nerves and vessels that run through the armpit. Radial nerve injury ("crutch palsy") causes hand and wrist weakness or numbness, and chronic pressure on the axillary and brachial arteries can damage the vessel wall and send clots to the hand. The result may be hand tingling, weakness, impaired circulation, or a more serious neurovascular injury. Correct fit and hand-supported weight-bearing prevent that mechanism. The nurse should treat crutch walking as a supervised clinical skill...