Today I was watching my mother trying to get around the house a few days after having ankle surgery and she just looked awkward. Then I realised her shoulders were up by her ears and she looked like she was teetering on stilts. Upon asking her how she was going she reported ‘these things are not easy, I didn’t realise my balance was so bad’. Unfortunately my mother had assumed that the crutches that she was prescribed were also set up perfectly for her and she was having terrible trouble trying to mobilise.
There are many lower limb injuries and surgeries that require us to use crutches for short or long periods of time while our injuries heal. They are an important accessory for rehabilitation because they allow us to perform our normal activities of daily living without any weight going through the leg. After the injury has healed to a certain desired level you need to start putting weight through gradually, which we call partial weight-bearing, until you can put all of your weight through the leg and no longer need the crutches.
It is important during your time on crutches to have them the right height and use them correctly to ensure you do not overload your shoulders, fall off balance or slip causing a new injury or overuse in your shoulders. As you can see in photo 1, Mum’s shoulders are hitched and she is leaning forward on her crutches with her buttock back. This is because her crutches are too high.
In photo 2 we have moved the crutches down by 2 notches and you can see her shoulders are now more relaxed and she can stand upright in a normal posture. Once in this position it is important that she keeps her shoulder blades back and down to load through her back instead of the front of her shoulders. With the force going through the handles lower to the ground now she is also more stable and less likely to trip or slip.
And how did she feel? “Much better, more in control and I can handle them better. Plus they are easier on my arms’. So next time you are on crutches or see a friend who looks like they are really struggling, perhaps have a look at their crutches. Firstly make sure they are the same height as each other. Secondly, when looking side-on and standing in normal relaxed posture, the handle of the crutches should be at the height of your wrist. Keep the shoulders back and down as best you can.
If you need any more advice, including when it is an appropriate time to get physiotherapy treatment, then give us a call at Back In Action Physio.