Axillary Crutches Vs Forearm Crutches

Axillary Crutches vs. Forearm Crutches: Choosing the Right Support for You

Choosing the right crutches can significantly impact your comfort, mobility, and recovery process. Whether recovering from an injury, managing a chronic condition, or needing temporary assistance, understanding the differences between axillary crutches and forearm crutches is crucial. This comprehensive guide will delve into the features, benefits, and drawbacks of each type, helping you make an informed decision about which crutch best suits your individual needs. We'll cover everything from proper fitting and usage to potential risks and long-term considerations.

Introduction: Understanding the Differences

Both axillary crutches and forearm crutches provide support for ambulation, but they achieve this in fundamentally different ways. Axillary crutches utilize the underarm area for support, transferring weight through the armpits and hands. Forearm crutches, also known as lofstrand crutches, have a cuff that fits around the forearm, distributing weight more evenly across the arms and hands. This seemingly small difference leads to significant variations in comfort, stability, and potential for injury.

Axillary Crutches: The Traditional Approach

Axillary crutches have been a staple in mobility assistance for decades. They consist of a long shaft with an underarm support and hand grips. The user’s weight is distributed between the hands and the armpits, which can be both a strength and a weakness.

Advantages of Axillary Crutches:

• Cost-effectiveness: Axillary crutches are generally less expensive than forearm crutches. This makes them a readily accessible option for many individuals.
• Widely Available: They are easily found in most medical supply stores and pharmacies.
• Simplicity: Their straightforward design makes them relatively easy to understand and use, at least initially.

Disadvantages of Axillary Crutches:

• Risk of Nerve Damage: This is the most significant drawback. Placing weight on the armpits can compress nerves and blood vessels in the armpit, leading to crutch palsy (radial nerve palsy) or other nerve damage. This is especially true if the crutches are improperly fitted or if too much weight is placed on the armpits.
• Shoulder and Neck Pain: The weight distribution often leads to strain on the shoulders, neck, and upper back, causing pain and discomfort, especially during prolonged use.
• Poor Weight Distribution: The pressure point on the armpits makes it difficult to maintain proper posture and can contribute to fatigue.
• Limited Adjustability: While some models offer adjustable height, the overall adjustability is limited compared to forearm crutches.

Forearm Crutches: A More Ergonomic Approach

Forearm crutches, or lofstrand crutches, offer a more ergonomic alternative to axillary crutches. They feature a cuff that fits around the forearm, providing support and distributing weight more evenly across the arms and hands.

Advantages of Forearm Crutches:

• Reduced Risk of Nerve Damage: Because weight is not borne on the armpits, the risk of nerve damage is significantly reduced compared to axillary crutches. This is a major safety advantage.
• Improved Posture and Comfort: The forearm cuff allows for more natural posture and reduces strain on the shoulders, neck, and back, leading to improved comfort, especially during longer periods of use.
• Better Weight Distribution: Weight is distributed more evenly across the arms and hands, reducing fatigue and improving stability.
• Increased Mobility: The design allows for greater maneuverability and freedom of movement compared to axillary crutches.
• Improved Upper Body Strength: Because less weight is borne by the upper body, the user has more strength and energy to maintain balance.

Disadvantages of Forearm Crutches:

• Higher Cost: Forearm crutches are generally more expensive than axillary crutches.
• Fitting Requirements: Proper fitting is crucial for optimal comfort and effectiveness. Improperly fitted forearm crutches can be just as uncomfortable, and even less stable, than poorly fitted axillary crutches.
• Steeper Learning Curve: It might take some time to get used to using forearm crutches effectively.
• Limited Availability: They might not be as readily available as axillary crutches in some areas.

Choosing the Right Crutches: A Step-by-Step Guide

Choosing between axillary and forearm crutches depends on individual needs and preferences. Here’s a step-by-step guide to help you decide:

1. Consult a Medical Professional: Always consult a doctor, physical therapist, or other healthcare professional before selecting and using crutches. They can assess your specific needs and recommend the most appropriate type of crutch.
2. Consider Your Injury or Condition: The nature and severity of your injury or condition will influence the type of crutch suitable for you. For example, individuals recovering from shoulder injuries might find forearm crutches more comfortable, while those with wrist injuries might find axillary crutches more appropriate (although the risk of nerve damage must be carefully considered).
3. Proper Fitting: Whether you choose axillary or forearm crutches, proper fitting is crucial. Ill-fitting crutches can lead to discomfort, pain, and even injury. A healthcare professional can assist with fitting to ensure optimal support and comfort. For axillary crutches, the armpit support should be about two to three finger widths below the armpit. For forearm crutches, the cuff should be snug but not constricting, allowing for comfortable forearm movement. The hand grips should be at a height that allows for a slightly bent elbow when standing upright.
4. Consider Your Lifestyle: Your lifestyle and activity level will also influence your choice. If you anticipate needing crutches for an extended period, investing in comfortable and well-fitting forearm crutches may be a better long-term solution.
5. Trial Period: If possible, try both types of crutches to see which feels more comfortable and provides better stability. Pay attention to your body’s response to each type. Pain or discomfort are warning signs that you need to adjust or select a different type of crutch.

Proper Crutch Usage and Safety Precautions

Regardless of the type of crutches you choose, proper usage is essential for safety and comfort.

• Maintain Proper Posture: Keep your back straight and avoid leaning heavily on the crutches.
• Use the Correct Gait: Practice the correct gait pattern recommended by your healthcare professional.
• Inspect Crutches Regularly: Check for any signs of wear and tear, loose parts, or damage. Replace worn-out crutches immediately.
• Wear Proper Footwear: Wear sturdy shoes with good traction to prevent slips and falls.
• Be Aware of Your Surroundings: Be mindful of obstacles, uneven surfaces, and potential hazards.
• Take Breaks: Rest frequently to avoid fatigue.

Frequently Asked Questions (FAQ)

Q: Can I use axillary crutches for a long period?

A: While possible, it's generally not recommended. Prolonged use increases the risk of nerve damage and other complications. Forearm crutches are generally better for long-term use.

Q: Are forearm crutches suitable for all types of injuries?

A: No. Forearm crutches might not be suitable for people with certain wrist or forearm injuries. Always consult your healthcare provider.

Q: How often should I replace my crutches?

A: Crutches should be inspected regularly for wear and tear. Replace them if you notice any damage or weakness, typically every 1-2 years for regular use.

Q: Can I adjust the height of forearm crutches?

A: Yes, most forearm crutches offer adjustable height to ensure proper fit.

Q: Which type of crutch is better for climbing stairs?

A: Both types of crutches require specific techniques for climbing stairs. Your physical therapist will guide you on the appropriate technique for your chosen crutches.

Conclusion: Making the Right Choice for Optimal Mobility

Choosing between axillary and forearm crutches is a crucial decision that impacts comfort, mobility, and recovery. While axillary crutches offer affordability and accessibility, the risk of nerve damage and other complications makes them less ideal for long-term use. Forearm crutches, despite a higher cost, offer superior ergonomics, better weight distribution, and a significantly reduced risk of nerve damage, making them generally the preferred option for extended periods of crutch use. Always consult your doctor or physical therapist for personalized advice based on your individual needs and health condition. Remember, the right crutches can make a world of difference in your recovery journey. The goal is to choose the option that promotes safe and comfortable mobility, enabling you to regain your independence and overall well-being.