CRUTCH WALKING

Sheila Maria G. Batoon

 WHY EARLY MOBILITY OF PATIENT
IS TO BE ENCOURAGED?
- TO AVOID COMPLICATIONS OF
PROLONGED BED REST
- TO PROMOTE HEALING
- TO LESSEN THE NEED FOR HOSPITAL
STAY
 MEASUREMENT OF CRUTCHES

• CRUTCH PAD DISTANCE FROM ARMPITS:

THE CRUTCH PADS (TOPS OF CRUTCHES) SHOULD BE
1½" TO 2" (ABOUT TWO FINGER WIDTHS) BELOW
THE ARMPITS, WITH THE SHOULDERS RELAXED.
• HANDGRIP:
PLACE IT SO THAT THE ELBOW IS SLIGHTLY BENT –
ENOUGH SO ONE CAN FULLY EXTEND THE ELBOW
WHEN TAKING A STEP.
• CRUTCH LENGTH (TOP TO BOTTOM):
THE TOTAL CRUTCH LENGTH SHOULD EQUAL THE
DISTANCE FROM THE ARMPIT TO ABOUT 6" IN FRONT
OF THE SHOE.
 TYPES OF CRUTCH WALKING
• NWB - NON WEIGHT
• TDWB (OR) TTWB BEARING
- TOUCH DOWN
WEIGHT
BEARING
(OR) TOE TOUCH WEIGHT
BEARING
• PWB - PARTIAL WEIGHT
BEARING
• WBTT - WEIGHT BEARING TO
(OR) TOLERENCE
• FWB - FULL WEIGHT
BEARING
 NON WEIGHT BEARING WALKING
INSTRUCTIONS
• PLACE NO WEIGHT ON THE AFFECTED LIMB
• DO NOT TOUCH THE GROUND WITH THE
AFFECTED LIMB WHILE STANDING OR
WALKING
• BEAR THE FULL WEIGHT THROUGH THE
NORMAL LIMB AND CRUTCHES WHILE
STANDING AND WALKING
 TO START WALKING
BALANCED STANDING
(TRIPOD POSISTION)
•USE THIS POSITION WHEN AT START OR END
A GAIT OR WHEN STANDING FOR ANY LENGTH
OF TIME.
•MOVE CRUTCHES TO THE FRONT ABOUT 12
INCHES. FIND THE BALANCE.
•DON'T REST THE ARMPITS ON THE CRUTCH
PADS.
•BEAR WEIGHT THROUGH NORMAL LIMB AND
THE HAND GRIPS OF THE CRUTCHES
TRIPOD POSITION
 NON WEIGHT BEARING

1. STAND ON UNAFFECTED
LEG, LIFT BOTH CRUTCHES
AT THE SAME TIME AND
PLACE THE CRUTCHES
ONE STEP’S LENGTH IN
THE FRONT
2. PUSH DOWN ON THE
HANDGRIPS WITH HANDS
WHILE SQUEEZING THE TOP
OF THE CRUTCHES
BETWEEN THE CHEST AND
UPPER ARMS.

3. PUTTING THE WEIGHT

THROUGH THE HANDGRIPS,
HOP FORWARD WITH THE
UNAFFECTED LEG TO MEET
THE CRUTCHES.

- REPEAT THE ABOVE 3 STEPS.

TOUCH DOWN WEIGHT BEARING (TDWB)
(OR) TOE TOUCH WEIGHT BEARING
WALKING (TTWB)
INSTRUCTION
LIGHTLY TOUCH THE AFFECTED LIMB’S
FOOT TO THE FLOOR, AND LET THE
CRUTCHES BEAR MOST OF THE WEIGHT.
IMAGINE AS IF STEPPING ON A RIPE
TOMATO: STEP LIGHTLY, SO IT WON’T BE
SQUASHED.
1. STANDING ON THE
UNAFFECTED LEG, LIFT BOTH
CRUTCHES AT THE SAME TIME
AND PLACE THE CRUTCHES ONE
STEP’S LENGTH IN FRONT
2. BRING THE AFFECTED LEG
FORWARD SO THAT IT IS IN LINE
WITH THE CRUTCHES. ONLY
PUT TOES DOWN ON THE
GROUND UP TO A MAXIMUM
OF 4 Kg OF PRESSURE.
3. PUSH DOWN ON THE
HANDGRIPS WITH HANDS
WHILE SQUEEZING THE TOP OF
THE CRUTCHES BETWEEN
CHEST AND UPPER ARMS.
4. PUTTING WEIGHT THROUGH
THE HANDGRIPS, HOP
FORWARD WITH UNAFFECTED
LEG TO MEET THE CRUTCHES,
OR SLIGHTLY AHEAD OF THE
CRUTCHES, MAKING SURE
THAT ONLY 4 Kg OF PRESSURE
IS PUT THROUGH THE
AFFECTED LEG.
- REPEAT THE ABOVE 4 STEPS.
PARTIAL WEIGHT BEARING
WALKING

INSTRUCTIONS
BEAR SOME WEIGHT ABOUT 50
PER CENT ON AFFECTED LIMB
AS ONE WALKS
1. STANDING ON UNAFFECTED
LEG, LIFT BOTH CRUTCHES
AT THE SAME TIME AND
PLACE THE CRUTCHES ONE
STEP’S LENGTH IN FRONT
2. BRING THE AFFECTED LEG
FORWARD SO THAT IT IS IN
LINE WITH THE CRUTCHES.
ONLY PUT UP TO 50% OF
BODY WEIGHT ON THIS LEG
AS PLACE IT ON THE
GROUND.
3. PUSH DOWN ON THE
HANDGRIPS
WITH HANDS WHILE SQUEEZING
THE TOP OF THE CRUTCHES BETWEEN
YOUR CHEST AND UPPER ARMS.

4. PUTTING YOUR WEIGHT THROUGH

THE HANDGRIPS, HOP FORWARD WITH
UNAFFECTED LEG TO MEET THE
CRUTCHES, OR SLIGHTLY AHEAD OF THE
CRUTCHES, MAKING SURE THAT ONLY
50% OF BODY WEIGHT IS PUT THROUGH
THE AFFECTED LEG.

-REPEAT THE ABOVE STEPS.

 FULL WEIGHT BEARING
WALKING

INSTRUCTION
BEAR MOST OF THE WEIGHT ON AFFECTED
LIMB AS TOLERATED. PLACE ONLY A LITTLE
REMAINING WEIGHT ON CRUTCHES.
• STANDING ON BOTH
LEGS WITHCRUTCHES
AT THE SIDE FOR
SUPPORT, LIFT BOTH
CRUTCHES AT THE
SAME TIME AND PLACE
THE CRUTCHES ONE
STEP’S LENGTH IN
FRONT
• BRING THE AFFECTED
LEG FORWARD SO
THAT IT IS IN LINE
WITH THE CRUTCHES.
• PUSH DOWN ON THE
HANDGRIPS WITH HANDS
WHILE SQUEEZING THE
TOP OF THE CRUTCHES
BETWEEN CHEST
AND UPPER ARMS.
• PUTTING SOME WEIGHT
THROUGH HANDGRIPS
AND AS MUCH WEIGHT
AS ONE CAN THROUGH
THE AFFECTED LEG, STEP
FORWARD WITH
UNAFFECTED LEG.
• REPEAT THE ABOVE
STEPS.
 ASCENDING THE STAIRS
• FACE THE STAIRS HOLDING ONTO
CRUTCHES & STANDING ON
AFFECTED LEG. ONLY PUT AS MUCH
WEIGHT AS ALLOWED AS PER
ORDERS ON THE AFFECTED LEG. IF
NON WEIGHT-BEARING – ONE CAN
CHOSE TO KEEP KNEE IN BENT
POSITION AS SHOWN IN THE
DIAGRAM IF POSSIBLE.
• PUT PRESSURE THROUGH CRUTCH
HANDGRIPS AS HOP UP WITH YOUR
UNAFFECTED LEG ONTO THE NEXT
STEP.
• THEN BRING AFFECTED LEG &
CRUTCH UP TO THAT STEP.
• REPEAT THE ABOVE STEPS UNTIL
ONE GETS TO THE TOP OF THE
STAIRS.
DESCENDING STAIRS
• Stand at the top of the stairs with
the toes of unaffected leg close to
the edge of the step and holding
onto two crutches, one on either
side.
• Place crutches onto the lower step,
bringing affected leg forward at
the same time. only put affected
leg down on the step if allowed
• Putting weight through your
crutches, slowly lower unaffected
leg onto the lower step,
remembering to only put weight
through affected leg if allowed as
per doctor’s orders.

• Repeat the above steps until you

get to the bottom of the stairs.
 GENERAL INSTRUCTIONS AND
PRECAUTIONS IN CRUTCH
• Take care on slick or wet surfaces (for example, the
WALKING
kitchen
and bathroom).
• Be careful of throw rugs; they should be taken up.
• Never hop around holding on to furniture; it may slide or
fall.
• Keep the crutches near you so they are always in reach.
• Wear low-heeled shoes that will not slip off (for example,
sneakers).
• For the first few days, a strong belt may be worn to allow
someone to assist
• Be careful of ramps or slopes, as it is a little harder to
walk.
 GENERAL INSTRUCTIONS AND
PRECAUTIONS IN CRUTCH WALKING

• Take care on slick or wet surfaces (for

example, the kitchen, and bathroom).
• Be careful of throw rugs; they should be
taken up.
• Never hop around holding on to
furniture; it may slide or fall.
• Keep the crutches near you so they are
always in reach.
• Wear low-heeled shoes that will not slip
off (for example, sneakers).

• For the first few days, a strong belt may

be worn to allow someone to assist

• Be careful of ramps or slopes, as it is a

little harder to walk.
THANK
YOU