You leave the hospital or the clinic with two crutches and, almost always, thirty seconds of explanation. Then you get home and find yourself facing the first step.
It is worth setting out the things that really matter, because a crutch used badly does more harm than it prevents.
First of all: the adjustment
This is the step that decides everything else, and it is almost always skipped.
Standing, arms relaxed by your sides: the handgrip should reach the level of the wrist crease. When you then lean on them, your elbow stays slightly bent, not fully straight.
If the crutches are too high, you will end up loading your armpits. If they are too low, you will bend forward and the weight will end up on your back. Both problems show up after two days, not after two hours.
The mistake that hurts your armpits
Underarm crutches are not leaned on the armpit. The name is misleading: that pad only serves to guide the crutch against the side wall of the chest, while the weight goes entirely onto the hands.
Leaning on the armpit compresses nerves and vessels that run right through there, and can cause tingling, numbness and loss of strength in the hand. If after a few days your armpits hurt or your hand goes to sleep, the cause is almost always this, or a height setting that is too high and makes it unavoidable.
Walking: the sequence
- Move both crutches and the injured leg forward together, placing them about a foot in front of you, not too far ahead or you lose stability;
- transfer the weight onto your hands;
- bring the healthy leg forward, placing it level with the crutches or just beyond them.
The rule to keep in mind: the healthy leg comes last, because it is the one that supports you.
Take short steps. Look ahead, not at your feet: it feels counterintuitive but your balance improves, and you can still feel where your feet are.
Stairs
This is the part that frightens people most, and it sums up in one sentence:
The good leg goes up first. The bad leg goes down first.
Going up: the healthy leg goes up onto the step first, then the injured leg and the crutches go up together.
Going down: the crutches and the injured leg go down first, then the healthy leg follows.
If there is a handrail, use it. Hold both crutches in your free hand (one under the other) and support yourself with the other hand. It is much safer than insisting on two crutches on a narrow staircase.
Partial weight-bearing
If you have been told "touch-down weight-bearing" or "30% weight-bearing", it means you can put only part of your weight on the limb. Respecting it by feel is harder than it seems: perception misleads you, and almost everyone loads more than they believe.
The simplest practical method: practise on a bathroom scale, placing your foot down until the number indicated shows, until the sensation becomes recognisable. A randomised trial from 2024 compared precisely the scale method with a sound biofeedback device to improve adherence to partial weight-bearing: a sign that the problem is real and recognised.
Moving to a single crutch
When the load allowed permits it and you walk steadily, you move to one crutch. With one detail that almost everyone gets wrong:
the crutch is held on the side OPPOSITE the injured leg.
It seems illogical, but this is how normal walking works: when the right leg moves forward, the left arm moves forward. Holding it on the same side means limping more and loading the limb worse.
Small things that change the day
- A backpack instead of a handbag: with crutches your hands are occupied;
- remove rugs from the routes you take at night, and keep a light on along the way to the bathroom;
- tips in good condition: when the rubber wears down it slips, and that is the most ordinary cause of a fall;
- stop before you are tired: most accidents with crutches happen at the end of the day.
Getting followed
Crutches are a means of getting to the point where you no longer need them. How you use them in the first weeks, the sequence, the load, the posture, affects how quickly you get rid of them and with what walking pattern you arrive there.
With Ri-Hub the first consultation is free: a physiotherapist on the Italian professional register watches how you walk over a video call, corrects the adjustment and the sequence, and sets up the progression towards full load. Follow-up sessions cost 29,90€.
If you need crutches after an ankle fracture, the full pathway is in Rehabilitation after an ankle fracture: the full recovery pathway.
If you are recovering from a knee replacement, the exercises are in Knee replacement: home exercises after surgery.
If your question is how long recovery will take, read Physiotherapy: how long the rehabilitation pathway lasts.
Learning this before the operation is much easier than after: preparing for an operation, is it worth moving beforehand?
Sources
- Audio-biofeedback versus the scale method for improving partial weight-bearing adherence in healthy older adults: a randomised trial, European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024
- Objective assessments for walking aid prescription in balance impairment and falls risk: a scoping review of current evidence, Disability and rehabilitation. Assistive technology, 2025
- Early weight-bearing following distal femur fracture fixation: a systematic review and meta-analysis, ANZ journal of surgery, 2025
Sources last checked: September 2026.
