Day 2 of 7

Choosing the Right Gait Pattern

Learn the three main walking patterns and when to use each

Day 1 Course Hub Day 3

Welcome to Day 2!

Now that your crutches are properly fitted, it's time to learn how to walk with them safely and efficiently. Today's lesson covers the three main crutch gait patterns and how to choose the right one for your recovery stage.

The 3 Main Gait Patterns

Your doctor or physical therapist will prescribe one of these patterns based on your weight-bearing restrictions:

🚫 Pattern #1: Non-Weight Bearing (NWB) - Three-Point Gait

When prescribed: Fractures, post-surgery, severe sprains where you cannot put ANY weight on injured leg

The movement sequence:

  1. Move both crutches forward together (6-12 inches)
  2. Swing your injured leg forward (keep it off the ground)
  3. Push down through your hands on the crutches
  4. Step through with your good leg
  5. Repeat

Key points:

  • Injured foot NEVER touches the ground
  • All weight supported by hands and good leg
  • Most demanding pattern - requires upper body strength
  • Typical duration: 4-8 weeks post-injury

💡 Pro Tip: The "Swing-Through" Variation

For faster movement: After planting crutches, swing BOTH legs through at once (injured leg stays up, good leg steps ahead of crutches). More advanced but very efficient once mastered.

⚖️ Pattern #2: Partial Weight Bearing (PWB) - Two-Point Gait

When prescribed: Healing fractures, post-op recovery (weeks 4-8), moderate sprains where you can bear 25-50% weight

The movement sequence:

  1. Move right crutch AND left leg forward together
  2. Put 25-50% weight on injured leg (as tolerated)
  3. Move left crutch AND right leg forward together
  4. Repeat in alternating pattern

Key points:

  • Opposite crutch moves with each leg (like normal walking)
  • Most natural, rhythmic pattern
  • Touch down with ball of foot first
  • Listen to pain - if it hurts, reduce weight

⚠️ Weight-Bearing Guideline

25% = weight of leg itself (foot touches but doesn't press down)
50% = standing on bathroom scale shows half your weight
75% = light pressure, like walking on eggshells
Always follow your doctor's specific percentage!

✅ Pattern #3: Weight Bearing as Tolerated (WBAT) - Modified Four-Point Gait

When prescribed: Final recovery stage, transitioning off crutches, minor injuries

The movement sequence:

  1. Move right crutch forward
  2. Step with left leg
  3. Move left crutch forward
  4. Step with right leg
  5. Repeat (each limb moves independently)

Key points:

  • Slowest but most stable pattern
  • Always have 3 points of contact with ground
  • Good for balance issues or fatigue
  • Use when weaning off crutches

Common Gait Mistakes (And How to Fix Them)

❌ Mistake #1: Looking Down at Feet

Why it's dangerous: Can't see obstacles ahead, throws off balance, causes neck pain

Fix: Keep your head up, eyes looking 10-15 feet ahead. Trust your peripheral vision for foot placement.

❌ Mistake #2: Taking Steps Too Big

Why it's dangerous: Increases fall risk, strains shoulders, creates unstable base

Fix: Take shorter steps (6-12 inches). "Slow and steady wins the race."

❌ Mistake #3: Rushing the Pattern

Why it's dangerous: Loss of coordination, skipping steps in sequence, falls

Fix: Use a rhythmic count: "Crutches...leg...good leg" (three-point) or "Right-left...left-right" (two-point).

❌ Mistake #4: Leaning Sideways

Why it's dangerous: Uneven weight distribution, hip/back pain, stability loss

Fix: Keep shoulders level and square. Use mirror to check posture.

Practice Drills for Today

🏃 Drill #1: The Hallway Walk (10 minutes)

  1. Find a clear 20-foot hallway or space
  2. Practice your prescribed gait pattern
  3. Count out loud: "1...2...3...4" to maintain rhythm
  4. Walk to end, turn around, walk back
  5. Repeat 5 times

🏃 Drill #2: The Stop-and-Go (5 minutes)

  1. Walk 10 steps using your pattern
  2. Stop completely and hold position for 3 seconds
  3. Resume walking for 10 more steps
  4. Repeat 5 times

Why it matters: Teaches you to stop safely without losing balance - critical for real-world obstacles.

🏃 Drill #3: The Doorway Navigation (5 minutes)

  1. Practice walking through a standard doorway
  2. Turn crutches slightly diagonal to fit
  3. Go through forwards, then practice backing out
  4. Repeat until smooth

💡 Pro Tip: Film Yourself

Use your phone to record a 30-second video of your walking. Watch it back and check: Are you looking up? Is your rhythm consistent? Are your steps small and controlled? This is how physical therapists spot issues!

Transitioning Between Patterns

As you heal, your doctor will advance you through these stages. Here's what to expect:

Timeline Pattern Goal
Weeks 0-4 NWB (Three-Point) Build upper body strength, protect injury
Weeks 4-8 PWB (Two-Point) Gradually load injured leg, rebuild strength
Weeks 8-12 WBAT (Four-Point) Wean off crutches, restore normal gait

*Timeline varies by injury type and individual healing. Always follow your doctor's specific guidance.

Your Day 2 Action Steps

  1. Confirm your prescribed pattern with your doctor or PT (if unsure)
  2. Complete all three practice drills above
  3. Film yourself walking and review for errors
  4. Practice 10 minutes morning and evening for the next 3 days
  5. Note any pain or difficulty to discuss with your healthcare provider

What's Coming Tomorrow

Tomorrow we tackle the #1 fear for most crutch users: Day 3: Mastering Stairs Safely. You'll learn:

See you tomorrow for Day 3! 🎯

Ready for Day 3?

Conquer your fear of stairs with proven safety techniques

Continue to Day 3