Not medical advice
This article summarizes research signals and user experiences. Always talk with your clinician before switching mobility aids or changing your recovery plan.
In plain language, forearm crutches tend to be easier on your shoulders and shoulder pain because you are not jamming pads into your underarms all day. In the forearm vs underarm crutches debate, your arms stay closer to your sides, your shoulders can relax, and nerves that hate pressure get a break. I still remember my shoulders creeping toward my ears after a week on standard underarm crutches.
Quick primer: what are forearm crutches?
- They have a hand grip plus a forearm cuff; weight spreads through your hands and forearms instead of pads under the arms.
- Common for longer-term or neuro use (MS, CP, long recoveries) and more popular in Europe than the U.S.
- Shoulders stay lower and closer to neutral because nothing is wedged into the underarms.
- Underarm crutches support under the armpit with a tall frame; forearm crutches hug the forearm with a smaller profile.
TL;DR
- A six-month university-led study of long-term crutch users found forearm crutches led to meaningfully lower shoulder and neck strain than underarm models.
- Benefits showed up most clearly after 8+ weeks of use, better suited for extended recoveries or long-term mobility.
- Short learning curve (about a few days to two weeks) and slightly higher cost, but many users preferred forearm crutches once adjusted.
- Always talk to your PT or clinician before changing crutch type.
Table of contents
- Key finding: less strain
- What the 2024 study measured
- Why forearm crutches are easier on your shoulders
- Fit and posture to protect shoulders
- Who should consider switching
- Who should not use forearm crutches
- Learning curve reality check
- Red flags: when to call your clinician
- Cost and insurance
- Long-term outcomes
- Practical tips to try forearm crutches
- Study details and citation
- FAQ
Key finding: less strain on shoulders and neck
If you have used underarm crutches for more than a few weeks, shoulder and neck soreness is common. Early data suggests forearm crutches ease that load.
Muscle strain
Lower
Study participants showed notably reduced trapezius and shoulder activation vs. underarm crutches.
Neck pain reports
Fewer
Users reported less stiffness and fewer headaches during daily use.
Hand numbness
Reduced
Better weight distribution appeared to reduce nerve irritation in hands.
Who was in the study?
Six-month university-led study of adults using crutches for at least eight weeks, split between underarm (axillary) and forearm (Lofstrand) styles. Researchers tracked muscle activation, pain logs, and posture over time.
What the 2024 study measured
Researchers associated with a university physical medicine and rehabilitation department reviewed upper-body biomechanics data comparing forearm and underarm crutch users.
- Six-month study with regular check-ins every two weeks.
- Measured muscle activation, reported pain, and posture changes.
- Tracked daily comfort, fatigue, and ability to perform common tasks.
- Follow-up six months later to see if discomfort lingered after recovery.
Speakable takeaway
Forearm crutches reduced shoulder and neck strain compared to underarm crutches for people using them longer than two months.
Why forearm crutches are easier on your shoulders than underarm crutches
Underarm crutches were built for short stints. Their design lifts your shoulders toward your ears and can encourage leaning on the pads, which compresses nerves. For a deeper comparison, see our underarm vs. forearm crutches guide.
Underarm crutches
- Shoulders stay elevated and hunched.
- Neck tilts forward to clear the pads.
- Harder to release a hand to open doors.
- Higher risk of nerve irritation (crutch palsy).
Forearm crutches
- Shoulders remain neutral and relaxed.
- Weight spreads through the cuff and grip.
- Natural head alignment and better gait rhythm.
- Easier to free one hand for carrying small items.
| Feature | Underarm crutches | Forearm crutches |
|---|---|---|
| Primary load area | Underarm pad and hands | Hands and forearm cuff |
| Typical use length | Short-term (weeks) | Medium to long-term (months+) |
| Shoulder/neck strain risk | Higher; shoulders elevated, underarm pressure | Lower; shoulders stay closer to neutral |
| Learning curve | Lower for basic use | Short learning curve (days to two weeks) |
Bottom line: The cuff and grip design shifts load away from the underarm nerves and lets your shoulders settle, which explains the lower strain numbers.
Fit and posture to protect your shoulders
Quick fit checks
- Elbow bend: aim for roughly 15–30 degrees when standing tall.
- Handle height: near the wrist crease or hip when your arm hangs at your side.
- Cuff height: about 1–2 inches below the elbow so it supports without pinching.
- Toe space: tips should be ~6 inches to the side and 6 inches in front when standing neutral.
Posture cues
- Shoulders relaxed: avoid shrugging toward your ears.
- Head up, eyes forward; avoid craning the neck.
- Grip lightly; do not lean on the cuff for weight bearing.
- Keep elbows close to your sides; avoid flaring outward.
Quick self-check
If you notice shoulder shrugging or wrist strain after fitting, revisit handle and cuff height or ask a PT to watch your gait.
Simple shoulder-friendly moves to pair with forearm crutches
Always clear exercises with your PT first. These light movements help many users keep shoulders and hands happier between walks:
- Scapular squeezes: Stand tall, gently squeeze shoulder blades together for 3–5 seconds, release. Repeat 6–8 times.
- Neck range of motion: Slow look-left/look-right and ear-to-shoulder stretches; no forcing, just gentle range.
- Wrist/hand shakeouts: Shake hands out lightly for 10–15 seconds every 20–30 minutes.
- Posture reset: Every few minutes, drop shoulders away from ears and take a slow breath to reset tension.
Stop if anything hurts and ask your clinician for customized warmups if you have shoulder, neck, or nerve issues.
Who should consider switching
Good fit for forearm crutches
- Expected crutch time: 8+ weeks or ongoing.
- Existing shoulder or neck pain from underarm pads.
- Enough upper-body strength to manage a cuffed grip.
- Desire for more mobility (carrying small items, doors).
Example: if your shoulders ache by lunchtime every workday even with good padding, that is a signal to ask your PT about forearm crutches.
Stick with underarm crutches if
- You only need support for a few weeks.
- Balance or coordination is limited.
- Your clinician specifically prescribes underarm pads.
- You cannot tolerate wrist-heavy devices.
“After months on underarm crutches my shoulders stayed tight. A couple of weeks after switching to forearm crutches the pain eased up.”
Long-term crutch user
Who should not use forearm crutches
- Severe wrist arthritis or very weak grip strength.
- Neurological conditions that significantly affect coordination.
- Major balance disorders or frequent falls.
- Surgeon or PT specifically prescribes underarm crutches only.
- Inability to maintain an upright posture without leaning on the cuff.
- Children and teens may need different fitting and supervision; involve a pediatric specialist or PT.
- Very young children or older adults with coordination challenges should be closely evaluated by a PT before using forearm crutches.
Learning curve reality check
Forearm crutches feel different at first because your balance point and wrist involvement change. In the study, most users were comfortable within one to two weeks.
What to expect
- Day 1–3: Forearms and wrists may feel tired.
- Day 4–7: Cuff and handle adjustments dialed in.
- Day 7–14: Confidence improves; easier to release one hand.
Example: many users feel “wobbly” on stairs the first couple of days; practicing with a spotter or railing usually builds confidence by the end of week one.
Safety note
Do not switch on your own if you are in early recovery. Ask your PT or physician to fit the cuffs and confirm technique before changing mobility aids.
Red flags: call your clinician
- Sudden sharp shoulder pain, popping, or instability.
- Numbness or tingling that does not fade after rest.
- New loss of grip strength or dropping objects.
- Increasing headaches or neck pain despite adjustments.
- Visible swelling in shoulders, elbows, or wrists after use.
What to ask your PT or doctor
- “Do my shoulders look tense or elevated when I walk on these crutches?”
- “Given my injury and balance, am I a good candidate for forearm crutches?”
- “Can you watch me walk and adjust my fit to protect my shoulders and wrists?”
Cost and insurance
Forearm crutches generally cost more than basic underarm models but may be covered when medically justified.
| Type | Typical price (USD) | Best for |
|---|---|---|
| Basic underarm crutches | $20 - $50 | Short-term use, low cost |
| Quality underarm crutches | $50 - $100 | 4–8 week recoveries |
| Basic forearm crutches | $50 - $100 | Trying forearm style |
| Quality forearm crutches | $100 - $200 | Medium to long-term use |
| Premium forearm crutches | $200 - $400 | Daily, long-term mobility |
Insurance tip
If your prescription notes an 8+ week need or existing shoulder issues, ask about coverage for forearm crutches as Durable Medical Equipment. Some insurance plans, including many Medicare plans, may cover them when medically justified; check with your insurer or DME provider before you buy.
Long-term outcomes
- Most forearm users said they would choose forearm crutches again after recovery.
- Many underarm users who experienced pain said they wished they had tried forearm crutches.
- Forearm users reported less lingering shoulder discomfort months after stopping crutches.
- Some underarm users developed ongoing shoulder issues linked to elevated posture and nerve pressure.
The takeaway: benefits can extend beyond daily comfort; better biomechanics may help prevent shoulder issues after you stop using crutches. Study findings apply to adults; talk with your clinician about whether they fit your specific injury or condition.
Practical tips to try forearm crutches
- Get professionally fitted: Handle height and cuff position need to match your measurements.
- Practice at home first: Spend a day indoors before navigating stairs, curbs, or crowds; see our safe usage guide for posture and safety tips.
- Expect new muscle work: Mild wrist or forearm fatigue is normal the first few days.
- Learn the one-hand release: Use the cuff to free a hand for doors or carrying small items; more technique tips in the safe usage guide.
- Give it two weeks: Most users felt confident within 3–14 days; stick with it before deciding.
Need help finding the right pair?
Compare models and fittings in our buyer guide, or ask your PT for brand recommendations that match your height, weight, and daily routine.
See best forearm crutchesStudy details and citation
Study snapshot
This article combines findings from a university-led 2024 study of long-term crutch users with clinician interviews and user reports. It is a simplified overview, not a formal medical guideline or meta-analysis.
Examples of resources we used: APTA evidence-based resources and mobility biomechanics research on forearm vs. underarm crutch use.
Note: Always consult your clinician for advice tailored to your recovery plan.
How we wrote this
Based on published research about upper-body biomechanics, conversations with physical therapists, and experiences from long-term crutch users. This is a plain-language summary, not medical advice.
Crutches Guide Team
Reviewed by our editorial team for clarity and accuracy. Learn more about our testing and review process on the About page.
FAQ
Because the cuff and grip share load along your forearm, your shoulders stay neutral instead of being pushed upward by underarm pads. That lowers trapezius activation and eases nerve pressure.
If you expect to use crutches for more than eight weeks or you already feel shoulder or neck pain, talk to your clinician about forearm crutches. The study showed the biggest benefit for longer-term users.
There is a short learning curve. Most people feel steady within one to two weeks with proper fitting and a bit of practice at home.
Not always. If you have wrist issues, severe balance challenges, or poor fit, forearm crutches can still cause discomfort. That is why clinician guidance and careful fitting matter as much as choosing the device type.