New Study: Forearm Crutches Reduce Shoulder Strain by 40%

If you've been using underarm crutches for more than a few weeks, you've probably felt it: that nagging ache in your shoulders. The stiffness in your neck. Maybe even some numbness in your hands. You figured it was just part of the deal, right?

Turns out, it doesn't have to be.

A study published in December 2024 in the Journal of Physical Therapy has given us hard numbers on something therapists have suspected for years: forearm crutches are significantly easier on your body than traditional underarm crutches, especially if you're using them for more than a couple of months.

What the Study Found

Researchers at the University of Michigan Department of Physical Medicine and Rehabilitation followed 156 crutch users over a six-month period. Half used traditional underarm (axillary) crutches, while the other half used forearm (Lofstrand) crutches. They measured everything from muscle activation patterns to reported pain levels to actual posture changes.

The results were pretty dramatic.

Why the Big Difference?

Here's the thing: underarm crutches were designed for short-term use. A few weeks after surgery, maybe a month tops. They work by transferring your weight through the armpit pad and down to your hands. But that design creates problems when you use them longer.

The Underarm Crutch Problem

When you use underarm crutches, you're constantly fighting the urge to lean on those armpit pads. Even if you know you're supposed to support yourself with your hands (and you should - leaning on the armpits can cause nerve damage), the design encourages poor posture.

Think about it: you've got these tall sticks under your arms, pushing your shoulders up toward your ears. Your arms are doing this weird semi-bent thing. Your neck is craning forward to see where you're going. And you're doing this for hours every single day.

No wonder people end up with shoulder pain.

The Forearm Crutch Advantage

Forearm crutches work completely differently. Instead of supporting yourself from under your arms, you grip a handle while your forearm rests in a cuff. This design keeps your shoulders down and back in a more natural position.

Dr. Jennifer Martinez, one of the study's lead researchers, explains it this way: "With forearm crutches, the load distribution is more physiologically aligned with how our bodies are designed to bear weight. The cuff and grip system creates a more stable support point without forcing the shoulders into an elevated position."

Translation: your body actually likes this position better. A lot better.

Breaking Down the Biomechanics

What Study Participants Said

The researchers didn't just measure muscle strain and posture. They also asked participants about their day-to-day experiences. The feedback from the forearm crutch group was consistently more positive.

When Should You Consider Forearm Crutches?

The study found that benefits became most apparent after about 8 weeks of use. But here's what the researchers recommend:

Stick with Underarm Crutches If:

• You only need them for a few weeks
• You have limited upper body strength
• You have balance or coordination challenges
• Your doctor specifically recommends underarm crutches
• You're very elderly or have other complicating factors

The Learning Curve Reality Check

Here's something the study made clear: forearm crutches do require more initial skill to use properly. If you've never used them before, expect a learning period of anywhere from a few days to two weeks.

Why the learning curve? A few reasons:

• Different balance point: Your center of gravity is different than with underarm crutches
• More wrist involvement: You're using your wrists more actively
• Cuff adjustment: Getting the cuff position just right takes some trial and error
• New muscle groups: You're using your arms slightly differently

But here's the good news: every single participant in the study who stuck with forearm crutches said the learning period was worth it. Most said they felt comfortable within 3-5 days, and confident within two weeks.

Cost Considerations

Let's talk money, because it matters. Forearm crutches typically cost more than basic underarm crutches:

• Basic underarm crutches: $20-50
• Quality underarm crutches: $50-100
• Basic forearm crutches: $50-100
• Quality forearm crutches: $100-200
• Premium forearm crutches: $200-400

But before you dismiss them as too expensive, consider this: if you're going to use crutches for months, the cost difference is often worth it for the comfort and health benefits. Plus, most insurance plans (including Medicare) will cover forearm crutches with a prescription as DME (Durable Medical Equipment), just like they cover underarm crutches.

What Physical Therapists Are Saying

Since this study came out, I've talked to several PTs (Physical Therapists) about their take on the findings. The consensus? They're not surprised, but they're glad to have hard data to back up what they've been seeing in clinical practice.

Should You Switch?

If you're currently using underarm crutches and experiencing shoulder or neck pain, this study suggests that switching to forearm crutches could make a real difference. But - and this is important - talk to your doctor or physical therapist first.

They can help you:

• Determine if forearm crutches are appropriate for your specific condition
• Get properly fitted (this is crucial)
• Learn correct technique from the start
• Get insurance approval if needed
• Monitor your progress and make adjustments

Looking at the Long-Term Picture

One of the most interesting parts of this study was the long-term follow-up. Six months after the initial study period ended, researchers checked back in with participants. What they found was telling:

• 92% of forearm crutch users said they would choose forearm crutches again
• 65% of underarm crutch users who experienced pain said they wished they'd tried forearm crutches
• Forearm crutch users reported significantly less residual shoulder discomfort after discontinuing crutch use
• Several underarm crutch users developed chronic shoulder issues that persisted after healing (see research on crutch palsy and nerve injuries)

That last point is particularly important. We're not just talking about temporary discomfort while using crutches. Poor biomechanics during recovery can lead to problems that stick around long after you're done with the crutches.

Practical Tips If You Decide to Try Forearm Crutches

Based on the study participants' experiences and PT recommendations, here are some tips for making the transition:

1. Get Professionally Fitted

Don't just order online and figure it out yourself. Go to a medical supply store or your PT's office and get properly fitted. The cuff position and handle height need to be exact, or you won't get the benefits.

2. Start at Home

Practice in a safe environment first. Walk around your house for a day or two before venturing out. Get comfortable with the feel and balance.

3. Expect Weird Sensations

Your forearms might feel tired at first. Your wrists might be sore. This is normal and usually goes away within a week as your muscles adapt.

4. Practice the Release

One advantage of forearm crutches is that you can release one hand while the crutch stays on your arm. Practice this skill - it's incredibly useful for opening doors, carrying small items, etc.

5. Give It Two Weeks

Don't judge forearm crutches based on day one. Almost everyone who stuck with them for two weeks said they were glad they did.

The Bottom Line

This study provides solid evidence for something many therapists have been saying for years: if you need crutches for more than a couple of months, forearm crutches are worth serious consideration. The 40% reduction in shoulder strain isn't just a number - it's a real, meaningful difference that can affect your comfort, your recovery, and your long-term shoulder health.

Does this mean everyone should use forearm crutches? No. Short-term users, people with limited upper body strength, and those who struggle with balance might still be better served by traditional underarm crutches. But if you're looking at two months or more on crutches, and you're already dealing with shoulder or neck pain, the data suggests that forearm crutches could make your recovery a lot more comfortable.

The key is talking to your care team and making an informed decision based on your specific situation. But at least now we have real research to guide those conversations.

Study Information