Safe usage

How to use crutches safely

Master the techniques that keep you stable, pain-free, and confident on crutches-gait patterns, stairs, weather, and pain prevention, all in one place.

Evidence-based, last updated January 2025

Built from peer-reviewed research, American Physical Therapy Association (APTA) and American Academy of Orthopaedic Surgeons (AAOS) guidance, and real-world testing. Always follow your provider's weight-bearing and activity instructions.

Medical disclaimer

This guide is general education, not personal medical advice.

It does not replace instructions from a doctor or physical therapist.

If you feel unsafe, dizzy, or in significant pain, stop and contact your clinician.

On this page

Gait patterns

Pick the pattern that matches your weight-bearing status. When in doubt, ask your clinician or physical therapist.

Three-point gait (non-weight bearing)

  • Move both crutches forward 12–18 inches.
  • Keep injured leg off the ground.
  • Push through handgrips, swing good leg past crutches, and repeat.

Partial weight-bearing gait (25–75%)

  • Move both crutches forward together.
  • Step with injured leg, only the allowed weight.
  • Use crutches for the rest, then step through with the good leg.

Four-point gait (max stability)

  • Move right crutch, then left foot, then left crutch, then right foot.
  • Always three contact points; slower but stable.

Swing-through gait (advanced)

  • Move both crutches forward together.
  • Push hard through hands and swing both legs past the crutches.
  • Use only when you have strong upper-body control.

Try the gait quiz

Use the Gait Pattern Quiz to match patterns to your weight bearing status and get quick reminders.

Navigating stairs safely

Stairs are the most common fall spot. Use handrails whenever possible. For carpeted stairs, see this detailed guide.

Going up (with handrail)

  1. Hold both crutches together in one hand; grip rail with the other.
  2. Step up with the good leg first.
  3. Push through rail and crutches, then bring the injured leg and crutches up.

Going down (with handrail)

  1. Hold both crutches in one hand; grip rail with the other.
  2. Place crutches on the next step down.
  3. Lower injured leg (or keep raised), then bring the good leg down.

No handrail (one crutch)

Up: Crutch on strong side; crutch and injured leg on the current step; push up with the good leg.

Down: Place crutch one step down; lower injured leg; use crutch to support as the good leg steps down.

If unsure, sit and scoot

It is safer to sit and scoot than to risk a fall. Safety first.

Sitting down and standing up

Sit down

  1. Back up to the chair until you feel it behind your legs.
  2. Hold both crutches in the hand on the injured side.
  3. Grip the armrest or seat with the other hand.
  4. Lower slowly, keeping the injured leg slightly forward.

Stand up

  1. Scoot to the chair edge.
  2. Hold both crutches by the grips in one hand.
  3. Push off the armrest or seat with the other hand.
  4. Stand on the good leg; place crutches under arms once steady.

Choose stable chairs

Armrests and firm seats make sit-to-stand much easier and safer.

Weather precautions

Rain and wet floors

  • Check tip tread; smooth tips slip easily.
  • Take shorter steps and place crutches deliberately.
  • Dry tips before stepping onto tile or hardwood.

Snow and ice

  • Use ice tips or retractable spikes.
  • Clear and salt walkways; consider alternatives (wheelchair, rides).
  • Stay inside during severe ice when possible.

Heat

  • Use padded grips and moisture-wicking clothing.
  • Hydrate-crutch walking is exercise.
  • Apply antiperspirant to underarm areas for axillary crutches.

Pain prevention

Underarm pain

  • Keep a two- to three-finger gap below the armpit; weight on hands.
  • Add padding to underarm area.
  • Re-check crutch height if shoulders hike up.

Hand and wrist pain

  • Padded grips or gloves; take frequent breaks.
  • Do wrist stretches; consider platform crutches if pain persists.

Shoulder and neck pain

  • Relax shoulders; avoid hunching.
  • Check height: top pads 1–2 inches below armpits.
  • Roll shoulders every 30–60 minutes; strengthen upper back.

Track discomfort

Use the pain tracker download to spot patterns and discuss them with your therapist.

ADA rights and travel

For official guidance, visit the U.S. Department of Justice ADA site at ADA.gov.

At work or school

  • Request reasonable accommodations: parking, elevator access, modified duties.
  • Accessible workspace and extra time between classes.

Public spaces

  • Access to ramps, elevators, and accessible restrooms.
  • Priority seating on public transit; reasonable modifications in businesses.

Air travel

  • Crutches allowed through TSA; request pre-boarding.
  • Store crutches overhead or gate-check; arrive early.
  • Ask to remain seated during screening if needed.

Need help?

ADA Information Line: 1-800-514-0301. Workplace concerns: EEOC at 1-800-669-4000.

Next steps

  • Practice your prescribed gait at home before public spaces.
  • Review the tools page for calculators and quizzes.
  • Download the pain tracker and safety checklist.
  • Talk with your provider about when to transition to a cane or no aid.