Hesperian Health Guides

Crutches

In this chapter:

Boy standing using crutches with hand showing three finger width between armpit and crutch.
Top of crutch should be 3 fingers’ width below armpit, so it does not press under the arms.
RIGHT
Elbow should be bent a little so that arms can lift body when walking.
Handgrip should be placed for comfort— usually about ⅓ of the way down crutch.



WRONG RIGHT

WARNING! Bearing weight under the arms like this can cause nerve damage that in time can lead to numbness and even paralysis of the hands.

Boy standing using crutches arrow pointing to top of crutch.
Teach the child to put weight on her hands, not on her armpits.


full weight on hands
Girl using crutches up to the elbows, arrow pointing to hand.
wrist drop from crutch pressure

Forearm and hand, bent at wrist.
One good way to make sure the child does not hang on the crutches with her armpits is to use elbow crutches like this.

There are many designs for underarm crutches. Here we show a few.

CRUTCHES FROM TREE BRANCHES, padded with wild kapok


Branch shaped like a letter Y, steps to transform it into crutches. Steps to put wild kapok on top of crutches to create padding and cover it with strips of cloth. Boy walking with crutches.

WOODEN CRUTCHES


Four steps showing how single stick is cut and transformed into a two branched crutch.
dowel 2½ cm to 3½ cm
padded top
wood screws
2½ cm if hard wood
3 cm if soft wood
piece of rubber
about ⅓
about ⅔
Man with leg in a brace walks using crutches.
Design from Poliomeyelitis, Huckstep.


METAL CRUTCH


DVC Ch63 Page 585-3.png
wood pole
Drill holes
¼ inch to ⅝ inch (6.5 mm to 1.6 cm) steel rod or re-bar
metal strip
Weld metal washers to rod
piece of tire
about ⅓
about ⅔
boy with leg brace walks with metal crutches.
from Poliomeyelitis, Huckstep.



ADJUSTABLE WOOD CRUTCH


STANDARD

different components of an adjustable wooden crutch.
sponge rubber padding
wing nut
thin bolt
washers
side view showing holes for height adjustment
Handgrip adjusts by putting bolt through higher or lower holes.
bolts with wing nuts
standard rubber crutch tip

LEATHER RING ELBOW CRUTCH


These crutches are easy to make and work well for children who have strong arms and hands.
components of a leather ring elbow crutch.
leather ring
rivets
sawed-off crutch
A disadvantage is that if a child falls he may have trouble getting his arms out quickly.


OTHER ELBOW CRUTCHES


STANDARD ADJUSTABLE

different components of a standard adjustable elbow crutch.
metal band covered by leather or padding
joint that allows movement of elbow band
adjustable
thin steel or aluminum tube
boy using elbow crutch.


USING LOCAL RESOURCES

crutch with components built using local things.
thick bamboo
bolts
bent bamboo or cane
cane wrap
bamboo
bolt
Design from Philippines
bamboo
crutch made from a branch.
piece of bamboo or plastic pipe or heat and bend any piece of thick plastic
Design from PROJIMO



Gutter crutch (“arthritis crutch”) for children who, due to elbow pain or stiffness, cannot use straight-arm crutches. Crutch for a child with weak elbow-straightening muscles.
STANDARD USING LOCAL RESOURCES
DVC Ch63 Page 586-5.png
adjustable
different componets of a "gutter crutch".
bamboo or plastic
Bend ends of branch and bind them together
tree branch with forks
componetns of a crutch fro a child with weak elbows.
crutch top with deep notch
padded block
loop of leather or soft, strong cloth

These are only examples. Once you get the idea, you can invent your own. A lot of experimentation is often needed to adapt crutches for children with severe arthritis.

Canes and walking sticks


Straight poles can help a child who has difficulty with balance. boy using a crutch, happier boy using a cane.
CAUTION! Use poles that are taller than child so if she falls, they will not poke her eyes.
girl walking with tall poles with flags on the top. Canes. Simple canes provide some balance and support, but the child has to use the walking muscles in both legs. DVC Ch63 Page 587-2.png
For the child who needs to strengthen a weak or painful leg, a cane makes him use his leg. A crutch lets him avoid using his leg, so the muscles that bend his leg get stronger, rather than the ones that straighten it (see "Precautions in Providing a Child with Aids, Equipment and Procedures".)


CANES CUT FROM FOREST PLANTS

two types of plant used to make canes.


ADJUSTABLE METAL TUBE CANE

components of an adjustable metal cane.
inside view
adjustable cane height
nut and bolt



3 OR 4 FOOTED CANE — FOR GREATER STABILITY

differnt three or four legged canes, hand grip made from wedging a piece of would in between a split on the top of a wood pole.
STANDARD METAL TUBE
wire to help keep legs from splitting
ALTERNATIVE HAND GRIP
Split top of pole
Bind base to keep from splitting more.




Rubber tip made from car tire for metal tube or bamboo crutch or cane
STANDARD CRUTCH AND CANE TIP

components of a rubber cane tip.
With a sharp knife or grinder, cut a plug of car tire in this shape.
Force it into the tube and fasten it with a screw.
metal ring
For walking in sandy places make crutch and cane tips extra wide.




This page was updated:04 Apr 2024