Underarm crutches, also known as axillary crutches, are one of the most common mobility aids prescribed for individuals with temporary injuries, post-surgical recovery, or certain disabilities affecting the lower limbs. However, whilst underarm crutches are widely used, they are not suitable for everyone. Depending on individual physical conditions, abilities, and needs, some people may need to consider alternative assistive devices.

This article will explore who should not use underarm crutches, and provide alternatives that may be better suited for these individuals. We will also discuss what can be done to help people with mobility difficulties improve their quality of life and independence.

Who should not use underarm crutches?

Underarm crutches are often prescribed as a temporary mobility solution after injuries or surgeries. However, using underarm crutches is not appropriate for everyone. Underarm crutches should not be used by people with upper body weakness, individuals with poor balance or coordination, those with long-term mobility issues, elderly individuals with frailty, and people with certain medical conditions. Individuals in these situations should seek other forms of assistive devices, such as walkers, rollators, or wheelchairs. By choosing the right tools, they can achieve safer, more stable support.

Here are some situations where underarm crutches are not suitable:

1. People with upper body weakness: Underarm crutches require significant upper body strength to use properly. If someone lacks adequate strength in their arms, shoulders, or torso, they may struggle to support their weight safely and could risk falling.

2. People with poor balance or coordination: Using underarm crutches requires good balance and coordination. Those with neurological conditions affecting these abilities may find underarm crutches increase their fall risk rather than providing stability.

3. People with long-term mobility issues: Underarm crutches are primarily designed for temporary use. The pressure they place on the underarm area can cause nerve damage if used incorrectly or for extended periods, making them unsuitable for chronic conditions.

4. Elderly individuals with frailty: Older adults with general frailty may find the physical demands of underarm crutches too challenging, potentially leading to exhaustion or falls.

5. People with certain medical conditions: Conditions such as arthritis in the wrists or shoulders, peripheral neuropathy, or conditions that cause tremors may make safe use of underarm crutches difficult or impossible.

What alternatives are suitable for people who cannot use underarm crutches?

For those who find underarm crutches unsuitable, several alternative mobility aids can provide better support and stability. These alternatives include: forearm crutches, walking sticks, walkers, rollator walkers, and wheelchairs.

1. Forearm crutches: Also known as elbow crutches or Lofstrand crutches, these provide support through the forearm rather than the underarm. They're often more suitable for long-term use and require less upper body strength than underarm crutches.

2. Walking sticks: For those needing minimal support, a walking stick or cane can provide balance assistance without the complexity of crutches. They're particularly useful for individuals with mild balance issues or minor leg weakness.

3. Walkers: Standard walkers provide more stability than crutches as they have four points of contact with the ground. They're ideal for individuals with poor balance or those who need more support than crutches can offer.

4. Rollator walkers: These walkers with wheels provide support while requiring less upper body strength than standard walkers or crutches. Many come with seats, making them ideal for those who need to rest frequently.

5. Wheelchairs: For individuals with significant mobility limitations, a wheelchair may be the most appropriate option, providing complete support without requiring strength or balance from the user.

These alternative options should be selected based on an individual's physical condition, needs, and the advice of healthcare professionals, ensuring their safety, comfort, and independence.

How can you provide support and assistance to people with mobility difficulties?

For people with mobility difficulties, beyond selecting appropriate assistive devices, we can provide additional support through regular equipment maintenance, home modifications, physical rehabilitation, emotional support, and community resources. These measures can significantly improve quality of life and independence.

1. Regular equipment checks and maintenance: Ensure all mobility aids are in good working condition, with regular checks for wear and tear. Adjustments should be made as needed to accommodate changes in the user's condition or needs.

2. Home adaptations: Consider installing handrails, ramps, wider doorways, and removing trip hazards to create a safer living environment. Bathroom modifications like grab bars and shower seats can be particularly helpful.

3. Physical therapy and exercise: Working with a physiotherapist can help maintain or improve strength, balance, and coordination. Tailored exercise programmes can significantly enhance mobility and reduce dependence on assistive devices.

4. Regular health assessments: Periodic evaluations by healthcare professionals can identify changes in condition or needs, allowing for timely adjustments to mobility strategies.

5. Emotional support: Mobility challenges can impact mental health and well-being. Providing encouragement, understanding, and access to support groups or counselling can be invaluable.

6. Community resources: Many communities offer resources for people with mobility difficulties, including transport services, home care assistance, and activity programmes. These resources can enhance independence and social engagement.

By implementing these supportive measures, individuals with mobility challenges can experience improved quality of life, greater independence, and better overall well-being.

What are the potential risks of using underarm crutches inappropriately?

Using underarm crutches incorrectly or when they're not the appropriate aid can lead to several health complications:

1. Nerve damage: Resting body weight on the underarm pad rather than the hands can compress the brachial plexus nerves, potentially leading to numbness, tingling, or weakness in the arm and hand.

2. Skin irritation: Friction from improper crutch placement can cause skin chafing and irritation in the underarm area.

3. Muscle strain: Incorrect technique can lead to muscle strain in the shoulders, arms, and back.

4. Falls and injuries: Using underarm crutches when balance is severely compromised increases fall risk, potentially leading to additional injuries.

5. Delayed recovery: Using an inappropriate mobility aid may hinder proper healing or rehabilitation of the original injury.

Are you currently using underarm crutches or considering them for yourself or someone else? It's always advisable to consult with a healthcare professional before choosing any mobility aid.

Summary

While underarm crutches are effective mobility aids for many individuals, particularly those with temporary injuries or during post-surgical recovery, they are not suitable for everyone. People with upper body weakness, poor balance, long-term mobility issues, frailty, or certain medical conditions may benefit more from alternative mobility aids.

By understanding the limitations of underarm crutches and exploring alternatives such as forearm crutches, walking sticks, walkers, rollators, or wheelchairs, individuals can find the most appropriate aid for their specific needs. Additionally, implementing supportive measures like home adaptations, physical therapy, and accessing community resources can significantly enhance mobility, independence, and overall quality of life.