APPENDIX 3

FITTING CRUTCHES
You will be fitted for your crutches at the place where you rent or buy them -- usually a medical-supply store. The following points are important in ensuring a proper fit:

1. Stand straight.
2. Adjust the length of the crutches so 2 or 3 fingers can fit between the top of the crutch and the armpit (about 2 inches).
3. Adjust the hand grip so your elbow bends about 25 degrees.
WARNING: Don't bear any weight in the armpits. This can cause permanent damage to the nerves of the arm and hand.

MOVING ON CRUTCHES
There are 4 major gaits used by people who need crutches:

SWING-THROUGH GAIT -- Fastest and most difficult.
SWING-TO GAIT -- Slower and easier, and good to use until you become skillful with crutches and can advance to a faster gait.
SHUFFLE GAIT -- Slowest of all, and most appropriate for older people.
3-POINT GAIT--Can be used only when a slight amount of weight can be borne on the weak side.

The last three gaits are described here. When you are ready to progress to a faster gait, such as the swing-through gait, you will need instructions and supervision from your trainer, nurse or doctor.

Also described are instructions on ascending and descending stairs and curbs. These are general suggestions that apply to everyone on crutches.

SWING-TO GAIT
This is a good gait for beginners.
1. Place both crutches forward simultaneously, 12 inches in front of your feet, 6 to 8 inches wider than your toes on both sides.

2. Push your hands down against the handles and shift your weight forward.

3. Swing your body to a point directly between the crutches. Let the heel on the healthy side land first.

Note: The Swing-through Gait is the same as the Swing-to Gait except that the body swings through and lands in front of the crutches.

SHUFFLE GAIT
This gait should be used when the Swing-to Gait is too difficult:

1. Place both crutches forward simultaneously, 12 inches in front of your feet, 6 to 8 inches wider than your toes on both sides.

2. Push hands down against the handles as you shift your body weight forward.

3. Slide the strong leg forward a few inches to a point between the crutches.

4. Follow with the weak leg, ending with the legs together.

3-POINT GAIT
Use this gait only when you are able to bear slight, increasing weight on the weak leg.

1. Place both crutches and the weak foot forward simultaneously, with the weak foot between the crutches. The weight is borne on the strong foot.

2. Push against the handles and shift your weight forward.
3. Swing your body forward with weight on your hands, and bear a slight amount of weight on the weak foot.

4. End with the strong foot ahead of the crutches.

ASCENDING STEPS & CURBS
1. Keep crutches on the lower step. Body weight is on the hands.

2. Raise the strong foot to the step above, trailing the weak leg.

3. Straighten the strong leg and advance the crutches to the next step above.

DESCENDING STEPS & CURBS
1. Place crutches on the lower step, and extend the weak leg forward. Body weight is on the hands.

2. Bend the strong leg and slowly lower the body.

3. Quickly move the strong leg to the lower step.

Reminder for ascending and descending steps with crutches: "The good goes up, the bad goes down."