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Forearm crutches: how to pick a pair, set the height and use them safely

By the Life in Good Form editors. Updated 2026-10-14.

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Forearm crutches vs underarm crutches

The American Academy of Orthopaedic Surgeons (AAOS) says that with underarm crutches your weight should rest on your hands, not on the underarm supports, to protect the nerves and blood vessels in the armpit. Forearm crutches have no underarm pad at all, so you carry your weight through the grips by design. The cuff does not carry weight either: the Canadian Red Cross notes that cuffs are not intended to support the user's weight and add stability only.

Which type you need depends on your injury, strength and how long you will use them. A doctor or physical therapist should make that call and show you the right walking pattern. For a short-term injury, see our guide to crutches for a sprain.

How to fit forearm crutches

1. With the therapist's help and any required support, check fit in your usual shoes. Do not stand unsupported or load an injured leg just to take a measurement.
2. Set the handgrip so it sits at the crease of your wrist. The Canadian Red Cross instructions give this as the handgrip height.
3. Hold the grips. Your elbow should bend about 30 degrees.
4. Adjust the cuff so it sits 1 to 2 inches below the bend of the elbow.
5. Set both crutches to the same height.
6. Lock the adjustments according to the specific model's instructions. The Red Cross guide describes securing the collars and checking that spring buttons fully engage in their holes.

A cuff set too high can dig into the elbow, and one set too low gives little control. If the handgrips feel too low, you will stoop; too high, and your shoulders hunch. Ask the therapist who issues them to check the fit before you go home.

These are reference points for fitting, not instructions to override a therapist's individual adjustments. Ask which footwear and walking conditions the fit assumes, and have it rechecked if your shoes, mobility or posture change. Do not alter the cuff by force unless the maker's instructions permit adjustment that way.

How to choose: weight capacity, height range and build

• User-weight capacity. Read the selected model's rating and how the maker defines it. Drive lists 300 lb for its adult steel forearm crutches and 500 lb for its bariatric steel model. Do not add the ratings of two crutches to calculate a higher user limit.
• Adjustment range. Check the handgrip-to-floor range and separate cuff adjustment against the therapist's fit. A height label or total crutch length alone is not a fitting measurement.
• Independent adjustment. Drive describes separate leg and forearm adjustments for both cited models. Check that the model you order supports the adjustments you need and that they lock securely.
• Weight and package quantity. Confirm whether a listed weight refers to one crutch or the pair. Drive's adult listing describes a pair, while its bariatric listing describes a single crutch. Check the actual package so you receive the number prescribed.
• Tips and grips. Check compatible replacement tips, grip size and cuff fit. Padding should not make the handle harder to grasp or interfere with control; compare the limits in our crutch-pad guide.

Ask about replacement parts, adjustment instructions and care before buying. An ergonomic label or a lighter material does not establish a suitable fit, load limit or walking pattern. If choosing a different design from the one you learned on, have the therapist assess it and demonstrate its use before relying on it.

How to use forearm crutches safely

The Canadian Red Cross says a physician or therapist should instruct adjustment and use. The pattern depends on whether you may put weight on an injured leg and how much support you need. Confirm those limits with the care team; do not infer them from how the crutch feels.

Ask for a demonstration of walking, turning, standing, sitting and any steps you need to negotiate. AAOS's illustrated stair instructions describe underarm crutches, so they are not a substitute for learning a forearm-crutch technique. Have the therapist show how your weight-bearing limits apply during steps and transfers; do not load the injured leg beyond those limits. Use an assessed rail or assistance plan and do not attempt an unfamiliar stair method alone.

AAOS recommends removing rugs, cords and spills, keeping routes and stairs clear and lighting the path to the bathroom. It describes carrying items hands-free in a backpack, waist pack or pocketed apron. Ask the therapist what load is appropriate and how to keep it from affecting your balance; both hands still need access to the grips.

Plan access to doors, bathrooms and resting places before depending on the crutches at home. If the layout or your balance makes the taught method impractical, ask about another aid instead of improvising. No crutch type guarantees against a fall.

Care and common mistakes

• Worn tips. Check the rubber tips regularly for rips, tears, cracks or worn tread, as the Canadian Red Cross advises, and stop using worn tips and contact the supplier for compatible replacements.
• Loose buttons. Before each use, make sure every spring button is fully engaged and aligned in the proper hole.
• Leaning on the cuff. The cuff steadies the crutch; your hands carry the load.
• Hard knocks. The Red Cross warns against sudden impacts or jolts, which can damage the frame.
• Dirty grips. The Red Cross guide describes mild soap, detergent or household cleaner for handgrips. Follow the maker's care instructions for your material and keep grips dry before use.

What to look for when you buy

Questions people ask

How do you size forearm crutches?

Have a therapist check the grip at the wrist crease, about a 30-degree elbow bend and cuff 1 to 2 inches below the elbow bend, as Red Cross guidance describes. Confirm secure locks and any individual changes needed.

Are forearm crutches better than underarm crutches?

Neither suits everyone. Forearm crutches use a cuff for stability; underarm crutches use a top support below the armpit. A clinician should choose and teach the design for your strength, balance and weight-bearing limits.

Should the cuff carry my weight?

No. The Canadian Red Cross notes that the cuffs are not intended to support your weight. Your hands on the grips carry the load, and the cuff keeps the crutch steady.

How do I use forearm crutches on stairs?

Ask the therapist to demonstrate the method for your cuff design, stair rail and weight-bearing restrictions. General underarm-crutch stair instructions do not establish a safe forearm method for every person.

What forearm crutch accessories are worth having?

Compatible replacement tips, properly fitted grip accessories and suitable hands-free carrying can be useful. Have the therapist check changes that affect grip, control or balance.

Sources

• Instructions for care and use of forearm crutches (cdn.redcross.ca), Canadian Red Cross
• How To Use Crutches, Canes, and Walkers (orthoinfo.org), American Academy of Orthopaedic Surgeons (OrthoInfo)
• Steel Forearm Crutches (shop.drivemedical.com), Drive Medical
• Bariatric Steel Forearm Crutch (shop.drivemedical.com), Drive Medical

Sources checked 2026-10-14.