How to Use Crutches: Complete Beginner's Guide (Fit, Walk, Stairs)

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Most people get handed a pair of crutches with about thirty seconds of instruction and sent on their way. This guide covers the parts that actually matter in your first week, whether you’re on standard underarm crutches or forearm crutches.

In this guide:

• Fit them before you take a step
• How to adjust crutch height
• Standing up and getting balanced
• The basic walk
• Sitting down
• Stairs
• Getting in and out of a car on crutches
• Navigating ramps, curbs, and outdoor terrain
• How to carry things while on crutches
• Forearm crutch walking technique
• Common mistakes in the first week
• Protecting your hands
• Finding the right pair

Fit them before you take a step

Bad fit causes most crutch pain. Get this right first.

Underarm (axillary) crutches:

• The top pad sits 1–2 inches below your armpit when you stand straight in flat shoes.
• The handgrip lands at your wrist crease with a slight bend in the elbow (about 15–30 degrees).
• Correct pad height is the most important adjustment. Too high and the pad compresses nerves in your armpit.

Forearm (elbow) crutches:

• The cuff sits 1–2 inches below your elbow.
• The handgrip lands at your wrist crease. See how to size forearm crutches for the full measurement method.

The single most important habit: carry your weight through your hands, not your armpits. The underarm pads are for stability, not for weight. Leaning on them pinches the nerves there and causes numbness in your hands.

How to adjust crutch height

Both crutch types use push-button or twist-lock height adjusters on the shaft:

1. Stand in the shoes you will wear most.
2. Set the overall length first (for underarm crutches, pad height; for forearm crutches, shaft length).
3. Adjust the handgrip height separately until your elbow has that slight bend.
4. Lock both adjusters and give them a firm tug to confirm they are seated.

If you are between positions on the height scale, use the lower one. A crutch that is slightly too short is easier to control than one that is too tall.

While you have the crutches in hand, glance at the rubber tips: smooth or cracked tips slip on hard floors, and replacing worn crutch tips takes a couple of minutes with no tools.

Standing up and getting balanced

Push up from the chair with your good leg and one hand on the armrest, holding both crutches in your other hand. Once standing, place a crutch under each arm and find your balance before moving. Do not rush the first few steps.

The basic walk

1. Move both crutch tips forward together, about one comfortable stride ahead, just outside shoulder width.
2. Shift your weight onto the grips through your hands; elbows bent, not locked.
3. Swing your good leg forward so the foot lands between or just past the crutch tips.
4. Transfer your weight back to your good leg and repeat.
5. Look ahead, not at your feet. A steady rhythm comes quickly.

How much weight goes on the injured leg depends on your surgeon’s instructions. Follow your weight-bearing status exactly, that determines your technique, not the crutch type.

Sitting down

Back up until you feel the chair edge against your good leg. Move both crutches to one hand. Reach back and grip the armrest or seat with your free hand, then lower yourself slowly using your good leg. Keep the injured leg slightly forward, not tucked under the chair.

Stairs

Stairs cause the most crutch falls. Read how to use crutches on stairs before you try them. The short version:

• Going up: good leg leads, then crutches and injured leg follow to the same step.
• Going down: crutches and injured leg lead, then good leg follows.
• Memory cue: “good leg goes to heaven, injured leg goes down first.”
• Use the handrail whenever one is available, and hold both crutches in one hand on the rail side.

Getting in and out of a car on crutches

Car transfers are one of the more common real-world challenges in early recovery. The technique differs by which side you are using.

Passenger side: Approach the open door with both crutches. Back up until you feel the seat edge behind you, then sit first. Once seated, swing both legs in together. To exit, swing both legs out so both feet reach the floor, then plant both crutch tips on the ground before you push up through the grips to standing. The tip contacts the ground before you shift your weight onto it.

Driver side: Exit by opening the door and swinging your legs out first, then reach for the crutches and push to standing. Entry reverses: sit down first, then swing both legs in.

Vehicle height: Low sedans and bucket seats sit close to the ground, which means a deeper drop and more effort to push back up. SUVs and trucks with a higher seat are easier to manage: less distance to lower, less force to stand. If you have a choice of vehicles during recovery, the higher seat height is simpler to work with.

Navigating ramps, curbs, and outdoor terrain

Outdoor surfaces require shorter strides and more deliberate crutch placement than flat indoor floors.

Wet or slippery surfaces: Keep both crutch tips pointing straight down, perpendicular to the direction of travel, not angled forward. Shorter strides keep your center of gravity over your base. On visibly wet pavement, test the first step before committing your weight.

Slopes and ramps: Lean your body slightly toward the uphill side. Shorten your stride length and slow your rhythm. On the way up, press firmly through both grips before advancing. On the way down, advance the crutches one short step at a time and step your good leg forward to meet them.

Standard curbs: Approach head-on rather than at an angle. Going up, step with your good leg first, then bring the crutches and injured leg up. Going down, advance the crutches off the curb first, lower the injured leg, then follow with your good leg.

No handrail available: Keep one crutch under each arm for full stability. Go one move at a time and confirm both tips are planted flat before shifting weight onto them.

How to carry things while on crutches

Both hands are on the crutch grips when you are moving, which means carrying anything requires planning.

Backpack: A backpack worn on your back is the most practical option. It keeps both hands free for the grips and the load sits behind you, away from your forward balance point.

Fanny pack or belt bag: A waist bag at hip height carries small essentials: phone, keys, wallet. It fits without adding bulk at the front of your body.

Crutch bag attachments: Crutch bags that clip to the shaft keep frequently needed items within reach without requiring you to set the crutches down. Look for one that attaches below the handgrip and does not interfere with your grip position.

What not to do: Carrying anything in your hand blocks your grip on the handle. Even a light object changes how you load the grip and can cause the crutch to shift unexpectedly. Keep both hands on the crutches while you are moving.

Forearm crutch walking technique

Forearm crutches use the same swing-through gait as underarm crutches, but a few details work differently.

Gait pattern: Advance both crutches, transfer your weight through the grips, then step your good leg forward. The difference from axillary crutches is that more load-transfer runs through your wrist and forearm, so grip position matters more. Keep the wrist in a straight line with your forearm, not bent back.

The cuff release: The forearm cuff wraps around your arm, but most designs are open-sided or hinged so the arm slides free if you fall. This is a safety feature: the cuff stays in place during normal walking and releases under the sideways force of a fall, so you are not attached to the frame if you go down.

Strength and adaptation: Forearm crutches engage your wrist, forearm, and core more than axillary crutches in the first few days. This levels out as your body adapts to the technique. If your wrists feel strained early on, check your grip position: elbow slightly bent, wrist neutral, weight distributed through the palm rather than the fingers.

For the full technique walkthrough, see how to walk with forearm crutches.

Common mistakes in the first week

• Leaning on the armpit pads. Weight goes through your hands. The pads just prevent the crutch from sliding sideways.
• Tips too far forward. Placing crutches too far ahead makes them slip and throws your balance. One stride is enough.
• Looking down. It feels safer but actually destabilizes you. Look forward.
• Rushing. Slow is smooth on crutches, especially on uneven surfaces.

Protecting your hands

Long recoveries on standard crutches can leave your hands and wrists sore. Gel or foam grip covers spread the load. If hand discomfort is the main issue, forearm crutches with ergonomic handles keep the wrist closer to neutral, see crutches that don’t hurt your hands.

Finding the right pair

The right crutch depends on your injury, your recovery length, and your body. The callout near the top is our highest-scored pick for longer recoveries, scored on comfort, durability, and the things that matter when you are on crutches for weeks. Take the quiz for a matched recommendation, or see the forearm vs. underarm comparison if you are still deciding which type fits your situation. Picking between a basic pair and a premium one often comes down to the frame material too, our wood vs. aluminum crutches breakdown covers the weight, adjustment, and capacity tradeoffs. When you are ready to choose, see our best crutches roundup for the top picks across every type, or best crutches for long-term use if you will be on them daily.

This is general information, not medical advice. Your physical therapist or surgeon’s weight-bearing instructions and technique guidance take precedence over anything on this page. Ask them to check your form.