UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: MEASURING CRUTCHES
& CRUTCH WALKING
Effective Date: April, 2004 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed April, 2005 November 2007 June 2009 October 2011
PURPOSE: To provide guidelines for assisting patients with crutch measurement and walking at UWMF
DEFINITION: Crutches are often needed to increase a patient’s mobility.
POLICY: The clinical staff will utilize the following guidelines to properly measure the length of crutches and
provide patient use instructions.
SUPPLIES: Tape measure, goniometer (if available), Pen, Crutches (wooden or metal), Provider’s order,
1. Check provider’s order and clarify any inconsistencies.
2. Wash hands and gather equipment.
3. Introduce yourself and identify the patient. Include date of birth.
4. Explain procedure to the patient while making the patient comfortable.
5. Provide good light and provide privacy by closing curtains or door.
6. Match length of crutch and adjust length using the following:
3 or 4 finger widths from axilla
6 inches lateral to patient’s heel.
NOTE: For metal crutches adjust length per
the pegs at bottom of crutch.
7. Position crutch handgrip with elbows flexed at
a 20 to 25 degree angle.
Verify flexion with goniometer (if available).
see picture at right.
8. Verify that distance between crutch pad and axilla is 3 to 4 finger widths.
NOTE: This will help to prevent breakdown. (See figure to the right)
9. Instruct patient to a tripod stance.
NOTE: this is completed when crutches are
Set approximately 6 inches in front
and 6 inches to the side of each foot.
(See figure to the right)
10. Teach patient one of four crutch-walking gates.
(See darkened areas on next 3 figures.)
Four point alternating or four point gate
(first figure to the right)
Give stability to client.
Requires weight bearing on both legs.
Each leg moves alternately with crutch.
There are 3 points of support at one time.
Three point alternating or three point gate
(second figure to the right)
Place weight on unaffected leg.
Then weight on both crutches.
Affected leg doesn’t touch ground.
Gradually progress to touch down.
Two point gate
(third figure to the right)
Moves crutch as same time as
Arm motion similar to normal walking.
Swing-through or Swing-to-gait
(similar to second figure above)
Weight on supported leg.
Places crutches on stride in front and then swings to or through them while weight is supported.
11. Ascending stairs
Assume a tripod position
Transfer body weight to crutches (Rule: feet first when going up)
Advance unaffected leg between crutches and stair
Shift weight from crutches to unaffected leg
Align both crutches on stair
12. Descending stairs
Transfer body weight to unaffected leg
Place crutches on stair (Rule: crutches first when going down)
Begin to transfer body weight to crutches, moving affected leg forward
Align unaffected leg on stair with crutches
13. Sitting in chair
Positioned at center front of chair with posterior aspects of legs touching chair.
Holds both crutches in hand opposite affected leg. If both legs are affected, crutches are held in hand of
Grasps arm of chair with other hand and lowers body into chair.
14. Getting Up
Perform three steps above in reverse order.
15. Document in the patient’s record:
Type and size of crutch
How the patient tolerated the process
Patients ability to return demonstration
WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support
REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator
REVIEWED BY: Lynn Posick, NP, Ortho/Rehab - Foot/Ankle
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby
Medical Director Date