Crutches transfer your body weight through your hands, which is a job hands were not designed for, and they do it for weeks at a time in someone who was fit and uninjured in the upper limb until the day they got them.
The result is a set of hand and wrist problems that show up two or three weeks into a leg injury and get blamed on nothing in particular.
What crutches do
- Weight through the heel of the palm, on a narrow handle, thousands of times a day
- The wrist held in extension on every step, under load
- Sustained grip to control the crutch
- Pressure under the armpit with underarm crutches, if they are the wrong height or you lean on them
Crutches fitted badly turn a six-week ankle injury into a six-month hand problem.
What it causes
- Numbness in thumb, index and middle fingers: carpal tunnel syndrome, from repeated loaded wrist extension
- Numbness in ring and little fingers, back of hand normal: Guyon’s canal syndrome, from pressure on the heel of the palm. The most specifically crutch-related one
- Weakness or numbness spreading down the whole arm with underarm crutches: pressure on the nerves in the armpit. Underarm crutches are meant to be gripped, never leaned on, and the gap under the arm should be about two fingers’ width
- Outer elbow pain: tennis elbow, from constant gripping
- Thumb-side wrist pain: De Quervain’s
- Aching at the base of the thumb in anyone who already had early thumb base arthritis, which crutches expose immediately
What to change
- Check the height. Handgrips should sit at wrist-crease height when your arms hang by your sides, so the elbow bends slightly when you take weight. Most people are using crutches set for someone else
- Pad the handgrips. Foam tubing or cycling gel tape spreads the load across the palm instead of concentrating it on one ridge. Cheap, immediate, and almost nobody is told to do it
- Keep the wrist as straight as you can when taking weight, rather than letting it fold back
- Ask about forearm crutches if you need them for more than a couple of weeks. They shift load to the forearm cuff and away from the palm
- Consider a knee scooter or walker for longer-term non-weight-bearing, which removes hand loading almost entirely
- Never lean on underarm crutches. Take the weight through your hands, not your armpits
Get it looked at if
- Numbness in any fingers that persists between uses
- Weakness in the hand or difficulty with fine tasks
- Numbness or weakness in the whole arm with underarm crutches — stop leaning and get it checked
- Wrist pain that has become worse than the original leg injury
Most of these settle once the crutches go, provided they are caught while the numbness still comes and goes. The ones that persist are usually the ones that were tolerated for weeks because the leg seemed like the real problem.
Tell whoever is managing your leg injury. A crutch height adjustment and some foam is a five-minute fix, and it is not a fuss.
The leg gets better on its own schedule. Your hands are on the clock the whole time.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.