Is your recovery window still open? Free one-page chart ↓
You Broke Your Ankle. Why Are Your Hands Going Numb?
Hand and wrist pain on crutches comes from your body weight going through the heel of your palm with the wrist bent back. Fix the handgrip height and pad the grips today. Tingling that comes and goes usually clears within days to a few weeks of the crutches going. Numbness that’s there all the time, or weakness, can take 6 to 12 weeks or longer, and needs checking.
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.
And that’s the trap. Everyone is watching the leg. The nerve in your palm is getting squashed several thousand times a day, and nobody is watching that.
What crutches do to your hands
- 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.
Why are my fingers numb from crutches?
Which fingers go numb tells you which nerve is being squashed. See pins and needles by finger.
- 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. Cyclists get the same thing from handlebars. See handlebar palsy.
- Weakness or numbness spreading down the whole arm with underarm crutches: pressure on the nerves in the armpit, often called crutch palsy. Underarm crutches are meant to be gripped, never leaned on, and the gap under the arm should be about two to three fingers’ width.
Why do my wrists and elbows hurt on crutches?
- 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.
- A sore, bruised heel of the palm: simple pressure on soft tissue. The padding below is the fix.
What happens week by week on crutches
- Week 1: a sore heel of the palm and achy forearms. That’s your hands adjusting. Fix the height and padding now, not later.
- Weeks 2 to 3: when numbness and elbow pain usually show up. If tingling lasts more than a few minutes after each walk, change the setup that day.
- Weeks 4 to 6 and beyond: many leg injuries need 6 weeks or more without weight. Problems that started at week 2 are now settled in. Ask about forearm crutches or a knee scooter.
- After the crutches go: tingling that came and went usually clears in days to 2 or 3 weeks. Elbow and wrist tendon pain usually takes 6 to 12 weeks to settle.
How is it diagnosed?
Mostly by the pattern and a short exam.
- Which fingers, and when: numbness only while crutching is a different stage from numbness that’s there at rest.
- Nerve tests in clinic: tapping over the nerve, holding the wrist bent, checking feeling in each fingertip and the strength of the small hand muscles.
- A nerve conduction test if numbness is constant, the hand is getting weak, or it hasn’t improved about 6 weeks after the crutches go. See nerve conduction results explained.
How do I stop crutches hurting my hands?
- Check the height. Handgrips should sit at wrist-crease height when your arms hang by your sides, so the elbow bends slightly (about 15 to 30 degrees) 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.
- Wear padded cycling gloves. Same principle, and they travel with you.
- Ask about ergonomic handgrips. Wider, palm-shaped grips spread the load better than a round tube.
- 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. A wheelchair loads the hands too, differently. See wheelchair users’ hand pain.
- Carry nothing in your hands. Backpack for the laptop, a crutch bag for the phone.
- Never lean on underarm crutches. Take the weight through your hands, not your armpits.
How long does numbness from crutches last?
Nerve compression runs on a window, and where you are in it matters more than how long you’ve been on crutches.
- Numbness only while crutching, gone within minutes of stopping: the window is OPEN. Fix the height and padding and it usually clears within days to 2 or 3 weeks of the crutches going.
- Numbness at rest and at night, as well as on the crutches: the window is CLOSING. A night wrist splint for carpal tunnel, a review of the crutches, and often 6 to 12 weeks for the feeling to return. See carpal tunnel night splint.
- Weakness, clumsiness with buttons, or thinning of the small hand muscles: the nerve is losing function. Get it checked this week. Recovery can take months, and it isn’t guaranteed if it’s left.
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.
Exercises while you’re on crutches
Do these every time you sit down for a break. Gentle, never into sharp pain.
- Open and close: make a loose fist, then spread the fingers wide. 10 times.
- Tendon glides: straight hand, hook fist, full fist, flat fist. 10 rounds, 3 times a day.
- Wrist stretches: arm straight, palm down, gently bend the wrist down with the other hand. Then palm up, gently back. 30 seconds each way, 3 times, a few times a day.
- Nerve glides for carpal tunnel tingling: slow, easy, 5 to 10 reps, 2 to 3 times a day. They should never bring on tingling that lingers.
- Wrist extensor holds (tennis elbow): forearm on a table, palm down, press the back of the hand up into your other hand without moving. 30 to 45 seconds, 5 times, once or twice a day.
Can I keep using crutches with wrist pain?
Usually yes, with the fixes above. Stopping isn’t an option if your leg needs protecting. What changes is the equipment, the padding and the amount.
- Short trips, more often, rather than one long walk.
- A splint at night, not while crutching. A rigid wrist splint under load can shift the pressure somewhere else.
- If you fall on the crutches and land on an outstretched hand with pain on the thumb side of the wrist, that’s a scaphoid fracture until proven otherwise. (Two injuries at once is a terrible bundle deal.)
Get it checked today if
- You can’t lift your wrist or fingers back (wrist drop) after using underarm crutches.
- Numbness or weakness in the whole arm with underarm crutches. Stop leaning and get it checked.
- A fall onto your hand while on crutches, with wrist pain at the base of the thumb.
Get it checked if
- Numbness in any fingers that persists between uses.
- Weakness in the hand or difficulty with fine tasks.
- Wrist pain that has become worse than the original leg injury.
- Numbness that hasn’t improved within about 6 weeks of the crutches going.
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.
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. Numbness that stays when you put the crutches down deserves a look this week.
Part of: Hand, wrist and elbow pain by job, sport and hobby
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.