The first journey from bed to bathroom after hip or knee surgery can feel surprisingly daunting. Learning how to use crutches correctly protects the operated joint, reduces the risk of a fall and helps you begin moving with greater confidence. The aim is not to rush or prove your strength. It is to move safely while your body heals, following the precise weight-bearing instructions given by your surgeon and physiotherapist.
Crutches are a temporary aid, but they have an important role in recovery. Used well, they allow you to remain independent while taking pressure away from a painful or healing hip, knee, leg or foot. Used with poor technique or at the wrong height, they can cause shoulder, wrist and hand pain, leave you unsteady and make everyday tasks harder than they need to be.
Start with the weight-bearing advice you have been given
Before focusing on technique, be clear about how much weight you may put through the operated leg. This varies considerably according to the procedure, the condition of the bone and soft tissues, and the details of your recovery.
Some people are allowed to put as much weight through the leg as comfort permits, using crutches mainly for balance and support. Others may need to place only part of their weight through the leg, touch the foot down lightly for balance, or avoid weight-bearing altogether for a period. These instructions are individual. Do not use another patient’s recovery timetable as a guide, even if you have had the same operation.
If you are unsure what your instruction means in practice, ask your physiotherapist or surgical team to demonstrate it again. It is far better to clarify this before you are at home managing stairs, uneven pavements or a busy kitchen.
How to fit crutches correctly
Most adults use forearm crutches, which have a cuff around the forearm and a handgrip. Underarm crutches are less common in the UK. Whichever style you have, correct adjustment makes a meaningful difference to your stability and comfort.
Stand upright in supportive footwear, with your shoulders relaxed. The handgrips should generally sit at the level of the crease of your wrist when your arms are resting by your sides. When holding the grips, your elbows should bend slightly, rather than being locked straight or sharply bent.
The forearm cuff should sit a few centimetres below the point of the elbow. It is designed to guide the crutch, not to carry your body weight. Your hands should take the pressure through the grips. If the crutches are too high, you may shrug your shoulders and strain your neck. If they are too low, you may stoop forward and lose stability.
Check that the rubber ferrules at the bottom are dry, secure and not worn smooth. A worn ferrule can slip on polished floors, wet paving or bathroom tiles. Replace it promptly if the tread is damaged.
How to use crutches when walking
Your physiotherapist’s method should always take priority, particularly where you have restrictions after surgery. For many people who can place some weight through the operated leg, the usual sequence is straightforward.
Move both crutches forward together by a short, comfortable distance. Step forward with the operated or weaker leg, placing it between or level with the crutches. Then bring the stronger leg through. Keep your gaze ahead rather than watching your feet, and take smaller steps than you normally would.
Avoid placing the crutches too far in front of you. This creates a stretched, unstable position and encourages you to lean forward. A calm, measured rhythm is safer and usually less tiring than trying to move quickly.
If you must not bear weight through one leg, move both crutches forward, keep the affected foot off the floor, then bring your stronger leg through. This requires more upper-body strength and can be tiring, so plan regular rests. Do not hop for long distances if you can avoid it, especially when you are fatigued or taking pain relief that makes you feel drowsy.
For partial weight-bearing, your physiotherapist may use bathroom scales to help you understand how much pressure is appropriate. This can be useful because many people either protect the leg too much, becoming stiff and weak, or place more weight through it than intended without realising.
Turning without twisting
Turning is a common moment for loss of balance. Rather than pivoting sharply on the operated leg, take several small steps and turn your whole body gradually. This is especially relevant after hip surgery, when your team may have given you specific movement precautions.
Keep the crutches close to your body when you turn. Do not leave one behind and twist towards it. In a narrow space, it may be safer to take your time, reposition each crutch and make a series of small movements.
Sitting down and standing up
Choose a firm chair with arms where possible. Very low, soft sofas can be difficult after hip or knee surgery, and your clinical team may advise avoiding them initially.
To sit down, back up until you can feel the chair against the back of your legs. Keep both crutches in one hand, holding the grips together if you can do so safely, and use the other hand to reach for the chair arm. Lower yourself slowly, extending the operated leg slightly forward if bending the knee is uncomfortable or if you have been advised to do so.
To stand, move towards the front of the chair. Keep both crutches in one hand and push up from the chair with the other. Once you are steady, place one crutch in each hand before you begin walking. Never pull yourself up by leaning heavily on the crutches while they are positioned ahead of you, as they can slide away.
Using crutches on stairs
Stairs need concentration, particularly in the first days at home. Use a handrail whenever one is available. Hold both crutches in the hand opposite the rail, if this feels secure and you have been shown how to do it. Keep one hand on the rail and take one step at a time.
The phrase “up with the good, down with the bad” is useful for many patients. Going up, step first with the stronger leg, then bring the operated leg and crutches up to the same step. Going down, place the crutches on the lower step first, then move the operated leg down, followed by the stronger leg.
This method does not suit every restriction or every home environment. If you have been told not to bear weight through the leg, or if your stairs are steep, narrow or lack a rail, ask for individual advice before discharge. It may be sensible to arrange temporary sleeping and washing facilities on one floor.
Make your home work for your recovery
A fall is most likely when you are distracted, rushing or carrying something. Before surgery, or as soon as you return home, clear trailing cables, footstools, loose rugs and pet toys from your usual route. Ensure good lighting between the bedroom and bathroom, including at night.
Wear shoes or slippers with a secure, non-slip sole. Avoid walking in socks on smooth flooring. Keep essentials such as medication, water, a mobile phone and tissues within easy reach, preferably in a small bag worn across the body or a crutch bag. Your hands need to remain available for the crutches, so avoid carrying cups, plates or laundry while walking.
Wet weather deserves extra caution. Slow down on wet leaves, uneven paving and sloped kerbs. If you feel unsteady outdoors, take someone with you until your confidence and strength improve.
When discomfort means you should ask for help
Some hand, wrist, shoulder and upper-arm fatigue is common when you first start using crutches. Check the height and your technique if discomfort persists. Padding the handgrips may help, but it should not make them too thick to hold securely.
Contact your surgical team or seek appropriate medical advice if pain in the operated leg is suddenly worsening, you develop new calf pain or marked swelling, the wound becomes increasingly red or leaks, or you feel faint and unable to mobilise safely. Urgent assessment is needed for chest pain or shortness of breath.
Also speak to your physiotherapist if you feel unable to follow the weight-bearing plan, are repeatedly losing your balance, or do not feel safe on stairs. A review can often identify a simple issue, such as crutch height, pain control or a technique that needs refining.
Moving on from crutches at the right time
Stopping crutches too early can lead to limping, increased pain and poor walking habits that are difficult to correct. Keeping them for longer than needed can also prevent you from rebuilding normal strength and confidence. The right point to reduce support depends on your operation, your balance, pain levels, muscle control and walking pattern.
Your physiotherapist may advise progressing from two crutches to one, usually held in the hand opposite the operated leg, before walking independently. This should feel controlled, not forced. The goal is a steady, balanced gait that supports your return to the activities that matter to you, whether that is walking the dog, getting back to work or simply moving around your home without fear. If you are uncertain at any stage, a brief conversation with your care team can provide the reassurance and practical guidance you need.