Sizing crutches correctly means the axillary pad sits 2–3 finger widths below the armpit, the handgrip aligns with your wrist crease, and your elbows bend 15–30 degrees.
The axillary pad pressed into the armpit compresses the radial nerve, and a handgrip at the wrong height forces your shoulders to carry weight they should not.
The goal of crutch sizing is straightforward — your hands carry the load, your armpits do not. Three adjustments do all the work: axillary pad height, handgrip position, and tip placement. Each has a precise target that makes the difference between a stable walk and a painful one.
The Three Measurements That Make or Break a Good Fit
Axillary pad clearance. The pad should sit 2–3 finger widths — about 1.5 to 2 inches — below the armpit. This gap keeps the radial nerve free of pressure. The Merck Manual Professional states the pad “should never press up into the armpit” because weight must be borne through the hands, not the axilla.
Handgrip height. Set the grip so it lines up with the crease of your wrist when your arm hangs naturally. With your hand on the grip, your elbow should show 15–30 degrees of bend. A bend at the shallow end (15°) means the grip may need to go up slightly; a deep bend (30° or more) means it needs to come down.
Tip placement. Stand with the crutch tips about 6 inches forward of your toes and 2–4 inches to the outside of each foot. This triangle of support keeps you stable and prevents tipping forward or backward.
These three settings interact — changing the pad height shifts where the handgrip lands — so always adjust them in order from top to bottom.
Step-by-Step Sizing Procedure
Follow this sequence in the shoes you will walk in.
- Stand upright with your shoulders relaxed and arms hanging at your sides. Look straight ahead.
- Place each crutch under your arm and adjust the axillary pad until 2–3 finger widths fit between the pad and your armpit.
- Set the handgrip height so it aligns with the crease of your wrist. Your elbow should now bend 15–30 degrees when you grip the handle.
- Position the crutch tips 6 inches forward and 2–4 inches to the side of each foot.
- Lock all pins, buttons, or popper mechanisms. Give each adjustment point a firm tug before walking.
- Take a few steps. Your weight should land on your palms, not your armpits. If you feel shoulder strain, wrist pressure, or a sense of tipping, go back through the sequence.
When the fit is right, walking should feel stable on the first try. The you feel pressure in your palms, your elbows stay slightly bent through the whole stride, and the crutch tips land ahead of you with each step.
Crutch Sizing Specifications at a Glance
| Measurement | Target Value | Why It Matters |
|---|---|---|
| Axillary pad clearance | 2–3 finger widths (~1.5–2 in or 5 cm) | Prevents radial nerve compression and wrist drop |
| Handgrip height | Aligns with wrist crease when arm hangs naturally | Enables proper elbow bend for stability and control |
| Elbow flexion when gripping | 15–30 degrees | Reduces shoulder strain and improves leverage |
| Tip forward distance | ~6 inches (15 cm) from toes | Prevents forward tipping during walking |
| Tip side distance | 2–4 inches (5–10 cm) from feet | Creates a stable base of support on any surface |
| Forearm cuff position | 1–2 inches below elbow | Keeps crutch attached without restricting arm movement |
| Weight bearing | Through hands (palms), never armpits | Core safety rule that prevents nerve injury |
Getting Crutch Sizing Right: What Each Adjustment Actually Does
Sustained pressure against a crutch pad can cause numbness, tingling, and in severe cases, wrist drop — a condition that affects hand function.
The handgrip height controls how efficiently your arms transfer force. At 15–30 degrees of elbow bend, your triceps and shoulders work together without overloading either joint. Too straight (less than 15°) and your shoulders take the full load. Too bent (more than 30°) and you lose leverage and tire faster.
Tip placement creates the stability triangle. The 6-inch forward offset ensures that if you lean back, the tips catch you before you tip. The side offset widens your base of support, which matters most on uneven ground or when turning.
Common Sizing Mistakes and How to Fix Them
| Mistake | What It Looks Like | The Fix |
|---|---|---|
| Leaning on armpits | Pad presses into armpit during standing or walking | Raise the crutch height until 2–3 finger widths of space exist; push through hands |
| Elbows locked straight | Arms fully extended, shoulders shrugged up | Lower the handgrip until elbows relax to 15–30 degrees |
| Elbows bent too sharply | Elbow angle tighter than 90 degrees | Raise the handgrip to reduce the bend |
| Tips placed too close | Crutch tips land at or behind the toes | Move tips 6 inches forward from the toes |
| Adjusting without shoes | Crutches feel short when standing in shoes | Re-fit crutches wearing the shoes you will walk in |
| Loose locking mechanisms | Crutch telescopes or collapses during use | Check all pins, buttons, or clips are fully engaged |
What If The Fit Still Feels Off?
A correct fit should feel stable from the first step. If you feel unstable, check tip placement first — it is the quickest thing to adjust and the most common cause of wobbling. If your shoulders ache after a few minutes, the handgrip is probably too low. If your hands go numb, the grip is likely too high or you are gripping too tightly.
For anyone who finds the axillary pad uncomfortable even at the correct height, padded accessories can help. Our roundup of the best crutch pads covers options that add cushion without changing your fit.
For a first fitting, ask a physical therapist or healthcare provider to check your setup. A professional fitting takes five minutes and catches the subtle mistakes that are hard to feel on your own.
FAQs
How do I know if my crutches are too high?
If your armpit rests directly on the pad or the pad lifts you up when you push down, the crutches are too high. The correct height leaves 2–3 finger widths of space between pad and armpit, and your hands carry the weight, not your shoulders.
Can I size crutches while sitting down?
No. You need to stand upright in the shoes you plan to wear while walking. Sitting shifts your posture and produces shorter measurements, leading to crutches that are too short and force you to hunch forward.
Do the same rules apply to forearm crutches?
Forearm (Lofstrand) crutches use a different upper design — the cuff sits 1–2 inches below the elbow, and there is no axillary pad. The handgrip height and elbow bend rules (15–30 degrees of flexion) are the same for both types.
What happens if I use crutches that are too short?
Short crutches force you to hunch forward with your elbows bent past 30 degrees. This overloads the shoulders, strains the lower back, and reduces stability because the tips end up too far forward relative to your body.
Should both crutches be the same height?
Yes. Both crutches should be set to identical axillary pad height and handgrip position unless a medical condition or injury specifically requires asymmetry. A physical therapist should guide any uneven adjustment.
References & Sources
- Merck Manual Professional. “How to Fit and Walk With Underarm Crutches.” Authoritative clinical procedure for crutch fitting.
- Cleveland Clinic. “How to Use Crutches.” Patient-facing guide covering fit and walking technique.
- Twin Cities Orthopedics. “Crutches 101: Everything You Need to Know.” Comprehensive overview of crutch types and sizing.
- Cool Crutches. “A Step-by-Step Guide on Adjusting Your Crutches.” Practical adjustment guide with measurement details.
- Verywell Health. “How to Adjust Your Crutches.” Patient-oriented sizing and positioning guide.