What Am I Supposed To Do with These Things?

Here in our office, the surgeons are booking surgical cases daily. Most of you who are here to see them are hoping not to have surgery. Unfortunately many of you are, for those of you with a knee surgery you may find the following information helpful. Post-operatively and even after injury you may be fit for crutches or a knee brace. I have put together some helpful information on how they should fit and how to use them.

Good Luck!

How your brace should fit
• Your post-operative knee brace should already be fit to your leg after surgery but once you change your bandage you’ll have to re-fit it
• If it is a hinged brace or a straight leg immobilizer your brace should cover most of your effected leg
• Your brace should be close to or at your mid thigh and should be secured with some type of Velcro attachment, you should tighten each strap so that it fits snugly and does not cut off your circulation in to your lower leg but keeps the brace in place while you are upright
• If your brace has a hinge in the middle of it, this hinge should be in the center of your knee joint with the two mechanisms that dial in motion on the inside and outside of your knee
• Your brace should then extend down your leg and end around your mid shin and ankle area again keeping the Velcro attachments tight enough not to cut circulation into your foot and toes but to keep the brace from falling down your leg

How your crutches should fit
• Axillary (underarm) crutches are measured with the crutch tips solidly on the ground.
• Both should be out from your body close to 6 inches on each side and also 6 inches in front of you.
• There should be 2-3 fingers width between your underarm and the crutch pad.
• The hand grips should fall at your side so that your elbow is bent to approximately 30 degrees.

Walking with your crutches
• While walking with your crutches you should be weight bearing with your hands and the crutches, your underarms should only be used to secure the crutches from moving back and forth not to bear your weight
• There are two types of crutch walking types that are ok after your surgery, Non-weight bearing and partial weight bearing.

• Non-weight bearing or three point gait is termed as such because only three point are touching the ground as you move your two crutches and your unaffected limb.
• You are to advance your crutches simultaneously ahead of you
• Pushing off on the hand grips lift your body up and through either to the level of the crutches or slightly in front of the crutches
• Again simultaneously advance the crutches in front of you and again push off on the hand grips and bring yourself forward to or ahead of the crutches

• Partial weight bearing gait is when you use both crutches and weight bear on both your affected and unaffected leg
• Partial weight bearing is only used when you feel comfortable to weight bear on your affected side because some body weight will be placed on this side
• In this gait, the crutches and lower extremities move at the same time
• Partial weight is placed upon both limbs and down into the crutch hand grips
• In this gait, the crutch and the affected leg advance at the same time, partial weight is placed on the affected leg and the rest is placed on the crutch hand grips
• The opposite unaffected leg is then advanced forward swinging through past the affected leg

Walking Up and Down Stairs with your crutches
• While walking up and down stairs if there is a railing you should use it to assist you
• If you are using two crutches, place both of them both under your outside arm away from the railing
• While advancing up the stairs advance “up with the good” unaffected leg bring your crutches up with the unaffected leg
• Bring your affected leg up to match the stair with the uninvolved leg and crutches
• Again bring your unaffected leg up to the next step and follow with your crutches
• Meet your crutches and unaffected leg with your affected leg

• Going down the stairs is just the opposite, while advancing down stairs you are to place your effected leg down first
• Grasp the railing in one hand and have your crutches on the outside
• Bring your crutches down a stair leading the way, while leaning on the rail bring down your affected limb using the crutches and your hand on the railing for support
• Follow by bringing down your unaffected limb
• Again bring down your crutches and affected limb and then bring down the unaffected limb