Forearm vs Underarm Crutches: How to Choose
The two designs load your body differently and suit different lengths of use. A plain comparison of how each works, who tends to end up on which, and where we are not a neutral party.
The honest starting point: we make both designs, so this is not a neutral comparison and you should not read it as one. What we can usefully do is describe how each one works mechanically, and what people tell us drives the choice, and leave the conclusion to you and whoever is advising you clinically.
The mechanical difference
The two designs put the load of each step through your body in different places.
An underarm crutch has two contact points: a padded top that rests against the side of your ribcage just below the armpit, and a handgrip further down. Weight is shared between your hand and that upper contact.
A forearm crutch has two contact points as well, but different ones: a handgrip, and a cuff that wraps your forearm below the elbow. The cuff is not primarily load-bearing. Its job is to keep the crutch attached to your arm and to control the angle. The load goes through your hand, wrist and arm.
That single difference drives nearly everything else.
Where each one is genuinely stronger
| Underarm | Forearm | |
|---|---|---|
| Learning curve | Short. Most people manage in minutes | Longer. Usually a week to feel natural |
| Demand on hands and wrists | Lower, load is shared | Higher, load goes through the hand |
| Hands free without putting it down | No | Yes, the cuff holds it on your arm |
| Manoeuvring in tight spaces | Bulkier, wider footprint at the top | More compact |
| Stairs and uneven ground | More stable footing, less arm control | More control, more demand on the arms |
| Typical availability | Every pharmacy and hospital | Specialist and online, mostly |
| Common length of use | Weeks | Months to years |
Why hospitals hand out underarm crutches
Because for the job a hospital is doing, they are the right tool. They cost little, adjust to almost any adult quickly, and can be taught in the time it takes to walk down a corridor. If someone is going home today on six weeks of partial weight-bearing, that is exactly what is needed.
The trouble is that the choice made for a six-week recovery quietly becomes the default for someone who turns out to need crutches for years, because nobody revisits it. A great many long-term users are on underarm crutches for no reason other than that is what they were given on day one.
Why long-term users tend to migrate
Two things come up over and over from people who have made the switch, and neither is a claim about health outcomes.
Your hands stay usable. With the cuff around your forearm you can let go of the grip, open a door, take out a wallet, hold a railing, and the crutch stays on your arm. With underarm crutches you tuck one under your arm or lean it against something, and it falls over. Across a day, that difference is constant.
They are less in the way. A forearm crutch is a narrower object. Getting through a doorway, sitting down in a restaurant, riding transit at rush hour: the design that ends at your forearm takes up less room than the one that ends under your armpit.
The counterweight is real. Forearm crutches ask more of your hands, wrists and shoulders, because there is no second contact point to share the load. If grip strength or arm function is a limiting factor for you, that is the thing to weigh, and it is a question for a physiotherapist rather than for a page written by a manufacturer.
What varies within forearm crutches
If you have already settled on forearm, the remaining decisions are about construction rather than category:
- Rigid leg or spring-assisted. A rigid tube transmits the load of each footfall straight back up the crutch. A spring-assisted leg compresses under that load and returns as you lift.
- Fixed tip or articulating tip. A fixed tip makes full contact only when the crutch is near vertical. An articulating tip pivots to hold contact through more of the step.
- Whether wearing parts are sold separately. Tips, cuffs and grips wear out on every crutch. Whether you can buy the part determines whether a worn crutch is a repair or a replacement. Ours are all stocked separately.
- How it is sized. Fitting from hip height is more accurate than fitting from overall height. The measurement is here.
- How many cuff sizes are included. Cuffs are where most fit complaints originate.
The short answer
If you are three weeks into a six-week recovery and the hospital crutches are working, there is no particular reason to change.
If crutches are part of your life rather than an episode in it, the design most Canadians in that position use is the forearm crutch, and it is worth trying properly before you conclude the ones you were handed are the ones you are stuck with.
And if you are unsure which category you are in, that is genuinely a question for a clinician who can see you walk, not for a comparison table.