Forearm crutches fit correctly when the handgrip lines up with your wrist crease, your elbow stays slightly bent at about 15°–30°, and the cuff rests 1–2 inches below the elbow bend.
Get the height wrong and the crutches fight you on every step — stubbed tips, stooped shoulders, elbows locked straight, and a dull ache in the wrists by mid-afternoon. The fix takes about five minutes with a tape measure and the shoes you actually walk in, and it comes down to one landmark: the crease on the inside of your wrist. Crutch sizing runs on that line, not on your total height, which is why two people the same height can need different settings.
Below is the entire process — setup, the exact adjustment order, and how to read the warning signs when a crutch is too long or too short.
How Do You Size Forearm Crutches Before the First Step?
Start by putting on the shoes you normally wear for walking, because heel height changes where your wrist crease falls. Sneakers and bare feet give you two different fits, and fitting in socks then walking in boots throws the whole measurement off.
Stand straight with your shoulders relaxed and your arms hanging at your sides. Now look at where the natural crease of your wrist sits relative to the floor. That distance is your target handgrip height. Most crutch models adjust within a published range — for example, one manufacturer lists floor-to-grip spans of 20 inches up to 41 inches across child through tall sizes — so match your number to the range before you buy. Loosen the spring pins or twist locks on the lower leg section and slide it until the grip lands on that line, then confirm the pins snap fully into their holes. A crutch that pops down mid-step is a fall waiting to happen.
Once the lower tube is set, hold both grips with your arms relaxed. Your elbows should bend a little, roughly 15° to 30° from straight — never locked rigid, never folded tight. If the arm is ramrod straight, the crutch is a touch too tall. If the elbow is sharply bent, it’s too short.
Setting the Cuff Height and Checking Weight Bearing
The cuff on a forearm crutch, sometimes called a Lofstrand or elbow crutch, should sit about 1 to 2 inches below the bend of your elbow. Slide the cuff collar to that spot and tighten it. A cuff that rides too high digs into the arm; too low and it stops guiding the crutch and starts pinching.
Cuff width matters too. Many cuffs open or close on a small strap or screw so you can widen or narrow the band around your forearm. Aim for snug — the crutch should feel held, not clamped. If the cuff spins freely around your arm, it’s too loose, and the crutch will wander during a step.
Then comes the part people get wrong: weight goes through your hands, not your armpits or the top of the cuff. Forearm crutches are built for hand support the way axillary crutches are built for the underarm pad, so pressing your body weight into the cuff defeats the design. Push down through the grip and let the cuff simply keep the crutch tracking alongside your leg.
Where should the tips land? Either way, plant wide enough that the tips clear your stride, then test a few steps indoors on a hard floor before you trust them outside. If you’d rather compare actual products with published size ranges and weight capacities, our tested roundup of the best forearm crutches for daily use lists each model’s fit specs in one place.
Crutch Too Long or Too Short? Read These Signs
Sizing errors show themselves in posture and in the tips, not on a label. Check the telltale signs below against what you’re seeing:
| What You Notice | What’s Wrong | Fix |
|---|---|---|
| Wrist crease sits above the handgrip | Crutch is too short | Extend the lower tube until the grip meets the crease |
| Wrist crease falls below the handgrip | Crutch is too long | Shorten the leg section a notch at a time |
| Stooped posture, shoulders rolled forward | Crutches too short, or weight pushed into the cuffs | Reset height, shift load onto the hands |
| Elbows locked straight | Crutch too tall | Drop the height until you get 15°–30° of bend |
| Tips stub the ground on each step | Crutch too long | Shorten, then recheck stride width |
| Cuff slides or spins on the forearm | Cuff too loose or wrong width | Narrow the cuff band, lower it to 1–2 inches below the bend |
| Sore underarms or shoulder pressure | Weight loaded above the handgrip | Bear down through the grips instead |
When Should You Refit Rather Than Keep Adjusting?
Refit whenever something about the setup changes, not just when it feels wrong. A new pair of shoes with a different heel height, a switch from indoor slippers to outdoor boots, or a cuff that’s been widened for a heavier jacket all shift the geometry. Run the wrist-crease check again at that point.
Follow the manufacturer’s manual when it disagrees with general guidance, since published size ranges and cuff heights do vary by brand. If you rely on insurance, be aware that coverage rules can limit which sizes and models get reimbursed, so confirm before ordering a specialty size.
Keep the sequence simple and repeatable: shoes on, stand tall, grip at the wrist crease, elbow slightly bent, cuff just below the elbow, pins locked, hands bearing the load. Recheck after any change, and replace worn rubber tips before they get smooth.
Common Questions
Should the forearm cuff touch my arm during a step?
Light contact is normal, steady pressure is not. The cuff’s job is to keep the crutch aligned with your leg while your hand carries the load. If you feel the cuff digging in or bearing weight, it’s set too high or too tight. Lower it toward the 1–2 inch mark below the elbow bend and loosen the band until it feels snug but not clamped.
Can I set the height once and leave it?
Only if nothing about your footwear changes. Heel height moves your wrist crease relative to the floor, so swapping thin sneakers for thick-soled boots can throw the grip off by an inch or more. Recheck the fit whenever you change the shoes you walk in, and confirm the adjustment pins are fully locked after every change.
Is forearm crutch fit different for kids?
The landmarks are identical — wrist crease, slight elbow bend, cuff below the elbow — but children need refitting more often because they grow quickly. Manufacturers publish separate child and kiddie size ranges with shorter grip and cuff spans, so match the child’s measured floor-to-grip distance to the correct range rather than trimming an adult pair to fit.
Sources
- Cleveland Clinic. “How to Use Crutches” Supports handgrip-at-wrist-crease fitting, elbow angle, and crutch tip placement.
- Government of British Columbia. “Forearm Crutches” Supports cuff position, weight bearing through the hands, and tip distance guidance.
- World Health Organization. “Crutches — Assistive Product Specifications” Supports adult and child applicability of elbow crutches.