The two most common options are forearm (Lofstrand) crutches and underarm (axillary) crutches. While both help offload weight from the legs, they differ in design, stability, and ideal use cases.

What Are Underarm (Axillary) Crutches?

Underarm crutches—commonly known as axillary crutches—are the classic “hospital-style” crutches that sit under the armpit with a handgrip lower down. The user’s body weight is transferred through the underarm pad and handgrip.

Key features:

• Provide a higher pivot point and a longer frame, which can feel more stable for beginners. 

• Are generally lighter and more portable, and easier to store or transport. 

• Often less expensive than forearm crutches, making them a practical choice for short-term use. 

Typical use cases:

• Short-term recovery after injury or surgery (often 1–3 months). 

• Patients with limited upper-body strength or balance, who benefit from the broader, higher support. 

• Situations where crutches are used intermittently (e.g., in the home or clinic) and not for extended daily mobility. 

What Are Forearm (Lofstrand) Crutches?

Forearm crutches—often called Lofstrand or elbow crutches—feature a cuff that wraps around the forearm and a handgrip below it. The user’s weight is supported through the forearm cuff and hand, rather than under the armpit. 

Key features:

• Cuff stabilizes the crutch on the forearm, improving control. 

• Encourages a more upright posture, which can reduce back strain and improve breathing. 

• Distributes pressure over the forearm and hand, lowering the risk of nerve or soft-tissue injury in the armpit. 

Typical use cases:

• Long-term or permanent mobility needs (e.g., neurological conditions, chronic lower-limb disability). 

• Active users who want more freedom on stairs, uneven terrain, or in crowded spaces. 

• Patients who have adequate upper-body strength and coordination and are comfortable learning a slightly steeper learning curve. 

Because they are often more ergonomic and stable for prolonged use, many clinicians prescribe forearm crutches for people who expect to rely on crutches for months or years. 

How to choose the right type?

There is no single “best” crutch for everyone. The choice depends on several factors:

• Duration of use:

  • Underarm crutches are typically chosen for temporary post-injury or post-surgical recovery. 

  • Forearm crutches are usually preferred for long-term or permanent mobility needs.

• Strength and balance:

  • Underarm crutches are often easier for patients who are weaker or less confident with balance. 

  • Forearm crutches require more upper-body strength and coordination.

• Environment and lifestyle:

  • Forearm crutches offer more freedom on stairs, uneven ground, and in tight spaces. 

  • Underarm crutches are simpler for short trips, quick outings, or intermittent use. 

Safety and Fit Matter

Regardless of type, proper fit and training are essential. Incorrect height or technique can lead to pain, falls, or nerve injury—especially with underarm crutches, where pressure on the armpit can affect the radial nerve. Many clinicians recommend a brief gait training session with a physical therapist or mobility specialist to ensure safe, efficient use.