When my multiple sclerosis got ornery in late 2009, I was forced to start using a walker. My legs just didn’t have the strength to get me where I needed to go. That bummed me out… and pissed me off. But then my physical therapist sister pulled out a 20-year old pair of beater forearm crutches that she had found stashed in the basement of her hospital. “Try these,” she said. Talk about a Godsend. I’ve been using forearm crutches—also called Canadian or Lofstrand crutches—ever since, and they have changed my life.
I’m now going to places that would have been off limits for a walker, from hiking in forests to playing on beaches to even snowshoeing in the mountains. Cobblestone streets and gravel roads are passable again on foot. Heck, navigating urban hazards like crowded restaurants, concerts and bars are a breeze. Along the way, I’ve also discovered that forearm crutches themselves are an art form, and there is a world of difference between a well-made pair of sticks and those slapped together circa 1990.
Enter SideStix, a young Canadian company out of Vancouver, which designs and manufactures high-end forearm crutches. They found ActiveMSers after I publicly pondered who made the best forearm crutches on planet Earth. Boldly, they suggested (natch) themselves. Really? I then talked in depth to Sarah Doherty, the founder of SideStix, about her "Stix" and what sets them apart. She has been an advocate and inspiration to the disabled since she lost a leg years ago to a drunk driver when she was riding her bike. She refused to let the accident define her, and went on to become a member of the US Disabled Ski Team and the first amputee without an artificial limb to climb both Rainier and Denali on crutches. She has also been an occupational therapist for decades, and now divides her time between the OT world and SideStix. Even after I warned her that my gear reviews are not always positive, she confidently sent me a pair to test, the custom-made SideStix Discovery PRO ($695) with outdoor attachments.
In the following guide, I’ll highlight the major areas to consider when purchasing forearm crutches, how the SideStix pair stacks up, and the challenges faced by my beater crutches. (Note: how to fit and properly use this type of crutch, and why they are so effective, is for another article.) Let’s start by breaking down each variable to consider when purchasing forearm crutches.
Construction: Aluminum, Titanium or Carbon Fiber
With so many construction options, choosing what material your forearm crutch boasts often comes down to your wallet thickness or quality of your insurance plan. Most inexpensive forearm crutches are made of an aluminum or steel composite. As you go up in price, you’ll find those along with a wide variety of other materials, including titanium, carbon fiber, and even wood. In the higher-end arena, titanium is lightweight, has impressive shock absorbing qualities and is strong. Carbon fiber is even lighter weight (shaving off up to a half pound per stick over aluminum), more shock absorbing, and stronger still. Like titanium, it’s also expensive. SideStix forearm crutches come with ultra lightweight carbon fiber primary tubes (aluminum tubes are available at half the cost) and they look cool as all get out. My full SideStix crutch assembly tipped the scales at a svelte 809 grams or 1 lb, 12 1/2 oz (for comparison, the beaters weighed 973 grams or 2 lbs 2 3/8 oz). That said, the dampening qualities of carbon fiber are diminished somewhat as the entire SideStix crutch is not all made of the pricey composite, although this option is being considered for the future. Recommendation: What you can afford
Carbon fiber is trick.
Tips: Basic or Fetterman
Not too long ago I had to make a pit stop at a gas station due to a wee bit of, ahem, need to wee. As is always the case when I REALLY have to go, the entire station was just mopped (aka, flooded). After gingerly making my way to the bathroom with my beater crutches, fearing for my safety with every step, I set them against the wall only to watch them both slide onto the wet tile floor in ear-splitting fashion. The poor store attendant was certain that I had fallen, cracked my skull on the condom machine, and died in her restroom. And that it was all her fault for such sloppy housekeeping. I did manage to get out before funeral arrangements had been made, but this tightrope exposed my beater crutch tips, slick as ice on wet floors, as barely a notch above Ford Pintos and lawn darts for safety. If there is one area where high-end and budget crutches differ shockingly, literally, it’s in the tips. Thomas Fetterman patented a crutch tip technology with a built-in shock absorbing system back in 1988 and it remains the industry gold standard. There is no better tip for forearm crutches, and it shows. SideStix uses Fetterman tips on their crutches (they also offer custom rotating tips for users with a "swing" gait, e.g., single-leg amputees, which I do not advise for MSers due to potential stability issues) and it made me realize how bad and rotted my beater stick tips were. The new ones articulate, bending into the floor, to give you mountain-goat footing while the gel shock absorption is comfortable and predictable. Wet floors? No problem—Fetterman claims 300% more wet-slip resistance over standard rubber. I believe it. The only downside: they are heavy. That’s why SideStix is deep in R&D to see if they can create an even better tip, a tall order. Recommendation: Tornado Tips (Fetterman)
My beater tips (right) should have been retired ages ago.
Sizing: Fixed, Adjustable, or Infinite Adjustable
On the surface this looks like a no brainer. Inexpensive forearm crutches have lots of sizing holes to fit lots of different body sizes, which helps keep the cost down due to mass production. They tend to be clunky and noisy with all the grace of a Roseanne Barr singing the national anthem. Of course you’d want a forearm crutch exactly customized to your body to fit you like a glove (not your gloves, OJ) or a hand-fitted suit with a dozen tailored measurements, right? Not so fast. Say you want to get down that scree field on Kilimanjaro after an exhausting summit day? You’d definitely want to extend your crutches at least a couple inches for the long and unstable downhill. If you are spending the day at the beach in bare feet, you’d probably want your sticks a bit shorter. I personally discovered the importance of adjustability when snowshoeing in my Sorels, which have massively thick soles. I extended my SideStix a few inches to compensate for both the soles and the soft snow. Perfect. The only downside with SideStix’s infinite adjustability is that it requires a small Allen wrench, which is an inconvenience. Tool-free adjustable sticks are on the drawing board. If you don’t plan to do a lot of crazy adventures with your crutches, fixed is a fine way to go. Me? I wanna go crazy. Recommendation: Infinite Adjustable
Infinite adjustability = maximum flexibility.
Grips: Standard or Ergonomic
There are a number of different grips available for forearm crutches, and my PT sis has steered me (wisely) to the type she feels is best: those with a wider base for the heel of your palms. Narrow standard grips, even those with padding or gel, still force much of your weight to the pressure point between your thumb and forefinger (picture doing dips on two pegs). In time, this can get painful and gel eventually loses its forgiving properties. A wider, flatter grip—tapering to a narrower end—allows you to distribute your weight better and efficiently control your stick, and is far more ergonomically friendly in my opinion. SideStix actually borrows from the high-end cycling accessory company Ergon to source their grips: the BioKork version of the GP1 (retailing at $40/pair). Made of lightweight cork, which has natural damping properties and is both antibacterial and hypoallergenic, these grips are dynamite and can be easily adjusted to any angle to fit snugly in your palms. Plus all your bike geek friends will run over and say, “Rad, Ergon grips.” Really, they will. If you don’t love them, they are easy to swap out (Right Grip crutch handles are popular). SideStix may improve the grip down the road with an in-house solution, but these are sweet as is. Recommendation: Ergonomic
Ergonomic grips target the heel of your palm (left shown).
Cuffs: Side, Front or 3/4, Metal or Plastic
The most basic decision you’ll have to make regarding cuffs for your forearm crutches boils down to the opening: side, front, or 3/4. I’d nix the 3/4 for MSers because it just doesn’t provide enough support. Between front and side, both have their advantages. Front openers may offer a touch more side-to-side stability and stealthiness (if forearm crutches could ever be stealthy), while side openers are better for daily living (your crutch won’t slip when you lift your arm) and are the most popular. In terms of material, there’s generic and inexpensive metal (often vinyl-coated) that you can bend to size, and custom-molded plastic complete with leather padding. SideStix makes their cuff of high-quality nylon plastic, which is lightweight, quiet, and size adjustable with heat (literally pop them in the oven to resize the opening larger or smaller). Since the cuff size in general is fixed—few of us travel with a portable oven—in order to fit a bulky coat simply remove the leather cuff, which is attached by Velcro. Recommendation: Side Opening, Plastic
SideStix cuff with side opening and removable leather pad.
Suspension: Rigid or Shock?
Some higher-end crutch manufacturers including SideStix offer a suspension system within the main shaft of the crutch to offer increased shock dampening (theirs is the Boundless PRO). This is a great concept and one I would highly recommend in particular for those who use the crutch for significant weight bearing (e.g., amputees) or for significant distances (e.g., hikes lasting hours), but the benefit may not be as appreciated by those with multiple sclerosis if the shock is too "bouncy." Some shock systems adds “fuzziness” and might not provide the same confident feedback as a rigid crutch. I've tested the SideStix shock and it is exactly how a shock should be: just enough damping to reduce upper body fatigue but not enough to throw off your balance. Indeed, it is so seamless, you likely will not even be aware that the shock is helping you with every step. Now, there also are some basic drawbacks, as the feature always adds price (about $100 extra per crutch) and weight (some 3 ounces), and requires more maintenance. But for a hike, they are invaluable. Since I've not tested other systems, I can only recommend the SideStix shock, as its rebound is slight and totally predictable, which may not be the case with other crutches. Proceed with caution in this arena at lower price points. Recommendation: Depends
A built-in shock is not critical thanks to articulating tips with shock dampening. But after testing, the right shock helps.
Attachments: Snowshoe, Sandshoe, or Spindle Pick
Okay, this is a loaded category. What truly sets SideStix apart from all other forearm crutch manufacturers is their unparalleled commitment to the outdoor enthusiast as evidenced by their wealth of attachments: an 8” snowshoe ($130), a 4” sandshoe ($80), and a spindle/ice pick ($69). The spindle pick (incidentally almost 3 ounces lighter than the Fetterman Tornado tip) turns your forearm crutches into trekking crutches with its stainless steel center spike, perfect for the trail and anything it throws at you—dirt, ice, roots, rock. I absolutely loved the secure footing on a recent 2-mile hike. Add the sandshoe (spindle pick required) and you’ll have the traction and float to go through sand, crusty snow, and mud. The snowshoe, made of the same aircraft aluminum and PVC-coated polyester mesh as the sandshoe, offers an even wider platform to get you through powder snow, which I highly recommend if you enjoy (or enjoyed) snowshoeing. All three work on pavement and inside (in a pinch). Just be careful not to scratch the floor, and realize that traction is severely compromised on tile (yikes!). Some use on hard surfaces like these may be necessary as you’d need both the Allen wrench and your standard tips to do the swap. Before my testing, I thought these attachments were going to be more of a novelty and awkward to use. But after it dumped 18 inches before a day of adaptive skiing I discovered how wrong I was. No slope, even the steep slippery ones, could slow me down. I tramped everywhere with abandon and had more than a dozen people ask me about the gear, including many from the adaptive ski program who had never seen such a thing. If you are just worried about ice and want to get traction easily on the fly (and go back to your standard tips quickly), Fetterman does make ice tips that will slip over your existing crutch or cane tip ($40/pair), which is convenient for short trips outdoors since it doesn’t require a tool. Recommendation: SideStix Sandshoe with Spindle Pick and Fetterman Ice Tips
The Sidestix sandshoe attachment is made for traction.
The 8" snowshoe can handle deep pow.
There are several other areas to consider when purchasing a new pair of forearm crutches that go beyond their basic construction.
Noise: Well-made fixed-length and infinite-length crutches are whisper quiet. With the SideStix, my wife Laura no longer has a “husband approaching” early-warning system. In the past, folks could hear me and my adjustable beaters (lots of metal-on-metal) from a block away.
Weight: You can buy crutches so light they almost float on air. And they tend to be cheap, plastic, and disposable. When deciding on a pair of crutches, weight matters most where it counts (primary shaft, e.g. SideStix’s carbon fiber), but quality trumps in other areas (tips, grips, cuffs).
Grip Angle: Carpal tunnel syndrome and forearm crutch use can go hand-in-hand. SideStix actually scientifically developed their grip angle to minimize this risk, canting it up ever so slightly (actually a technical challenge), making it an unsung and unusual benefit of the crutch.
Travel/Portability: This sounds great on paper but in practice is rarely recommended in a crutch. These collapsible types are not typically appropriate for day-to-day use. That said, if you primarily use a wheelchair or scooter and want to have a pair of crutches on hand for those occasions when you need to get around in tight spots, perfect.
Price: Cost is a huge variable. Forearm crutches range in price from $25 for the most basic drug-store versions to over $1,000 for those custom-made (my SideStix with all the attachments cost $976). Health insurance can soften the blow.
Warranty: Less expensive crutches, which can wear quickly especially for full-time crutch users, often have short warranties. Look for lengthy or lifetime warranties if you plan to put the crutches to serious use.
Metal cuffs can be particularly noisy.
Basic adjustable aluminum crutches can be heavy.
ActiveMSers Bottom Line
Buying forearm crutches is a lot like buying a new car. Anything you purchase will technically get you from Point A to Point B. Do you need to spend a grand to get a decent pair of forearm crutches? No. You also don’t need that sports car (or high-end bike or insert pricey passion here) in your garage, either. If you have never used forearm crutches, your budget is snug, or you are on the fence, I’d recommend purchasing an inexpensive pair to try out or renting a pair of SideStix through their new rental program. (TIP: avoid using insurance for an inexpensive pair, as you probably are allowed this type of purchase only once every five years or so.)
While I find using forearm crutches much less fatiguing than using a walker (since it allows me to take better advantage of my mostly still-intact upper-body strength) you may have a different experience. Using them also requires a modicum of balance, albeit far less than one might imagine; in fact I’ve never fallen using a pair. Interestingly, I look like I can barely hobble around my house with a single cane, but I can hike miles with forearm crutches. Lastly, they can take time to learn how to use properly. Since I’ve hiked with trekking poles for years, the transition was easy for me, but may take time for novice users.
After using my beaters for two years and then testing the SideStix for the past few months, I’ve learned that there is a vast gulf between hand-me-downs and high-end. Does SideStix make the best forearm crutches on the market? For the outdoor enthusiast, there’s no question—absolutely. Every component—from the carbon fiber shaft to the Ergon grips to the Fetterman tips to the custom molded cuffs to the limited lifetime warranty—sets the bar incredibly high. I'm blown away by the versatility of these go-anywhere Canadian crutches, their performance amplified by the diverse array of outdoor accessories. They are my top recommendation for the disabled athlete, adventurer or explorer.
There are other fine, high-end crutches to consider, in particular if you prefer a fixed-length custom crutch like those made byThomas Fetterman andSuperlite, both highly regarded. But if it comes down to money, as it often does with us MSers, sticks under $100 like those from Millennial are perfectly acceptable and will help get you where want to go. StrongArm mobility, also not tested, makes an interesting looking pair.
My dream sports car is an all-wheel-drive twin-turbo Nissan GT-R with 545 horsepower, 463 lb-ft of torque, and a 0-60 mph time of less than 2.7 seconds. But at $96,820, it’s a sports car for which I’ll almost certainly never splurge. I’d argue the high performance SideStix, 1/100th the cost and built to last a lifetime, are arguably worth the splurge for the freedom to go virtually anywhere. At least that’s the argument I’d use on my wife! And if that doesn’t work, beg. You won’t be sorry.
Freedom on the snow.
Freedom on the trail.
Members of ActiveMSers can save 10% on SideStix equipment (direct sales only). To get your discount, join today by signing upfor our newsletter. NOTE: ActiveMSers has arranged this exclusive discount with SideStix and has no other affiliation with the company, receiving no compensation or commission for any sales.