In our opinion there are 3 main factors that drive the continued use of underarm (sometimes referred to as axilla, axillary or standard) crutches in the US and Canada.
COST. The number one reason for their continued use is cost. Underarm crutches have been the ”staple” walking aid that hospitals, surgical centers and rehabilitation centers have been issuing patients for decades. The sheer volume keeps prices low which both healthcare facilities and insurance companies enjoy. In many cases, doctors, physical therapists and rehabilitation specialists are limited to what they prescribe to their patients due to what they are supplied by their employer (hospital, surgical center, rehabilitation center, etc)
PERCEPTION. Strangely, there is still a general perception that forearm crutches are only for individuals with long term physical disabilities. It is our opinion that the popularity of forearm crutches among long term disabled users should be the motivating factor to use them. Here are just some of the reasons for their popularity among long term users; comfort, ease of use, prevention of nerve damage, agility, speed, easier/safer to ascend/descend stairs, improved posture, improves and allows for a variety of walking styles (gaits), improved stability over rough or uneven surfaces, smaller/compact for travel and aesthetically pleasing designs.
EDUCATION. There is a lack of education and training for orthopedic doctors, physical therapists and rehab specialists treating short term surgeries and injuries. Typically doctors and rehab specialists treating long term disabilities (Spinal Cord Injuries, Multiple Sclerosis, Cerebral Palsy, Muscular Dystrophy, Ehlers-Danlos Syndrome, Stroke Patients, etc) are the ones exposed to the benefits and superiority of forearm crutches. However, due to the proliferation of the internet, individuals are educating themselves and there is a continued, positive trend towards the use of forearm crutches in the US and Canada.