“Alas for Tiny Tim, he bore a little crutch, and had his limbs supported by an iron frame!”
A Christmas Carol has long proved one of Dickens’ most popular works. Debate still continues over what disease afflicted poor Tiny Tim, but I find it interesting to think about the crutch he used.
As a child, crutches were almost a hallmark of the adventurous, from falling out of trees to the consequence of a luxurious skiing accident. Broadly speaking, a crutch is a medical device which helps a person walk from one spot to another. By helping to bear their body weight, crutches aid mobility in people with either short-term injuries to life-long disabilities.
The first evidence of their use dates back to the time of the Pharaohs, clearly visible in a carving dating to nearly 3000 BCE. The earliest crutches were essentially a T-shaped design, which slowly morphed into the more popular V-shape in use today. They were made form a piece of hardwood cut to length, and split near the top to create this V-shape. A wooden underarm piece could then be attached for both underarm and handle use. Although uncomfortable as they lacked cushioning, they proved effective.
Today, crutches are essentially of two basic designs. Canadian, Lofstrand or forearm crutches are the more popular design used outside of America. They have cuffs which give forearm support, along with grips which allow the user to either hold or rest their hands. These act together to help support the patient’s weight. These type of crutches tend to offer the best alternative for long-term use, and for people with impaired upper body strength.
Perhaps for these reasons, underarm or axillary crutches are more commonly used in the States. These consist of a pad designed to rest below the armpit and against the rib cage, along with a hand support parallel to this. The body’s weight is taken by the hands, not the armpit; if used incorrectly, a condition known as crutch paralysis, or crutch palsy can arise from pressure on nerves in the armpit, or axilla.
In 1917 Emile Schlick patented the first commercially-produced crutch, catering to the need of wounded returning WWI soldiers. Later, the first customisable crutches – they had a height-adjustable frame – were designed by A.R. Lofstrand, Jr. Crutch mills soon became common through out New England, some of which remain in production today, using production methods dating back to the Civil War.
Plus, both types of crutches offer an alternative use: they are ideal for poking people to gain attention.
And so back to Tiny Tim.
In the 1860s, William Treloar, future Lord Mayor of London, became inspired to help crippled children after attending a public reading of A Christmas Carol. He established the Lord Mayor Treloar Cripple’s Hospital and College, in Alton, where pioneering orthopaedic treatments were used to help children deformed by tuberculosis and other diseases. The hospital still exists today.