How to Negotiate Stairs After an Injury or Surgery

To avoid falling while ascending or descending stairs after an injury, it is important to learn the correct techniques for negotiating steps. Using stairs after hip or knee replacement surgery can be especially scary since the last thing you want to do is reinjure yourself and compromise the prosthetic.

Fortunately, with some training and a little practice, you can learn to negotiate stairs safely and with absolute confidence.

The saying "put the right forward" takes on an entirely different meaning when you are recovering from a lower extremity injury. Despite what some may think, there is a "right" and "wrong" foot, and the one you lead with changes depending on the direction you are moving.

What this means is that you should lead with your stronger leg to walk up the stairs and your weaker leg to walk down.

When ascending stairs, remember that a strong leg is needed to propel you upwards; the other leg just follows. When descending stairs, you need a good leg to bear your body weight as you lower your injured one.

Until this becomes automatic, repeat the words "up with the good, down with the bad" before navigating steps, curbs, or any steep incline or decline.

Having a banister or handrail makes navigating the stairs all the easier. If you don't have one and can't afford to install one, you may need an assistive device like a cane or crutch to provide you greater balance.

To use a cane or crutch correctly when ascending or descending stairs:

1. Hold onto the railing with one hand and place the cane or crutch on the opposite side of your injured leg.
2. Lift your stronger leg onto the step when going up and start with the injured leg when going down.

If using a walker, you can still negotiate stairs as long as you have a handrail. To do so:

1. Turn the walker sideways with the crossbar next to you.
2. Place the two front legs of the walker on the first step.
3. Hold the walker with one hand and the handrail with the other.
4. Supporting your weight evenly between the handrail and walker, step up with your good leg.
5. If descending the stairs, follow the same instructions, but step down with the injured leg.

There are other precautions you should take when learning to walk up and down stairs while healing. Among the primary concerns is the avoidance of slips and falls.

If the stairs are polished or slick, you can purchase temporary adhesive floor treads to provide more traction or wear gripper socks with rubber treads. Gripper socks can even help if you have a synthetic runner as the carpet fibers can sometimes be slick.

You should also check the height of a step if approaching the stairs for the first time. While standard rises are around 7 inches (18 centimeters) tall, some are higher and may cause problems if you can't lift your leg high enough or lower your leg steadily enough.

The same applies to the depth of the step. If you can't place your entire foot on a step with at least an inch or two to spare, navigating the stairs can be dicey. It may force you to tilt your ankle or walk on the ball of your foot, both of which can cause you to slip and fall.

If you are helping an injured friend or family member walk up or down the stairs, it is important to position your body correctly to provide maximum support with minimal interference. As a rule of thumb, you should never walk alongside them or act as a human crutch. Doing so not only crowds them in but makes it difficult to intervene them if they stumble or fall.

If your loved one is walking up the stairs, stay behind them by one or two steps. Rest one hand on the back of the pelvis for support. It this way, if they fall backward, you're in the right position to brace them.

If your loved one is walking down the stairs, stand one or two steps below them. You should face them as you descend the stairs, steadying them by the shoulder or front of the chest.

If you have difficulty with stairs, your physical therapist can teach you exercises that strengthen the "anti-gravity" muscles that keep you upright and stable as you navigate inclines or declines. These exercises can be done during physical therapy as part of a home exercise routine:

• Bridging
• Straight leg raises
• Hip hikers
• Wall squats
• Hip strengthening exercises
• Calf and ankle exercises

Talk to your physical therapist about how often to do the exercises so as not to overdo it. If you overwork the leg muscles, you may end up being more, rather than less, wobbly.