How to Go Up and Down Stairs After Foot Surgery or Injury

To avoid falling while going up or down stairs after an injury or foot surgery, it is important to learn the correct techniques for negotiating steps. A big part of this is leading with the correct foot. Which one you should choose depends on the direction you are moving and the foot that is affected.

Learning to climb stairs safely is often part of physical therapy (PT) for injuries and surgical recoveries, such as after hip replacement or knee replacement surgery. But you will need to know how to do this whether PT has been prescribed to you or not so that you both protect your foot and avoid falls.

This article covers why it's important to lead with certain feet when climbing the stairs, how to navigate stairs with an assistive device like a cane, and other safety tips. It also discusses exercises often recommended to strengthen the muscles involved in stair climbing and how best to help someone else go up and down a flight.

Leading With the Correct Foot

You should lead with your stronger leg to walk up the stairs and your weaker leg to walk down.

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

This may take some thinking at first, but should become automatic with time.

Using Assistive Devices

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 going up stairs:

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

To go down stairs:

1. Put your cane on the step first.
2. Put your weaker leg on the step.
3. Put your good leg, (which carries your body weight) on the step.
   

If you're 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.

Stair-Climbing Safety Tips

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

You should also check the height of a step if approaching the stairs for the first time. While standard risers 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.

You can't modify steps, of course. But being aware of these hazards can remind you that you need to be extra careful when on them.

You might also consider temporarily relocating your sleeping quarters to the first floor or moving items you use throughout the day there so that you are only going up and down the stairs once a day. And remember—if help is available, use it when you need it.

Strengthening Exercises

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.

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.

Finally, if you've undergone surgery, check with your orthopedic surgeon before embarking on any exercise plan. As eager as you may be to heal quickly, more is not always better.

Assisting an Injured Friend

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 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. 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.