Stairs After an Injury

Daniel Sedran

July 21, 2021

Outdoor stairs with a railing

There are certain tasks that are common in most of our daily lives. Among these include activities like walking, standing, lifting, and stairs. For many people, stairs are just one simple movement on that list, but they can be more difficult than we tend to appreciate. When someone has a disability, or have recently suffered an injury, this once simple task can become quite challenging. This is particularly true when the injury is to our lower extremity: lower back, hips, knees, and ankles.

What makes the stairs challenging?

The stairs require much more from each of the joints mentioned above. Going up or down the stairs requires more hip, knee, and ankle movement than walking on flat ground. The increased range of motion, along with the change in elevation, also result in more work for the muscles. Particularly when going downstairs, the knee and ankle are forced to bend to further ranges. After an injury, from a combination of pain, swelling, and other factors, the muscle use and joint motion become more difficult.

What can you do about this?

In the early stages following an injury, placing one foot on each step (reciprocal pattern) can be near impossible. Instead, you might need to use a “step-to” pattern until we have sufficient range of motion again. This means that both feet end up on each step of the flight of stairs. It takes longer, but results in much less demand on the joints and muscles. This helps to make using stairs a realistic goal. More specifically, there is one saying that you should remember if you ever experience an injury:

“Up with the good, down with the bad”

This saying is easy to remember and is also the easiest way to get back on the stairs. It means that on the way up, the “good leg” (uninjured leg) steps first. On the way down, it is the “bad leg” (injured leg) that take the first step. Stepping first with your injured leg on the way down can be intimidating at first. For this reason, make sure you don’t try this for the first time on your own. This pattern results in the least amount of pressure on the injured leg. It will save you from a lot of pain, and help you get up and down the stairs more easily.

Is that all?

It is important to remember the most important tip of them all: safety first. First, always use whatever physical supports that are available. The most important physical support is the railing. If there is a railing available, use it! In the other hand, using the gait aid (crutch/cane) that you are using at that time is a good idea. If you are close enough, you can also use a wall. Secondly, in the early stages, it is important to have external support (from another person) if possible. A loved one, someone you live with, a neighbour, etc. are great sources to help guide you and assist as needed. Make sure you always prioritize your safety. In the meantime, it is important to work on overall strength, function, and range of motion according to your physiotherapist. Keeping on track with your treatment plan will help to get you back to using the stairs how you’re used to.

What if this pattern isn’t working for you?

It is best to speak with your physiotherapist or other trusted health professional. Going up and down on your bum (“bum scooting”) is another safe option. Even with this, having support and using proper technique is essential to prevent injury. It is always recommended to try stairs with guidance first, as they can be very dangerous.

What To Expect?

If this is your first time going up and down stairs since injury, you may experience some soreness 24-48 hours after completing it. This is similar to any exercise that you haven’t done for some time. If that’s the case, take time to rest and consult your physiotherapist if it persists. As with all exercise, make 

Stay safe and take care,

Daniel Sedran, MScPT

Registered Physiotherapist
First Line Physiotherapy