Mastering Post-TKR Stairs

MRIs and x-rays do not always tell the story.  Before my TKR, I had four knee scopes back on the early 2000's.  Before each one, the imaging studies showed nothing wrong.  Turns out that I had two meniscus tears (one each knee) and two ripped up femoral condyle cartileges (one each knee).  In all cases, the ortho had to go in to see what was wrong and fix it.  Just the way it is sometimes.  The good thing is that the imaging for you shows no bone-on-bone situation and obviously no need for a TKR.  Get it scoped...

same

So tell me... what does going up a step with your good leg and dragging up the bad one do for your recovery?  What does that do to strengthen your dead quadricep muscle?  Absolutely nothing.  That's why you lead with your BAD leg.  I did this over and over everytime I went to PT.  Strengthening your bad leg is the only way to recover.

The good is that one is more protected from falling down the stairs breaking your neck and lord only knows what a fall would do to a new total knee replacement, but I don't think it would be pretty.

I can just see an inexperienced person arriving home after a total knee replacement, facing their stairs for the first time, and breaking their neck trying to follow something you developed for strengthening before they had the strength to even attempt stairs!

If you had labeled your dissertation USING THE STAIRS TO STRENGTHEN YOUR QUADRICEPs

So tell me....I have just had a total knee replacement, I am just arriving home and facing the stairs for the first time, and the directions from a respected contributor on Patient is to lead with my bad leg going up. If you can not see the folly in your instructions....

Not a single Physical Therapist in the USA would ever teach anyone going up the stairs to lead with their bad leg because it is dangerous.

If you had headed your dissertation

HOW TO USE THE STAIRS TO STRENGTHEN YOUR QUADRICEPS

and included a caution that this exercise was not to be used until...

I would have applauded your advice.

No, Chico. Our advice must be mindful of the safetu of others.

Well I think you are very wrong, at my Hospital in Newcastle they told me this to remember when going down stairs BAD leg first as if you were going to hell, and going upstairs GOOD leg first as if you were going to heaven I have been doing that now for postop 6 weeks and I am fine. You are telling people ( you might be being kind or big headed)  what to do which is wrong Information and that could be damageing there knee or hip please leave it to the Medical staff they know what they are doing !

Again, I will tell you...  In PT, all the stair exercises I did were bad leg first in order to strengthen the atrophied quad.  It would be interesting to do some research on this topic but I just don't have the time.

In the end, follow your PT/doc's instructions.

Hello Chico, I never had knee surgery but it is painful going up any stairs let alone just putting my foot up into 4" inch one step up of my house..should I yet try to do this even though I feel the pain much just below & across my knee cap? & try not to put too much weight on it when I go the one step inside?

You need to be safe when you do the one step into your home.

Hold onto the banister

Keep the bad knee straight.

With the good leg step up onto the step, then bring the bad leg up onto the same step.

When you go outside from inside your house

hold onto the banistet.

Keeping the bad knee stiff, step down with the bad leg first.

Then bring your good leg down to the same step.

Take your time, and be safe.

Chico's method is not a safe method for you just yet.

If you've never had surgery, you need to see an ortho for some imaging and a diagnosis.  Most likely it's something fixable by artroscopy.  TKR patients usually have had knee degeneration over many years and surgeries.  Haven't heard of a lot of people who feel pain and go right to a TKR.  Most important thing for you right now is to find out what's causing the pain and get some relief.

Hi,  what Chico has stated, is what I was told to do here in UK by physio, - normally 3 weeks post op - bear in mind this is after total knee replacement - if you have other knee problems, it's best you seek professional advice. As people on here on going on their personal experiences. Good Luck 

I was starting to think what it was a "country" thing...like American PTs were instructed one way and UK PTs another.  But that's not true.  I see variations in technique from everywhere.  Maybe we should ask that they all get together in one PT room and fight it out.  Last one standing wins.  Then there will be an international standard!

The other thing is that the posts on this topic have been quite passionate.  That's good...takes your mind off your knee while you beat me up.  I don't mind.  Although, if it gets more heated than this, it's still no problem.  I'm a Sicilian from Brooklyn...got Carmine-No-Neck and Louie-The-Wrench idling in the '68 Caddie out back.  Their forte: Persuasion.  Things always work out fine...at least for me...

that's the way I was taught also, in the USA.  Up with good, down with bad.

 

Agree entirely. I would be dead now if I followed this. Going up  my lead leg would have collapsed and I would have fallen down the stairs. Every expert I have spoken to in  the Uk says "good leg to heaven, bad leg to hell"

End of!

up with the good and down with the bad. perhaps i was relying on this too much and favouring my good knee. i would hop down the stairs basically. i like this exercise and i am doing two steps at a time leading up and down with my operated leg. i like the latter line which says goals are meant to push us to become better. feeling some relief already in only two days as i have diligently started in on the different new exercises. amazing. thanks all!