Mastering Post-TKR Stairs
Posted , 27 users are following.
Going Up...
- Go to a stair.
- Hold on to the handrail!!
- Put the foot of your BAD leg on the step.
- Pull yourself up to the step.
- Bring up your other foot.
- Put the foot of your bad leg back down on the floor.
- Balance on that leg while you bring your other foot down.
- Repeat...a lot.
A few other thoughts regarding "up"...
1. You'll probably need to hold on to a handrail at the beginning. The goal is to do it by yourself without holding on to the rail for balance.
2. You will have a tendency at the beginning to crouch a bit and "spring off" with your good leg. Don't...that's cheating. The whole point is to build strength in the quadricep of your bad leg. Success is using the strength of that leg alone to get you to the next step.
3. This is a basic up and down exercise. As you progress, go to the next step...and then the next...with the bad leg first building your strength. Finally, go up a flight of stairs normally with alternating legs...and then without holding on to anything.
Going Down...
- Go to a stair.
- Hold on to the handrail.
- Put the foot of your GOOD leg on the lower step.
- Bend your knee and bring the foot of your bad leg down.
- Do the same all the way down.
- Repeat...a lot.
A few other thoughts regarding "down"...
1. You will have a tendency to not bend the bad leg but to "swing it around" to get to the lower step. Don't do this. Concentrate on bending your leg, achieving good ROM to get your bad leg down to the next step. Keep your leg IN LINE and not swinging it out to the side.
2. Once you get stronger, lead with your bad leg and balance on it while bringing your good leg down. This will rely on your stronger quads.
3. You'd better hold on to a handrail while doing this...probably for a long time. Don't trust the new knee completely until your quads are really strong and you feel that you have your balance back.
TKR CHALLENGE...
Go up the stairs TWO AT A TIME!!!!!! Yes, this will take you a year or more to achieve...At nine months p/o and almost 69 years old, I'm not close to doing this on a whole flight of stairs although I can do the first double (but I still cheat by pulling on the handrail a bit...very annoying...gotta try harder). Goals are meant to push us to become better. This one's mine. Will it be yours???
3 likes, 57 replies
marilyn10235 CHICO_MARX
Posted
Hi all, I am weighing in with my pennyworth!
I was also told lead up stairs with good leg & down with operated leg. Yea all well & good but once you are more able to exercise I also agree with Chico, I've been trying to do the stairs using my bad leg 1st, but it's hard. I hadn't gone up & down stairs normally for years as have been waiting to be accepted on waitiing list for TKR.
I was advised by my surgeon not to go for the bilateral due to increased risk & increase in recovery/rehab. Seeing him this arvo, feeling nervous now!!
XX
danie61 CHICO_MARX
Posted
lesley_63511 danie61
Posted
Hi Danie as your pain eases you will be able to do more and more after the tkr. Stairs are a challenge but go slowly...going up use the stronger leg first bringing the operated leg up slowly bending it as normally as you can on to the same step. Then of course going down the bad leg first followed by the good leg. As all heals stairs will become easier. I'm 10 weeks post op and still climb stairs cautiously as I get pain under the patella. Another exercise I do to strengthen my quads etc is sitting in my car pushing the clutch in and out slowly. It has helped me considerably getting back to driving too. Good luck from a fellow South African 😊
terri59470 CHICO_MARX
Posted
Another one respectfully disagreeing here in the UK; I'm on my 3rd TKR (this last one, 3 weeks ago, being a revision of the first one done just 2 years ago), and each time I've been told to lead with the GOOD going up and the BAD going down - up to heaven, down to hell. There are plenty of quad-strengthening exercises prescribed without using the up-and-down stairs for that purpose, especially in the early stages.
I think this just goes to illustrate how many different schools of thought there are on TKR recovery, and even the "experts" have varying ideas of what is most beneficial.
Here's to happy, healthy, and above all SAFE recovery for all, and if in doubt refer to your Health Care Professional.
CHICO_MARX terri59470
Posted
I honestly didn't think this topic would be so controversial but I guess there are multiple schools of thought on this subject. All I did was state what I was taught in PT only to find others who were taught the opposite. The only thing I can say is: Listen to your PT and doc and do what they tell you.
terri59470 CHICO_MARX
Posted
And I've only just realised it's a 3 month old discussion, sorry for stirring it up again - I blame the fact I'm only 3 weeks out from my Revision and still away with the fairies half the time 😆
frances92164 CHICO_MARX
Posted
david13856 CHICO_MARX
Posted
Hi Chico 10 hours after my TKR I was up and down the hospital stairs under the watchful eye of a beautiful physiotherapist. Of course I was still under the influence of the anesthetic and I felt great. I was amazed my op leg could bear my full weight 16.5 stone (231lb) times like this when I wish I'd stuck to the diet. On day two post op I was discharged with flying colours but by then the swelling had started. When it came to facing the stairs at home for the first time my op leg was nearly twice the size of my good leg and it would have been impossible to climb them in the way you describe. So I take on board what your pt is saying about building up muscle but even now at 3 weeks post op I think I'd still have difficulty putting my op leg first going up. anyway I might give it a go later today. I'll let you know how I get on, or maybe not if I break my neck.
CHICO_MARX david13856
Posted
Nooooooo..... Not a chance you'll be doing stairs that early. That initial "high" was because you were still feeling the effects of the anesthesia and were loaded with pain meds. Once the scar tissue starts to grow, that when the knee stops working and you have to regain your ROM. It was about 2 1/2 months post-op before I even tried stairs with a better ROM...couldn't do it...muscles were way too weak.
In order of priority...first you get your ROM back to 0 / +120, then you rebuild all the strength in your dead quads, glutes and core to support the new knee, and finally, with that strength, you can master stairs. One step at a time.
david13856 CHICO_MARX
Posted
I may have been doped up but I assure you I didn't imagine those stairs. I was admitted on the Friday I was the last patient to go down at 9-30 pm I was back in my room by 10-15 pm I had a machine that sounded like a jack hammer pounding away at both feet all night, needless to say I didn't sleep. Saturday morning I was served tea at 6 am, Obs at 7 am Visit from surgeon and breakfast by 8 pm Physio at 8-15 INCLUDING STAIRS, Sunday home, I've been up and down stairs ever since, That's how the NHS works in the UK, if you disagree I'll give you the name of the hospital and you can check it out for yourself.
CHICO_MARX david13856
Posted
No need. The whole stairs "thing" has been controversial since it seems that PTs, docs and hospitals everywhere have very different ways dealing with it. After reading thousands of posts on here, it seems like most people don't have the leg strength to master stairs (up and down with alternating legs not holding a rail or using a walking aid) until far into their recovery. I followed my PTs instructions, above, and was doing TWO at a time going up at 14 months. But then, I've been cheating... Played hockey for over 45 years so I think there's plenty of "muscle memory" left in my quads that may give me an unfair advantage. Everyone makes their choices...just stay focused and get better...
yolande1230 CHICO_MARX
Posted
missmagwumps CHICO_MARX
Posted
I haven't been able to do stairs properly since 1987 - this is going to take me a while, especially after my TKR 5 months ago - a work in progress and pleased I found this in one of your posts ! Have printed it off and will keep at it...thanks again x
CHICO_MARX missmagwumps
Posted
missmagwumps CHICO_MARX
Posted
I know - I was told good first, bad 2nd...leading with heaven up, hell down....but whatever, I'll just be happy to achieve it which ever way I try .....will let you know next month but doubt my agility will ever allow me two at a time at any stage but never say never, eh ! As I said it has been years since I've ever been able to use stairs properly but now I've finally had the TKR - who knows....I'll give it a good go ! Thanks x
CHICO_MARX missmagwumps
Posted
marilyn10235 missmagwumps
Posted
Hi there, just weighing into the stairs debate!
i was told whilst in hospital, up with the good & down with the bad. The physio made me practice before I was discharged.
However at my 2nd physiotherapy session, the physio there told the same as Chico, up with the bad etc. She also set me exercises which were 2 sets of 10 steps up with the bad, 2 sets is 10 steps down with the good but very slowly, holding the bend for as long as poss before setting the foot onto the step. This I had to build up to as I couldn’t hold the bend for too long before setting foot on the step, but now can do as she wanted me to. It is hard but ultimately very good exercise, esp if you have a little scar tissue around the actual knee area, which can really hold things up, I felt the scar tissue pull at 1st.
Just take it slowly & carefully on the bottom step at 1st, then all the way up & back down. It really does wonders!
Marilyn
XX
missmagwumps CHICO_MARX
Posted
I started with practicing on the bottom step for a few days and now trying a flight of stairs I can't seem to stop 'launching' myself at the stairs when trying to do them in the normal way....I realised i haven't been able to get up stairs properly since the 90's so it wont be easy to get into a normal rythm again - it's almost like taking a small leap/jump to pull myself onto the next step with a very pronounced limp and my spine is suffering from it (have had spine issues almost as long a knee).....do you think this is normal in making progress or am I doing something wrong maybe......it seems I am involuntarily trying to avoid putting pressure on the knee and using my body/arms to pull myself up instead of the knee.... so hard to decribe what I am doing but you may understand ! I am suffering a lot more pain since trying to master stairs and it's putting me out of action for 2-3 days if I overdo it.....probably why I am unintentionally not doing it properly! Can you help with any suggestions ? Thanks
CHICO_MARX missmagwumps
Posted
"Launching" means that you're trying to use your body weight as a pendulum to compensate for your dead quad and glute. The motion of going up to a step with your "bad" leg should, like a normal person, be completely a function of your muscles which have atrophied. They must be rebuilt. This is the stair work as detailed above. First ROM, then the muscle rebuild and lastly the stair work. It's the last great hurdle in a recovery.