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Short Summary
Main recommendation: After total joint replacement surgery, climb steps leading with the good (non-operated) leg and descend leading with the operated leg, following the rule "up with the good, down with the bad." Get help from a caregiver and use the method your physical therapist recommends for each step situation, such as a walker for a single step or railings and a cane or handheld assist for multiple stairs.
Key Points
- Stronger leg does the lifting going up and the lowering going down, which is the reason behind the "up with the good, down with the bad" rule.
- For a single step or curb, a walker is used, with the walker placed on the step first.
- When multiple stairs are involved, a walker is unsafe and should be folded and carried by the caregiver.
- Railings on one or both sides are the preferred support, with a cane or a helper's hand as the second support.
- Caregiver should be behind you on the stairs in tandem for safety, and you should take one step at a time.
Details Worth Noting
- Concrete instructions:
- Single step or curb: bring the walker and feet as close to the step as possible, lift all four walker legs onto the step, step up with the good leg, push on the walker, and bring the operated leg up after it.
- Single step going down: get close to the edge, lower the entire walker to the ground, push down on the walker with both hands, step down with the operated leg first while the good leg lowers you, then bring the good foot down.
- Stairs going up: hold the rail with one hand and a cane (or the helper's hand) with the other; the helper's hand should be palm up and yours palm down; the caregiver follows behind in tandem; move one step at a time, and have the caregiver unfold and place the walker at the top.
- Stairs going down: hold the rail with one hand and the cane in the other if needed; lower the cane, step down with the operated leg first while the good leg lowers you; repeat one step at a time while holding the rail until the walker is back in front of you.
- Your physical therapist decides the best option for your situation, so these methods are general guidance from the video.
- Receiving help when first returning home is recommended for steps and stairs.
- If you have no cane, the video says you may hold someone's hand instead.
- With two rails you don't need a cane, though the video notes many people don't have this option.
Bottom Line
Going up or down steps after joint replacement relies on leading with the right leg, using rails or a walker appropriately, and having a caregiver close by. Follow your physical therapist's guidance on which method suits your home.
