BY: ARNAN SISSON

February 19th, 2024

This article is the perfect read for anyone who has had a recent surgery or someone who has developed general weakness and balance issues over the years. Training to walk again without relying on a cane, walker, or wheelchair is comparable to reteaching ourselves how to climb stairs. This type of treatment must be done in progressive steps for the best possible outcome. Rushing through this type of program without a good progression or using a series of good exercises to get you there can result in a few things that may happen.

You could rush into it and not develop the strength you need to get up the stairs. That could put you at risk of feeling uneasy or even worse could result in a fall. One thing that we notice even more often is that most people will just struggle and become frustrated expecting instant results. This will often create a mindset that you will never be able to climb up those stairs. I have personally seen several patients who don't even sleep upstairs in their bedrooms. Imagine not being able to find comfort in your own home like everyone deserves. Not to worry, we are here to help!

First and foremost if you've just had surgery make sure to always follow the surgical precautions. These can be quite different for each surgery, so before you do any progressions make sure you speak with your surgical team to get an ok just because there are certain precautions with some surgeries that may prohibit a progression.

With that being said you want to get the muscles in your legs conditioned to stair climbing in a safe way. The way that offers the most support is turning so that you are facing the rails and getting both hands on the rail then side-stepping up and down the stairs(the stair step shuffle!). Also, remember if you have one side or leg that is stronger than the other you want to lead up the stairs with that side and go down with your weaker leg. A good phrase that we remind people to use is “The good leg goes to Heaven and the bad leg goes you know where”, this will help you remember which leg to begin with.

Baby steps are keys for starting, start by just doing one step then go back down, one step and go back down while holding both hands on the rail, and just for the first few days spend a few minutes doing that. Once you build up your confidence then you can add a few more steps and every day after you want to increase either the number of steps or increase the sets. After the first few weeks, you should be doing it for about 15 minutes once or twice a day. Over time you will be able to go up and down about 15 to 20 times a day.

This will give you a nice sturdy base of strength and stability to progress without putting you at risk for a fall. In the next progression once you feel confident with the first and start hitting those set goals, you want to face the stairs head-on like you normally would and are going to use one hand on the rail. Just like before you are going to lead with your good leg and when coming back down lead with the weaker leg (if you have one). Just like last time you are going to start with one step doing reps for a short time progressing and adding more steps, and time(reps) as you feel confident, remember this is not a quick race it’s a marathon so you don’t not want to rush this because you not only want to be comfortable but also maintain stability when going up and down the steps.

Once you become more confident you can start adding stairs or sets to your single-handed stair climbing and continue to build up technique and strength where you are doing that for 15 minutes at a time and about 20 sets.

At that point, we can proceed to the next stage where you want to mimic stair climbing with no hand support. What we tell patients to do is to get their hand one or two inches above the handrail, then try to climb one step. Doing that will give your body a chance to use all of its muscles and go up normally.  If you don’t have the strength then your hand will be there to grab the rail. This will give you that safety buffer where you can still do stair climbing without too much risk.

If you are unable to do that it just means you have to build your strength up more. You can do that by returning to the previous exercise we talked about or even by giving us a ring and we can design a program that will help speed everything up and strengthen up those hip and knee muscles in the clinic. Once you're able to do one stair with your hand not touching, you want to spend a few days getting used to that, then gradually add a few steps and sets to where you’re doing that for 20 minutes or so every day.

Once that is achieved that final step is keeping your hand down once you feel confident doing a few steps normally like all the rest you will continue to add a few steps and sets and eventually you’ll be doing 20 minutes or normal stair climbing. It may be a very boring progression, but I have used that progression for years and it works very well. The most important thing is it gains your independence back but does so in a safe way.

So if you want to get more information on that step progression, feel free to ring us at (804)493-3256 for a FREE phone consultation. During this call we can determine what are the biggest things that are leading to your weakness and the best 2 to 3 approaches to get you back your strength and back up those stairs.