A total hip replacement (THR) is a significant step toward regaining mobility and reducing pain. Safely navigating everyday activities like stair climbing requires specific techniques during recovery. The hip joint must be protected from excessive strain and certain movements, especially in the early post-operative period. By learning and consistently applying new body mechanics, you can confidently and safely use stairs as you progress through your rehabilitation. This guide provides actionable steps to ensure your movement protects your new hip joint.
Clearance and Assistive Devices
Before attempting to use stairs, you must have clearance from your physical therapist or surgeon to ensure your recovery is at an appropriate stage. Most patients begin stair training under supervision before leaving the hospital, typically within a few days of surgery. A secure handrail is a prerequisite for any initial attempt, as it provides a stable point of contact and balance.
If a handrail is only available on one side, you should use your assistive device, such as a cane or crutch, in the hand opposite the rail. This setup allows the rail to support the majority of your weight while the device acts as a secondary balance point. Ensure you are wearing supportive, non-slip footwear to maximize grip and prevent accidental slipping. The use of an assistive device remains necessary for stability until your therapist advises you have sufficient strength and balance to manage without one.
Proper Technique for Ascending Stairs
Ascending stairs requires the non-operated leg to perform the majority of the muscular work, a technique often summarized as “up with the good.” Begin by firmly gripping the handrail with one hand and positioning your assistive device alongside you. Use the handrail and your arms to bear some of your weight, which lessens the load on your lower body.
The first movement is to step up with your non-operated, or “good,” leg onto the next step. Once that foot is securely planted, shift your body weight forward and upward onto that strong leg. Finally, bring the operated leg and your assistive device up to meet your non-operated leg on the same step. This one-step-at-a-time method minimizes the bending of the operated hip, helping to avoid violating post-operative hip precautions.
Proper Technique for Descending Stairs
Descending stairs reverses the technique for ascending, which is often remembered as “down with the bad.” This method ensures that the strongest muscles in your non-operated leg control the slow, eccentric lowering of your body weight. You should firmly hold the handrail and position your assistive device on the lower step first.
Next, you will lower the operated, or “bad,” leg down to the same step as the assistive device. The knee of your non-operated leg must remain slightly bent to absorb and control the descent, preventing a jarring motion. Only after the operated leg and the device are stable on the lower step should you bring the non-operated leg down to meet them. Maintaining this slow, controlled sequence with both feet landing on the same step protects the new joint from excessive impact.
Maintaining Safety on Stairs
Ensuring the surrounding environment is safe is just as important as mastering the movement technique itself. You should never attempt to carry any object, especially heavy items, while using the stairs during the initial recovery period. Keeping both hands free to use the handrail and your assistive device is necessary for maintaining balance and preventing a dangerous fall.
Environmental hazards should be eliminated by ensuring the stairwell is brightly lit and all steps are clear of clutter, such as shoes, rugs, or loose objects. Avoiding specific post-operative violations is crucial for long-term safety. You must not twist your body at the hip while maneuvering on the stairs, and you should always take one step at a time, avoiding any temptation to skip steps, which can cause excessive hip flexion and strain on the new joint.