Navigating stairs while using crutches presents one of the most significant challenges to mobility during recovery. Mastering the proper technique is essential for maintaining independence and preventing a dangerous fall. This skill should ideally be reviewed and practiced first with a physical therapist to ensure the steps align with your specific injury and weight-bearing status. The correct sequence of movement relies on using your body’s strongest muscles for lifting and lowering, thereby minimizing strain on your upper body and protecting the injured limb.
Essential Safety Fundamentals
The core principle for stair travel with crutches is the simple rule: “Up with the good, down with the bad.” This maxim dictates that the uninjured, or “good,” leg should initiate the movement when ascending, while the injured leg and crutches—the “bad” elements—should lead the way when descending.
If a sturdy handrail is present, utilize it for a third point of contact and stable balance. To free up one hand for the rail, both crutches must be consolidated and held together in the hand opposite the rail. Before attempting any movement, check that the staircase is clear of tripping hazards like loose rugs, clutter, or wet spots.
The rubber tips on the crutches must be dry and have good tread to maintain adequate friction on the stair surface. Proper crutch adjustment is also necessary, with the handgrips set to allow a slight bend in the elbow while the top pads rest approximately one to two inches below the armpits. This setup shifts the primary support burden to the hands and wrists, protecting the nerves and blood vessels in the armpit area from excessive pressure.
Step-by-Step Procedure for Ascending
To begin the ascent, position yourself directly facing the bottom step with your weight centered over your uninjured foot. If a handrail is available, grasp it firmly with the hand on the side of your uninjured leg, holding both crutches securely under the opposite arm.
The first action involves lifting the uninjured leg and placing the entire foot firmly onto the next step. Next, shift your body weight forward onto the newly placed uninjured foot, stabilizing your balance.
The crutches and the injured leg then follow, moving up to join the uninjured foot on the same step. It is crucial that the injured limb remains non-weight-bearing, held slightly forward or bent to clear the step without making contact. Repeat this sequence—good leg up, then crutches and injured leg follow—for each step until you reach the top.
Step-by-Step Procedure for Descending
Start the descent by standing close to the edge of the top step, facing forward, with your weight balanced over your uninjured foot. If using a handrail, consolidate both crutches in the hand opposite the rail and grip the rail securely with your free hand.
The first segment of the downward movement involves lowering the crutches and the injured leg simultaneously to the step below. The crutch tips must be placed securely near the center of the step, and the injured leg should be held out in front to prevent accidental weight bearing. Next, transfer your body weight onto the crutches and the handrail, bending the knee of the uninjured leg to slowly lower your body.
Finally, the uninjured foot is brought down to join the crutches and the injured leg on the lower step, maintaining a slow and steady motion throughout. The entire sequence—crutches and injured leg down, then the uninjured foot follows—is repeated. This careful, deliberate process ensures that you are constantly supported, preventing an uncontrolled drop or loss of balance.