Navigating stairs with crutches is a challenging maneuver during recovery, requiring significant upper body strength, coordination, and balance. This process applies primarily to standard underarm crutches, where the user’s hands and arms bear weight instead of the injured leg. Mastering the correct technique for both ascending and descending is essential to prevent injury, protect the healing limb, and maintain mobility. The following instructions provide a clear, safe framework for managing this task, regardless of whether a handrail is available.
Essential Safety and Preparation
Before attempting to use stairs, a thorough safety check of both the equipment and the environment is required. The rubber tips at the base of the crutches must be dry, clean, and intact, as worn or wet tips compromise the non-slip grip needed for stability. Proper crutch adjustment is essential: the handgrips should allow for a slight bend in the elbow (15 to 20 degrees) so the arms can effectively bear body weight. The tops of the crutches should sit about two finger-widths below the armpit to prevent pressure on nerves and blood vessels.
Assess the staircase environment for hazards like poor lighting, loose carpeting, or wetness. Wear non-slip footwear with a firm sole, avoiding socks, slippers, or shoes that lack adequate traction. Users must remain mentally focused, as distraction or impairment from medication compromises the required motor control and balance. If balance feels unstable or if attempting this maneuver for the first time, having a spotter stand below on the stairs is an important precaution.
Technique for Going Up Stairs
The guiding principle for ascending stairs is “up with the good,” meaning the uninjured, stronger leg should always lead the movement onto the next step. This technique leverages the strength of the good leg to lift the body’s entire weight, which is mechanically easier and safer than pushing up with the arms alone. The process varies slightly depending on the presence of a railing, which provides a valuable anchor for stability.
If a handrail is available, position the unaffected hand on the railing and gather both crutches into the hand on the injured side. The crutch tips remain firmly planted on the current step, with the user’s weight shifted onto the handrail and the crutch handgrip. The uninjured foot steps up onto the next stair, transferring body weight to that foot to lift the body. Finally, the injured leg and both crutches are brought up to meet the good foot on the same step.
If no railing is present, the user must rely solely on the crutches for support, holding one under each arm as if walking normally. The crutch tips should be placed near the back edge of the current step, ensuring they are not too close to the side where they could slip off. The good leg steps up to the next stair, and the arms press down on the crutch handgrips to help lift the body. Once stable, the injured leg is kept non-weight-bearing, and the crutches are moved up to join the good leg on the new step before repeating the process.
Technique for Going Down Stairs
The descent is more challenging due to gravity and the requirement to control downward momentum, following the rule “down with the bad.” This means the crutches and the injured leg move down to the next step first, with the strong leg acting as the final, controlled braking mechanism. Maintaining the injured leg in a non-weight-bearing position is important, holding it out slightly to ensure the foot does not catch on the edge of the stair.
With a handrail, the user places the unaffected hand on the railing and holds both crutches in the hand on the injured side, aligning the crutches in a cross or T-shape for a secure grip. The crutch tips are placed firmly onto the center of the step below, followed immediately by the injured leg, which is held off the ground. The user then shifts their weight onto the handrail and the crutch handgrips, slowly bending the knee of the good leg to lower the body to the step below. The good foot is the last component to move down, joining the crutches and the injured leg on the lower step.
When a railing is absent, both crutches are used for maximum stability, one under each arm. The user must place the crutch tips onto the step below, ensuring they are positioned securely away from the edge. The injured leg is kept forward and clear of the step, moving down simultaneously with the crutches. The arms bear the weight as the good leg slowly bends to control the descent, and the good foot then joins the crutches and the injured leg on the lower stair. This method requires greater upper body strength and deliberate, slow movements to prevent a sudden loss of balance.