The key rule for walking up stairs with crutches is simple: lead with your good leg. Step up with your stronger, uninjured leg first, then bring your injured leg and crutches up to the same step. Going back down, reverse the order: crutches and injured leg go first, strong leg follows. Physical therapists use the phrase “up with the good, down with the bad” to help patients remember.
The technique changes slightly depending on whether there’s a handrail, whether you can put any weight on your injured leg, and how confident you feel. Here’s how to handle each scenario.
Make Sure Your Crutches Fit First
Poorly fitted crutches make stairs harder and riskier. The top pad of each crutch should sit about 1.5 to 2 inches below your armpit, not pressed up into it. Leaning your weight into your armpits can compress nerves and cause numbness in your hands. Your weight should go through your hands, not the pads. The handgrip should be set so your elbow bends at roughly 15 to 30 degrees when you’re standing upright.
When standing still, the bottom of each crutch should land about 2 inches out from the side of your shoe and about 6 inches in front of your toes. If the crutches are too long or too short, adjusting stairs will feel unstable no matter how good your technique is.
Going Upstairs With a Handrail
A handrail gives you the most stability, so use one whenever it’s available. Hold the handrail with the hand on your stronger side. Take both crutches and hold them together in your other hand, tucked under the armpit on your injured side. You can cross them slightly to keep them from spreading apart.
The sequence, one step at a time:
- Step up with your good leg. Push down through the handrail and crutches to support your weight as you step your stronger foot onto the next step. Make sure your whole foot lands on the step, not just the ball.
- Straighten your good knee. Use that leg to lift your body weight up.
- Bring your injured leg and crutches up to the same step. Don’t try to skip ahead to the next one.
- Pause and get your balance before repeating.
Your weight should feel evenly distributed between the handrail and the crutches throughout each step. Move slowly. There’s no benefit to rushing, and one slip can set your recovery back significantly.
Going Upstairs Without a Handrail
Without a rail, keep one crutch in each hand. Stand close to the bottom step with your crutches slightly in front of you.
Step up with your good leg first, just like the handrail version. Then bring both crutches and your injured leg up together as a single unit. Your strong leg does all the climbing work. Place each crutch in the center of the step so it doesn’t slide off the edge. Go one step at a time and pause between each one.
This version demands more upper body strength and balance. If it feels unsteady, consider having someone stand behind you the first few times until you’re confident.
Going Downstairs
Going down reverses the order completely. This time your injured leg leads.
With a handrail, hold the rail on your stronger side and both crutches in the other hand. Place the crutches on the step below, then step down with your injured leg. Finally, bring your good leg down to the same step. Keep your injured leg slightly out in front of you so it doesn’t catch on the step edge.
Without a handrail, hold one crutch in each hand. Lower both crutches to the step below first. Then step down with your injured leg, followed by your good leg onto the same step. Your arms absorb much of your body weight through the crutches as you lower yourself.
Going downstairs typically feels scarier than going up because gravity is working against you. Shorter, controlled movements help. Resist the urge to lean forward.
If You Can’t Put Any Weight on Your Leg
Non-weight-bearing means your injured foot is not allowed to touch the floor at all. This makes stairs considerably harder because you’re essentially hopping on one leg while supporting yourself with your arms.
Going up: hold the handrail with one hand and both crutches (crossed together) in the other. Keep your injured leg bent and held slightly behind you so it stays clear of the steps. Push down hard on the rail and crutches, then hop your good foot up to the next step. Bring the crutches up after you.
Going down: hold the rail and crutches the same way. This time, keep your injured leg out in front of you. Place the crutches on the step below, shift your weight onto the rail and crutches, and gently lower yourself down on your good leg.
This takes significant arm and core strength. If it doesn’t feel safe, there’s no shame in going up and down stairs on your backside. Sit on the lowest step, place your crutches to the side within reach, and use your arms and good leg to scoot yourself up one step at a time. At the top, place a sturdy stool or chair near the top step so you have something stable to push yourself up onto when you stand.
Tips That Make a Real Difference
Always go one step at a time. Even if you normally take stairs two at a time, your balance and strength are different on crutches. Each foot and each crutch tip should land fully on the step surface, not hanging off the edge. Place crutches in the center of each step.
Wear shoes with good grip. Socks on hardwood stairs are a fall waiting to happen. If your stairs at home are slippery, non-slip adhesive strips on the step edges are cheap and easy to install.
Have someone nearby the first few times, especially if you’re non-weight-bearing. They should stand behind you when you go up and in front of you when you go down, so they can catch you if you lose balance. Once you’ve done it a few times and feel stable, you can go solo.
If you’re exhausted or in a lot of pain, don’t attempt stairs. Fatigue is one of the biggest risk factors for falls on crutches. Reorganize your living space temporarily so essential items are on one floor if possible.