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Issues with going down stairs after tkr

Posted by zippmary @zippmary, 5 days ago

I am almost 7 months post TKR. I feel it went well in almost all regards- I walk, recumbent and upright bike, eliptical, Yoga- I am close to doing a complete butt the heel child's pose. However, I am still finding going down the stairs challenging. I live in NYC and I often take the subway and it is an issue. Can anyone else relate. I had 3 months post opt PT and we only did the stairs a couple of times. Please chime in with advice.

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Mentor
Sue, Volunteer Mentor | @sueinmn | 5 days ago

@zippmary When I had problems after my last hip revision, even though it had been several months, I asked for a referral to PT for related back pain and was granted 12 more sessions.
Can you ask either the surgeon or your primary to write an order specifically for stairs? I've ridden the subways, and being slow on the stairs can be a safety issue with all the people rushing past.

REPLY
elaineva | @elaineva | 4 days ago

Stairs were my biggest challenge post Revision TKR in 2022. During an assessment half way through my 12 weeks of PT, I was asked if there were any challenges I wanted to work on, I chose to focus on stairs. Since my house is multi-level. The PT facility was on the lower level of the Ortho Practice so a portion of my sessions was going up/down stairs. This was very helpful. So
I agree, PT sessions focusing on stairs might be worth it. Full disclosure -I only have 90 degree bend…so going down stairs is still scary to me, even with handrails.
I travel a lot and avoid stairs (and escalators) in crowds because I’m slow. I find an elevator instead, and cross fingers it’s a working one.

REPLY
1 reply
nursefran68 | @nursefran68 | 4 days ago
In reply to @elaineva "Stairs were my biggest challenge post Revision TKR in 2022. During an assessment half way through..." + (show)
@elaineva

Stairs were my biggest challenge post Revision TKR in 2022. During an assessment half way through my 12 weeks of PT, I was asked if there were any challenges I wanted to work on, I chose to focus on stairs. Since my house is multi-level. The PT facility was on the lower level of the Ortho Practice so a portion of my sessions was going up/down stairs. This was very helpful. So
I agree, PT sessions focusing on stairs might be worth it. Full disclosure -I only have 90 degree bend…so going down stairs is still scary to me, even with handrails.
I travel a lot and avoid stairs (and escalators) in crowds because I’m slow. I find an elevator instead, and cross fingers it’s a working one.

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Both my surgeon and PT informed me that stairs would be the greatest challenge, and they were certainly correct. I would say it took just about a full year for me to be fully confident doing stairs, especially going down. I recall one day when after going down stairs I realized "Oh, that was normal - and I really didn't have to give it much thought!" It's like the old joke about getting to Carnegie Hall: Practice, Practice, Practice. And try not to over-think it.
Hang in there - and good luck!

REPLY
ddsack | @ddsack | 3 days ago

Going down stairs requires that for one moment you take all your weight on one leg while flexing the knee, and then bring that weight up again. There are PT exercises that can help strengthen your muscles to accomplish this. Some of them involve standing facing to the side on the bottom step and dipping your TKR knee while tapping your other good toe on the floor below. You do this from both sides as well as facing front and back. You can hold on to a rail or put your hands on the wall for support. It's very hard to do to start with, your toe may not reach the floor to start with, but being able to take the weight on your TKR leg is the point of it. Doing it three or four times a day, 10 reps facing each direction really helps strengthen the needed stair use muscles.

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