Stairs: A User Guide

August 24, 2023 4:58 AM

I am not a Stairs Person but I've got a Stairs Problem. Am I just bad at them?

We are currently, for the next couple months, living in a home with interior stairs. This happened before in December, and they were terrible weird narrow curving basement stairs and I blamed that format for the knee problem that went from "huh my knee is a little sore" to "nothing is broken but you appear to have sprained basically all your lateral soft tissue down to the ankle" and being cane-dependent even indoors in about two weeks' time. It took three months to recover to the point I could navigate the world without the cane most of the time. I did have teleguidance from my PT and I have been doing my strengthening exercises, but I have not really had that kind of stairs challenge again until now.

At least then I was only trapped downstairs in a basement apartment unable to leave without pain and a high risk of reinjury. Now, the exit/kitchen/my workspace is downstairs and all the beds and the toilet are upstairs. These steps are wider, though they are still terrifyingly steep to me, with unfortunately only one handrail.

As soon as I walked into the house for the first time, I went and got my cane out of the car and am using that every single time, up and down. I am single-stepping on the downward navigation, and side-stepping because my giant ski-feet are much longer than the stair steps. I use a backpack to take things with me to avoid extra trips (and I have a kind husband who will run errands up/down), and frankly I'm opting for dehydration to an extent that isn't sustainable. (I have a camping toilet, I just haven't talked myself into deploying it yet.)

I woke myself up twice last night because I use the heel of that leg to roll over and it hurt in a way I recognize all too well.

Like, should this be so fraught? People seem to live with stairs all the time, even middle-aged ladies with estrogen-deficient connective tissue. I'm fat, which isn't going to change this month, and it also means that full-wrap knee braces pinch and bite if they even fit at all. I do have a support strap I'll try for the next day or two to see if it at least prevents escalation. What else should I be doing? Are there different stair climbing/descending techniques I should be using? IS there an amazing brace for fat knees? (How does anyone keep their children safe in this nightmare environment?? How do more people NOT fall down stairs??)

posted by Lyn Never to Health & Fitness (23 answers total)

When I'm injured, I sit on the stairs and slide up or down on my butt.
posted by metasarah at 5:30 AM on August 24, 2023 [5 favorites]

You are not "bad at stairs," but you have some physical issues that make stairs difficult and dangerous for you, and which cause you injuries. It doesn't matter that for most people stairs are not an issue. (I live in a 3 story narrow house with rooms oddly distributed, kitchen on the top floor, laundry on the first floor, living area on the middle floor) and I have to go up and down stairs dozens of times a day. However, my knees are OK and so I don't even notice it. And my kids grew up in this, and after 2 years old, were not thought to be in danger. But none of that matters: it is more like, I have a nut allergy, and I sometimes wonder "How can all these people just bite into any strange food without worrying, don't other people worry that there could be an allergen in it!" But it's my body that has specific needs that the world doesn't really match and I need to accommodate it. So I would first of all recommend that you just take your own physical needs as a given, not worry that stairs are 'supposed" to be fine, because for you they are not fine.
That said I would look into getting an inexpensive stair climbing aid, such as this.
And then moving your work space to the bedroom, it's only for two months. Go to the kitchen once a day and bring a picnic lunch upstairs if possible. Make your bedroom into a mini tiny studio apartment as best you can.
And mainly browse stair climbing aids like the one i linked to. Good luck!
posted by lesser whistling duck at 5:34 AM on August 24, 2023 [19 favorites]

For this fat person with a knee problem (that was made worse on stairs), these stick-on knee supports have been a game changer. I don't love that they're disposable, and they certainly don't provide as much support as a proper knee brace, but depending on your injury, it might provide enough support to make stairs less painful.

That said - I do also have a knee brace that fits me properly, which I got at a DME store (they sell durable medical equipment like walkers and braces etc) a number of years ago. If there's one near you it may be worth checking out. I hope you find relief soon!
posted by okayokayigive at 5:46 AM on August 24, 2023 [3 favorites]

According to a physiotherapist I saw: stairs are really, really bad for knees,

and if you have cartilage loss and are fat,

living somewhere with stairs will speed up losing the rest of your cartilage faster than living somewhere without stairs.

He basically ordered me to move house to a stair-free environment.
posted by chariot pulled by cassowaries at 5:49 AM on August 24, 2023 [7 favorites]

When I first moved from a ground-floor apartment into my current house (where "ground" floor is one flight of stairs up from the street and the bedrooms are on the second floor) my knees hurt ALL THE TIME. I had no pre-existing joint issues, I was/am in a BMI range such that no one gives me shit about it, and would generally have considered myself to be in good shape (bike commuter, recreational hiker). I still skipped trips up/downstairs because my legs were just so tired and my knees so sore all the time. I did not injure myself but I worried about it a lot.

So basically: yes, STAIRS ARE REALLY HARD! Mostly we don't notice it much because we use stairs about the same amount all the time, but when you move house it becomes obvious. Ultimately, I think living in this house has improved my leg strength, but it took at least six months, maybe a year, and as I say I was starting from a place where I was in good joint health, not recovering from a previous stair-related injury.

RECOMMENDED TECHNIQUE: have you tried going downstairs "in reverse"? This way, your center of balance stays "uphill" instead of pulling you down the stairs, you can put your weight on the balls of your feet, and it's very easy on your quads. Also assuming the handrail is adequate you can hang from the handrail a bit as you go down.
posted by mskyle at 5:54 AM on August 24, 2023 [10 favorites]

+1 to the KT tape for knees that are uncomfortable in a brace.
posted by joycehealy at 6:06 AM on August 24, 2023 [2 favorites]

During her many years of knee problems before replacement, going down stairs backwards was my mom's primary solution, and it worked really well for a long time. It really lets you control your descent more than going down forward, which is basically a lightly managed fall.
posted by gideonfrog at 6:17 AM on August 24, 2023 [1 favorite]

Are you locked into staying there? (Like, won't get your money back and can't afford to consider other options during this time.) If not, if there is any wiggle room in that at all, the smart move might be to find a new place to stay that doesn't have stairs. There's no gain to be living somewhere that is going to cause you to be impaired with a long recovery time -- you're not only having a crummy time now, but you might be having a crummy time for a few months more if like last time you end up with pain from this.
posted by Dip Flash at 6:20 AM on August 24, 2023 [1 favorite]

I agree with everything above. Just a side note to say that different physical therapists might have different approaches and exercises and advice, and if you're finding that yours isn't doing much for you, I'd consider a change. I have had much success with PT over the years but, coincidentally, the one time I saw absolutely no progress despite many evenings working through my assigned routine was a knee injury. Different PT, different exercises, suddenly my knees were better. YMMV.

Good luck.
posted by AbelMelveny at 6:27 AM on August 24, 2023 [2 favorites]

I can't offer advice, but I can echo and support those comments emphasizing that just because most people can use stairs doesn't necessarily mean that you (safely, comfortably) can. Stairs are brutal for knees. I'm fairly fit, I work out regularly, I run up and down many flights of stairs in my house many times a day - and also, if I hurt my knees even a little, stairs become incredibly painful and I start being extremely slow and careful in how I use them. People do 'live with stairs' but a lot of us truly should not, and while you may be stuck with them for now, it is totally legitimate and appropriate to say 'well I'm not one of those stair-using people.' I have a history of awful knee problems in my family and I fully expect that at some point I'm going to start feeling a lot of pain when I use stairs, and I'll just... have to start avoiding them. Lesser whittling duck's analogy to food allergies is a good one, I think. Yes, most people can use stairs casually. No, you cannot. It sucks. Society is kind of dumb about understanding this, much of the time. But also... there's no trick here, no gimmick; stairs are safe for most people, most of the time but you are unfortunately not one of them.
posted by Tomorrowful at 6:38 AM on August 24, 2023 [2 favorites]

Nothing especial to add, but if you've got one good knee and one bad knee, you need to be stepping up with the good knee first and stepping down with the bad knee first - this was taught to us as up to heaven and down to hell.
posted by london explorer girl at 7:01 AM on August 24, 2023 [10 favorites]

I am also a fat middle-aged woman and while I am not bad at stairs in general, I am bad at one specific flight of stairs in my house. Something about the specific pitch and width of those steps makes me feel like I am always one breath away from hurtling down them and hurting myself badly. Mostly I do what's already been offered here - single stepping and side stepping and using the handrails for support.

A friend who was badly injured and had a lot of stair problems while recovering did the "just sit on your butt and scoot down the stairs" thing for a while and other than being VERY interesting to the family cats, that seemed to be a workable stopgap.
posted by Stacey at 7:03 AM on August 24, 2023 [2 favorites]

if you've got one good knee and one bad knee, you need to be stepping up with the good knee first and stepping down with the bad knee first - this was taught to us as up to heaven and down to hell.

Came to say basically this, though without the clever memory aid! This is what I do when my knee is acting up. But that comes and goes so it is more temporary than what your ailment seems to be, so in your case I think doing only that as a fix will eventually irritate your good knee, so probably worth doing in conjunction with other solutions.
posted by solotoro at 8:01 AM on August 24, 2023

In addition to the knee-brace-specific KT tape, there are also ways to tape your specific knees for your specific problems. I know that my specific knee and my specific knee problems have an unusual taping technique that makes me sigh in relief, but is completely not something I can get with a pre-made brace.

I would ask your PT about ideas for taping specifically.
posted by Ms Vegetable at 8:50 AM on August 24, 2023 [2 favorites]

If my knees are being grumbly, there are two things I do to try and make my stairs less problematic. First, I try to keep my lower leg in a straight vertical line as I'm pushing up -- knee aligned wth ankle. Second, I check out my hydration level. Unlubricated joints are unhappy joints.
posted by kate4914 at 9:35 AM on August 24, 2023

As someone who grew up with incredibly steep stairs the instant you walked in the door, I'll say I learned to walk them on my toes (hi, I have your ski feet!), which may/may not work for you.

I'm not assuming your legs are weak - that's one of the awesome parts of being fat :) However, that does rely on ankle strenth/stability/calves/etc. that may make that a bad solution.

Is it up or down or both? I am fat and struggle with down (now) far more than up - I may be slow and huff and puff more than I'd like but I feel solid and confident in that direction. Is that the case for you too? If so, and your other mobility is good, no lie, I'd go down on my butt!

My grandmother delt with the steep stairs at the house I grew up in by going very slowly, hanging on the (solid) rail for dear life and going backwards.

She never fell and seemed to feel more comfortable, as odd as that sounds.


Seriously, you are strong - I wasn't "just saying that" about being fat, it's a well-known and highly accepted thing in weightlifting circles, and my favorite fact when I was weight training. I could out-deadlift all but the most advanced folks at the gym (and way out of proportion to what I could squat!) and I credit it to a life of being overweight.

The other surprising advantage is less osteopenia - carrying weight means strong bones. (Though as you say, menopause (and weight) sure is hell on joints.

Good luck - I am thinking 'slow and steady' thoughts your way!
posted by esoteric things at 10:50 AM on August 24, 2023

Ace bandage wrap for knee support.
posted by JohnnyGunn at 11:45 AM on August 24, 2023

For the last seven years, I have lived in a house with steep stairs that curve at the top.

Not longer after I moved in, I started having problems in one of my knees. I eventually deduced that what was happening was that as I was descending the stairs, I was twisting that knee while also flexing it with weight on it. This flexing/torsion/weight combo was specifically happening on the curving upper steps.

What I had to learn to do was to consciously separate those motions -- so that I'm not putting weight on the knee while also trying to turn. That typically means putting both feet on one step, then stopping and turning my body and legs, then taking another step, then possibly stopping to turn again, then continuing.

It means going down the stairs more slowly, and it probably looks weird, but it fixed my knee problems.
posted by Artifice_Eternity at 1:30 PM on August 24, 2023 [2 favorites]

Have you tried yoga physical therapy? It was incredibly helpful for my hip & back issues and general ability to move comfortably. I agree that turning on your knees is really hard on them; I ignore a fair number of turns when dancing. I use a knee brace, it mostly keeps me mindful of protecting whichever knee is crankiest.
posted by theora55 at 1:57 PM on August 24, 2023

A couple different reactions... When my gout acts up I can barely move my ankle and knee which is debilitating when I live upstairs, and the restroom is downstairs, and so's the food. :) I ended up with a couple coping strategies...

* I wear knee braces (on both knees) when I feel I need it. There are some pretty darn good ones on Amazon that doesn't cost an arm and a leg, depending on what your insurance covers. I bought my own, and they helped.

* I waddle up the steps... spread my knees wide apart, so I can get my ankles at the proper angle to get them onto the steps. Not pretty, but it gets the job done.
posted by kschang at 6:00 PM on August 24, 2023

I have weak knees (and tore the meniscus in my right knee a few years back), and find that small adjustments in posture can make stairs a lot more comfortable. YMMV, but this is what works for me: stand with my spine straight, my head centered at the top of my spine and my pelvis tucked in (so my butt isn't sticking out behind me), and as I go up the stairs imagine that I'm driving my bodyweight up from the very center of the soles of my feet, with my glutes and quadriceps activated and working together to help support my knees. For going down stairs, the same thing but this time I imagine that my bodyweight is being supported at the very center of the soles of my feet. I don't know if this has any scientific basis but it helps me.
posted by mydonkeybenjamin at 8:34 AM on August 25, 2023

It sounds like stairs just don't agree with your body, like a couple of people have said, which is inconvenient for you; but you're not somehow uniquely bad at stairs, they are bad for you.

Stairs also don't agree with me, for a variety of reasons - poor balance, poor proprioception, wobbly joints, fatigue - and since I don't and never will have an accessible home, I've just embraced going up and down on my bum, or my hands and knees, or occasionally scuttling up on hands and feet like some kind of creature.

There is no law that stairs have to be done upright on your feet, if that hurts you. You are protecting yourself from injury by not making your body do that thing it hates.

And if you can, rearrange things so you don't need to be going up and down as much, even if it's not possible to avoid them entirely. Is there a way you can work upstairs, if the alternative is hurting yourself? If you're dehydrating yourself to avoid having to get to the bathroom, this is serious stuff and it's time to break out every possible option that might help you.
posted by BlueNorther at 3:48 PM on August 27, 2023

Response by poster: Thank you all so much! I made immediate changes based on suggestions here and have had no exacerbation of the existing issue, and am able to do up-and-down trips as necessary. The discovery of a terrifyingly tiny half-bath on the first floor (we thought it was a closet...I mean it WAS a closet at some point, but now you can turn sideways and shimmy past the tiny sink and use the toilet if absolutely necessary) helped, but my primary technique is:

- Use the cane EVERY TIME
- "Up to heaven, down to hell" always leading with the good leg
- Single-stepping only (I realized after posting this that I was single-stepping down but going up in the normal fashion, and these specific stairs are too steep and deep for that)
- Backpack so hands are free and no unnecessary trips to retrieve forgotten items

Now that the weather has turned cool, I picked up some grippy-socks too, which give me more confidence on the bare wood.

I keep meaning to get the KT tape so I can try it on neighborhood walks, but haven't yet. I tried going backwards because I agree with the principle but it gave me vertigo.

This also helped me identify that there's still a range-of-motion limit on that knee when weight-bearing and bending for the down-steps, it only wants to bend so much before it just goes "done now, please fall the rest of the way" (see also: falling out of my van last month trying to step backwards onto the curb). We're going to work on that with exercises a bit.
posted by Lyn Never at 7:24 AM on September 26, 2023 [3 favorites]