Can I Do Stairs After a Hip or Knee Replacement?

When do you first attempt stairs?

In most cases, stairs are assessed and practised before you leave hospital — usually on Day 1 or Day 2 after surgery. Your physiotherapist will guide you through the technique with a handrail and assess that you can manage safely. If you live in a home with many stairs, this is prioritised during your inpatient stay to ensure you are ready before discharge.

Early mobilisation is a central part of modern joint replacement recovery. Getting you up and moving — including on stairs — is not rushed carelessly, but it is encouraged deliberately. The evidence supports early activity: it reduces the risk of blood clots, prevents muscle deconditioning, and accelerates overall recovery.

Most patients are surprised by how quickly they can manage stairs after surgery. The pain that was stopping them before the operation — the arthritic pain — is gone. What they feel in those early days is surgical soreness and muscle fatigue, which are manageable and improve progressively.

Watch — Dr Liew Explains

Can I Do Stairs After a Hip or Knee Replacement?

Dr Chien-Wen Liew walks through the stair technique, timing, and what to watch for during recovery after hip or knee replacement.

The technique — going up

Physiotherapists use a simple phrase that patients remember easily: "Good leg to heaven, bad leg to hell." It sounds blunt, but it describes exactly what to do.

When going up the stairs, lead with your stronger leg — your non-operated side. Place it on the step above, then bring your operated leg up to meet it. This way, the stronger leg does the work of lifting you, and the operated leg simply follows.

• Hold the handrail firmly throughout
• Take one step at a time — don't alternate feet until your strength and confidence have returned
• Keep your weight centred over your foot, not leaning forward
• Wear supportive footwear with grip — no thongs, slippers, or woolly socks

Going up requires the most quadriceps strength — the muscles on the front of your thigh. These muscles are often weakened from years of arthritis pain (you may have been unconsciously avoiding activities that load them). Rebuilding this strength is a key focus of your physiotherapy in the weeks after surgery.

The technique — going down

Coming down is the reverse: lead with your operated leg first. Place it on the step below, then bring your stronger leg down to meet it. Again, one step at a time.

Many people find coming down stairs harder than going up, at least initially. This is because descending requires controlled eccentric muscle work — essentially lowering your body weight slowly through the operated leg. The knee in particular can feel unstable going down in the early weeks.

• Go slowly and deliberately — there is no rush
• Hold the rail for the full descent, not just the first step
• If your stairs have a rail on only one side, plan which direction you travel so the rail is on the correct side for descent
• If stairs feel particularly difficult at first, it is fine to sit and lower yourself on your bottom as an alternative in the very early days — many patients do this and it is nothing to be embarrassed about

What to watch for

Mild muscle ache and fatigue on stairs is normal in the early weeks, particularly going up. This is not a warning sign — it is your muscles working and strengthening. It will improve steadily as you rehabilitate.

However, there are things that should prompt you to contact your surgical team:

• Sudden significant increase in pain — especially if combined with swelling, redness, or warmth around the joint
• A feeling that the joint has "given way" — unexpected instability on stairs is worth reporting
• Persistent pain that is not improving week on week — recovery should show a general trend of improvement, not plateau or worsen
• Calf pain or swelling — this can be a sign of deep vein thrombosis (DVT) and requires urgent assessment

The key is distinguishing between the expected discomfort of recovery — which is manageable and improving — and something that represents a problem. If you are unsure, always contact your surgeon's rooms.

Planning ahead — if your home has stairs

If your home has stairs and no handrail, this is something to address before surgery, not after. A handrail on at least one side of every staircase is strongly recommended for the recovery period. Your occupational therapist or physiotherapist can advise on temporary rails if needed.

If you live in a multi-storey home and your bedroom is upstairs, consider whether you can set up a temporary sleeping arrangement on the ground floor for the first few weeks. This removes the need to navigate stairs multiple times a day when you are at your most fatigued and reduces the risk of a fall.

Other practical adjustments that help:

• Ensure all stairs are well lit — especially if you get up at night
• Remove loose rugs or obstacles at the top and bottom of stairwells
• Keep frequently used items on the same floor so you are not making unnecessary stair trips
• Have your phone accessible so you can call for help if needed

Long-term — will stairs always feel like this?

No. The early weeks on stairs are the hardest part of recovery, and they are temporary. Most patients find stairs feel significantly more natural by the 6-week mark, and by 3 months the majority are navigating stairs without thinking about technique at all.

The reason stairs improve so dramatically is that joint replacement removes the arthritic pain that was making every step difficult before surgery. Once that is gone, and once the surrounding muscles have rebuilt their strength through rehabilitation, stairs become a normal activity again — not something to be managed carefully.

Many of my patients tell me that stairs were one of the things they most dreaded before surgery, and one of the things they are most pleasantly surprised by after. The technique helps in the short term. The outcome — a pain-free, functional joint — is what makes it effortless in the long term.

Frequently Asked Questions