How to Use Crutches on Stairs (Up, Down, With and Without a Handrail)

Stairs are the moment most people on crutches feel nervous about. The technique is straightforward once you know the pattern, and one rhyme covers both directions.

The rhyme: “Up with the good, down with the bad”

Physical therapists use this phrase because it captures the logic in a form people remember under stress:

• Going up: your good (uninjured) leg leads. It has the strength to push your body weight up to the next step.
• Going down: your bad leg and the crutches lead. They lower to the step below first, then your good leg follows.

Every method below uses this same sequence. The handrail and no-handrail techniques differ in how you hold the crutches, not in the leg order.

Going up stairs with a handrail

A handrail is a fixed anchor, more reliable than a crutch tip on a stair edge. Use it.

1. Stand at the bottom step. Hold the rail with the hand on the rail side, and tuck both crutches together under your other arm (grips forward, tips pointing back and up slightly so they clear the steps).
2. Step up with your good leg to the first step.
3. Bring the crutches and your injured leg up to that same step.
4. Pause. Find your balance before you move to the next step.
5. Repeat, one step at a time.

Do not try to establish a rhythm until you feel confident. Slow and deliberate is the right pace.

Going down stairs with a handrail

1. Stand at the top step, facing down. Hold the rail with one hand, both crutches under the other arm.
2. Lower the crutches and your injured leg to the step below.
3. Bring your good leg down to join them.
4. Pause, confirm your footing, then repeat.

Look at where you are going rather than straight down at your feet. Looking too far down pulls your weight forward.

Going up stairs without a handrail

When there is no rail, each crutch goes back under its own arm:

1. Stand close to the bottom step, one crutch under each arm.
2. Press down firmly through both grips.
3. Step up with your good leg to the first step.
4. Bring both crutches up to that step, then your injured leg. Make sure both tips land flat before you shift your weight.
5. One step at a time.

A useful check: after each step, press down lightly on both grips to confirm the tips are stable before you move again. This pause feels slow at first and becomes automatic quickly.

Going down stairs without a handrail

1. Stand at the edge of the top step, one crutch under each arm.
2. Place both crutch tips on the lower step first.
3. Lower your injured leg to that step.
4. Bring your good leg down to meet them.
5. Reset, confirm both tips are planted, then move to the next step.

Keep your weight in your hands and your eyes on the next step down, not your feet or the bottom.

Not feeling ready? The sit-and-scoot method

If a staircase has no rail and the drop feels risky, sit-and-scoot is not a workaround or a failure. Physical therapists teach it as a practical technique for challenging staircases.

Sit on a step. Hold both crutches across your lap (or prop them at the side so they do not slide away). Use your arms and your good leg to push yourself up or down one step at a time on your seat. It is slower and harder on clothing, but far more stable than a wobbly descent on two crutches with nowhere to grip.

Not sure whether you’re ready for crutches at home yet? Take the quiz to get a personalized recommendation for your situation.

Safety tips that actually matter

Crutch tip condition. The rubber tip is the only thing between the crutch and the stair surface. A cracked, smooth, or compressed tip loses grip without warning. Check tips before any stair attempt and replace them when the tread wears down. Replacement tips are inexpensive; falls are not. See how to replace crutch tips if you are unsure.

Wet and outdoor stairs. Rain, morning dew on stone, and tiled outdoor steps are the worst surface for crutch tips. Slow down significantly, test the first step before committing, and consider waiting or finding an alternative route if the steps are visibly wet. Non-slip shoes or rubber-soled footwear help on the contact side.

Socks alone are not enough. Socks with rubber grips are better than bare feet, but they compress under body weight and still slip on smooth floors. Lace-up shoes with rubber soles are more reliable on stairs.

Do not rush. Rushing is a common cause of falls on stairs. There is no comfortable rhythm on stairs the way there is on flat ground. Each step is its own move.

Equipment matters on stairs

Well-fitted forearm crutches are easier to control on stairs than standard underarm crutches. The reason is practical: forearm crutches sit lower on the arm, have a narrower profile, and tuck together more cleanly under one arm when you need to grip a handrail. Underarm crutches are bulkier and harder to consolidate in one hand.

The cuff design also matters: a forearm cuff that is set correctly (about 1 to 1.5 inches below the elbow) keeps the crutch attached to your arm even when you briefly release the grip, which is useful when you are repositioning on a step. See forearm vs. underarm crutches for a full comparison, and how to size forearm crutches if your current pair does not feel right.

The tips matter too: articulating tips that stay flat through the full range of motion are more stable on an angled stair edge than standard fixed tips.

Ask a PT before you attempt stairs independently

Physical therapists typically include stair training as part of early crutch instruction, and for good reason: what feels stable from the inside is not always what a trained observer sees from the outside. A PT can catch problems in your foot placement, crutch angle, and sequencing before they become falls. If your discharge instructions did not include supervised stair practice, ask your care team to add it. One session on a real staircase is usually enough to feel confident.

This is general information, not medical advice. Ask your physical therapist or surgeon to assess your stair readiness and watch your technique before you attempt stairs independently at home.