Do you find yourself dreading stairs, even fearful of them? Do you wish you could comfortably negotiate stairs like you used to rather than just relying on your strongest leg? This post presents stair negotiation exercises, both for going up stairs as well as going down stairs. These exercises will improve your stair negotiation ability, at home, while shopping or visiting family. You will feel safer in your own home and everywhere you travel.
Over my forty years of work as a Physical Therapist, I have helped hundreds of individuals recover from surgery, car accidents, and de-conditioning. The key is to rebuild their strength and confidence. It can take a little training, breaking old habits, learning new ones but everyone succeeds and you will too!
What Is Stair Negotiation?
Stair negotiation is the ability to safely go up and down stairs. In physical therapy, we use this term to describe the coordinated combination of leg strength, balance, and movement patterns you need to ascend and descend steps without pain or risk of falling.
For many older adults and people recovering from surgery or injury, stair negotiation is one of the most challenging activities of daily living. Research shows that stair negotiation increases the load on your knee joint by three and a half times your body weight compared to level walking. That is why even people who walk comfortably on flat ground can struggle with stairs.
The good news is that stair negotiation is a skill you can rebuild. The exercises below follow a progressive approach I have used with hundreds of clients. You start where you are comfortable and gradually build strength and confidence until you can negotiate stairs independently.
Stair Negotiation Exercises
A lot of my clients have either moved into single level bungalows or retirement homes with elevators. They might have to step up onto a sidewalk or the entrance into their homes, but rarely encounter a set of stairs.
As a result, they haven’t negotiated stairs in a long time. When they visit families in multi-story homes, attend appointments in buildings with stairs, they are surprised by the challenge of climbing or descending a set of stairs.
These are big issues for them. They haven’t done an eight inch step in a while and they soon experience knee and hip pain. They are often fearful of losing their balance and falling.
Today I will show you how to get back to doing steps, feel safe and strong enough to negotiate stairs, and regain your confidence.
Exercise to Easily Negotiate Going Down Stairs
Going down stairs, as you know, can be difficult and scary. Stair negotiation is more challenging going down stairs than going up stairs.
Why is that?
Going down stairs requires your legs muscles to control the lowering of each leg. This is an eccentric contraction, the most demanding type of muscle contraction. Going up stairs is a concentric contraction and is much easier and less demanding on the leg muscles.
To master going DOWN stairs, you will build up to doing this controlled lowering, eventually on just one leg. I show you a step wise progression in the video below.
Start With 50% Of Your Weight On Each Leg
Start with fifty percent of your weight evenly distributed on each leg. Follow these steps as demonstrated in the video:
- Stand tall with your feet hip width apart.
- Use a stool, a stacked pillow on your sofa, or a tall bed to practice from.
- Take a relaxed breath in.
- Exhale and slowly lower yourself into the chair. Keep your knees over your feet.
- Exhale through the move. It will help give you more core stability and balance and help reduce the fear or anxiety your body may be feeling. No need to go very deep.
The range you need for stairs is about half of what you need when sitting on a chair.
- Start with three to five repetitions.
- Build an extra repetition every other day until you can comfortably do ten repetitions.
The goal is to build your strength gradually so as not to flare up any joints and to allow all the muscles around your hips and knees to strengthen.
Gradually Increase The Amount of Your Weight You Support on One Leg
Work towards being able to hold all your weight on one leg. It may take a few weeks to build the strength, but you will get stronger and the stairs will get easier to negotiate.
Place a sturdy chair in front of the surface you have been working from, then stagger your feet so that you can feel 60% of your weight going through the back foot and 40% on the front.
In the video, I place a second chair in front of me. Behind me is the other chair. This position is secure so I am now able to stagger my stance and distribute my weight. I start with a 60/40 weight distribution and build from there.
- Do five on each leg.
- Gradually build to ten on each leg.
- Some of you may be able to add more weight faster than others. You are all unique and will progress at the pace that you can.
- When it starts to feel easier, place seventy percent of your weight on your back leg.
- Every other day gradually add a little more weight onto your back leg.
- Slowly over time build to ten repetitions on each leg.
Using the railing will allow you to take up the weight that you are not able to control on one leg. As you get stronger and able to control more of your weight through your knees, you will be able to rely less on the railing.
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Five Simple Tips to Easily Negotiate Going Up Stairs
If you have knee pain, feel unstable, or feel winded by the time you reach the top of the stairs, the following five tips will help you with all of these. I cover these in my video below:
Follow these steps:
- Start with a smaller step height to practice the new technique and gain confidence.
- When possible, place your whole foot on the step.
- Keep your knee over your foot and not in front of it, nor to the side of it.
- Bring your butt back and bend from your hips. This sets up your strongest leg muscle, your buttocks, to do more of the work. Take a breath in …
- Exhale through pursed lips as you PUSH the STEP away from you, bringing your hips forward. Feel the tightening in your butt muscles.
Breath Control and Stair Negotiation
The exhalation with the effort will help you recruit your core muscles and make you more stable.
Coordinating your breath will also ensure you’re not holding your breath. You will not be out of breath by the time you reach the top. Your body will interpret your breathing and know that you are in control!!
Practice this with the support you need to feel safe and secure as you regain confidence in your legs. Once you have mastered a three to four inch step, you are ready to go to a full sized step.
Stair Negotiation: Strengthen Your Lower Body
Stronger legs (and lower body) will make stair negotiation much easier. You can supplement the two routines above with some simple leg strengthening exercises. The video below includes three leg strengthening exercises for beginners.
My strength training guide is an excellent resource as well.
Stair Negotiation: Improve Your Balance
Good balance and stability will increase your safety and help you go up and down stairs with more confidence. The two balance exercises in this video are designed to help you improve your balance.
My balance and fall prevention guide is an excellent resource as well.
Stair Negotiation: Posture
Posture influences everything: your balance, your strength, flexibility, and agility. As a result, postural alignment has a significant effect on stair negotiation. Here are two posture exercise videos you can use to improve your posture. My Posture Guide is another great resource.
Stair Negotiation Exercises in the Pool
Some of my clients are lucky enough to live in condominiums where there’s a pool. The pool will have stairs going down into the water.
If you start on the stairs that are in the water, the buoyancy of the water will help lift up your body weight and will help you do the steps. This technique allows you to start right away with a six inch step or seven inch step.
Start with the water at chest height and then progress to a higher step so that the water is eventually at hip height. The water buoyancy will gradually support more of your body weight on the step.
Common Stair Negotiation Challenges
Many of my clients come to me with specific concerns about stairs. Here are the most common issues I see and what you can do about each one.
Knee Pain Going Up or Down Stairs
Knee pain with stairs is one of the most frequent complaints I hear. Going up stairs loads the knee as you push your body weight upward. Going down stairs is often worse because the knee must control a slow, heavy lowering (eccentric contraction) with each step.
If your knees hurt on stairs, focus on the ascending technique from the video above: bring your hips back, place your whole foot on the step, and push through your heel. This shifts the load from your knee to your much stronger gluteal muscles. Strengthening your quadriceps and gluteals with the progressive lowering exercises in this post will also reduce knee strain over time.
If knee pain persists, consult your physical therapist or physician to rule out underlying conditions.
Legs Shaking When Going Down Stairs
If your legs shake or feel unsteady when you go down stairs, your quadriceps muscles are telling you they are working near their limit. Going down stairs demands an eccentric (lengthening) contraction of the quadriceps to control each step, and this is the most demanding type of muscle work.
The controlled lowering progression I describe above, starting at 50/50 weight distribution and gradually building to single-leg control, is specifically designed to address this. Start with the chair-supported lowering at whatever depth feels manageable. Over a few weeks, your quadriceps will strengthen and the shaking will diminish.
Hip Pain Going Up Stairs
Hip pain when climbing stairs often comes from weakness in the gluteal muscles, particularly the gluteus medius, which stabilizes your pelvis as you stand on one leg during each step. When this muscle is weak, your hip has to absorb forces it is not equipped to handle.
The five tips for ascending stairs in this post address this directly. Bringing your hips back and pushing through the step engages the gluteals.
Supplementing with the leg strengthening exercises shown in the video will further build the hip strength you need.
Feeling Out of Breath at the Top of the Stairs
If you feel winded after climbing a flight of stairs, coordinating your breathing with your effort makes a significant difference. The breath control technique I demonstrate in the video, exhaling through pursed lips as you push through each step, prevents breath-holding and keeps your oxygen flowing.
With consistent practice, your cardiovascular fitness for stair climbing will improve. If breathlessness is severe or accompanied by chest pain, dizziness, or lightheadedness, see your physician.
Physical Therapy Stair Training Exercises
As a Physical Therapist, I approach stair training with a structured progression. The exercises in this post follow the same evidence-based principles I use in clinical practice. Here is a summary of the full physical therapy stair training program:
- Phase 1 — Build foundational strength (weeks 1–2). Practice the controlled lowering exercise with 50/50 weight distribution. Start with 3–5 repetitions and build to 10. Add the three beginner leg strengthening exercises from the video above.
- Phase 2 — Progress to asymmetric loading (weeks 2–4). Shift to 60/40, then 70/30 weight distribution on the lowering exercise. Begin the balance exercises shown in the video. Practice the five ascending stair tips on a low step (3–4 inches).
- Phase 3 — Functional stair practice (weeks 4 and beyond). Progress to a full-height step. Practice descending with increasing single-leg control. Reduce your reliance on the handrail as your strength and confidence improve.
Every person progresses at a different pace. The phases above are guidelines. Listen to your body, add repetitions gradually, and do not push through sharp pain.
If you have had joint replacement surgery, a fracture, or a neurological condition, work with your physical therapist to adapt this program to your specific needs and precautions.
Extra Safety Tips
Here are a few tips that will make your stair negotiations much safer:
- Use handrails to provide support and stability.
- Wear footwear that is stable and provides good traction.
Poor control with stairs is often an indicator of overall de-conditioning. Follow a safe and progressive exercise program that helps you regain your strength.
Using a Cane or Walker on Stairs
If you use a cane or walking aid, the general rule for stairs is: up with the good leg, down with the bad leg, cane follows the bad leg.
When ascending: step up with your stronger leg first, then bring your cane and weaker leg up to the same step. When descending: place your cane on the step below first, then step down with your weaker leg, then follow with your stronger leg.
Always use the handrail on the opposite side from your cane when one is available. If you use a front-wheeled walker, you will need to switch to the handrail for stairs, walkers are not safe on steps.
Talk to your physical therapist about the specific technique that works best for your mobility aid and your condition.
Conclusion
Physical therapy exercises for stair negotiation can transform your relationship with stairs from anxiety to confidence. Whether you are dealing with knee pain, leg weakness, hip discomfort, or fear of falling, the progressive approach in this post gives you a clear path forward.
Start with the foundational exercises and build gradually. Use the breath control technique to stay calm and stable. Address any specific challenges, knee pain, shaking legs, hip pain, or breathlessness, with the targeted guidance above. And remember that every person progresses at their own pace.
Over my forty years as a Physical Therapist, I have seen hundreds of clients go from dreading stairs to negotiating them safely and independently. With consistent practice, you will get there too.
If you found this post helpful, explore my strength training guide, balance and fall prevention guide, and posture guide for more ways to improve your mobility and independence.
Stair Negotiation Exercises FAQs
Margaret Martin
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