#deanslife · accessibility · equality · fitness · injury · racing

Stairs are not Sam’s friends

Image description:
The Girona Cathedral, also known as the Cathedral of Saint Mary of Girona, is a Roman Catholic church located in Girona, Catalonia, Spain. It is the seat of the Roman Catholic Diocese of Girona.
Also, it has lots and lots of steps leading up to it!

Oh, old European cities. I love you. But I hate your stairs. SO MANY STAIRS.

Why do I hate stairs? They hurt my knees. It’s seriously painful even on days when I’m walking pain free. Down is way worse than up. Handrails help. I’m now a person who notices when they’re there and when they’re at the right height. I also sometimes worry that the stairs are making my knees worse.

So I turned to the Internet with my question. Dr. Google, do stairs simply hurt my arthritic knees or do they make things worse? Here’s a good a survey of the relevant literature.

“Stair climbing increases loads on the knee joints. And if we take into consideration the mechanical factor for appearing and progression of degenerative joint disease, it is clear that damage to joint cartilage increases with stair climbing. So reduced loads are beneficial for knee arthrosis.”

“Combination of stairs and weight or better loading and repetition of it is discussed as having some effect of knee joint degeneration. It is calculated that when someone is walking on plain ground he puts about 5 times the body weight or load in every step into the joint. When stairs are used or walking up or down hill the person is loading the knee up to 7 or 10 times the body weight or load according to the speed used. So repetition (circle of loading) – weight (and load) – and inclination of the ground has possibly effect of degenerative knee disease”

“The reasons why patients are advised to avoid them when OA shows up is that stairs are stress raisers, especially descending them. The point is that OA knees regardless the severity,  are often unstable and in these conditions stairs may  induce shear stresses on the cartilage and speed up the degenerative process. “

So I guess I should try to avoid them. I raised the issue at the knee surgery clinic on Monday when I was there for my regular appointment. Their message was clear. “You need to modify your activity. Avoid stairs when you can.”

See you on the escalator/in the elevator!

Though in these old cities there isn’t much choice.

Image description: Yellow brick buildings flanking a narrow walkway of stairs, in the old city of Girona.

5 thoughts on “Stairs are not Sam’s friends

  1. Stairs aren’t too bad for me, but cobblestones, that’s another issue! We walked all over Italy last winter, and my hips HATED the cobblestones. I don’t know how the ladies there walked around with such grace (and in such heels)!

  2. Hi Sam. I wish I could meet up with you to help fix your knees. I’ve been reading your blog for years and I’ve thought this before…I’m finally writing. I’m a 65yo personal trainer with OA everywhere – shoulders, knees, spine, hips. When I found out last year in a bout of knee inflammation that I have 0 cartilage behind the left patella and a meniscus tear in the right, I was told by an orthopedic surgeon that I lunge and squat too much. I said “Dude. (yes I said that) I ONLY JUST experienced pain with “bone on bone” (I hate that phrase) is thanks to of all of the squats, lunges… and deadlifts” And I walked out. I was in so much pain I thought I would never ride a bike again. It was hard to get into and out of the car. Within weeks I felt better an I am currently asymptomatic. I was told 7 years ago after 2 severe bike crashes that I was a good candidate for hip replacement. After 6 months of PT I rode the 110 mi NY Granfondo in 7 hours flat in the pouring rain. Today my hips are working fine – even better than ever. As a trainer most of my clients are over 50 and they all have joint and OA issues. They are all learning how to do stairs more effectively, how to jump and land (it’s about landing – gravity sucks, literally), and all of them have learned the mechanics of indoor rowing, and it’s a part of every client’s program. Rowing has been a game changer for all of them and for me. It’s about turning on the glutes and turning off the knees. Posterior core. I am my own guinea pig for all of the glute strategies – and they work. I’m a fellow cyclist (and mom of former pro cyclist); fellow mom (of 6, grandma of 9); and now a power lifter – aspiring to compete. Ha! That’s something I never remotely thought I would be doing at 65. You can save your knees by turning on your glutes. Your arthritis pain doesn’t have to own you. By the way, we’re planning a bike trip in Sept. possibly to Girona, where we have a friend. The Salt, Fat, Acid, Heat episode was the best! Love your blog and adventures. Onward. From An Admirer, Polli Schildge @getupkeepmoving

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