Do you dread that morning descent to get to your first cup of coffee, knowing your knee will be giving you grief every step of the way? We deal with this complaint almost every day in our clinics, and questions about navigating stairs among the most common. Let’s examine some reasons why you experience knee pain when coming down stairs and discuss what we can do to help.
Many different types of tissue could be contributing to general knee pain, including bone, ligaments, meniscal tissue, nerve tissue, tendons, or muscle. It depends on which part of the knee you’re having pain that can clue you or your physical therapist in on what might be going on. Other areas of the body may be contributing to your knee issues; for example: pain radiating from the lumbar spine (low back) or your hip (IT band syndrome or piriformis syndrome) to your knee. Since it’s your knee sending those pain signals, you may be unaware that these areas are the root of your symptoms; as physical therapists, we take these connections into consideration as we evaluate your condition. That’s why it’s always a good idea to get checked out by our staff to ensure you are doing the right things at home to help you recover quickly and effectively.
More generally, individuals experiencing pain while descending stairs may have issues related to either the knee or kneecap joints, themselves (bone and connective tissue) or the patellar tendon, which is an extension of the quadriceps (thigh) muscle. Walking down the stairs (as opposed to up) typically puts a bit more pressure on the joint and tendon because you are putting your full weight on that single leg as you are bending your knee to come down the stairs. This will exacerbate any already irritated tissue (if, for example, you already have osteoarthritis or tendonitis) and may worsen symptoms.
So, what can we do to help? We can start addressing any muscle imbalances by strengthening the muscles surrounding the joint! This includes the quadriceps, hamstrings, hip adductors (inner thigh), gluteal (back of hip) muscles, and gastrocnemius (calf) muscle. You want to start in a non-weightbearing position first (lying on your back) then progress to partially weightbearing (think step up) to full weightbearing (think partial squat or lunge). This way you strengthen the muscles without irritating the tissue, then progress to functional positions to simulate daily activities. Stretching, taping and bracing may also be part of a personalized treatment plan.
It’s always a good idea to get checked out by one of our physical therapists if you do have any type of knee (or other) pain to properly diagnose your issue and ensure a safe, effective plan!