“Why Does My Knee Hurt When Walking Down Stairs?”

We hear it a lot: “Each time I’m coming down a flight of stairs I feel a sharp pain in my knee. It’s not necessarily hurting any other time–just when I’m stepping down. What’s going on?”

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 have pain that can clue you or your physical therapist in on what exactly is 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. As physical therapists, we take these connections into consideration as we evaluate your condition; however, you may be unaware that these areas are the root of your symptoms. 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? Strengthen 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 (such as a partial squat or lunge). This way you strengthen the muscles without irritating the tissue, then progress to functional positions to simulate daily activities.


As always, please call us to schedule an appointment if you do have any type of knee (or other) pain in order to ensure an effective plan!