Knee Pain Going Down Stairs? Here’s How to Treat It

If you experience knee pain when going down stairs, it’s natural to try to avoid the activity as much as possible. But resist the urge to seek out every escalator or elevator you can find. Avoiding stairs can actually worsen knee pain. “Going up and down stairs builds functional strength and mobility,” says Renee Bullis, PT, DPT, a physical therapist at Hinge Health. If you stop taking the stairs, muscles weaken and joints stiffen — both of which can increase pain and limit your activity even more.

Instead, you can use movement to build strength, improve mobility, and reduce pain. Read on to learn why you might be feeling knee pain when going down stairs and what you can do to feel better, including exercises recommended by Hinge Health physical therapists.

Why Do I Have Knee Pain Going Down Stairs?

You may think that going down stairs is easier than going up them, but descending can have its own challenges. When researchers analyzed forces on knees, they found that walking down stairs puts about 10% more stress on the knees than going up, according to a study in the Journal of Biomechanics. 

“Going down stairs requires significant knee and ankle mobility, and your knee has to move further over your toes than when ascending stairs,” explains Dr. Bullis. “This requires your quad muscles to work in a lengthened position, which is more challenging for the muscles surrounding your knee.”

Keep in mind, your knees are designed to take on this kind of challenge — it’s what they’re built for. But sometimes other factors can hinder knee function and result in pain. Here are some common causes of knee pain when going down stairs.

• Arthritis. Whether it’s the result of changes in the knee joint (osteoarthritis) or an autoimmune condition (like rheumatoid arthritis), knee arthritis can contribute to achy joints when taking the stairs.

• Patellofemoral pain syndrome. This is a fancy word for pain in the front of the knee. It’s often referred to as “runner’s knee” because it’s more common in people who do activities that involve running, but you don’t have to be a runner to develop it. Patellofemoral pain syndrome is often caused by doing more activity than your body is ready for, resulting in pain when engaging the knee joint. 

• Iliotibial (IT) band syndrome. Your IT band runs down the side of your leg from your hip to just below your knee. When the band becomes inflamed or irritated from repetitive use, it can cause knee pain that flares up when descending stairs.

• Bursitis. Bursae are fluid-filled sacs in the knee joint that act like tiny pillows to reduce friction and cushion bones, tendons, and muscles. Knee bursitis is an inflammation of one or more bursae resulting from extended pressure on your knee joint, such as from kneeling for hours while gardening or overdoing an activity (like ramping up mileage when cycling) that your body isn’t fully prepared for. Bursitis can cause pain that flares whenever the joint is engaged, including when going down stairs.

• Muscle imbalances. When some muscles are weaker or tighter than others, it can impair the ideal functioning of your knee and contribute to pain with certain movements.

No matter what might be behind your knee pain when going down stairs, staying active and strengthening and stretching the muscles that support your knees can help ease the pain.

These exercises recommended by Hinge Health physical therapists improve strength, mobility, and balance, which are necessary for going down stairs without knee pain. “It’s important to take care of your knees for long-term strength and mobility, so you can do all the things that you want to do and stay active,” says Dr. Bullis. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for Knee Pain When Going Down Stairs

“Motion is lotion,” says Dr. Bullis. Movement — including continuing to take the stairs — is essential for relieving knee pain going down stairs. Taking the stairs builds muscle strength, lubricates joints for better mobility and flexibility, and helps you ‌be more resilient to pain. It’s also an essential part of many people’s daily lives that they want to do without pain, even as they age.

In fact, walking down stairs is an effective way to counteract muscle and strength loss in people over the age of 65, according to a study in the European Journal of Sport Science. However, you may need to make some modifications as you work to build strength and resiliency. Here’s what you can do.

• Do exercise and physical therapy. Strengthening and stretching the muscles surrounding your knees provides support and reduces force on the knee joints. If you don’t get relief from the exercises above, a physical therapist (PT) can design a plan to address your specific needs. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Use the railing. “It can offset or redistribute weight to reduce knee pain,” says Dr. Bullis. Over time, once all the structures in your legs and knees are stronger, you’ll become less reliant on it for support. 

• Adjust your stride. Step down with your painful leg first, advises Dr. Bullis. “There’s less knee bend if you’re leading with that leg,” she explains. Then, step down with the opposite leg, landing both feet on the same step. Continue so both feet land on each step instead of alternating. Another option is to stand sideways, facing and holding onto the railing. You’ll still step down with your painful leg first, landing both feet on each step as you go.

• Wear supportive shoes. Wearing supportive shoes can cushion the impact on your knees as you descend stairs, making each step feel more comfortable. This extra support can help reduce the strain that might otherwise cause discomfort in your knees.

• Keep climbing. If you don’t have pain on the ascent, climb stairs any chance you get. “It helps strengthen the muscles around your knee,” says Dr. Bullis.

PT Tip: Walk Downhill

If you live in a hilly area or have hills nearby, try slowly incorporating more hills into your walks. “It can help to build quad strength and increase pain tolerance within the knee joint without being as hard on your knees as going down stairs,” says Dr. Bullis.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Kutzner, I., Heinlein, B., Graichen, F., Bender, A., Rohlmann, A., Halder, A., Beier, A., & Bergmann, G. (2010). Loading of the knee joint during activities of daily living measured in vivo in five subjects. Journal of Biomechanics, 43(11), 2164–2173. doi:10.1016/j.jbiomech.2010.03.046

2. Regnersgaard, S., Knudsen, A. K., Lindskov, F. O., Mratinkovic, M., Pressel, E., Ingersen, A., & Dela, F. (2020). Down stair walking: A simple method to increase muscle mass and performance in 65+ year healthy people. European Journal of Sport Science, 22(2), 1–29. doi:10.1080/17461391.2020.1856936

3. Zhai, J., Qiu, Y., & Wang, J. (2019). Does Flexible Flatfoot Require Treatment?: Plantar Pressure Effects of Wearing Over-the-Counter Insoles when Walking on a Level Surface and Up and Down Stairs in Adults with Flexible Flatfoot. Journal of the American Podiatric Medical Association, 109(4), 299–304. doi:10.7547/16-103