How to Treat Knee Pain When Climbing Stairs, According to Physical Therapists

If walking around on flat surfaces feels fine but your knees start to ache as soon as you start climbing stairs, you might be wondering what’s going on. While your knees are designed to withstand a lot of pressure, stepping onto a staircase engages different muscles and makes you move at an angle while working against gravity. As you climb, your knees may end up bearing a force that’s anywhere from three to six times your body weight.

That extra pressure alone shouldn’t hurt, but if you’ve been doing a lot of stair climbing, have an underlying health condition, or even just turn the wrong way you might find that taking the stairs is suddenly painful, says Heather Broach, PT, DPT, a physical therapist at Hinge Health. Feeling an ache or twinge isn’t a cause for alarm, and it doesn’t mean you should stop moving, either. But it is a sign that something might be amiss and that you could benefit from building strength in and around your knees.

Here, learn more about what causes knee pain when climbing stairs and how to prevent and treat it — especially with exercises from our Hinge Health physical therapists.

Les bases de l'anatomie du genou

Pour comprendre la Douleur du genou lors de la montée des escaliers, il est utile de connaître quelques bases sur ce qui compose ton genou et sur le fonctionnement de cette articulation importante.

• Les os: Les os de l'articulation du genou sont la rotule, le fémur (os de la cuisse) et le tibia (os du tibia). Le fémur s'articule à la fois avec la rotule et le tibia.  

• Les ligaments: Quatre ligaments principaux maintiennent tout ensemble. Deux sont considérés comme des ligaments "collatéraux", et ils agissent comme des sangles qui stabilisent ton genou en le maintenant de chaque côté. Deux sont des ligaments "croisés", qui se trouvent à l'intérieur de l'articulation du genou elle-même. Ils se croisent en X et servent à stabiliser ton genou lorsqu'il se déplace vers l'avant ou vers l'arrière. 

• Les tendons : Ce sont des bandes épaisses qui relient les muscles aux os. 

• Cartilage : Il s'agit d'une matière caoutchouteuse qui absorbe les chocs et qui tapisse les extrémités des os du genou et les aide à glisser lorsqu'ils se déplacent l'un contre l'autre. 

• Les ménisques: Chaque genou possède deux cales de cartilage très épais et résistant qui agissent comme un amortisseur, explique le Dr Broach. "Il est censé absorber les chocs et améliorer la façon dont les os du fémur et du tibia s'assemblent." 

• Les bourses: Ce sont de minuscules sacs remplis de liquide qui aident encore à réduire les frottements et à fournir un rembourrage supplémentaire.

• Les muscles: Ton genou comprend plusieurs muscles qui t'aident à plier et à redresser l'articulation. 

• Les nerfs: Tu peux sentir tout ce qui se passe dans ton genou, en particulier toute Douleur qui pourrait survenir, grâce aux nerfs de ton genou qui transmettent des impulsions électriques à ton cerveau.

Common Causes of Knee Pain When Walking Up and Down Stairs

There are many possible causes of knee pain. Some people have knee pain walking on a variety of surfaces, but if the discomfort kicks in specifically when you’re climbing stairs, then one of the following problems may be to blame — at least in part, says Dr. Broach. Note that no matter what may be contributing to your knee pain, strengthening and stretching can help all of the following conditions:

Patellofemoral pain syndrome. This usually shows up as pain in the front of the knee, says Dr. Broach. Some people call it “runner’s knee” but you don’t have to be an athlete to develop it. It often stems from overuse or a rapid uptick in physical activity.

Meniscus tear. Do you feel pain more on the inner aspect or outer aspect of your knee? It could be a meniscus, says Dr. Broach. “It could be as little as a pinch. Sometimes you turn the wrong way and two bones kind of catch it,” she notes. If you do have popping, swelling, or trouble straightening your knee, then you might have a larger meniscus tear. While these can be the result of doing an exercise that involves pivoting or twisting, meniscus tears can also occur spontaneously as the result of normal age-related changes in the knee. 

Note: While a meniscus tear can sound really serious, the associated symptoms often improve with simple exercises. Plus, they’re not always noticeable. In fact, up to 67% of older adults without knee pain showed signs of a meniscus tear on MRIs, according to a 2023 study.  

Chondromalacia patella. This is a fancy term that means there’s some wearing of the underside of the patella, which can cause irritation or a dull ache in the kneecap when you flex your knee, says Dr. Broach. Sometimes, this happens for no apparent reason — it just occurs over time as the ligaments and tendons that attach the patella to the thigh cause it to track more laterally (towards the outer aspect of the knee). 

IT band syndrome. The iliotibial (IT) band that runs down the outside of the thigh is thick and hard to stretch because it’s made up of dense tissue — a lot like the material of a seatbelt in a car, says Dr. Broach. Although the IT band is a really tough and strong tissue, it has bursae under it, and sometimes that rubs and irritates the IT band as a result of how you’re moving around. This can contribute to pain on the outside of the knee and discomfort when going down the stairs. (Going down stairs is usually worse than going up, notes Dr. Broach.) 

Muscle imbalance. “Most people in everyday life are ‘quad dominant,’ meaning they do most things — including walking up and down stairs — by relying on the muscles on the front of the thighs,” says Dr. Broach. There’s no right or wrong way to walk up and down the stairs, but engaging your glutes and hamstrings can alleviate some pressure on the front of your knee, which can be good if you’re having knee pain. By working on strengthening your glutes and hamstrings, your body should naturally engage these muscles when you use the stairs and give your knees a bit of a break.

Treatment for Knee Pain When Walking Up and Down the Stairs

There are many different ways to treat and manage knee pain when going up and down stairs, including: 

Do targeted exercises. There are a lot of different ways to strengthen the structures in and around your knees, depending on where you feel your pain most. Good options typically include hip flexor stretches, single-leg lifts, and hamstring stretches, among others. “I try to select exercises that don’t provoke pain, but still encourage a lot of strengthening,” says Dr. Broach. 

Focus on body awareness. One crucial part of physical therapy for knee pain is teaching patients to be aware of how their body is moving and how it feels during different activities, says Dr. Broach. She adds that if a muscle imbalance is the problem, as it often is, she will try to determine why it’s happening and how to counteract it. Some people may need to work on strengthening their hip muscles to better stabilize the pelvis, for instance. 

Modify your walking technique. It might sound silly — of course you know how to walk up and down stairs! — but changing how you navigate stairs can provide really quick relief from pain, while strengthening muscles helps an underlying problem. Here are a few techniques you can explore to see how they feel for you: 

• Hold onto a wall or railing opposite your painful leg. 

• Squeeze your glutes as you climb or step down a stair. 

• Try putting your whole foot on the step. 

• Keep your weight in your heels. 

• Try keeping your torso more upright instead of leaned forward. 

• Squeeze your hamstring and thighs as you step. 

Different techniques work for different people, so it’s worthwhile to experiment and see if you notice a difference in your pain with different strategies.

These exercises recommended by Hinge Health physical therapists are designed to strengthen your knees while also relieving any tightness or pain you may feel in your hip or lower back.

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.

PT Tip: Move to Improve

It’s normal to want to avoid an activity that causes pain. But avoiding the stairs altogether because they cause pain can actually delay healing and rob you of important opportunities to build strength.