Why Does My Knee Hurt Going Down Steps?

If your knees get sore on steps or you find yourself going down sideways to make it easier, this article is for you.

Climbing steps in everyday situations is unavoidable. Whether it’s an actual set of steps or stepping down from a curb, this everyday task can be challenging — especially with knee pain.

Let’s dig deeper.

Up & Down

Surprisingly, some individuals can climb steps pain-free, but going down hurts.

Why? Compared to going up a step, going down places greater strain on the knee(1). This is especially true at the undersurface of your kneecap, known as your patellofemoral joint. Walking down steps puts 346% of your body weight onto the kneecap, while going up a step puts 316%(2).

To put this into perspective, a person weighing 185 pounds is placing nearly 640 pounds of force through the kneecap while going down a step. Unfortunately, the strain on the knee gets worse when other areas of the body, mainly the ankles and hips, are either weak or tight.

The range of motion required for stairs is much greater than other daily tasks, like walking. Loss of motion due to tightness or previous injury (i.e. ankle sprain or fracture) can cause your body to compensate and increase the strain on the knee.

Lack of strength in the hips and ankle can also cause the knee to compensate while on stairs. Research suggests knee pain during stair negotiation is consistent with altered activity and weakness of the hip muscles (6).

Believe it or not, knee pain is a shared complaint in all age groups.

Typically, knee pain is attached to one of the following diagnoses:

1. Osteoarthritis
2. Chondromalacia Patella
3. Meniscus Tears
4. Patellofemoral Pain

Luckily, many people struggling with these conditions can be treated conservatively without the use of injections or surgery.

What Can I Do?

1. Start with Rest

The first goal is to “quiet the knee.”

Using ice and rest can often get your knee to a better place. It is also important to limit the aggravating factor of your knee pain (stair climbing, walking, running), at least temporarily. To heal, you should do your best to avoid activities that aggravate your knee.

2. Add Exercises

The tip above is great to help you feel better, but you need to get back to your day-to-day and hobbies, too. That’s why it’s important to choose exercises that can build strength and flexibility in key areas. Exercises that improve flexibility, strength, and balance in areas that support your knee are the best place to start.

3. Strengthen and Stretch

Hip (the glutes), knee (the quadriceps muscle), and ankle strengthening exercises are important to protect the knee and allow it to heal. Stretching exercises targeting the calf, hamstrings, and hip flexors are important to prevent the knee from compensating.

4. Weight Management

It can be tough to exercise when your knee hurts, but weight management can make a big difference.

For every pound of body weight, an additional five pounds of pressure is placed on the knees(7). An aquatic or biking program is a good place to start for those who find most exercise programs too painful.

The Takeaway?

When your knee hurts on stairs, there’s a lot you can do to improve or even resolve the issue. A proper exercise routine can improve knee health and quality of life now and into the future.

References

1. T. P. Andriacchi, G. B. Andersson, R. W. Fermier, D. Stern, J. O. Galante “A study of lower-limb mechanics during stair-climbing.” J Bone Joint Surg Am. 1980 1980 July; 62(5): 749–757.
2. Kutznera I, Heinleina, B, Graichena F. Loading of the knee joint during activities of daily living measured in vivo in five subjects. Journal of Biomechanics. 2010 Aug;43(11):2164–2173.
3. Mian OS, Thom JM, Narici MV, Baltzopoulos V. Kinematics of stair descent in young and older adults and the impact of exercise training. Gait Posture 2007;25(1):9-17.
4. Brouwer B, Olney SJ. Aging skeletal muscle and the impact of resistance exercise. Physiother Can 2004;56(2):80-87.
5. Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR. Stair negotiation in older people: a review. J Am Geriatr Soc 2000;48(5):567-580.
6. Brindle TJ, Mattacola C, McCrory J. Electromyographic changes in the gluteus medius during stair ascent and descent in subjects with anterior knee pain. Knee Surgery, Sports Traumatology, Arthroscopy. 2003 Jul;11(4):244-251.
7. http://www.nlm.nih.gov

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