Why Does My Knee Hurt When Going Downstairs?

If your knee hurts when walking downstairs, but feels fine during other activities, you’re not alone. This is a common complaint and can be particularly frustrating when everyday activities such as using stairs, squatting or getting up from a chair become uncomfortable.

Why does going downstairs hurt?

Walking downstairs places a relatively high load through the knee joint. Your quadriceps muscles have to work eccentrically — controlling your body as you lower each step. If the knee or surrounding muscles aren't coping well with this load, pain can develop.

One of the most common causes is patellofemoral pain, where pain is felt around or behind the kneecap. It can be associated with changes in activity, muscle weakness, reduced strength around the hip and knee, or an increase in running or other exercise.

Knee osteoarthritis can also cause pain when using stairs. As the joint becomes less tolerant of load, activities such as descending stairs can become increasingly uncomfortable.

Why does it hurt downstairs but not upstairs?

Going downstairs requires your muscles to control your descent against gravity. This places a different demand on the knee compared with walking on level ground or climbing stairs.

This doesn't necessarily mean that something is being damaged every time you feel pain. Pain is influenced by many factors, including the sensitivity of the tissues, muscle capacity, previous injuries and how much load the knee has recently been exposed to.

What can you do?

Completely resting the knee isn't usually the best long-term solution. Instead, gradually improving the knee's ability to tolerate load can be beneficial.

Strengthening the quadriceps, glutes and surrounding muscles, alongside appropriate mobility and movement exercises, can help improve function and confidence.

It can also be useful to temporarily modify activities that significantly aggravate your symptoms before gradually building them back up.

When should you get your knee assessed?

If your knee pain is persistent, worsening, associated with significant swelling, locking or giving way, or is preventing you from exercising normally, an assessment can help identify the likely cause and guide your rehabilitation.

At Head 2 Toe Osteopathy, we can assess your knee, look at how the surrounding joints and muscles are contributing to your symptoms, and develop an appropriate treatment and exercise plan to help you return to the activities you enjoy.

Don't let knee pain stop you using the stairs. Getting the right advice early can help you understand what's causing your symptoms and what you can do about them.