One of the most frequent complaints about knee pain is of aching when climbing up and down stairs. So, while taking the stairs is undoubtedly a great exercise for your overall health, it does put a lot of stress on the knees—especially when going down. So, although walking up and down stairs can be beneficial as a strengthening exercise, if it causes knee pain, it may be time to consult with your physician.

Knee Anatomy and Knee Pain

Your knee joins four bones: the femur (or thigh bone), the tibia (or shin bone), the patella (or kneecap), and the fibula (or calf bone). The tibia and fibula connect below the knee joint, the femur connects above the knee joint, and the patella rests on the femur and the connecting cartilage. These bones are, in turn, supported by ligaments and muscles that work to keep the knee stable and mobile.

When you bend your leg to walk up or down stairs, the patella slides over the femur (see above). In a healthy knee, articular cartilage keeps your kneecap stable and cushioned and provides lubrication to the knee joint. If you are experiencing knee pain when climbing or descending stairs, it is likely that the cartilage is damaged so that the kneecap is sliding out of position, causing pain and discomfort.

Causes of Knee Pain When Going Down Stairs

Going up stairs can be uncomfortable or even painful, however, going down puts much more pressure on the knees. When you go down stairs, the force on the kneecap is 3.5x your body weight. This means that if you weigh in the neighborhood of 80kg, your knees bear a force of 280 kg For such a small surface area, this is a lot to carry—which explains why so many people struggle when descending stairs. Just for comparison, walking up stairs only exerts a force 2.5x a person’s body weight. Squatting, on the other hand, exerts a force of up to 8x a person’s body weight.

1) Knee Osteoarthritis

Over time, the cartilage that supports your knee can break down or degenerate, causing bones to move irregularly and without adequate cushioning. 4.11 million people over the age of 45 have knee OA in England – 1.4 million have severe knee osteoarthritis. Symptoms of knee osteoarthritis include grinding or clicking in the knee when moving, inflammation, pain, and stiffness after periods of sitting or lying down.

There is no cure for knee osteoarthritis, but it can be addressed with both invasive and non-invasive treatments. AposTherapy is a non-invasive, CE marked treatment for knee osteoarthritis with a patient satisfaction rate of 96%.

2) Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is more frequently known as jumper’s or runner’s knee and refers to anterior knee pain. This syndrome occurs when irregular movement takes place in your patella (knee cap), often due to altered muscular control around the knee joint.

Patellofemoral pain may indicate a condition called chondromalacia patella. This occurs when the articular cartilage on the underside of the kneecap deteriorates, causing inflammation and pain. Symptoms include grinding or clicking in the knee when moving the joint or swelling and pain in the knee cap.

There are several reasons why you may be experiencing patellofemoral pain when going down stairs. It may be because of anatomical abnormalities, flat feet, or muscle weakness and can occur at any age.

3) Muscle Strain

Minor muscle injuries are usually not serious and will heal with time, but if the affected muscles are around the knee, this can cause pain when going down stairs.

4) IT Band Syndrome

This injury is often caused by repetitive knee-bending activities like running, biking or hiking. The iliotibial, or IT band is a tendon that runs from the pelvis to the top of the shin and over the side of the knee. Because of its connection to the knee, if your IT band is inflamed, you may experience severe knee pain when climbing stairs.

5) Ligament Injury

Ligaments like the ACL and MCL connect to the knee. If you have had an injury where these ligaments are sprained or even torn, this will cause lack of control and pain when climbing stairs. Knee ligament injuries may be serious and may require surgical intervention.

6) Compensation Injury

When you sustain an injury to your foot or ankle, it can change how you stand and walk. By compensating for the injury, you alter your body’s biomechanics and put excess load on the knee when going down the stairs. This can cause pain and may require biomechanical intervention to correct your gait.

5 Tips to Go Up and Down Stairs with Less Pain

  1. Make sure you step onto the stairs with your whole foot and not just your toes. Stepping with just your toes can compress your knee and cause pain.
  2. When climbing, push off from your outer heel. This activates your gluteus muscles for greater efficiency and puts less strain on the knee.
  3. To reduce the load on the affected leg, physiotherapists often explain leading up the stairs with the good leg, and down the stairs with the painful leg.
  4. Try not to walk up stairs when your knee is not aligned over your foot. If your knee is angled inward, this can lead to poor control, pain and further injury.
  5. Address underlying causes of knee pain when climbing or descending stairs. Often, pain indicates a misalignment, weakness, or injury that is manifesting in knee pain.

How to Deal with Knee Pain

If you are experiencing knee pain going up or down stairs, or in general, there are a range of treatment options available that are non-invasive and will likely reduce inflammation and pain.

1) R.I.C.E.

One of the most common ways of dealing with knee pain is RICE, which stands for Rest, Ice, Compression, and Elevation. If you’ve injured your knee or are experiencing knee pain, these four at-home treatments can help.

  • Rest your knee and stop any activity that may be causing you pain.
  • Ice your knee to reduce pain and swelling. Apply cold for 10 to 20 minutes, 3 or more times a day, immediately following an injury or the activity that caused pain. Icing can be followed by applying heat once the swelling is gone.
  • Compression involves wrapping or bandaging your knee to reduce swelling to immobilise it. It’s important not to wrap your knee too tightly. And if the pain doesn’t improve after a couple of days, consult your physician to rule out a more serious knee injury.
  • Elevate your foot and knee on pillows whenever you are seated to keep the swelling down. Even better, lay down and keep your knee elevated above your heart level.

2) OTC Medication

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can be effective in treating knee pain temporarily, but if pain worsens, there may be an underlying cause that has to be looked at.

3) Weight Management

Managing your weight can help reduce the strain on your knees, which, in turn, can reduce pain. Maintaining a healthy weight and balanced diet are also important for overall health and wellness.

4) Exercise and Physiotherapy

If you have knee pain, exercise and physiotherapy will strengthen the muscles around the knee for improved stability and mobility. Some examples of appropriate exercises include water therapy and gentle stretching. Physiotherapy can also improve flexibility and strength, even if the pain is severe.

5) Support Aids

Supportive aids such as walkers, braces and splints, or therapeutic taping may help reduce knee pain, but it’s important to ensure that you are getting the right device for your needs.

6) Biomechanical Devices

Devices developed to improve gait and reduce the weight load on the knee can help alleviate knee pain. AposTherapy, for example, is a biomechanical aid that has been shown to reduce knee pain and improve gait for patients with knee osteoarthritis.

7) Prescription Medication

If your knee pain is severe and doesn’t improve with over-the-counter treatment, your physician may prescribe painkillers and anti-inflammatories, or corticosteroid injections.

Conclusion

Knee pain can be debilitating and often appears when going up or down stairs. If you experience knee pain when walking down stairs, there are some easy things you can do to reduce discomfort and make stairs less daunting. There is no reason why knee pain should get in the way of your everyday activities, and if it is, consult your physician for more serious intervention such as wearing biomechanical devices to improve gait and reduce pain.