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

Learn why knee pain when going up and down stairs occurs, and what you can do to prevent and treat it.

Published Date: May 23, 2023
Woman-holding-her-knee-on-the-floor-at-stairs

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

Learn why knee pain when going up and down stairs occurs, and what you can do to prevent and treat it.

Published Date: May 23, 2023
Woman-holding-her-knee-on-the-floor-at-stairs

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

Learn why knee pain when going up and down stairs occurs, and what you can do to prevent and treat it.

Published Date: May 23, 2023
Woman-holding-her-knee-on-the-floor-at-stairs

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

Learn why knee pain when going up and down stairs occurs, and what you can do to prevent and treat it.

Published Date: May 23, 2023
Woman-holding-her-knee-on-the-floor-at-stairs
Table of Contents

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.

Our Hinge Health Experts

Dr. Heather Broach, PT, DPT
Physical Therapist
Dr. Broach is a Hinge Health physical therapist who enjoys treating shoulder, low back, knee, and ankle issues.
Jonathan Lee, MD, MBA
Orthopedic Surgeon and Medical Reviewer
Dr. Lee is a board-certified orthopedic surgeon and an Associate Medical Director at Hinge Health.
Dylan Peterson, PT, DPT
Physical Therapist and Clinical Reviewer
Dr. Peterson is a Hinge Health physical therapist who focuses on developing clinical exercise therapy programs and member education.

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Knee Anatomy Basics

In order to understand knee pain when climbing stairs, it helps to know some basics about what comprises your knee and how this important joint works.

  • Bones: The bones in your knee joint are the patella (kneecap), femur (thigh bone), and tibia (shin bone). The femur articulates with both the patella and the tibia.  

  • Ligaments: Four main ligaments hold everything together. Two are considered “collateral” ligaments, and they act like straps that stabilize your knee by holding it on each side. Two are “cruciate” ligaments, which are inside the knee joint itself. They cross over in an X formation and serve to stabilize your knee as it moves forward or back. 

  • Tendons: These are thick bands that connect muscle to bone. 

  • Cartilage: This is a rubbery, shock-absorbing material that lines the ends of the knee bones and helps them glide as they move past each other. 

  • Menisci: Each knee has two wedges of very thick and tough cartilage that acts like a bumper pad, says Dr. Broach. “It’s meant to absorb shock and improve how the bones of the femur and tibia come together.” 

  • Bursae: These are tiny fluid-filled sacs that further help to reduce friction and provide extra cushioning.

  • Muscles: Your knee includes several muscles that help you bend and straighten the joint. 

  • Nerves: You can feel whatever is happening in your knee, especially any pain that might arise, thanks to nerves in your knee that carry electrical impulses to your brain.

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.

Exercises to Reduce Pain When Climbing Stairs

Get 100+ similar exercises for free

  • Hip Flexor Stretch
  • Mini Squat
  • Bridge
  • Hamstring Stretch
  • Side Lunge

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.

Heather Broach, PT, DPT
I like to empower patients to engage and strengthen their muscles so that they can do what they need to without being in pain.

Incorporating strengthening exercises into your day and moving in any way that feels good to you is a great way to do that. It helps make you more resilient to pain when you take the stairs and go about your daily routine. “If you’re on the right track, you should see a good bit of change within the first few weeks. If not, we may need to recalibrate and just tailor your plan to better suit your needs,” says Dr. Broach. 

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.

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References

  1. Costigan, P. A., Deluzio, K. J., & Wyss, U. P. (2002). Knee and hip kinetics during normal stair climbing. Gait & Posture, 16(1), 31–37. doi:10.1016/s0966-6362(01)00201-6

  2. Marom, N., & Mann, G. (2015). Asymptomatic Meniscal Tears. Sports Injuries, 965–969. doi:10.1007/978-3-642-36569-0_70

  3. Knee Joint. (2023, March 2).Cleveland Clinic. https://my.clevelandclinic.org/health/body/24777-knee-joint

  4. The Knee. (n.d.). University of Texas Health Science Center at San Antonio. Retrieved from https://www.uthscsa.edu/patient-care/physicians/sports-medicine/knee-anatomy

  5. Iliotibial Band Syndrome. (n.d.). Cedars-Sinai. Retrieved from https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/iliotibial-band-syndrome.html#:~:text=Iliotibial%20band%20syndrome%20causes%20pain,you%20exercise%2C%20especially%20while%20running

  6. Mulcahey, M. K., Hettrich, C. M. & Liechti, D. (2020, October). Patellofemoral Pain Syndrome. OrthoInfo – American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/patellofemoral-pain-syndrome/

  7. Meniscus Tear. (n.d.). Penn Medicine. Retrieved from https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/meniscus-tear

  8. Knee Pain. (2020, November 4). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15607-knee-pain-chondromalacia-patella