Why Do I Have Knee Pain When Walking Down Stairs?

There are more joints in our bodies than there are bones. And the largest two joints bear most of our body weight.

These are the hip joints—the largest ball and socket joints—and the knee joints—the largest hinged joints.

The joints are protected by a cartilage lining, which allows us to go through our daily activities moving easily and smoothly. However, cartilage does break down through repetitive movements like running, jumping, or as we age.

When the cartilage starts to deteriorate, this is when we begin to experience pain in the joints when doing everyday activities.

One of the most frustrating experiences can be trying to go up or down stairs while you have knee pain.

In this article, we’ll be looking at the reasons why your knee hurts when going up or down stairs.

We’ll also share some tips on how to treat your knee pain and how you can go down the stairs safely when you’re experiencing it.

Why does my knee hurt when I walk down stairs?

When we go about our daily activities we’re placing stress on the knee, which is protected by a thick layer of cartilage at the back of the kneecap which is a free-floating bone.

The articular cartilage helps to keep the kneecap lubricated so that it can glide up and down as well as keep the kneecap stable.

When we go down stairs, we’re applying a force of 3.5 times our body weight on the kneecap. This means that if your current body weight is 180 pounds, then every step you take going down a stair exerts a force of 630 pounds on the patella.

It’s hard to believe that the patella can handle that amount of force!

But if the cartilage is damaged or deteriorating, then the kneecap can slide out of position.

This can lead to a restriction on your range of movement and cause pain when you go down or up stairs, even if you’re moving slowly.

What are general treatments to improve knee pain?

If you’re experiencing knee pain, there are steps you can take to reduce the pain and inflammation.

However, it’s important to note that if the knee pain is severe or restricts your range of movement when you’re also doing other activities, then you should consult with your medical practitioner.

When you first start to feel knee pain, don’t ignore it. The best thing that you can do for your knee is to take care of it.

Follow the RICE principle, as this will help to alleviate pain, reduce swelling and promote healing.

RICE stands for:

  • Rest
  • Ice
  • Compression
  • Elevation

Take a break from your training routine and daily activities and rest your knee. This will allow it time to heal and prevent further damage to the cartilage, as well as the joint.

You can take an anti-inflammatory medication like ibuprofen—Advil or Motrin IB—as this will alleviate the pain and reduce inflammation.

Apply ice to your knee four to six times a day, for no longer than 20 minutes at a time, as this will help reduce the swelling.

You can use a compression sleeve on the knee, as this will insulate your body heat and increase the oxygen and blood flow to the knee. This not only helps to reduce the stiffness, pain, and swelling, but it helps to promote healing.

Then, elevate your foot above your heart level, as this will help to keep the swelling down.

Massaging the affected area will help to reduce the stiffness, as well as increase the oxygen, blood flow and nutrients to the muscles which promotes healing.

Light stretching exercises will help maintain the knee’s full range of motion and reduce stiffness in the muscles and ligaments around the knee.

A sore knee doesn’t have to interrupt or bring your exercise routine to a complete stop. You can do active recovery, as long as you’re doing low-impact exercises like swimming, using the elliptical machine, cycling or walking. However, you should only try walking if you’re not limping.

Strength and stability exercises will help to develop the muscles in your legs, which will help to stabilize the knee and prevent further injuries.

Maintaining a healthy weight will reduce the amount of force that’s placed on the joints, which will help to reduce pain.

Tips on how to go down stairs safely

You don’t have to start avoiding stairs or looking to move to a one-story apartment or a house without stairs. We’ve got some tips that will help you get down the stairs safely and without experiencing knee pain.

Choose your shoes carefully, as you want to wear shoes that are going to provide you with good support. This applies to slippers and moccasins as well.

Look at wearing shoes that have a minimal heel—no high heels—and that have non-slip sole. When you’re going downstairs, use the weaker knee, as you’ll have gravity helping you.

When you go upstairs you want to use your stronger leg—the leg that doesn’t have a sore knee—as you’ll be putting all your weight on it. Always make use of the handrail as this will help to stabilize you and you have better control of how quickly you’re going up or down the stairs.

Make sure that you put your entire foot on the step, not just your toes or forefoot. This will allow you to push off with your heel, rather than putting all the pressure on your forefoot.

When you push off with your heel, you will be changing the way in which the muscles work; you’ll be using your glutes as opposed to your knee and quads. This will help to prevent knee pain, as your glutes are one of the strongest muscles in the body.

Don’t try and walk up the stairs sideways, as you’ll be using a different set of muscles that may be weaker, which could lead to you becoming unstable.

What common 3 knee injuries can cause the pain and what are treatments?

1. Runner’s knee

What is it and what are the symptoms?

Runner’s knee, which is also known as Patellofemoral Pain Syndrome, is a broad term that’s used to describe a variety of conditions that cause pain around and behind the knee.

You’ll have pain around the knee when you walk, kneel, run, climb up or go down stairs, and when you stand or sit down. Aside from the pain, there may be swelling around the knee or you may hear a grinding or popping sound when you move.

This is due to the way the patella moves. When you move, the cartilage of the kneecap rubs against the trochlea and this irritation to the cartilage is what leads to the pain.

Who is at risk?

Anyone can suffer from runner’s knee and there are a number of factors that can increase a person’s chances of developing it. Teenagers have a high risk of developing runner’s knee, as they could have a muscle imbalance that’s been caused by a rapid growth spurt.

People with flat feet could develop runner’s knee, due to the amount of pressure that’s placed on the knee joints.

Women are also more susceptible to developing it, as the knee alignment is different from that of men because they have wider hips. Excessive weight can also lead to runner’s knee.

Athletes are prone to runner’s knee, as the repetitive movements and high level of activity places pressure on the knee joints.


There are a number of factors that can cause runner’s knee, such as a biomechanical abnormality, due to a muscle imbalance or weak thigh muscles, glutes, and hips.

Flat feet can also lead to this condition, especially if the foot doesn’t have enough arch support as weight isn’t dispersed evenly, which puts pressure on the joints.

Overpronation can also cause runner’s knee, as the thigh muscles pull the kneecap outwards as your feet roll in, which places strain on the kneecap.

It could be caused by tight muscles and tendons from overuse—like excessive training—or it can be triggered by an old injury, as well as a kneecap that’s misaligned. Excessive weight places stress on the joints.


The best way to treat runner’s knee is to use the RICE principle—use the treatment tips above—do light stretching, like a standing calf stretch or standing quad stretch.

Add strength training to your workout routine and include exercises that will help to strengthen your quads, hamstrings, glutes, and hips.

2. Osteoarthritis

What is it and what are the symptoms?

Osteoarthritis occurs when the cartilage in the joint starts to wear away, either from degenerative changes or from wear and tear.

You’ll experience pain in the knee, either during movement or after. The knee joint will feel stiff and you may notice it more when you’ve been sitting for a while or when you get out of bed in the morning.

You may have a restricted range of motion and find that you can’t bend or straighten your knee completely.

While going about daily activities, if you notice an abnormal sensation in the knee, like something is scraping against the bone or you hear cracking or popping sound, this can indicate osteoarthritis. There is often swelling around the knee which is caused by the soft tissue of the joint.

Who is at risk?

More than 32.5 million people are affected by osteoarthritis in the United States.

Genetics plays a role when it comes to osteoarthritis, and if any members of your family have developed it, this will increase your risk. As we get older, we’re at risk of developing the condition, as are people who are overweight.

People who have damaged joints from repetitive stress or an injury have an increased risk of developing osteoarthritis in that joint.

Both men and women can be affected by osteoarthritis, however it’s more likely to develop after the age of 50 for women and up until the age of 45 for men.


Osteoarthritis occurs in the joint when the cartilage between the joints starts to wear away, due to either degenerative changes or wear and tear to the cartilage.

As the cartilage breaks down, the bones start to rub against each other which causes pain and discomfort.


While there is no cure for osteoarthritis, in severe cases a medical practitioner may recommend doing a replacement surgery of the joint—like knee replacement surgery.

Surgeons will cover both ends of the bone joints with either ceramic, plastic, or metal. This will stop the joint bones from rubbing against each other, which causes pain and inflammation.

Medical practitioners may suggest the following therapies as treatment:

  • Medications such as Analgesics, Corticosteroids, Counterirritants or Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • If the person has excessive weight, the medical practitioner will recommend a weight loss program
  • Increasing physical activity
  • Supportive aids like a cane or crutch
  • Physical therapy that includes strength training

3. Chondromalacia Patella

What is it and what are the symptoms?

Chondromalacia Patella happens when the cartilage behind the kneecap softens and begins to break down. Without the protective layer of the cartilage, the bones begin to rub together and this can cause pain in the knee.

You may find that your range of motion is affected and your knee won’t move past a certain point. There will also be a dull pain in the front of the knee, which will be aggravated when you move or sit for too long.

The knee may feel stiff and there will be swelling. It may also sound as if your knee is grinding, or there could be a popping sound. If it’s left untreated and it becomes more severe, there will also be a loss of muscle strength in the quadriceps.


Abnormal tracking of the patella where it moves towards the outside of the femur causes the back of the patella to scrap against the femur. It can also be caused by a muscle imbalance around the knee, overuse of the joint, an injury to the meniscus, as well as misaligned muscles that are meant to support the knee.

If the knee has had a break, fracture, or dislocation of the kneecap, then this could lead to Chondromalacia Patella.

Who is at risk?

There are people who are predisposed to developing chondromalacia patella. However, anyone can develop this condition. Flat-footed runners or people who are knock-kneed or more susceptible to it.

Women are also predisposed to developing this condition, as there is more lateral pressure that’s placed on the knee joint. Individuals who are overweight would be more susceptible to developing chondromalacia patella.

Athletes, be it soccer players, runners, or cyclists, can develop this condition due to the repetitive movements and pressure that’s placed on the joints.

If there’s a discrepancy in the length of your leg, then you could develop chondromalacia patella, as this would change your gait, which would place pressure on the knee joint


Treating chondromalacia patella would require resting and icing the knee. You would need to wear either a knee strap or knee brace to stabilize the kneecap, and take ibuprofen to reduce the inflammation, as well as alleviate the pain.

This would require that you go for physical therapy that would focus on strengthening specific leg muscles; hamstrings, abductors, adductors, and quadriceps. This would help to balance the muscles which would prevent the misalignment of the knee.

If you’re experiencing pain in your foot with chondromalacia patella, then you’ll need orthotic shoe inserts.

The inserts will help to reduce the pressure on the joints and realign the feet, which can improve the overall gait and posture of the body. This can reduce knee pain.

Other causes of knee pain can be:

Pain in the knee can often be a symptom for other conditions or injuries like:

  • Bursitis
  • Iliotibial band syndrome
  • Torn meniscus
  • Ligament tear or sprain
  • Fractures
  • Plica syndrome
  • Sprained ankles
  • Foot injuries

Should I see a physician if the pain remains or gets worse?

If you’ve been trying the RICE principle and the symptoms haven’t improved after a week, or they get worse, then you should seek medical attention from a doctor.

The health professional will conduct a physical exam, and may even order x-rays on the knee to determine the cause of your knee pain. Once they’ve given you a diagnosis, you’ll know the way forward on how to treat the condition.

Arthritis Foundation. (2020). Osteoarthritis. Arthritis.org.

C, W. (2018). Chondromalacia Patella Symptoms & Treatment. MedicineNet.

Center For Disease Control and Prevention. (2021). Osteoarthritis (OA). Www.cdc.gov.

Centers for Disease Control and Prevention. (2020, February 27). The Cost of Arthritis in US Adults. Www.cdc.gov.

Cortés Godoy, V., Gallego Izquierdo, T., Lázaro Navas, I., & Pecos Martín, D. (2014). Effectiveness of massage therapy as co-adjuvant treatment to exercise in osteoarthritis of the knee: a randomized control trial. Journal of Back and Musculoskeletal Rehabilitation, 27(4), 521–529.

Francis, P., Whatman, C., Sheerin, K., Hume, P., & Johnson, M. I. (2019). The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location and Specific Pathology: A Systematic Review. Journal of Sports Science & Medicine, 18(1), 21–31.

Hasegawa, M., Chin, T., Oki, S., Kanai, S., Shimatani, K., & Shimada, T. (2010). Effects of methods of descending stairs forwards versus backwards on knee joint force in patients with osteoarthritis of the knee: a clinical controlled study. BMC Sports Science, Medicine and Rehabilitation, 2(1).

Huraj, E. (1977). [Knee–the largest joint in the body]. Rozhledy v Chirurgii: Mesicnik Ceskoslovenske Chirurgicke Spolecnosti, 56(7), 460–466.

Medicine, J. H. (2019). Patellofemoral Pain Syndrome (Runner’s Knee). Www.hopkinsmedicine.org.

NIAMS. (2019, August 2). NIAMS Health Information on Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Perspectives in Total Hip Arthroplasty, S. A. (2014). Ball-and-Socket Joint – an overview | ScienceDirect Topics. Www.sciencedirect.com.

Staff, A. H. (2020, July 31). Knee Pain Going Down Stairs? Here’s What You Need To Know. AposHealth®.

University of Michigan Health System (UMHS). (2019, June 26). Rest, Ice, Compression, and Elevation (RICE) | Michigan Medicine. Www.uofmhealth.org.