Knee Pain Going Down Stairs

By Chloe Wilson, BSc(Hons) Physiotherapy

Find out about the common causes of knee pain going down stairs

Knee pain going down stairs, and as you go back up, is a common problem and can make life really tricky.

It is not surprising so many people complain of pain when you consider that the force going through the kneecap is 3.5x body weight when you come down the stairs.

That means for a person weighing 120lbs, as they come down, a force of 420lbs goes through the kneecap which has a contact surface area of only 12cm2.

Causes of Knee Pain Going Down Stairs

In most cases knee pain going down stairs usually indicates a problem with the knee cap (patella) and how it moves. The kneecap is a small bone, shaped like an upside down triangle which sits in the patella groove at the front of the knee and glides up and down as the knee moves.

Huge forces go through it with every day activities. As a result, the back of the patella is lined with the thickest layer of cartilage in the whole body as it is designed to withstand massive compressive forces.

Anything that interferes with how the patella moves, or that affects the cartilage lining the knee cap will magnify these huge forces and lead to knee pain going down stairs.

Let's take a look at the four most common causes of knee pain going down stairs:

1) Runners Knee

Runners Knee, also known as Anterior Knee Pain or Patellofemoral Pain Syndrome, is the most common cause of knee pain going down stairs.

Runners Knee is a common cause of knee pain on the stairs

What is it: Runners Knee is a condition where there is a problem in the way the patella moves up and down

Causes: Muscle tightness/weakness, flat feet, abnormal anatomy

Symptoms: General ache and knee cap pain, grinding, mild swelling

Aggravating Activities: Repeated activities, stairs, prolonged inactivity

Who Does it Affect: Can affect anyone, at any age, whether they are active or not. Accounts for approximately 25% of all knee injuries seen in sports injury clinics

Treatment: Visit the Runners Knee section

2) Chondromalacia Patella

What is it: Chondromalacia is a conditions where there is damage to the cartilage on the back of the kneecap

Knee pain going downstairs is often caused by a problem with the cartilage on the back of the kneecap

Symptoms: Achy knee cap pain, swelling, clicking/grinding

Aggravating Activities: Getting up from sitting, sports, pressure through the kneecap, stairs

Who Does it Affect: Most common in young, healthy people. More common in women.

Treatment: Visit the Chondromalacia Patella section

3) Osteoarthritis

What is it: In osteoarthritis, there are degenerative changes (wear and tear) in the knee bones and cartilage of the knee

Symptoms: Morning stiffness, pain, swelling, clicking/grinding, reduced knee movements

Aggravating Activities: Worse after prolonged rest, activity, cold weather, stairs

Who Does It Affect: Most common over the age of 50

Treatment: Visit the Arthritis section

4) Pes Anserine Bursitis

What is it: With Pes Anserine bursitis, the problem is not with the kneecap directly, but inflammation of the nearby pes anserine bursa, a small fluid filled sac that reduces friction between knee tendons and bone

Pes Anserine Bursitis often causes pain on stairs

Symptoms: Pain and swelling approximately 2-3 inches below the knee joint on the inner side of the knee

Aggravating Activities: Stairs (going up tends to be worse than coming down), sleeping on your side (due to pressure on the bursa), hamstring stretches

Who Does It Affect: Most common in overweight women, runners and swimmers (particularly breaststroke)

Treatment: Visit the Pes Anserine Bursitis section

Forces Through The Knee Cap

Squatting places forces around 7-8x bodyweight through the kneecap

People often don't realise quite how much the force through the knee varies in different situations. Let's have a quick look at the forces that go through the kneecap with different activities.

Walking: 0.5x body weight
Climbing Up Stairs: 2.5x body weight
Going Down Stairs: 3.5x body weight
Squatting: 7-8x body weight

It really highlights why some activities cause so much pain.

Want To Know More?

Of course, lots of knee problems will feel worse on the stairs, but these are the four problems where knee pain on stairs is one of the most prominent features.

If none of these are sounding like your problem, visit the knee pain diagnosis section, for help working out was is causing your pain, and to learn what you can do about it.

To find out about these common causes of knee pain going down stairs, click on the links above.

  1. Knee Pain Guide
  2.  ›
  3. Symptoms
  4.  ›
  5. Knee Pain On Stairs

Page Last Updated: 14/9/18
Next Review Due: 14/9/20


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