Knee Pain on Stairs or Walking: What It May Mean
By Nova Physical Therapy | North Hollywood, CA | Published October 2026
Maybe it's the stairs at work, the walk from the parking lot, or getting up after a long movie. Your knee aches, and you start wondering whether something is wrong inside the joint.
Knee pain is one of the most common reasons people look for help, and the good news is that many causes respond well to the right kind of exercise. This article explains what knee pain on stairs or while walking may be associated with, what tends to help, and which signs mean you should get your knee checked soon.
The short answer
Knee pain on stairs or when walking has several common causes, including irritation around the kneecap (patellofemoral pain), arthritis, overuse, and injuries to the ligaments or meniscus. Where the pain is, when it started, and what makes it worse all offer clues, but only an in-person evaluation can sort out the cause. For the most common types, guidelines put progressive strengthening exercise at the center of care. In California, you can see a physical therapist for an evaluation without a referral.
Why does my knee hurt on stairs?
Stairs ask a lot of your knee. Climbing and especially going down stairs load the joint while it's bent, and that puts extra demand on the area behind the kneecap.
That's why pain in the front of the knee or around the kneecap during stairs is often linked with patellofemoral pain, sometimes called "runner's knee" or anterior knee pain. The American Physical Therapy Association's guideline notes that pain with squatting, stair climbing, and prolonged sitting with the knees bent are among the most typical signs of it (Willy et al., JOSPT 2019). It's one of the most common knee problems seen in sports medicine clinics, but it affects non-athletes too.
Other things that may be associated with stair pain include:
• Knee osteoarthritis, especially in people over 50, often with stiffness after rest
• Tendon irritation below the kneecap, common in people who run or jump a lot
• Bursitis, which can make kneeling and bending painful
• A past injury to a ligament or the meniscus that never fully recovered
Why does my knee hurt when I walk?
Pain while walking can come from the same sources, but the pattern often differs. People with knee arthritis commonly notice stiffness and achiness that's worse first thing in the morning or after sitting, then eases a bit once they get moving. Pain that builds the longer you walk can point to a joint or tendon that isn't yet strong enough for the load you're asking of it.
Where you feel the pain is a useful clue to share with your clinician (Cleveland Clinic):
• Front of the knee: often linked with kneecap pain, arthritis, or bursitis
• Inside edge: may involve the inner ligament (MCL) or arthritis
• Outside edge: may involve the outer ligament, the meniscus, or the IT band
• Back of the knee: may involve tendons, a Baker's cyst, or tight muscles
These are patterns, not a diagnosis. Two people with pain in the same spot can have very different causes.
Is it arthritis or something else?
It's a common worry, and the honest answer is that you can't tell for sure from symptoms alone. Some general patterns:
• Osteoarthritis tends to develop gradually, is more common with age, and often comes with stiffness and mild swelling, sometimes in both knees (NHS).
• Patellofemoral pain often starts in teens and younger adults, is felt around or behind the kneecap, and flares with stairs, squatting, or long periods of sitting.
• Meniscus or ligament problems usually follow a twist, pivot, or impact, and may come with swelling, catching, or a sense the knee is unstable.
Even if you do have arthritis, that's not the end of the story. Exercise is strongly recommended for knee osteoarthritis by the American College of Rheumatology and Arthritis Foundation guideline (Kolasinski et al., 2020), and the American Academy of Orthopaedic Surgeons recommends supervised or home exercise over no exercise to improve pain and function (AAOS, 2021).
What can I do to ease knee pain?
While you're figuring out what's going on, a few general steps tend to help many people:
• Adjust, don't stop. Total rest usually isn't needed. Reduce the activities that clearly flare your knee for a short time, and keep moving in ways that feel tolerable.
• Use the rail. Holding a handrail on stairs takes some load off the knee while it settles down.
• Break up long sitting. If sitting with your knees bent bothers you, stand up and move every 30 to 45 minutes.
• Build back gradually. When you return to walking, stairs, or exercise, increase the amount a little at a time instead of jumping back to your old routine.
Questions about pain medication, injections, or imaging are best directed to your physician.
How can physical therapy help knee pain?
A physical therapist starts by looking at how your knee and the rest of your leg move. An evaluation may include:
• When the pain started and what makes it better or worse
• Strength testing of the thigh and hip muscles
• How you squat, step, walk, and balance
• Knee motion, swelling, and joint stability
• Screening for signs that need a physician's evaluation
From there, treatment focuses on what the research supports. For patellofemoral pain, the APTA guideline found that progressed exercise targeting both the hip and knee muscles is the best approach, and that passive treatments like ultrasound and electrical stimulation are not helpful (JOSPT, 2019). Taping or simple shoe inserts may help some people, but only alongside exercise.
For knee arthritis, guidelines support strengthening, aerobic exercise, balance training, and self-management education. There's no single best exercise for everyone; the right plan depends on your knee, your goals, and what you can tolerate.
A typical plan may include:
• Strengthening for the thigh, hip, and calf muscles
• Step, squat, and stair practice, progressed gradually
• Balance and movement control exercises
• Guidance on returning to walking, sports, or work tasks
• A home program you can keep doing on your own
Physical therapy doesn't guarantee a specific result, and recovery time varies. But for many common causes of knee pain, a well-progressed exercise plan is the first-line approach.
When should I get my knee checked?
Schedule an evaluation if knee pain lasts more than a few days, keeps coming back, or is getting in the way of your daily routine.
Get medical care promptly if you notice (NHS; Cleveland Clinic):
• You can't put weight on your leg or bend your knee
• The knee is badly swollen or looks misshapen
• The knee locks, gives way, or painfully catches, especially after an injury
• The knee is hot and red, especially with a fever or chills
New swelling, warmth, or tenderness in the calf along with pain behind the knee also needs prompt medical attention, since it can signal a blood clot.
Go to the emergency room after a car accident or bad fall, if you think a bone may be broken, or if you can't move your knee or leg.
We screen for these signs during every evaluation and refer you to a physician when findings call for medical assessment.
Do I need a referral for physical therapy in California?
Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.
Frequently asked questions
Why does my knee hurt going down stairs more than up?
Going down stairs loads the front of the knee while it's bent and while your muscles are working to control the descent. That's why stair descent often bothers people with kneecap pain or arthritis more than climbing.
Is walking bad for knee pain?
Usually not. For many people, staying active helps. Guidelines recommend exercise, including walking, for knee arthritis. If walking clearly flares your pain, shorten your walks for a while and build back gradually.
Should I wear a knee brace?
Some braces can help certain types of knee arthritis, but a brace works best as part of a broader plan. Your physical therapist or physician can tell you whether one makes sense for you.
Will I need an MRI?
Not always. Many common knee problems are identified with a history and physical exam. Imaging decisions are made by your physician, often when there's been an injury or symptoms aren't improving.
How long does it take for knee pain to get better?
It depends on the cause, how long you've had it, and how consistently you follow your plan. Many people notice gradual improvement over several weeks of regular exercise.
Can physical therapy help knee arthritis?
Exercise is one of the most strongly recommended treatments for knee osteoarthritis. A physical therapist can design and progress a plan that fits your knee and your goals.
Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.
Schedule an evaluation
If your knee hurts on stairs, on walks, or when you stand up, an evaluation can help sort out what's driving it and which next steps fit you.
Nova Physical Therapy | North Hollywood, CA | Serving Burbank, Studio City, Toluca Lake, and Valley Village
Call (818) 639-3402 | Book an appointment online
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Knee pain has many causes, and only an in-person evaluation can determine what's right for you. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.
References
1. Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral Pain: Clinical Practice Guidelines. J Orthop Sports Phys Ther. 2019;49(9):CPG1–CPG95. Link
2. Patellofemoral Pain: Using the Evidence to Guide Physical Therapist Practice. J Orthop Sports Phys Ther.2019;49(9):631–632. Link
3. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020. Link
4. American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Knee (Non-Arthroplasty): Evidence-Based Clinical Practice Guideline. August 2021. Link
5. Cleveland Clinic. Knee Pain. Updated July 2025. Link
6. NHS. Knee Pain. Link