Why Does My Knee Hurt When I Go Up or Down Stairs?

Why Does My Knee Hurt When I Go Up or Down Stairs? A Physical Therapist Answers

By Nova Physical Therapy | North Hollywood, CA

Patient Question

"Why does my knee hurt when I go up or down stairs, and can physical therapy help?"

The Short Answer

Knee pain during stair climbing is a common musculoskeletal complaint. Going up and down stairs requires coordinated movement and muscle performance from the hips, knees, ankles, and trunk while the knee manages increased loading.

Symptoms may be influenced by factors such as reduced lower-extremity muscle performance, changes in activity level, mobility limitations, repetitive loading, previous injuries, or movement coordination.

A licensed physical therapist can evaluate strength, mobility, balance, movement patterns, and functional limitations to determine which factors may be contributing to your symptoms and develop an individualized treatment plan.

Why Can Stairs Make My Knee Hurt?

Walking on level ground and climbing stairs place different demands on the body.

During stair negotiation, the muscles surrounding the hips and knees must help control your body as you move upward or downward.

Several factors may contribute to symptoms, including:

• Reduced quadriceps muscle performance
• Reduced hip muscle performance
• Limited ankle or hip mobility
• Reduced muscular endurance
• Changes in activity levels
• Repetitive loading
• Previous knee injuries
• Physical deconditioning
• Changes in movement coordination

The presence of knee pain does not automatically identify which structure is responsible. A comprehensive evaluation can help determine which impairments may be contributing to the functional limitation.

Why Does My Knee Hurt More Going Down Stairs?

Many people notice that descending stairs is more uncomfortable than climbing them.

Walking downstairs requires the muscles of the lower extremity to control your body's descent against gravity.

This may increase demands on the knee and surrounding muscles.

If current strength, coordination, or activity tolerance is insufficient for those demands, symptoms may become more noticeable.

A physical therapist can assess stair mechanics and determine whether strength, mobility, balance, or movement-control deficits are present.

Does Knee Pain on Stairs Mean I Have Arthritis?

Not necessarily.

Knee pain during stair climbing may occur in individuals with several different musculoskeletal presentations.

Although osteoarthritis can contribute to knee symptoms in some individuals, pain during stairs alone cannot determine a diagnosis.

Research has also demonstrated that structural findings on imaging do not always correlate directly with pain or functional limitations.

A physical therapist evaluates the entire clinical presentation rather than relying on one symptom or imaging finding alone.

Should I Stop Using Stairs?

Not necessarily.

Completely avoiding an activity may not be required for every individual experiencing knee pain.

Depending on your symptoms and examination findings, temporary activity modification or gradual exposure to stairs may be appropriate.

A physical therapist can help determine an appropriate level of activity and progression based on your individual presentation.

Can Strengthening My Hips and Legs Help?

For many knee-related conditions, strengthening is an important component of rehabilitation.

Depending on examination findings, exercises may target:

• Quadriceps
• Hip abductors
• Hip extensors
• Calf muscles
• Trunk musculature
• Overall lower-extremity endurance

Exercise selection, resistance, frequency, and progression should be individualized rather than using the same program for every patient.

Can Physical Therapy Help Knee Pain?

Current clinical practice guidelines support exercise-based rehabilitation for many common knee conditions.

Depending on examination findings, treatment may include:

• Therapeutic exercise
• Progressive strengthening
• Hip and knee strengthening
• Mobility exercises
• Balance training
• Functional movement training
• Stair training
• Walking progression
• Activity modification education
• Home exercise programs
• Manual therapy when clinically indicated

Physical therapy focuses on improving movement, restoring function, increasing activity tolerance, and helping patients safely return to meaningful activities.

What Does Research Say?

Clinical practice guidelines support exercise therapy for several common causes of knee pain.

For patellofemoral pain, evidence supports exercise programs targeting both the hip and knee musculature. Exercise is also strongly recommended for improving pain and function in individuals with knee osteoarthritis.

Research increasingly emphasizes active rehabilitation, progressive strengthening, patient education, and individualized management rather than relying exclusively on passive treatments.

What Happens During a Physical Therapy Evaluation?

At Nova Physical Therapy, every patient receives an individualized evaluation that may include:

• Medical history review
• Functional movement assessment
• Strength testing
• Knee mobility assessment
• Hip and ankle mobility assessment
• Balance evaluation
• Walking assessment
• Squatting assessment when appropriate
• Stair assessment when appropriate
• Activity limitation assessment
• Goal setting

Following the evaluation, your physical therapist develops an individualized plan of care based on your examination findings and personal goals.

When Should You Seek Medical Attention?

Although many cases of knee pain are musculoskeletal in nature, medical evaluation may be necessary if symptoms include:

• Significant trauma
• Inability to bear weight
• Significant or rapidly increasing swelling
• Visible deformity
• Fever with a hot or markedly swollen joint
• Progressive weakness
• Significant loss of function

Seek appropriate medical attention if these or other concerning symptoms occur.

Why Patients Choose Nova Physical Therapy

At Nova Physical Therapy, our mission is simple:

We Care.

We believe every patient deserves individualized care, clear communication, and a thorough understanding of their condition.

Our treatment philosophy emphasizes:

• Evidence-based care
• Individualized treatment plans
• Patient education
• Functional outcomes
• Progressive strengthening
• Movement optimization
• Long-term health and wellness

Our goal is not simply to help you perform exercises in the clinic. We want to help you improve the physical abilities needed for everyday activities—including walking, climbing stairs, working, exercising, and participating in the activities that matter to you.

Frequently Asked Questions

Why does my knee hurt going downstairs but not walking?

Descending stairs generally places different demands on the knee and lower-extremity muscles than level walking. Strength, mobility, coordination, and activity tolerance may influence symptoms.

Does knee pain on stairs mean my cartilage is damaged?

Not necessarily. One symptom cannot determine the condition of your cartilage or establish a specific diagnosis. Clinical examination and, when medically indicated, additional testing may be necessary.

Are squats good for knee pain?

Squats may be appropriate for some individuals, but exercise selection and dosage should be based on the person's symptoms, examination findings, and functional goals.

Can physical therapy help me climb stairs normally again?

Physical therapy may help improve strength, mobility, balance, movement control, and stair tolerance when impairments in these areas are contributing to the limitation.

Schedule an Evaluation

If knee pain is making it difficult to climb stairs, walk, exercise, work, or participate in everyday activities, Nova Physical Therapy can help.

Our licensed physical therapists provide comprehensive evaluations and individualized rehabilitation programs focused on improving movement and restoring function.

Contact Nova Physical Therapy today to schedule your comprehensive physical therapy evaluation.

Disclaimer

The information provided in this article is intended for educational and informational purposes only and should not be considered medical advice, diagnosis, or treatment. Reading this article does not establish a physical therapist-patient relationship with Nova Physical Therapy or any of its providers.

Treatment and exercise recommendations should be individualized based on a licensed physical therapist's examination, clinical judgment, patient presentation, medical history, and applicable scope-of-practice requirements. Referral to another healthcare professional may be recommended when findings are outside the physical therapist's scope or require additional medical evaluation.

If you experience significant trauma, inability to bear weight, substantial swelling, visible deformity, fever associated with a hot or swollen knee, or other concerning symptoms, seek appropriate medical attention.

Individual results may vary. Nova Physical Therapy does not guarantee specific outcomes from physical therapy, exercise, or any healthcare intervention discussed in this article.

References

1. Willy RW, et al. Patellofemoral Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health. Journal of Orthopaedic & Sports Physical Therapy.
2. American Physical Therapy Association (APTA). Guide to Physical Therapist Practice.
3. Kolasinski SL, et al. American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research.
4. World Health Organization (WHO). Musculoskeletal Health.
5. Centers for Disease Control and Prevention (CDC). About Physical Activity and Arthritis.

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