Knee Pain Going Down Stairs? The 4 Likely Causes + How To Fix It

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If you are experiencing knee pain going down stairs, you are not alone; it is a common ailment that runners suffer from.

As a runner, you are likely to have had a knee injury yourself or know someone who has at some point. In fact, research shows that knee injuries account for a staggering 50% of all running injuries. 

You can experience knee pain going down stairs for a number of reasons, ranging from previous injuries, training methodology, running gait, and lifestyle factors.

The most common knee injuries you are likely to experience are; runner’s kneeIT band syndrome, patellar tendonitis, knee bursitis, a torn meniscus, and osteoarthritis. 

When treatment protocols are followed, knee pain can be manageable and preventable, even if your knee hurts going down stairs.

In this article, we will look at each one of the common causes individually in order to best equip you with the tools to tackle them.

In this article, we will look at:

  • Why Does My Knee Hurt Going Down Stairs?
  • 4 Common Causes of Knee Pain Going Down Stairs
  • 6 Exercises To Fix Knee Pain

Let’s get into it!

A person holding their knee in plain while going down stairs.

Why Does My knee hurt Going Down Stairs?

You can have knee pain walking down stairs for a number of reasons.

It is not surprising when you consider that the force going through the kneecap is a staggering 3.5x body weight when walking downstairs.

But it is unlikely that the knee pain is arising due to you walking downstairs; the likelihood is that there is a niggling injury that has temporarily lowered your capacity to handle the load, and as such, walking downstairs has become painful.

Before we discuss each individual injury that might be causing knee pain going downstairs, we will discuss the elephant in the room, often hidden behind each injury.

Overuse

Many runners, especially beginners, often make the mistake of increasing their mileage too rapidly without giving their joints and connective tissues enough time to adapt and strengthen.

This can lead to overuse injuries, which account for a significant portion of running-related injuries.

Recognizing the signs of overtraining and implementing a structured training approach is crucial to maintaining a healthy and injury-free running routine.

A runner sitting down holding their knee.

A review conducted in 2002 on running injuries revealed that 80% of them were due to overuse.

Unfortunately, it is difficult to predict when we are pushing ourselves too hard until it is too late, as a dull ache can quickly escalate into acute pain. Therefore, it becomes vital to establish a degree of structure in our training to prevent overuse injuries.

Overuse is subjective and depends on the individual runner’s capacity for stress and subsequent recovery. Fortunately, we have control over how much we train and rest.

To determine if you are overtraining, consider the following factors:

  • Running Volume: If you are new to running, it is crucial to increase your mileage gradually. Progress should be gradual, allowing your body sufficient time to strengthen and adapt. Even if you have been running consistently, be mindful of recent inconsistencies or sudden spikes in training volume.
  • Running Intensity: Increasing the intensity of your runs puts additional strain on your body. Make sure to balance high-intensity workouts with sufficient low-heart-rate training to provide adequate recovery periods.
  • Location: If you have recently incorporated fast and steep downhill running into your routine, it can place added stress on your knee joints. Pay attention to any changes in your running environment that may contribute to increased strain.
  • Sleep Quality: Aim for 7-9 hours of quality sleep per night. Rest is crucial for the body’s recovery and strengthening processes. Evaluate your lifestyle to identify potential factors that may affect your sleep, such as excessive alcohol consumption, work stress, or excessive screen time.
  • Introducing New Activities: If you have recently started activities like cycling, hill sprints, or strength and conditioning exercises at the gym, it’s important to allow your body sufficient time to adapt. Gradually incorporate new activities to minimize the risk of overuse injuries.

By considering these factors and adopting a mindful approach to your running routine, you can mitigate the risk of overtraining and maintain a healthy balance between training and recovery, ensuring long-term enjoyment and progress in your running journey.

Related: The 10% Rule: Is it a Valid Way to Increase Mileage?

A person holding their knee going down stairs.

4 Common Causes of knee pain going down stairs

There are a number of distinct injuries that may present if your knee hurts going down stairs.

Here are the most common causes:

#1: Runner’s Knee – Patellofemoral Pain Syndrome (PFPS).

Location:

Runner’s knee is commonly characterized by a persistent, dull ache or discomfort located at or beneath the front or side of the kneecap.

Additionally, runners may experience pain behind the knee post-running, as well as discomfort while squatting, walking up or down stairs, kneeling, or sitting for extended periods.

Causes:

Several factors contribute to the development of Runner’s knee, including weak quadriceps muscles, overpronation during running, or a sudden increase in mileage.

Insufficient strength in the quadriceps can lead to excessive movement of the patella, causing deviation in its tracking along the femur’s trochlear groove.

Overpronation, on the other hand, results in compensatory internal rotation of the tibia, which can trigger inflammation in the knee joint.

A person running with a knee brace.

Treatment:

When treating Runner’s knee, it is initially important to avoid activities that worsen the symptoms.

Gradually reintroduce movements as long as they do not induce excessive pain.

Long-term prevention of injuries necessitates progressive strengthening exercises, focusing on the quadriceps, hamstrings, and glutes.

In the short term, utilizing ice and heat therapy can provide relief. Additionally, wearing a Rrunner’s knee brace may offer support and alleviate discomfort.

By following these measures, runners can effectively manage and mitigate the symptoms of Runner’s knee, promoting a safer and more enjoyable running experience.

For a full run-down on Runner’s Knee, check out – Runner’s Knee Explained: How To Diagnose And 9 Exercises To Treat It

A runner holding their knee.

#2: Meniscus Tear

Location:

A meniscus tear refers to the tearing of a piece of cartilage positioned between the shin and thigh bones, both laterally and medially.

This type of injury typically causes pain and swelling around the knee, hindering the full extension of the leg.

Causes:

Meniscus tears are a prevalent knee injury, commonly resulting from overuse or sudden movements involving twisting or changes in direction.

Treatment:

Treatment for a meniscus tear depends on the type and severity of the tear that you have. It is recommended to consult with a medical professional in order to get the best information for you. In many cases, surgery is not required.

If you suspect a meniscus tear, it is advisable to cease running until the pain and swelling subside.

Conservative treatment methods include the application of ice, heat therapy, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) if necessary.

Gradually resume running, taking caution, and listening to your body. If the pain persists or worsens, it is crucial to discontinue running and seek medical attention.

In severe cases, surgical intervention may be necessary.

Working closely with healthcare professionals can ensure an appropriate recovery plan and help you safely return to running activities.

For an in-depth look at meniscus tears, check out: Can You Run On A Torn Meniscus? Expert Recovery + Rehab Tips

Knee Pain Going Down Stairs? The 4 Likely Causes + How To Fix It 1

#3: (Iliotibial) IT Band Syndrome

Location:

IT Band Syndrome (ITBS) typically presents as moderate pain or discomfort on the outer side of the knee.

Causes:

Previously, it was believed that ITBS resulted from friction and subsequent inflammation caused by the IT band rubbing against the lateral femoral epicondyle.

However, recent evidence suggests that the ITB does not actually move across the lateral femoral condyle, making friction-related inflammation unlikely.

Instead, ITBS is now attributed to compression of the fat pad and bursa tissue between the iliotibial band and the thigh bone.

Treatment:

To manage IT band syndrome symptoms, it is crucial to avoid activities that exacerbate the condition, incorporating an initial period of active rest.

While avoiding aggravating activities, it is important to remain actively engaged rather than passively resting.

Cross-training activities like swimming and cycling, combined with a gradual and progressive strength and conditioning program, can aid in recovery and help prevent future occurrences.

For an in-depth look at ITBS, read more: Iliotibial Band Syndrome For Runners: Diagnosis, Symptoms, And Treatment

A runner on the ground holding their knee.

#4: Patellar Tendonitis (aka Jumper’s Knee)

Location:

Patellar tendonitis, also known as Jumper’s Knee, causes pain below the knee where the patellar tendon connects the kneecap and shin, hindering full knee extension.

It often causes knee pain walking down stairs.

Cause:

The primary cause of patellar tendonitis is often attributed to a rapid increase in mileage and/or intensity during training.

Insufficient rest leads to cumulative stress on the patellar tendon, resulting in inflammation and subsequent pain.

Weak or tight quadriceps and hamstrings increase the likelihood of excessive stress on the tendon when the training load is increased.

Treatment:

To address patellar tendonitis, it is important to avoid activities that worsen the condition.

Begin with a period of active rest, allowing the tendon to recover.

Gradually reintroduce low-load activities, progressively increasing volume and load while monitoring pain levels.

Additionally, wearing a patella brace can help reduce stress on the patella and provide support during activities.

However, it is advisable to consult with a healthcare professional for a thorough evaluation and personalized treatment plan to effectively manage and rehabilitate patellar tendonitis.

A banded squat.

6 exercises to fix knee pain

Experiencing knee pain walking down stairs can really knock your confidence when it comes to running.

Waiting for the pain to go away is very rarely the correct plan of action.

Instead, getting actively involved in the process of strengthening the muscle and tendons around the knee gives you the best chance to get back out there pain-free!

These exercises will slowly increase the load experienced by the knee; as your knee gets stronger, you can make the exercises harder by increasing volume, time under tension, or load.

#1: Resistance Band Squat

A banded squat.
  1. Begin by stepping up with your left foot, focusing on pressing through the heel to straighten your left leg fully.
  2. Next, bring your right foot up to join the left foot on the elevated surface.
  3. Bend your knee and carefully step your right foot back down to the starting position.
  4. Repeat the sequence, alternating between stepping up with the left foot and then the right foot, ensuring controlled movements throughout.
  1. Place the resistance band just above your knees and ensure it is securely in position.
  2. Stand with your feet slightly wider than hip-width apart, and rotate your feet outward at an angle of 5 – 10 degrees.
  3. Lower yourself down by pushing your hips back, maintaining the outward pressure of your knees against the resistance band.
  4. Rise back up to a standing position and repeat the exercise.

Perform 3 sets,10-15 repetitions.

#2: Step Up

A step up.

Perform 3 sets of 2-3 minutes intervals

#3: Walking Lunge

  1. Maintain an upright and tall posture, engaging your core muscles while keeping your shoulders back and chin lifted.
  2. Initiate the movement by taking a deliberate and long step forward with your right foot. As you do so, allow your left heel to naturally lift off the ground.
  3. Gradually lower your back knee towards the floor, stopping just before it touches the ground.
  4. From this position, push firmly through your right heel, activating the muscles in your right leg to lift your left leg off the ground as you return to a standing position.

Perform 4 sets, 10-15 repetitions

#4: Box Jump

A box jump.
  1. Position yourself in front of the box, ensuring your feet are hip-width apart.
  2. Bend your knees and hinge your hips backward, generating the power to jump off the balls of your feet.
  3. Execute the jump, aiming to land both feet simultaneously on the box. As you land, allow your knees and hips to flex, aiding in absorbing the impact of the landing.

Perform 4 sets, 10 repetitions

#5: Single-legged Squat

A single legged- squat.
  1. Begin by assuming a single-leg stance, standing on one leg. Lift the opposite leg and extend it straight, positioning it slightly forward. For better balance, you can either keep your arms by your side or extend them out in front of you.
  2. Activate your core muscles, maintaining a relatively upright posture throughout the exercise. Initiate the movement by shifting your hips backward and descending into a squat position.
  3. Engage your glutes as you push through the planted foot, driving yourself back up to a standing position. Focus on keeping the extended leg lifted between repetitions.

Perform 3 sets, 10 repetitions

Summary

Knee pain walking down stairs is a common problem. But it is preventable.

Overuse accounts for the vast majority of running injuries; by sticking to a training plan, we can avoid doing too much too soon and getting swept up in the excitement of running.

If you are training for a marathon, check out:

Photo of author
Ben is a qualified Personal Trainer and Sports Massage Therapist with a particular interest in running performance and injury. He has spent the last 9 years working with runners at his clinic in Brighton. Ben is a keen runner and avid cyclist. Evenly splitting his time between trail running, road biking, and MTB.

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