Knee Pain Going Upstairs & Downstairs

There are several possible causes for knee pain when going up or down the stairs. Common causes can include:

• Muscle fatigue - when your muscles tire from overexerting them, they can ache when moving.
• Wear and tear - as you get older, the cartilage around your joints can wear down causing pain when you move, especially going up and down stairs.
• Knee injury - if you damage the knee or bruise the area around it, you'll likely find it painful when moving.
• Kneecap damage - thinning of the cartilage that lines the back of the kneecap
• Altered Biomechanics: abnormal foot position and hip angles can increase the forces going through the knee.
• Inflammation - any swelling in the knee can make it difficult to get up and down stairs.

Using the stairs puts added force on the knee joint and knee cap. When you go upstairs it's 2.5x your bodyweight being placed on this area and when you downstairs, it's a whopping 3.5x your bodyweight. This added pressure shows why it can be so much more difficult climbing stairs and even going down them.

Going up and down stairs requires a mix of:

• Strength and mobility in muscles such as hamstrings, quads, calves and glutes.
• Flexibility in knees to be able to bend going up and down each step.
• Balance and coordination on each step.

If the knee joint has any kind of swelling, bruising, inflammation or damage, using stairs will make it feel much worse and will impede your ability to go up or down stairs like you would usually be able to.

People will usually try to limit or even avoid using stairs altogether if they can, just so they don't have to feel pain in their knees. There are some solutions you can try that could help.

1. Take it one step at a time - Climbing the stairs with a slow and steady approach can be really helpful. Instead of only putting one foot on each step while you walk, place both feet on each step so there should be a moment where you have both feet planted next to each other. This works going up and down stairs.
2. Lead with your strongest leg - Along with taking it one step at a time, stepping forward with your strongest leg first makes a huge difference. If you're upstairs, you want to be leading with your best leg, followed by your weaker one. And when you go down stairs, lead with your weaker leg first allowing your stronger leg to follow next to help give you better stability.
3. Use handrails - Using the handrail/bannister helps to take some of the weight that is being put on your knees as you're using some of your upper body strength to pull yourself up or down.
4. Stretch your knee first - By doing a simple exercise like bending and straightening your knee for a couple of minutes before you use any stairs, you can help relax the joints around your knees. They can tighten when they haven't been used for a bit and this will help to lubricate them so they don't feel as stiff.
5. Use a walking stick - If you're really struggling, you should consider using a walking stick, especially if the stairs you are using do not have any handrails. Studies have revealed that using an aid such as a walking stick can reduce the forces being applied to the medial side of the knee by up to 45%. The walking stick should always be closest to your weaker leg. Avoid putting it on the higher step as you're unable to put as much weight onto it with your shoulder being at a poor angle.
6. When using a walking stick to go upstairs, first step up with your strongest leg followed by your weaker leg so they're both on the same step. Lastly bring the crutch up to the same step both your feet are on.
7. Going downstairs with a walking stick, place your walking stick on the step in front of you, then with your weaker leg step down onto step, then lastly move your strongest leg onto the same step.
8. Plan ahead - If your knee pain is severe when using stairs, try to plan ahead and limit how often you need to go up and down stairs. When you wake up, try to take everything you need downstairs in one trip if possible. You could use a backpack if you have a few things to take downstairs or if you require using the handrails.
9. Use a knee support or brace - This can help to reduce any instability and knee while using stairs. This should not be considered a long term solution and should only be used while you're training to strengthen your knee.
10. Exercise - Weak muscles supporting your knee will likely result in more pain going up or down stairs as it's extra force being applied to your knee joints and knee cap. Do exercises that will help increase strength in your knee to improve your instantaneous strength (how strong your muscles can contract) and your endurance strength (how long your muscles can perform for).

Exercises to help knee pain when using stairs*

Sit To Stand Strengthening - This exercise helps to strengthen the muscles in your thighs and also the centre of your body that provide you with stability.

To perform this exercise:

1. Sit in a chair with both feet planted flat on the floor. Either place your arms by your side or out in front of you.
2. Move your head and shoulders forward while pushing down through your legs and standing up straight.
3. When sitting back down, push your buttocks out and bend your knees as you lower yourself back down into the chair.
4. Repeat this exercise seeing how many reps you can do in 1 minute or if you reach exhaustion before then.

This exercise can be made more difficult using a lower chair, performing each rep with a shorter break. You can even try not sitting all the way down, standing right back up as you feel your buttocks touch the seat for a bigger challenge.

You can try progressive overloading by increasing the number of reps you do each week and by reducing the amount of rest between each rep.

Step up strengthening

1. Stand with your feet together flat on the floor in front of a step or stairs.
2. Step forward with your strongest leg onto the step then move your weaker leg onto the same step.
3. Step back down to your starting position moving your weaker leg down first followed by your stronger leg.
4. Repeat this exercise for 1 minute recording how many reps you are able to do.

You can make this exercise easier using a handrail or a walking stick. It can be made more challenging by alternating which leg you step up with first and by increasing your speed.

Knee slides for flexion

1. Start by lying on your back with your strongest knee bent and the leg you are training positioned straight in front of you.
2. Move the leg positioned in front of you towards your buttocks by sliding the heel and bending the knee as far as feels comfortable.
3. Hold this stretch for 3 seconds before sliding your leg back down straight into the starting position.
4. Repeat this exercise 20-30 times.

Prone knee hangs for extension

1. You'll need a bed or platform where you can have your feet hanging off to perform this exercise.
2. Lie on your stomach with the knee that feels tight in a bent position, with a towel folded underneath it. Your other leg should be straight.
3. Carefully straighten the knee you are working on so it hangs of
4. Slowly let your stiff knee straighten so it hangs off the end of the bed.
5. Relax your leg and allow gravity to naturally pull your knee down more so it straightens out further.
6. Hold your leg in this position for 30 seconds then bend the knee up and down a couple of times to help loosen it.
7. Repeat this exercise 10 times.

You could try wearing an angle weight or shoe to increase the stretch.

By regularly stretching and performing the above exercises, you should be able to build up strength in your knee which should help reduce pain you feel when walking up or down stairs.

If you feel like the pain is significantly impacting your day-to-day life or are unable to walk up or down stairs you should consider contacting your doctor or local healthcare professional for advice and potential treatments they can offer.

If you are needing some advice on knee pain you may be feeling when you use stairs, you can contact our friendly team today who will be happy to provide you with any advice we can offer.