“My knees hurt when I walk downstairs”
A ProVital Physiotherapy Guide
Having knee pain when walking downstairs is a very common problem, and patellofemoral pain, pain around or behind the kneecap, is particularly common among active people and younger adults.
Research estimates that patellofemoral pain affects around 1 in 5 people in the general population each year.
What Does Knee Pain When Going Downstairs Mean?
Going downstairs requires high demand from your knees because your leg muscles have to provide stability and control as you lower your body down the stairs.
Other activities such squatting or running is also commonly associated with patellofemoral pain. However, knee pain can have many different causes, so identifying the location and behaviour of the pain becomes crucial.
What Structures Are Involved?
There are several structures that can contribute to knee pain, including:
Patella (kneecap): it glides back and forth with the thigh bone during knee bending and extension.
Patellofemoral joint: the joint at which the patella joins the thigh bone.
Quadriceps muscles: assist in controlling knee movement during stair descent.
Patellar ligament: joins the patella with the shin bone.
Hip and ankle muscles/joints: may affect the knee joint movement and loading.
Most importantly, pain doesn't always mean that one structure is “damaged.” Knee pain is often influenced by how the entire lower limb moves and manages load.
How Can We Solve It?
Instead of simply avoiding stairs, our goal is to help you build strength, improve movement and confidently get you back sports and everyday activities.
At ProVital Physiotherapy, we assess your knee, hip and lower-limb movement to identify factors that may be contributing to your pain.
Exercise-based rehabilitation is strongly advised for patellofemoral pain, with treatment tailored to your symptoms and activity needs. Hence, the treatment may include personalised exercise strategy, strength and conditioning, manual therapy and education, depending on your individual needs.
If going downstairs has become something you dread because of knee pain, it may be time to get it assessed.
References
Collins, N. J., Barton, C. J., van Middelkoop, M., Callaghan, M. J., Rathleff, M. S., Vicenzino, B. T., Davis, I. S., Powers, C. M., Macri, E. M., Hart, H. F., & Crossley, K. M. (2018). 2018 consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: Recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. British Journal of Sports Medicine, 52(18), 1170–1178. https://doi.org/10.1136/bjsports-2018-099397
Neal, B. S., Lack, S. D., Bartholomew, C., & Morrissey, D. (2024). Best practice guide for patellofemoral pain based on synthesis of a systematic review, the patient voice and expert clinical reasoning. British Journal of Sports Medicine, 58(24), 1486–1495. https://doi.org/10.1136/bjsports-2024-108110
Smith, B. E., Selfe, J., Thacker, D., Hendrick, P., Bateman, M., Moffatt, F., Rathleff, M. S., Smith, T. O., & Logan, P. (2018). Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS ONE, 13(1), e0190892. https://doi.org/10.1371/journal.pone.0190892
Willy, R. W., Hoglund, L. T., Barton, C. J., Bolgla, L. A., Scalzitti, D. A., Logerstedt, D. S., Lynch, A. D., Snyder-Mackler, L., & McDonough, C. M. (2019). Patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy, 49(9), CPG1–CPG95. https://doi.org/10.2519/jospt.2019.0302
