knee pain with stairs the prehab guys

How To Decrease Knee Pain Using The Stairs

It is 8:00 AM and you have four flights of stairs to walk down before you can get to your class or your job on time. You know you are going to have knee pain. “But I don’t have any pain once I get down the stairs and walk across campus or walk into the office.” We understand, many of us are in the same boat when it comes to knee pain with stairs. Don’t worry, we are here to clear up why you may be experiencing this knee pain, and how you can combat knee pain with stairs on your own! 



Let’s talk about knee pain going up and down stairs. One of the first things that come to mind when thinking about knee pain going up and down stairs is after an injury. It is common in individuals who have torn their ACL, that they will have a symptom of pain while going down the stairs. But just because you have pain going down the stairs, do not assume that you automatically have an ACL tear. Typically, ACL tears have a known mechanism of injury and have other symptoms like swelling, in addition to simply having pain going down the stairs.

If you have not had a recent injury, there could be a couple other things that could be causing the pain. The pain could be coming from the kneecap or the tendons attached at the top or the bottom of the kneecap. Typically, when people have pain that seems to be coming from the kneecap, or anterior knee pain, they do not have swelling and they do not necessarily have pain when they are walking on a flat surface. Additionally, after a surgery to the knee joint, such as a total knee replacement, stairs become a difficult challenge to overcome. 



Pain in the anterior knee going up and down the stairs occurs because there is an increased demand placed on the kneecap. The knee becomes positioned on the step above or below, and that creates an angle that drives the kneecap into the long bone of the leg, the femur. As a result, all of that force which is placed on the knee can irritate the cartilage behind the kneecap. In addition, the quadriceps tendon, which attaches on the top of the kneecap, or the patellar tendon below the kneecap can also become irritated by the demanding load.

While we are talking about an increased demand placed on the kneecap, we must consider how frequently the demand is placed on the kneecap, ultimately causing the pain. If you think about how many times we encounter stairs during our daily lives, whether it is multiple times during one day or during the week repeatedly, it can be one of the most challenging and frustrating encounters for people with knee pain due to the high volume of frequency. But fear not, don’t let the stairs conquer you. It is time for YOU to conquer those stairs! The movement of our knees going past our toes is not only safe, but necessary! Not convinced? Read this article below. 

READ: Knees Over Toes – Is it Safe?

knees over toes knee pain with stairs the prehab guys


Knee Pain With Stairs? Change Your Center of Body Weight! 

The stairs are something that we simply cannot avoid during our daily lives; therefore,  we must learn how to train the knee to accept all the demands that are placed on the knee during these activities. We can do that by simply changing the center of the body weight when our knee is in the bent position such as placing a foot on a step above or below us. When we change the center of our body weight when navigating the stairs, we can reduce the demand placed on the cartilage of the kneecap and or the tendons.

Typically, when people are using the stairs, the center of their body weight, or their trunk, is leaning forward over the knee and the weight is centered in the front of the foot. The more the knee translates forward past the toes, the more stress is placed on the knee. This is known as a knee strategy, which is NOT a bad thing. However, if one is dealing with a painful knee, such as when overcoming an injury, or initially after surgery, taking some stress off the knee may be helpful. This is where a hip strategy can come into play. Rather than shifting more of the weight forward on the knee, a hip strategy utilizes more of the muscles of the hips by shifting the weight back towards the heels and decreasing the amount of forward knee translation. An example to differentiate the two is shown below. 


Knee Strategy Exercise – Anterior Step Down

Notice how the wedge used in this exercise is naturally placing more stress on the knee. This is a great way to adapt the knee to the increased stress that is normally taken on with stairs, getting up from a chair, squatting to pick up objects from the floor, and many other daily tasks.


Hip Strategy Exercise – Posterior Step Down

The posterior step down shown here allows one to shift their weight back towards their hips, and utilize more of the muscles on the back of the legs, while also taking some stress off the knee.


Learn How To Conquer Stairs and Other Tasks With Our Program!

knees over toes programming knee pain with stairs the prehab guys

Dealing with knee pain that is preventing you from negotiating stairs, getting off a chair or couch, or performing other daily activities. If so, it is time for you to conquer that knee pain with our program! Click HERE to get started today.


Build Tissue Resilience In Your Knees

Just because you are having pain using the stairs does not mean that you will never be able to use the stairs again. Our bodies are constantly healing and repairing all types of tissues in our bodies. Whether you are having knee pain using the stairs from a ligament injury, or from overuse in the cartilage or tendon of the knee, don’t worry because these tissues can heal! In fact, research supports that weight-bearing exercises help to remodel & heal tissues such as cartilage, ligaments, tendons, and bone!

By paying attention to your body position, like your center of gravity, to reduce the demand on your knee when it is sensitive you can experience less pain. Meanwhile at the same time, by strengthening the large muscle groups around your knee, you can create stronger tissue, or tissue resilience. Once your body starts to gain resilience, and your knee symptoms have begun to calm down, that is the time when you can begin to reintroduce more load to the structures of the knee


knee prehab knee pain with stairs prehab guys audio experience


Front Foot Elevated Split Stance Lunge

Sample Knees Over Toes Exercise Program Video

The front foot elevated split squat stance exercise is a fitting example of how exercise can assist with tissue resilience in the cartilage of the knee. With the front foot elevated it is natural that our body weight tends to lean forward while performing the exercise. It is also natural that our body weight is distributed towards the front of the foot on the step.

By keeping our chest up and the weight distribution in the heel of our foot we can reduce the demand applied to the cartilage of the kneecap create tissue resilience.


WHERE TO START – Non-Weightbearing Exercises 

So, if you do have the option to avoid using the stairs when your pain is exceptionally high, or it is early after an injury, you can still strengthen your hip muscles with non-weight bearing exercises. 

 Side Plank Clam Hip Thrust, on Knees


Next Step – Start To Train The Injured or Painful Knee!

When people begin to use stairs again for the first time after an injury, they tend to do a couple of things. The first thing they tend to do is to avoid using the injured leg by leading the steps with the uninjured side. And that might be OK early in the injury but eventually, we do want to begin using the injured leg. A terrific way to start is by leading with the injured leg or by turning your body and using the stairs going sideways.


Knee Rehab Hacks From Home!

Watch this video in which Mike talks about using the steps sideways when you have knee pain and why you should stop avoiding using the injured leg on the stairs. 

Look at this lateral lunge. You can see that by turning the body laterally you can keep the body upright and keep the weight in the heel of the foot while lifting and lowering your body on this step.


Lateral Step up

Sample Knees Over Toes Program Exercise Video 


Single Leg Reach – Frontal 


Slow Down The Pace!

The second thing that people tend to do when they have knee pain going up and downstairs is they tend to slow down the pace at which they go up and down the stairs using their non-painful leg to be a bit more careful OR they speed it up when using their painful side. In both scenarios, try not rushing the stairs! By slowing down the pace at which we use the stairs, we actually get extra time spent on the stairs to get stronger. 

Anterior Step Downs 


Squat Hold – Heel Raise

Eccentric strengthening, or slowly lowering your body down in the case of going downstairs, will help you strengthen your hips and quadriceps, but do not stop there to create true tissue resilience and get rid of your knee pain. You should progressively load these exercises. 


Quicker Movements With More Frequent Repetitions

To progress strengthening, try performing quicker movements at a higher frequency. So, transitioning from an eccentric exercise where we might be lowering our lifting our bodyweight during a count of three to five seconds, we decrease the time to one to two seconds to lift or lower the body. Continue to progress as pain allows by increasing the number of repetitions from 4 to 6 repetitions to 12 to 15 repetitions. Especially when we are talking about an activity like stairs where we encounter the stairs hundreds of times a week in our daily lives the volume of repetitions is going to be is central to creating tissue resiliency and getting rid of knee pain using the stairs.

Forward Hop


Depth Drop


Closing Thoughts

Think about your intent for your exercise – if you want to be able to go down the stairs without pain you must train your body to lower the bodyweight down on a single leg. You cannot avoid the knees in most activities of daily living, including the stairs, so you must train your knees to be able to maintain the movements. Eventually, when your pain using the stairs has improved you can use any strategy when using the stairs, which ultimately gives you more freedom to move!


About The Author

Lindsey Rozinski, LAT, ATC

[P]Rehab Writer & Content Creator

lindsey rozinski prehab guysLindsey Rozinski is a Licensed Athletic Trainer from Milwaukee, WI. Lindsey graduated from Carroll University in Waukesha, WI with a Bachelor of Science in Athletic Training. Lindsey currently works for a hospital-based outreach athletic training program. She provides athletic training to a growing division one high school in southeast Wisconsin, with sports teams, and individuals, competing at the state tournament level. Lindsey has professional skills in myofascial release, edema mobilization, and proprioceptive neuromuscular facilitation. In her spare time Lindsey enjoys traveling, exploring state and national parks, kayaking on lakes, and practicing yoga.


Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

No Comments

Post A Comment