If you have ever experienced knee pain going down stairs, you’re in good company. Knee pain is one of the more common joint complaints seen in doctors’ offices and there can be a wide range of causes. (1)https://pubmed.ncbi.nlm.nih.gov/16481170/
What causes knee pain going down stairs?
Typically, if you’re walking down the stairs, or downhill, the front thigh muscle (quadriceps) is contracting as you step down. As the quadriceps muscle contracts it increases tension on the the quadricep and patellar tendons that contain the kneecap (patella) and attach to the shin bone (tibia). If you’re pain is in the front of the knee below the knee cap, then your pain is most likely coming from the patellar tendon or its attachment to the tibia. If your pain is right above the patella, then the pain is usually from the quadriceps tendon. If your knee pain going down stairs feels like its inside the knee you may be dealing with either arthritis in the knee or a meniscus issue in the knee joint. Finally, pain in the back of the knee going down stairs may be due to either hamstrings or calf muscle issues or a bulge in the back of the knee called a Baker’s cyst.
Understanding Knee Anatomy for Knee Pain
Pain in the front of the knee
Patellar tendon issues are the most common cause of pain in the front of the knee (anterior knee pain) and this pain can be worse with activities that increase loading of the knee, such as walking down stairs, down a slope, or a hill.
If the pain is new, there may be inflammation or irritation of the patellar tendon attachment to the tibia called tendonitis. If the pain has been present for longer than several weeks, there may not be any more inflammation or irritation and in these cases, we see more scarring or failing healing in the tendon that we call tendin-osis (instead of tendin-itis, which means tendon inflammation).
What to do if you have knee pain going down stairs
If you’re just starting with the knee pain and its not too severe, then you can usually try a little ice or cold pain on the knee as well as some relative rest for a couple days and see if that helps. Sometimes gentle stretching of the quadriceps muscle will also help alleviate the pain.
Exercises to fix knee pain from going down stairs
Most of the exercises to help fix your knee pain from going down stairs focus on strengthening the quadriceps (thigh muscle) as well as the gluteal (buttock) muscles. Stretching exercises can also help with the knee pain and prevent you from having more pain with stairs. (2)https://pubmed.ncbi.nlm.nih.gov/16481170/
Quadriceps Contractions – Quad Set Exercise
The “Quad Set” is the most basic quadricep exercise and usually the first exercise that rehab specialists will start their knee surgery patients on post-surgery. Its a simple but effective leg exercise to teach you how to properly contract the quadriceps muscle without overloading the knee.
The Quad Set is done sitting on the floor (or bed or couch) and requires a small rolled up towel or pillow under the knee. The focus of the exercise is simply to push the knee straight down, forcing the towel or pillow into the floor. This motion of pushing down with cause you to contract your quadriceps and is a great exercise for learning how to specifically focus on the quadriceps muscle.
Seated Quad Extensions – Short Arc Quads
The quad extension or short arc quadriceps exercise builds upon the Quad Set exercise above. With the Short Arc Quad exercise, the focus changes from pushing the knee into the floor to simply lifting the heel off the ground.
As you lift the heel off the ground, you’ll also feel the quadriceps muscle contract. Hold your foot off the ground with the knee straight for 5 to 10 seconds and then lower the foot back to the ground to rest. Repeat the Short Quad Arc exercise 10 to 15 times.
Advanced Exercises for Knee Pain Going Down Stairs
If you’ve mastered the basic quad exercises and are looking for more advanced exercises the help with your knee pain from going down stairs, the Single Leg Squat is a great exercise. Not only does this lower body exercise strength the quadriceps muscle, it also requires you to contract the gluteal muscles on the leg you are standing on. By maintaining good gluteal strength you’ll notice better stability as you descend stairs or walk downhill.
Eccentric Exercises for Knee Pain Going Down Stairs
Eccentric exercises have been proven to help not only in patellar tendinosis (3)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658948/, but also in Achilles tendinosis. (4)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527202/
The one challenge with eccentric exercises for the knee is that they do require a decline board angled at about 45 degrees. If you have a home treadmill, you can raise the elevation all the way up and with the treadmill off, do the eccentric squats facing towards the back of the treadmill.
When to see your doctor about knee pain going down stairs
If you have a sudden injury, from slipping or falling, and have continued moderate or severe knee pain, then it’s a good idea to see your doctor to determine if there is an injury to structures inside the knee.
You should also see your doctor if there is:
- Significant swelling, redness or warmth to the knee
- Inability to fully straighten or bend the knee
- Swelling or bruising into the calf
- Weakness or numbness into the leg or foot
- Pain that is not getting better with rest, ice and elevation
- Other concerns that the knee is not getting better (or getting worse).
Remember to be consistent with doing the exercises and you’ll soon find that you soon won’t have knee pain going down stairs anymore!
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