Why You May Have Knee Pain When Going Up Stairs and How to Treat It

If walking around on flat surfaces feels fine but your knees start to ache as soon as you climb stairs, you might be wondering what’s going on. While your knees are designed to withstand a lot of pressure, knee pain going up stairs can be a common occurrence because it engages different muscles and makes you move at an angle while working against gravity. As you go up, your knees may end up bearing a force that’s anywhere from three to six times your body weight.

That extra pressure alone shouldn’t hurt, but if you’ve been doing a lot of stair climbing, have an underlying health condition, or even just turn the wrong way, you might find that taking the stairs is suddenly painful, says Heather Broach, PT, DPT, a physical therapist at Hinge Health. Feeling an ache or twinge isn’t cause for alarm, and it doesn’t mean you should stop moving, either. But it is a sign that something might be amiss and that you could benefit from building strength in and around your knees.

Here, learn more about what causes knee pain going up stairs and how to prevent and treat it — especially with exercises from our Hinge Health physical therapists.

Knee Anatomy Basics

In order to understand knee pain when going up stairs, it helps to know some basics about your knee and how this important joint works.

• Bones. The bones in your knee joint include the patella (kneecap), femur (thigh bone), and tibia (shin bone). 

• Ligaments. Four main ligaments hold everything together in your knee. They include the ACL (anterior cruciate ligament), MCL (medial collateral ligament), LCL (lateral collateral ligament), and PCL (posterior cruciate ligament). The MCL and LCL act like straps that stabilize your knee by preventing it from bending too far inward or outward, while the ACL and PCL are inside the knee joint itself and control forward and backward movement of the knee. 

• Tendons. These are thick bands that connect muscle to bone. 

• Cartilage. This is a rubbery, shock-absorbing material that lines the ends of the knee bones and helps them glide as they move past each other. 

• Menisci. Each knee has two wedges of very thick and tough cartilage that acts like a bumper pad, says Dr. Broach. “Menisci are meant to absorb shock and improve how the femur and tibia come together.” 

• Bursae. These are tiny fluid-filled sacs that help reduce friction and provide extra cushioning in your knee. 

• Muscles. Your knee includes several muscles that help you bend and straighten the joint. 

• Nerves. You can feel whatever is happening in your knee, especially any pain that might arise, thanks to nerves in your knee that carry electrical impulses to your brain.

6 Common Causes of Knee Pain When Walking Up Stairs

There are many possible causes of knee pain, but if the discomfort kicks in specifically when you’re going up the stairs, then one of the following factors may be at play — at least in part, says Dr. Broach. No matter what may be contributing to your knee pain, strengthening and stretching can help all of the following conditions. 

Patellofemoral Pain Syndrome 

This usually shows up as pain in the front of the knee, says Dr. Broach. Some people call it “runner’s knee” but you don’t have to be an athlete to develop it. It often stems from overuse or a sudden uptick in physical activity. 

Symptoms of patellofemoral pain syndrome include:

• A dull, aching pain in the front of the kneecap, around, or behind it.

• Pain during activities that involve bending your knee, like walking, running, climbing stairs, kneeling, squatting, or getting up from a chair.

• Pain after sitting for an extended period with your knees bent.

• A feeling of wanting to straighten your leg due to stiffness when sitting for a long period.

• Tenderness to the touch.

• Swelling around the knee.

• A popping or rubbing feeling when you bend your knee.

Meniscus Tear 

Do you feel more pain on the inside or outside of your knee when going up the stairs? It could be a torn meniscus, says Dr. Broach. Each knee has two menisci — rubbery C-shaped discs of cartilage that help cushion your knee joint. Menisci help distribute load where the thigh bone and the shin bone meet. Meniscus tears are often the result of doing an exercise that involves pivoting or twisting. They can also occur spontaneously as the result of normal age-related changes in the knee. 

Symptoms of a torn meniscus include:

• Pain. If it’s from an acute tear due to injury, knee pain tends to develop gradually over a 24-hour period. It typically worsens with twisting or pivoting movements.

• Stiffness. You may not be able to move your knee through its full range of motion. 

• Swelling. Like pain, swelling in the knee gradually worsens over the first 24 hours after the injury.

• Catching or locking of your knee. 

• A feeling that your knee may give out.

Keep in mind: While a meniscus tear can sound really serious, the associated symptoms often improve with simple exercises. Plus, they’re not always noticeable. In fact, up to 67% of older adults without knee pain showed signs of a meniscus tear on MRIs, according to a 2023 study.  

Chondromalacia Patella

This is a fancy term that means there’s some changes to the underside of the patella, which can cause irritation or a dull ache in the kneecap when you flex your knee — which happens when you go up stairs, says Dr. Broach. Sometimes, this happens for no apparent reason — it just occurs over time as the ligaments and tendons that connect the kneecap to the thigh bone pull your kneecap toward the outside of the knee more than usual. 

Symptoms of chondromalacia patella include:

• Pain. It often feels like a dull ache around the kneecap. 

• Swelling in the knee.

• Discomfort when walking up stairs or after prolonged periods of sitting. 

Muscle Imbalance

“Most people in everyday life are ‘quad dominant,’ meaning they do most things — including walking up stairs — by relying on the muscles on the front of the thighs,” says Dr. Broach. There’s no right or wrong way to walk up the stairs, but engaging your glutes and hamstrings can alleviate some pressure on the front of your knee, which can be good if you’re having knee pain going up stairs. By working on strengthening your glutes and hamstrings, your body should naturally engage these muscles when you use the stairs and give your knees a bit of a break. 

Symptoms of muscle imbalances related to the knee can include:

• Pain when going up stairs.

• Tight or stiff quads.

• Tight or stiff hamstrings. 

Knee Osteoarthritis

Knee osteoarthritis develops when the smooth, spongy cartilage that cushions the knee joint changes. Over time, this can cause bones to sit closer together and sometimes rub against one another during movement, leading to irritation and inflammation.

Symptoms of knee osteoarthritis include:

• Stiffness, making it harder to bend and straighten your knee.

• Creaking or cracking noises in the knee. 

• Pain that flares up after activity. 

• A sensation that your knee is weak or about to buckle. 

• Pain that worsens with weather changes.

Knee Ligament Injuries 

Ligaments are like strong ropes that hold your knee bones together and help with stability. Sudden twisting or pivoting motions of the knee can sometimes irritate or contribute to a sprain or tear of one of the main knee ligaments (such as the ACL, MCL, LCL, or PCL). 

Symptoms of a knee ligament injury include:

• Sharp knee pain at the moment of injury.

• Feeling or hearing a popping sound when the injury occurs.

• Swelling in the first few hours.

• Loss of range of motion.

• Difficulty walking or bearing weight on your injured knee.

• Sense of instability.

• Knee giving out, or feeling like it will give out. 

• Soreness.

These exercises recommended by Hinge Health physical therapists are designed to strengthen your knees while also relieving any tightness or pain you may feel in your hips or lower back, particularly when going up stairs.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for Knee Pain When Walking Up the Stairs

There are many ways to treat and manage knee pain going up stairs, including: 

• Physical therapy. Working with a physical therapist can help you strengthen the muscles around your knee and improve your knee flexibility. They may suggest exercises that target the quadriceps, hamstrings, and glutes so your knees have better support and undergo less strain. A physical therapist can also guide you in finding a stair-climbing technique that works best for you so you have less pain when climbing stairs. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Do targeted exercises. There are a lot of different ways to strengthen the structures in and around your knees, depending on where you feel your knee pain most when going up stairs. Good options typically include hip flexor stretches, straight leg raises, and hamstring stretches, among others. “I try to select exercises that don’t provoke pain, but still encourage a lot of strengthening,” says Dr. Broach. The exercises listed above are a good place to start.

• Focus on body awareness. One crucial part of physical therapy for knee pain is teaching patients to be aware of how their body is moving and how it feels during different activities, says Dr. Broach. She adds that if a muscle imbalance is the problem, as it often is, she will try to determine why it’s happening and how to counteract it. Some people may need to work on strengthening their hip muscles to better stabilize their pelvis, for instance. 

• Modify your walking technique. It might sound silly — of course you know how to walk up the stairs! But changing how you navigate stairs can provide really quick relief from pain, while strengthening muscles helps an underlying problem. Here are a few techniques you can explore to see how they feel for you. Keep in mind that different techniques work for different people, so you might need to experiment and see if you notice a difference in your pain with different strategies.  

  • Hold onto a wall or railing opposite your painful leg. 

  • Squeeze your glutes as you step up. 

  • Try putting your whole foot on the step. 

  • Keep your weight in your heels. 

  • Try keeping your torso more upright instead of leaned forward. 

  • Squeeze your hamstrings and thighs as you step up. 

PT Tip: Move to Improve

It’s normal to want to avoid an activity that causes pain. But avoiding the stairs altogether because they cause pain can actually delay healing and rob you of important opportunities to build strength. “I like to empower patients to engage and strengthen their muscles so that they can do what they need to without being in pain,” says Dr. Broach. 

Incorporating strengthening exercises into your day and moving in any way that feels good to you is a great way to do that. It helps make you more resilient to pain when you take the stairs and go about your daily routine. “If you’re on the right track, you should see a good bit of change within the first few weeks. If not, we may need to recalibrate and just tailor your plan to better suit your needs,” says Dr. Broach. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Costigan, P. A., Deluzio, K. J., & Wyss, U. P. (2002). Knee and hip kinetics during normal stair climbing. Gait & Posture, 16(1), 31–37. doi:10.1016/s0966-6362(01)00201-6

2. Marom, N., & Mann, G. (2015). Asymptomatic Meniscal Tears. Sports Injuries, 965–969. doi:10.1007/978-3-642-36569-0_70

3. Knee Joint. (2023, March 2). Cleveland Clinic. https://my.clevelandclinic.org/health/body/24777-knee-joint

4. The Knee. (n.d.). University of Texas Health Science Center at San Antonio. Retrieved from https://www.uthscsa.edu/patient-care/physicians/sports-medicine/knee-anatomy

5. Iliotibial Band Syndrome. (n.d.). Cedars-Sinai. Retrieved from https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/iliotibial-band-syndrome.html 

6. Mulcahey, M. K., Hettrich, C. M. & Liechti, D. (2020, October). Patellofemoral Pain Syndrome. OrthoInfo – American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/patellofemoral-pain-syndrome/ 

7. Meniscus Tear. (n.d.). Penn Medicine. Retrieved from https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/meniscus-tear