Published on: 5/6/2025
Knee pain when walking down stairs happens because the knee joint, especially the area behind the kneecap, experiences extra pressure during stair descent. This extra stress can cause pain, particularly if there is cartilage wear or joint damage.
When you go down stairs, your knee bends more and works harder to control your movement. This action increases the pressure on the patellofemoral joint—the part where your kneecap meets your thigh bone. In people with knee osteoarthritis, the cartilage may be worn thin, which means the smooth cushion that helps the bones glide over each other is damaged. This loss of cushioning leads to more friction and pain. Additionally, conditions like chondromalacia patella occur when the cartilage on the underside of the kneecap softens or wears away, making movement even more painful during stair descent. The extra force during each step forces the joint to absorb more impact and can exacerbate symptoms. Studies studying the biomechanics of stair descent show that increased knee flexion and joint loading contribute largely to the discomfort. Understanding these factors can help guide exercises and treatments to ease the pain and improve joint motion.
(References)
Igawa T, Katsuhira J. Biomechanical analysis of stair descent in patients with knee osteoarthritis. J Phys Ther Sci. 2014 May;26(5):629-31. doi: 10.1589/jpts.26.629. Epub 2014 May 29. PMID: 24926119; PMCID: PMC4047219.
Özkan Ö, Babayeva N, Torgutalp ŞŞ, Kara ÖS, Dönmez G, Korkusuz F. Pain during walking and ascending stairs before hyaluronic acid injection was common in patients with knee osteoarthritis: a qualitative study. Turk J Med Sci. 2021 Apr 30;51(2):693-699. doi: 10.3906/sag-2007-248. PMID: 33244944; PMCID: PMC8203138.
Manske RC, Davies GJ. EXAMINATION OF THE PATELLOFEMORAL JOINT. Int J Sports Phys Ther. 2016 Dec;11(6):831-853. PMID: 27904788; PMCID: PMC5095938.
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