For many, knee pain and walking down stairs go hand-in-hand. But while this pain is common, it's definitely not normal, says Lara Canham, DPT, an orthopedic clinical specialist in Colorado.
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Unless you're recovering from a knee injury, you should be able to walk down stairs without pain, she says. So if you've accepted that knee pain while walking down stairs is just your new normal, it's time for a more positive outlook.
"There are things you can do to fix this," Canham says. But the fix depends on the cause of your knee pain. So take a peek here at some of the most common reasons you may be feeling the twinge.
If you try one of these solutions and don’t see improvement — or worse, your pain increases — after 4 to 6 weeks, visit a physical therapist.
If You: Stomp Down the Stairs
You Might: Lack Eccentric Leg Strength
When you walk down stairs, you have to control yourself against the pull of gravity every time you step down, Canham says. This is eccentric strength, or the ability to handle force when your leg muscles are in a stretched position. It's different from the concentric leg strength needed to push through your feet to walk up a flight of stairs.
If you lack the strength needed to control your descent, you'll plop down hard, which adds stress to your knee joints. Over time, that stress can cause pain in the front of one or both knees.
The next time you walk down stairs, notice how your foot lands with every step. Ideally, you want to land softly. If you find you can’t control your landings (a loud stomp should clue you in), you could stand to build some eccentric leg strength.
To do that, Canham suggests practicing eccentric single-leg chair squats. Here’s how to do them.
- Begin standing facing away from a chair, feet hip-width apart.
- Lift one foot off the floor. Then, bend your standing knee and sit back into your hips.
- Keeping your weight in one leg, lower yourself to the chair on a 4 count. Try to sit with control instead of plopping down.
- Once you’re seated, use both legs to return to standing.
- Repeat for 6 to 12 reps on one leg before switching to the other. Aim for 3 to 4 sets per leg.
If Your: Knees Cave in or Push Out
You Might: Have Poor Hip Stability
Your hips — plus your glutes and a handful of smaller muscles — play a key role in helping you down the stairs. Mainly, your hips work to keep your thigh muscles moving directly in line with your knees.
Trouble pops up when your hips aren't strong enough to control the movement of your thighs within the hip joint. "If your hip isn't keeping your thigh stable, then the kneecap that sits on your thigh isn't going to be very stable either," Canham says.
When your hips can't keep your thighs in line, your knees may compensate by driving in or out when you step down. Multiply that action by dozens of steps taken over several weeks and you've got pain inside, outside or behind one or both knees.
Take a video of yourself walking down the stairs or have someone watch and notice what your knees do. You want your knees to track over your ankles every time you take a step down. However, if they cave in or push out, this may signal you need to work on hip strength and stability.
Build functional hip strength and stability with these moves from Canham. If you notice that one move feels more challenging, or it’s harder for one side of your body, you’ve probably identified a trouble spot. Give this area special attention to build it up to the same level as your other muscles.
Move 1: Glute Bridge
- Lie on your back with knees bent and feet hip-width apart on the floor.
- Tighten your abs and push your feet into the floor to raise your hips until they’re aligned with your knees and shoulders.
- Squeeze your glutes before lowering your hips to the floor.
- Repeat for 3 to 4 sets of 12 to 15 reps.
Move 2: Lateral Banded Walk
- Stand with feet hip-width apart, a small resistance band looped around your legs just above your knees.
- Lower into a quarter-squat and step one foot to the side. Follow with the opposite foot so your legs are once again hip-width apart.
- Step softly and keep your trunk level as you side step.
- Do 3 to 4 sets of 12 to 15 reps in each direction.
Move 3: Clamshell
- Lie on your side with your knees bent 90 degrees and hips stacked. Let your head rest on your bottom arm.
- Bring your knees in toward your body until your feet are in line with your glutes. This is your starting position.
- Keeping your bottom knee on the floor and the sides of your feet glued together, lift your top knee as far as you can without rotating your hip.
- Squeeze your glute at the top of the movement, then lower your knee to the starting position.
- Repeat for 3 to 4 sets of 12 to 15 reps per side.
If Your: Heels Lift
You Might: Have Stiff Ankles or Tight Calves
Walking down stairs is like doing a mini single-leg squat over and over again. But in order to do those squats effectively, you need plenty of ankle mobility.
"If your ankles are really stiff or your calves are tight, you might have to move in a different way to get around that stiffness," Canham says.
Usually, this means shifting your weight too far forward, which adds loads of stress to the knee joint. Again, you'll likely feel pain in the front of your knee or behind the knee cap.
Just as with squats, you want to keep your heels down when you descend the stairs. “Sometimes I’ll have my patients try to go down the stairs or squat with their ankles fixed,” Canham says. “They notice that it certainly changes their mechanics!”
The next time you walk down stairs, try to keep your heels down. If your calves and ankles are too tight to manage, Canham suggests rolling out your calf muscles daily to loosen them up. This should help increase flexibility in your ankles and ease the strain on your knees.
To roll out your calves:
- Sit on the floor with your legs extended in front of you.
- Place a water bottle, foam roller or tennis ball under one calf. Roll until you find a tender spot and stop there. Cross the other leg over the top and let it rest on your bottom leg to help pin it in place.
- Roll your bottom ankle in circles 10 times in each direction to knead the tender spot.
- Find a new tender spot and repeat. You can also try pointing and flexing your bottom foot.
- Continue for 2 minutes before switching legs.
Experiment with how much pressure you place on your calf. You can easily increase or decrease pressure by swapping out your roller. For example, a tennis ball will be gentler on your muscles than a denser option like a golf ball.