Why Is My Knee Pain Worse Going Down Stairs?

Written By Kira Nee

Does your knee pain flare up more when you're walking downstairs or going downhill? You're not imagining it this is a very common pattern we see at Tugun Osteopathy.

While knee pain can have many causes, pain that worsens on descent (rather than climbing stairs) often points to specific mechanical or muscular imbalances in the leg. Let’s explore why your knee hurts going downstairs, what conditions may be involved, and how osteopathy can help relieve it.

 🔍 Why Does Going Downstairs Hurt More Than Going Up?

When you're going downstairs, your knees work harder to control and absorb load through the quads and surrounding muscles. This increases compressive forces through the front of the knee particularly the patellofemoral joint (where the kneecap meets the thigh bone).

If this joint isn't tracking properly or the surrounding muscles aren’t doing their job efficiently, pain can result especially under load or repetitive motion.

🧠 Common Causes of Knee Pain Going Downstairs

 1. Patellofemoral Pain Syndrome (PFPS)

Often called “runner’s knee”, this condition involves irritation under the kneecap. It’s one of the most common reasons for pain when going downhill or downstairs.

Symptoms include:

  •  Pain at the front of the knee

  • Worse with stairs, squats, or sitting for long periods

  • Clicking or grinding sensation

2. Quadriceps Muscle Imbalance or Weakness

The vastus medialis oblique (VMO) is a key stabiliser of the kneecap. If it's underactive, the kneecap can track unevenly, leading to increased pressure and pain.

3. IT Band Tightness or Glute Dysfunction

Tightness in the iliotibial band or weakness in the glutes can cause abnormal pulling on the kneecap, altering its tracking and increasing pain during controlled movement like descending stairs.

4. Meniscus or Cartilage Irritation

Damage or wear to the meniscus (the cartilage in your knee) can also lead to pain with stairs or deep bending. This type of pain often feels more sharp or catches.

5. Knee Osteoarthritis

In older adults, wear-and-tear changes in the cartilage can increase stiffness and pain especially when going downhill or loading the joint at an angle.

👐 How Can Osteopathy Help?

At our osteopathy clinic, we take a whole-body, biomechanical approach to diagnosing and treating knee pain.

Osteopathy can help by:

  • Assessing the knee, hip, and ankle to find underlying dysfunction

  • Using manual therapy to improve joint mobility and reduce soft tissue tension

  • Supporting patella tracking through myofascial release and activation of the VMO

  • Correcting posture and gait patterns that overload the knee

  • Prescribing rehabilitation exercises to build strength and stability through the quads, hips, and core

 The goal is to treat the root cause, not just the symptoms, so you can walk up and down the stairs pain-free.

🚶‍♀️ Helpful Tips to Reduce Knee Pain on Stairs

  • Don’t rush: take one step at a time with control

  • Try using a handrail to assist

  • Strengthen your glutes, quads, and calves with targeted exercises

  • Stretch regularly, especially your hip flexors, hamstrings, and IT band

  • Consider wearing supportive shoes or orthotics if your foot posture is contributing

 

Key Takeaways

  • Knee pain that worsens when going downstairs often relates to patellofemoral issues, muscle imbalance, or joint overload.

  • Common contributors include weak quads, tight hips, and misalignment.

  • Osteopathy can help relieve knee pain naturally, through hands-on treatment, biomechanical correction, and functional rehab.

 If you’re struggling with knee pain we are here to help, book online, call, or DM us to find out more.

Kira Nee
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