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Knee Bone or Joint Injury

Knee Hurts Going Down Stairs

Minute Read


Posted 4 months ago


Last updated: 29/11/2022


by James McCormack

Why Does My Knee Hurt Going Down Stairs?

There are many reasons for why your knee hurts when going down stairs. As you step down your knee will bend and you will have your weight solely on one leg. The force of your full weight therefore, goes through your knee as it bends. As the knee bends to lower you down the step, it will also need to shift forwards over your foot to allow for the forward movement needed. This increases the pressure in the knee in general, and at the front of the knee through the patellofemoral joint in particular.

If your knee hurts when going down stairs you should seek the advice of a medical professional such as a physical therapist or sports doctor to have a thorough assessment, a diagnosis and a plan to improve the problem. Here are the most common reasons why your knee hurts going down stairs.

Patellofemoral joint pain

Chondromalacia patella, Patella Alta and Osteoarthritis of the patella are all causes of patellofemoral joint pain. The patellofemoral joint is the joint between the knee cap and the bone of the thigh, the patella and the femur. As the knee bends the contact between these bones increases. Chondromalacia patella is a painful condition of degeneration of the cartilage of the patella, and can be a part of patellofemoral arthritis. Patella Alta is a condition where the location of the patella is too high and therefore the surfaces do not move with each other efficiently. Therefore there is increased wear and tear which can lead to Chondromalacia patella and knee arthritis.

You can read more about these conditions in our related articles:
Chondromalacia PatellaPatella AltaKnee ArthritisPatellofemoral Pain Syndrome

Patella Tendinopathy

Tendinopathy or tendonitis is the overload or degeneration of a tendon which can make it weaker, painful and feel stiff and thickened. Patella tendonitis affects the patella tendon which is the second part of the quadriceps tendon that is located below the patella and  attaches to the tibial tuberosity. This tendinopathy will often feel more painful when the quadriceps muscle is loaded and the tendon is under strain, and can be worse while the muscle and tendon lengthen. Therefore, in the case of going down stairs, the quadriceps is working to slow the bend of the knee, so the tendon is under strain and the knee is bending so the quadriceps and patella tendon are lengthening. The result is often that the knee hurts when going down stairs.

Fat pad impingement

The Hoffa’s fat pad is located under the patella tendon at the front of the knee. As the knee bends pressure can be put on this structure, which usually is not an issue. However, if the fat pad is irritated it is often swollen or enlarged. In this case the fat pad can get pinched with movements of the knee. In particular, on full straightening of the knee but also if the knee is bent far. So the knee may hurt going down stairs.

Read more about Hoffa’s Fat Pad Impingement and Hyperextension Brace which is useful for recovery of this condition.


The meniscus is a thick fibrocartilage structure that sits between the femur and the tibia, attached by ligaments. It helps to increase the stability of the knee joint and to absorb impact. If there is an irritation to the meniscus, or damage such as a tear the it will feel painful when pressure is placed on it. Bending the knee can add additional pressure to the meniscus so an irritated or injured meniscus can cause pain in the knee going down stairs. Usually this will be experienced either on the inside or the outside of the knee as the meniscus is made of two halves, medial and lateral.

Read more about Lateral Meniscus Tear and treatments, or Medial Meniscus Tear, Meniscus Tear Exercises.

Osgood-Schlatter or Sinding-Larsen Johansson with children

These two conditions are mostly only seen in children as it affects soft bones, which is the case before the skeleton is fully matured and hardened. Both are conditions of inflammation of the bone at the attachment of a tendon. Osgood-Schlatter’s Disease affect the attachment of the patella tendon to the tibial tuberosity at the front of the shin bone, and Sinding-Larsen Johansson affects the inferior pole of the patella when the patella tendon originates from. Any stress in the form of traction from a working muscle or loaded tendon can cause pain on these points. Therefore, the individual will often report that their knee hurts going down stairs.

Pain location chart for Osgood-Schlatter and Sinding-Larsen Johansson

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.


Related Articles:

Muscles of the KneeKnee ArthritisPatellar Tracking Disorder

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