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Patient Questions  /  Knee pain going down stairs

Knee

Why Does My Knee Hurt Going Down Stairs?

Going down stairs puts more load on the front of the knee than going up, because your thigh muscles work as brakes while the knee bends. Kneecap pain and knee arthritis are the most common reasons it hurts, and both usually improve with the right strengthening.

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Why down is harder than up

On the way down, your quadriceps (front thigh muscles) lengthen under load to control each step. That puts extra pressure between the kneecap and thigh bone. If those muscles, or the hip muscles that keep your knee lined up, are weak or tired, the knee takes more strain.

Common causes

  • Kneecap pain (patellofemoral pain) causes aching around or behind the kneecap on stairs, squatting, kneeling and after sitting a long time. It's common in active people of all ages.
  • Knee arthritis causes pain on stairs, stiffness after rest and aching after a busy day, usually from middle age on.
  • Less often, a meniscus problem causes catching or pain with twisting.

What helps in the meantime

  • Use the handrail and take stairs one step at a time, leading with the stronger leg going up and the sore leg going down.
  • Keep active, but cut back on what clearly flares it, like deep squats or long downhill walks, for a while.
  • Build strength in the thigh and hip muscles, which is the treatment with the best evidence for both kneecap pain and arthritis.

When to see a doctor

See a doctor promptly if you have:

  • A hot, red, swollen knee, especially with fever
  • A knee that locks and won't straighten, or gives way repeatedly
  • Sudden, severe swelling after an injury, or you can't put weight on the leg
  • Calf pain, swelling or warmth, which needs urgent attention to rule out a blood clot

How physical therapy at ARI can help

A physical therapist finds out what's causing the pain, then builds a strengthening program for your thigh and hip muscles, adjusted so it doesn't flare the knee, and shows you easier ways to handle stairs while you get stronger.

At ARI Physical Therapy in Bakersfield, every visit is one-on-one and in person with a licensed physical therapist, and our clinic director, Deepa Konnur, PT, MPT, OCS, is a board-certified Orthopedic Certified Specialist. We accept most private insurance plans and Medicare, and we have staff who speak Spanish and Hindi.

Read our full guide: Knee arthritis and knee pain →

No referral needed to start. In California, you can see a physical therapist directly for up to 12 visits or 45 days, whichever comes first. Some insurance plans still require a referral for coverage; call us at (661) 282-8584 and we'll help you check.

Related questions

Ready to feel better?

Talk to a licensed physical therapist at ARI, one-on-one. Request an evaluation and we'll get back to you, usually within one business day.

Request an EvaluationCall (661) 282-8584

This page is general information, not a diagnosis. If you have symptoms, a licensed clinician should evaluate you.

Clinically reviewed by Deepa Konnur, PT, MPT, OCS, board-certified Orthopedic Certified Specialist · Reviewed September 2026