Knee pain going up stairs: why it happens and how to reduce it

Dr. Megan Hill

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  • Stairs place more demand on the knee than flat ground because the bend, push-off, and load all increase at the same time.¹
  • Pain at the front of the knee often points to patellofemoral pain, which commonly shows up with stairs, squatting, or sitting for long periods.² ³
  • Small changes like using a handrail, slowing down, taking one step at a time, and building strength may help settle mild, newer pain.⁴
  • If stair pain is worsening, spreading, or changing how you move through daily life, it is worth getting assessed.

Why stairs put more demand on your knees

Flat ground asks your knee to do its job quietly. Stairs ask for more. Each step needs a deeper bend, more control, and more force to lift your body upward against gravity.

That extra demand is why people often notice pain on stairs before they notice it anywhere else. A knee that feels mostly manageable while walking may start complaining the moment you climb, especially if the joint is already irritated or the surrounding muscles are not sharing load well.

That pattern is useful. Pain that shows up specifically on stairs often tells you something about what your knee is struggling to handle. It narrows the picture, which makes the next step easier to figure out.¹ ²

What the location of knee pain can tell you

The location of the pain in your knee is important in determining the cause and solution of stair-induced knee pain.

  • Pain around or behind the kneecap is a common stair-related pattern. This is often patellofemoral pain, sometimes called anterior knee pain. It tends to be aggravated by stairs, squatting, running, hills, or sitting for a long time with the knee bent.² ³
  • Pain deeper in the joint or toward one side of the knee can point toward other structures being stressed, including cartilage, meniscal irritation, or osteoarthritis.
  • Pain on the outside may be more related to how the hip and thigh are controlling the leg.
  • Pain at the back of the knee is less straightforward and is worth paying closer attention to if it keeps happening.

Try not to self-diagnose from the stair-pain alone. The point is to notice the pattern. Track the place it hurts, when it starts, and whether it builds with each step as all of these factors give you specific and useful clues.

Common causes of knee pain when climbing stairs

Woman in pink long-sleeve shirt hugging a bent knee, seated and looking down against a soft yellow background.Patellofemoral pain (the pain felt just around and under the base of the kneecap) is one of the most common causes of stair pain. That usually reflects a mix of load, movement, and muscle control rather than one dramatic injury. It is often linked to the way the kneecap and the rest of the leg handle repeated bending under load.² ³

Weakness or poor coordination higher up the chain can contribute too. If the hips are not helping control the leg well, the knee often absorbs more strain than it should. Tightness through the calf or thigh can also affect how the knee moves on stairs.

The root cause is often not related to tracking around the kneecap. Likely, the pain comes from joint irritation, early osteoarthritis, or the after-effects of an old injury that never quite rebuilt full strength and confidence. That is why two people can both say "stairs hurt my knee” and still need different solutions.

What can help before you seek professional support

If stair pain is mild and fairly new, you can try a few of these tactics at yourself to see if you can manage and reduce this short term pain. Sometimes the pain will be fleeting or temporary, and other times these tactics will lead to reduction in symptoms and flare-ups.

  • Start by changing the load: Using a handrail helps. Slowing down helps too. So does walking up the stairs one step at a time for a while if the pain is flaring. These are not signs of weakness. They are ways of giving the irritated structures a chance to settle.
  • Check your footwear: Shoes that feel broken down or unsupportive can change how load travels through the foot, ankle, and knee. A more supportive shoe will not solve every knee problem, but it can reduce one variable that may be adding to the strain.
  • Build strength where the knee needs help: For many people, the muscles around the knee and hip need more capacity. That is especially true when pain shows up on stairs but the knee feels mostly fine on flat ground. Exercises that improve quadriceps and hip strength are commonly recommended for patellofemoral pain and other stair-related knee patterns.⁴
A woman exercises indoors, performing a side lunge on a blue mat in a bright room with plants and a chair.

Try these specific tactics to reduce knee pain

  • Use the handrail to reduce load.
  • Slow down rather than pushing through pain.
  • Take one step at a time if needed.
  • Wear supportive shoes instead of worn-out ones.
  • Start simple strengthening work if the pain is mild and not worsening.

When stair pain needs more than home strategies

Not every painful knee needs physiotherapy right away. But some patterns should move you past trial and error sooner.

If the pain is getting worse, spreading to other parts of the knee, causing swelling, locking, or giving way, or making you avoid normal daily tasks, it is worth getting assessed. The same goes for pain that has not improved after a couple of weeks of sensible changes.

Pain after a twist, fall, or specific injury deserves more attention too. That is a different pattern from discomfort that developed gradually over time.

What physiotherapy can help you uncover

When knee pain on stairs keeps coming back, the issue is often bigger than stairs alone. The knee may be weak in certain ranges, overloaded in others, or relying on movement patterns that keep it irritated every time the bend and push-off increase.

That is where physiotherapy can help. A professional clinician can assess what seems to be driving the pain, which movements are aggravating it, and what kind of strength, mobility, or support work may actually help rather than keep the cycle going.

For many people, that is the turning point. Instead of endlessly modifying stairs and hoping things settle, they finally understand what the knee is reacting to and how to calm it down.

How Sword supports recovery from home

If stair pain keeps affecting daily life, support has to be practical enough to fit real life. Physiotherapy in a clinic is helpful, but you need to schedule an appointment during work hours, travel to the clinic, then remember your exercises and the correct form after your session.

That is where Sword's physiotherapy plans are so helpful, giving you 24/7 access to real-time guidance from the comfort of home. Sword is designed to support you when pain gets in the way. If you’ve been waiting for a referral, stuck in a cycle of missed follow-ups, or told to just live with it, Sword offers a better way forward.

Created by clinicians and degree-qualified physiotherapists and powered by motion sensing cameras and AI technology, Sword is a clinically validated recovery program that you can access at any time and from any place. That means you can complete your program on your schedule without the need to book appointments or commute to a busy clinic.

There is good evidence behind this approach. A study in people with chronic pain found that remote care helped people improve in function and symptoms at about the same rate, with no meaningful difference between the two groups.²

Get back control of your knee pain and stop avoiding stairs 

Smiling woman poses in athletic wear with digital skeletal overlay and green arrows, symbolizing fitness or movement tracking.Stair pain has a way of shrinking your world in small, stubborn ways. You take the lift instead of the stairs. You avoid hills. You start noticing every flight before you even reach it.

The right support can start reversing that. Sometimes the first shift is subtle: less pain on the first few steps, less hesitation, more trust in the knee. Then you stop bracing for the staircase every time you see one. Progress rarely arrives all at once, but it often begins when the knee feels less reactive and daily movement starts to feel more normal again.

Sword makes recovery even easier than traditional physiotherapy. You don't have to seek a referral, schedule an appointment, or travel to a busy clinic. That's why people complete Sword's guided recovery plans at higher rates than for traditional in-clinic care2.

You deserve care that meets you where you are and moves with you toward where you want to be. Most Canadians with employer group benefits have physiotherapy coverage they have never touched. Not because they do not need it. Because the card sat in the wallet and the questions felt like too much to sort out before they had even started. If you are not sure whether your plan includes coverage for Sword, check your coverage now and you can get started on your recovery plan right away.


Footnotes

  1. 1

    NHS inform. Patellofemoral pain syndrome. Notes that stairs, hills, squatting, and other loaded knee-bending activities commonly aggravate kneecap pain.

  2. 2

    NICE Clinical Knowledge Summaries. Knee pain assessment: non-traumatic causes. Describes patellofemoral pain as anterior knee pain aggravated by ascending or descending stairs, squatting, running, or long periods of sitting.

  3. 3

    JOSPT Perspectives for Patients. Patellofemoral pain: treating painful kneecaps. Explains that patellofemoral pain is commonly felt around the kneecap and often worsens with stairs, hills, running, or prolonged sitting.

  4. 4

    British Journal of Sports Medicine. Best practice guide for patellofemoral pain. Supports knee-targeted and hip-targeted exercise therapy as core treatment components for patellofemoral pain.

  5. 5

    Correia, F.D., et al. (2022). Digital versus conventional rehabilitation after total hip arthroplasty: A single-centre, parallel-group pilot study. JMIR Rehabilitation and Assistive Technologies, 9(2), e34489. https://doi.org/10.2196/34489

  6. 6

    Sword Health outcomes data, October 2024. Among eligible members in Sword's program dataset, 56% recovered the ability to perform daily activities.

  7. 7

    69% of members report feeling better or much better after completing AI physiotherapy. Sword proprietary data, October 2024

  8. 8

    Sword Health outcomes data, October 2024. Sword reports an 81% completion rate for its AI physiotherapy programs.

  9. 9

    Simovitch R, et al. Sleep alterations following elective shoulder surgery: a systematic review. Shoulder & Elbow. 2023.

  10. 10

    Pak SS, Janela D, Freitas N, et al. Comparing Digital to Conventional Physiotherapy for Chronic Shoulder Pain: Randomized Controlled Trial. Journal of Medical Internet Research. 2023.

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