Why does my knee hurt going down stairs?
It's one of the most common complaints: the knee bothers you going down stairs, but going up you barely feel it. That's not a coincidence, and the difference says a lot about what's happening inside.
Dr. Gustavo Álvarez5 min readSeptember 28, 2026Why it hurts more going down than up
Going down a step, the quadriceps isn't pushing: it's braking. It works while lengthening to control the descent of your body weight, and that kind of contraction generates far more tension than going up.
At the same time, the kneecap is pressed against the femur. With the knee bent and the body lowering, pressure in that area is several times body weight. If the cartilage there is irritated or worn, that's exactly the movement that exposes it.
The most common causes
Pain going down stairs is associated with several conditions, including:
- Patellofemoral pain, when the kneecap doesn't glide optimally over the femur.
- Wear or softening of the cartilage behind the kneecap.
- Meniscal injuries, especially if there is also locking or a sensation that the knee catches.
- Weakness of the quadriceps or hip muscles, leaving the knee uncontrolled during the descent.
- Recent overload from a rapid increase in activity, a change of footwear or of training surface.
What you can do in the meantime
Before an evaluation, a few measures usually help control symptoms:
- Go down placing the whole foot flat and holding the handrail to spread the load.
- Avoid the activities that reproduce the pain for a few days, without stopping moving altogether.
- Work on quadriceps and glute strength with exercises that don't cause discomfort.
- Check whether the pain coincides with a recent change in routine, footwear or training volume.
When not to wait
- The knee locks, catches or gives way when you put weight on it.
- It swells repeatedly after activity.
- The pain wakes you at night.
- It hasn't improved after six weeks of relative rest and physical therapy.
- There was an impact or a sudden twist that marked the start of the pain.
This article is for educational purposes and does not replace a medical evaluation. Every knee is different and the right treatment depends on the diagnosis.