Knee Pain
Why does my knee hurt going down stairs or getting up from a chair?
The pattern matters
Pain around or behind the kneecap during stairs or squats can fit patellofemoral pain, which means pain around the joint between the kneecap and thigh bone. Knee arthritis can also make stairs uncomfortable. Swelling, a recent injury, or a knee that gets stuck and won’t straighten changes what we look for. [1, 2, 3]
What I do when the step hurts
We can start with a step-down you can safely repeat. I might change the step height or support, look at how you load the knee, and check whether hip or ankle motion is relevant. If we make a treatment change, we repeat the step and compare what you feel. That helps me decide whether to build on the change or try something else. [4]
How we build back to your day
For knee arthritis, exercise can improve pain and function. We can start with a manageable amount and adjust the range, resistance, or number of repetitions. How the knee feels later that day or the next morning helps us decide how quickly to progress. [5, 6, 7]
Frequently asked questions
I can go up the stairs fine. Why do I need the rail coming down?
I’d ask which step makes you reach for the rail and what you feel when you lower yourself. We can compare a supported step-down at a height you tolerate. The result gives us a place to start with the stairs you actually use.
A step felt easier here. What should I notice on my stairs at home?
Use the rail as you normally would. Notice whether you pause, favor one side, or lean on it more as you descend. We can compare those details at your next visit.
Why does my knee hurt getting off the floor when I can get out of a chair?
I’d ask whether kneeling, bending the knee farther, or shifting your weight is the harder part. We can compare a supported version and talk through which options let you get up more comfortably.
What if the first few squats feel fine and the last ones make my knee sore?
I’d ask how many you do before that happens and how it feels later. We can compare depth, load, or repetitions one at a time so you have a clearer sense of which change fits.
Does a meniscus tear on MRI mean I need surgery?
Meniscal changes can appear on scans even in people without knee pain. In the ESCAPE trial, exercise-based physical therapy was comparable to surgery at five years for people with degenerative tears. A knee that physically locks after an injury needs a different assessment. [8, 9]
Do I need an MRI first?
It depends on the exam and injury history. For ongoing knee pain, X-rays are often the first imaging test when imaging is indicated. MRI may help answer a more specific question. [10]
When should I get my knee checked right away?
Get medical care right away if you can’t put weight on your leg after an injury, your knee swells a lot soon after an injury, or it feels hot and swollen and you have a fever. [11]
Should I stop squatting?
If a deep squat consistently brings on pain, we can test a smaller range or a different setup. We’ll pick a starting point that fits your goals and see how the knee responds afterward.
How will I know if treatment is carrying over?
Use a task that repeats in real life. Can you walk downstairs with less support? Does your knee feel better when you get up after dinner? Those answers help us decide what to work on next.