By Dr. Joseph Mejia, DO, FAAPMR
Medical Director, Performance Ortho

Knee pain on stairs is one of the most common and frustrating complaints we treat at Performance Ortho. Many patients tell us they can walk “mostly fine,” but the second they start climbing stairs, their knee feels sharp, unstable, stiff, or like it might give out altogether. Going up and down stairs places very different forces on the knee compared to normal walking, and pain during this movement can reveal issues that walking alone may not.

For over 25 years, Performance Ortho has helped patients across central NJ find minimally invasive, root-cause solutions to all types of orthopedic and knee conditions. Unlike most clinics our treatment plans are catered to your personal recovery goals, and our collaborative care model ensures that patients are never jumping from office to office in search of comprehensive treatment outcomes.

Why Stair Pain Feels Different Than Walking Pain

Stairs demand more from the knee joint than walking on a flat surface. Specifically, scaling stairs demands more pressure on the kneecap, especially when going downstairs. Stairs also demand greater stress on the quadriceps and patellar (kneecap) tendon, creating an increased load through the cartilage and joint surface as well as increased reliance on balance and stability.

As we age, these unique stressors on joints that are accustomed to a more even distribution of stress across the joint can present acute, chronic pain that rest and medication alone can rarely solve. These unique stress points often lead to more specific diagnoses when consulting a Performance Ortho medical professional.

“Stair pain is a clinical clue. When going up or down steps hurts more than walking, it often tells us the kneecap and cartilage system isn’t tracking or absorbing force correctly. This is a great building block for our Physicians to begin pinpointing an effective treatment route.”

— Dr. Joseph Mejia, DO, FAAPMR

Common Causes of Climbing-Related Knee Pain

As discussed, stair pain typically comes from cartilage irritation and/or tendon overload. Here are the most common causes:

1. Runner’s Knee
   This is one of the #1 reasons patients feel pain on stairs. Typical symptoms include pain around or behind the kneecap, pain worsening when going downstairs rather than upstairs, and achy pain after sitting, sometimes referred to as “movie theater knees”. This often happens when the kneecap tracks improperly, causing friction and inflammation.
2. Knee Osteoarthritis (Early or Advanced)
   Arthritis isn’t just an “old person” problem. Many active adults in NJ develop early degenerative knee changes that show up first when climbing or descending stairs. Typical symptoms include stiffness in the morning or after sitting, swelling, reduced knee range of motion, and pain that builds with activity.
3. Meniscus Tear
   The meniscus acts like a shock absorber. Stairs can trigger meniscus pain because the knee compresses and rotates slightly during stepping. Common signs of a potential tear may include pain on the inside or outside of the knee, locking or sharp pain, and swelling after activity.
4. Jumper’s Knee
   Especially common in athletes, runners and active adults. Jumper’s knee often feels like pain
   below the kneecap, pain when pushing up stairs and soreness after activity.
5. IT Band Syndrome or Hip Weakness
   Many knee stair issues can start above the knee. Weak hips/glutes can cause the knee to collapse inward slightly, placing extra strain on the kneecap, joint cartilage and ligaments.

This is why we look at the whole lower chain, not just the knee. At Performance Ortho, a comprehensive evaluation is always a part of your treatment pathway, ensuring all symptoms are properly diagnosed and treated towards long-term relief.

When Stair Knee Pain Means You Need to Be Evaluated

Not all stair knee pain requires urgent medical care. But if it’s persistent or worsening, you
shouldn’t “wait it out.”

You should get evaluated if you have:

• Pain lasting more than 2–3 weeks
• Swelling after activity
• Pain going downstairs consistently
• Buckling, giving out, instability
• Locking, catching, or inability to fully straighten
• Difficulty weight-bearing
• Pain disrupting sleep

“If stair pain is changing the way you move, it becomes a biomechanics problem that can
accelerate cartilage wear and increase injury risk well beyond traditional discomfort.”

— Dr. Joseph Mejia, DO, FAAPMR

At Performance Ortho, we focus on identifying the true cause, not relying on guesswork, so treatment can be targeted and efficient.

Non-Surgical Treatment Options in New Jersey

Most stair-related knee pain cases can be treated without surgery, especially when treated early. Common non-surgical solutions include precision diagnosis and imaging when necessary. Often, physical therapy and movement correction will be recommended to quickly stem any additional overuse related degeneration in the knee. Bracing or taping may also be recommended, which can be especially useful for ensuring kneecap stability, mitigating pain and preventing early arthritis. When appropriate, we may recommend Viscosupplementation (joint lubrication support for arthritis) and/or regenerative medicine interventions like stem cell and PRP. Often, the injection choice depends on what structure is causing stair pain.