Why does the outside of my knee hurt when I go down stairs?

Why the way down hurts more than the way up

Coming down, your front knee bends under load while the quadriceps work as a brake. This compresses the joint and tightens the tissues around it at about 20 to 40 degrees of bend, the range where the IT band rubs most over the outer thigh bone. Going up uses the muscles differently, so many people notice the difference straight away.

Which cause is more likely depends on the rest of the story. A younger, active person whose pain followed more running or hiking points towards the IT band. A twist followed by swelling and catching suggests the lateral meniscus. Gradual aching with morning stiffness in someone over about 50, sometimes with knock knees, suggests arthritis in the outer compartment.

Making stairs easier now

• Lead down with the less painful leg and use the handrail
• Take one step at a time while the knee is sore
• Use the lift where you can for a few weeks, especially in multi-storey buildings and malls
• Strengthen the thigh and hip with gentle exercises such as step-downs from a low step and side-lying leg raises
• Keep a healthy weight, since stairs multiply the load through the knee

Red flags

Seek prompt assessment if the knee swells after an injury, locks so you cannot straighten it, gives way on the stairs, or if the outer knee is hot and red with fever. A knee that suddenly cannot bear weight after a fall needs an X-ray the same day.

Getting a diagnosis in Doha

If stair pain persists beyond a few weeks or is getting worse, an examination with Dr. Gelber at Aman Hospital usually clarifies the cause. Specific tests for the IT band, the meniscus and joint alignment guide whether you need an X-ray, an MRI or simply a targeted rehabilitation plan.