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

Why stairs down hurt more than stairs up

Going down, your thigh muscle (quadriceps) works while it lengthens to lower your body slowly. That braking action presses the kneecap firmly into its groove on the thigh bone, at an angle where the contact pressure is high. If the tissues around the kneecap are irritated, this is the moment they complain.

Going up stairs relies more on the hip and buttock muscles, so many people notice that the same knee feels fine on the way up and sore on the way down.

Likely causes

• Patellofemoral pain (runner's knee): a dull ache around or behind the kneecap, common in active adults and teenagers, often with no injury
• Softening or wear of the cartilage under the kneecap (chondromalacia patella or early kneecap arthritis), sometimes with grinding
• Patellar tendon irritation just below the kneecap, usually in people who jump or do heavy leg training
• A kneecap that tracks poorly or has slipped out before, which can feel unstable on stairs

What you can do now

Take stairs one step at a time with the good leg leading down and hold the rail for a few weeks. Reduce deep squats, lunges and long downhill walks while it settles, but keep moving: cycling, swimming and walking on flat ground are usually well tolerated.

Strengthening the quadriceps and the hip muscles on the outside of the buttock is the treatment with the strongest evidence for this pattern. A physiotherapist can set exercises at a level your knee accepts. Losing some weight, if relevant, reduces the load on every step.

When to see a knee surgeon in Doha

Book an assessment if the pain has lasted more than six to eight weeks despite sensible changes, if the knee swells, gives way or locks, or if the pain started after a fall or a twisting injury. Seek prompt care if you cannot straighten the leg or bear weight.

At Aman Hospital, Dr. Gelber examines how the kneecap moves, checks muscle strength and alignment, and decides whether an X-ray or MRI is actually needed. Most patients with this pattern are treated without surgery.