At Dynamic Sports Medicine, we see knee pain every day—from weekend warriors to competitive athletes. If your knee aches during squats, screams going down stairs, or throbs after a run, you’re not alone. And more importantly: most knee pain is treatable without giving up the activities you love.
If you’ve been told you have “bad knees” or that you should just avoid squats forever, there’s good news. Understanding where your knee hurts and when it hurts tells us a lot about what’s going on—and how to fix it.
Why Stairs Are So Painful
If stairs are your nemesis, you’re not alone. Going down stairs is one of the most common complaints with knee pain—and there’s a biomechanical reason for that.
Descending stairs puts massive demands on your knee. Your quad has to control your body weight eccentrically (lengthening under load) while your knee is in a flexed position. This creates extremely high stress at the patellofemoral joint.
1.5x body weight through knee when walking
3x body weight going UP stairs
4x body weight going DOWN stairs
7x body weight in deep squats
This is why stairs often hurt before other activities do—they’re one of the highest-demand movements for your kneecap.
The silver lining: If we can improve your knee’s capacity to handle stairs, you’ll usually see improvement across all activities. Stairs become a useful benchmark for progress.
Pain During Activity vs. Pain After
This distinction matters more than most people realize. The timing of your pain often points to different underlying issues—and requires different treatment approaches.
Pain During Activity Usually Means:
– Load is exceeding your current tissue capacity
– May improve as you “warm up”
– Usually responds well to load modification
– Common with patellofemoral issues
Pain After Activity Usually Means:
– Cumulative stress or inflammation building up
– Feels fine during exercise, then aches hours later
– May need more recovery-focused approach initially
– Common with tendon irritation
Both patterns are treatable, but they require different initial approaches. That’s why a proper assessment matters—you need to know what you’re dealing with.
Common Causes of Activity-Related Knee Pain
Patellofemoral Pain
Pain around or behind the kneecap, often worse with stairs, squats, or prolonged sitting. This is one of the most common knee complaints we treat.
Patellar Tendinopathy
Pain at the base of the kneecap, common in jumping sports and activities with repeated loading. Sometimes called “jumper’s knee.”
IT Band Issues
Lateral (outside) knee pain, often in runners, that builds during activity and eases with rest.
What these have in common: Most activity-related knee pain shares a similar root cause—load exceeding capacity. Your knee can handle a certain amount of stress. When demands exceed that threshold, pain develops. The good news? Capacity can be rebuilt.
What Doesn’t Work
– Complete rest — leads to deconditioning and doesn’t rebuild capacity
– Just avoiding squats forever — doesn’t address why squats hurt in the first place
– Relying on knee sleeves or braces — can help temporarily but aren’t a long-term solution
– Stretching alone — flexibility is rarely the primary issue
What Actually Works
At Dynamic Sports Medicine, we use a systematic, evidence-based approach to get you back to full activity:
– Identify the driver — Determine what type of knee pain you have and what’s causing it
– Modify, don’t stop — Find the right training dose that keeps you active while allowing tissues to adapt
– Rebuild capacity — Progressive loading to restore your knee’s ability to handle squats, stairs, running, and whatever else matters to you
Most people with activity-related knee pain see significant improvement within 6-8 weeks of proper treatment. The goal is getting back to everything you want to do—not avoiding activities forever.
Who Can Benefit from Our Approach?
– Athletes & Gym-Goers — Get back to squats, lunges, and leg training without pain
– Runners — Return to full mileage without nagging knee issues
– Weekend Warriors — Stay active in your recreational sports and hobbies
– Anyone Tired of Avoiding Stairs — Yes, you can take the stairs without wincing
Done Avoiding Stairs and Squats?
Book an evaluation and we’ll figure out exactly what’s causing your knee pain—and build a plan to fix it.
Common Questions About Knee Pain
Why does my knee hurt when I squat?
Knee pain during squats often comes from load exceeding capacity at the patellofemoral joint or patellar tendon. This can be due to sudden increases in training, poor movement patterns, weakness in the quads or hips, or pre-existing irritation that hasn’t been addressed.
Is it bad if my knee hurts going down stairs?
Pain going down stairs puts high demand on your patellofemoral joint—up to 4x your body weight. It’s a common symptom of anterior knee pain but doesn’t necessarily mean serious damage. However, persistent pain that limits your daily activities should be evaluated.
Should I stop exercising if my knee hurts?
Not necessarily. Complete rest often leads to deconditioning and delayed recovery. The key is modifying load and movements while you address the underlying cause. Many people can continue training with appropriate modifications.
Do I need an MRI for my knee pain?
Usually not initially. Most activity-related knee pain can be diagnosed and treated based on history and physical examination. MRIs are helpful when symptoms don’t improve with proper treatment, or when there’s concern for structural issues.
How long does knee pain take to heal?
Most people with activity-related knee pain see significant improvement within 6-8 weeks of proper treatment. However, this varies based on the specific condition, how long you’ve had it, and your activity goals.
