My Knee Hurts in the Front When I Go Down Stairs
If the area just below your kneecap stings when you go down stairs or squat, it is likely patellar tendinitis. This is an overuse injury caused by repeated load on the tendon that connects the kneecap to the shinbone. We treat it by calming the inflammation first, then waking up the weakened muscles, then teaching the joint the corrected movement.
What Is Patellar Tendinitis?
The patellar tendon runs from the bottom of the kneecap to the shinbone (tibia). It transfers the force generated by the thigh muscle (quadriceps) through the kneecap to the shinbone, which is what lets you straighten your knee.
Function
Absorbs impact when you straighten your knee or land from a jump, while transferring muscle force to the bone.
How the Problem Develops
Repeated jumping, running, or going up and down stairs pushes the tendon past the load it can handle. Tiny amounts of damage and inflammation build up right where the tendon attaches below the kneecap.
When Does It Hurt?
Going Down Stairs
Bending the knee while gradually absorbing your body weight places the greatest load on the tendon.
Squatting or Staying Bent for a While
The pain shows up as pressure builds where the tendon attaches.
Landing After a Jump
Common in sports with a lot of jumping, like volleyball or basketball, which is why it’s often called jumper’s knee.
Pressing Below the Kneecap
There is a distinct tender point right where the tendon attaches.
What Causes It?
Overuse + Muscle Imbalance
Suddenly increasing your training volume, or having a stiff quadriceps, dumps extra load onto the tendon all at once.
Sudden Spike in Training
When you suddenly increase how often you jump or run
Stiff Quadriceps
A tight thigh muscle increases the pulling force on the tendon
Landing Mechanics
Landing with the knee caving inward concentrates load on one side of the tendon
Hard Surfaces and Shoes
Concrete floors or shoes with no cushioning pass landing impact straight into the tendon
Patellar Tendinitis vs. Patellofemoral Pain Syndrome: What’s the Difference?
Not all pain around the kneecap is patellar tendinitis. You can tell it apart from patellofemoral pain syndrome by where it hurts and which movements make it worse.
| Category | Patellar Tendinitis | Patellofemoral Pain Syndrome |
|---|---|---|
| Pain Location | Right below the kneecap, where the tendon attaches | Behind and around the kneecap, more diffuse |
| Worse With | Going down stairs, landing from a jump — moments of sudden load on the tendon | Going up or down stairs, standing up after sitting a long time — anything that keeps the knee bent for a while |
| Tenderness | A clear, localized tender point where the tendon attaches | Tenderness only appears when pressing more broadly around the kneecap |
| Who Gets It | Athletes who jump or run repeatedly | Common even in young people who sit for long stretches |
The two conditions can occur together, so a proper physical exam is needed to tell them apart. Learn more about patellofemoral pain syndrome →
How We Approach It at Yonsei Shinmyung
We calm the tendon inflammation and gradually rebuild the load it can tolerate at the same time.
- Step 1: We calm the inflammation.
Circulation HD is used to address the inflammation and adhesions at the tendon attachment. - Step 2: We wake up the muscles.
Circulation PT loosens a stiff quadriceps and strengthens the hip and core muscles, spreading out the load so it doesn’t concentrate on one side of the tendon. - Step 3: We teach the joint the corrected movement.
We analyze how you go down stairs and land, then correct the pattern so load stops piling up on the knee.
Self-Care Tips
Warm Up the Front of the Thigh
Applying warmth to the front of the thigh before exercise can ease stiffness.
Quadriceps Stretching
Slowly stretch the front of your thigh to reduce the pull on the tendon.
Adjust Jumping and Stair Use
When it hurts, cut back on jumping activities and use a gentle ramp instead of stairs when you can.
When Should You See a Doctor?
• When the pain lasts more than 2 weeks
• When it hurts even just to walk
• When the area below the kneecap stays swollen and warm
Related Questions
Frequently Asked Questions
How long does patellar tendinitis take to heal?
Tendon tissue heals more slowly than muscle. Depending on how severe the pain is and how active you are, recovery usually takes a few weeks to a few months. Reducing high-impact activity and gradually increasing the load the tendon can handle is the key to lowering the chance it comes back.
Can I keep exercising?
It is best to cut back for a while on movements that make the pain worse, such as jumping or sprinting. Low-load activities like walking on flat ground or swimming can continue. Staying active within a pain-free range tends to help recovery more than complete rest.
Why does it hurt more going down stairs than going up?
Going down stairs requires the knee to bend while gradually absorbing your body weight, which places a greater load on the tendon. Going up, by contrast, loads the tendon while it is shorter and less stretched. This difference is why patellar tendinitis tends to hurt more noticeably going down.
This feels similar to patellofemoral pain syndrome. Can I tell the difference at home?
Pressing on the painful spot gives you a rough idea. A distinct tender point just below the kneecap points to patellar tendinitis, while a broader ache around and behind the kneecap points to patellofemoral pain syndrome. The two conditions can occur together, so a physical exam is needed to confirm the diagnosis.
Does Your Knee Hurt Every Time You Go Down Stairs?
We use pain-location and movement assessment to determine whether it’s patellar tendinitis or patellofemoral pain syndrome.
Book OnlineReferences
- Rio E, Kidgell D, Purdam C, et al. Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 2015;49(19):1277-1283. PMID 26069301
- Malliaras P, Cook J, Purdam C, Rio E. Patellar tendinopathy: clinical diagnosis, load management, and advice for challenging case presentations. J Orthop Sports Phys Ther. 2015;45(11):887-898. PMID 26390269
- Rudavsky A, Cook J. Physiotherapy management of patellar tendinopathy (jumper’s knee). J Physiother. 2014;60(3):122-129. PMID 25092422
- Lian ØB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med. 2005;33(4):561-567. PMID 15722283