David Gardiner & Associates 045-853726

Does your knee hurt going down the stairs?

Want to know how to stop it?

Believe it or not, going down the stairs actually puts more weight or force on your knee cap (patella) than going up stairs. Studies report it can be as much as x4 times your bodyweight. So if you weigh 10 stone, the force on your knee cap (patella) when going down the stairs can be as much as 40 stone! Cartilage acts as a natural shock absorber in the body so it’s no wonder that the thickest piece of cartilage in the human body is found behind the patella. Pain at the front of your knee on descending the stairs or going from sitting to standing is known as anterior knee pain.

There are many possible factors that cause anterior knee pain when descending the stairs. For a comprehensive assessment it is best to see Chartered Physiotherapy (book on line @ http://physiotherapyworks.ie/book-online/ or call us on 045-866075)

Below we’ve out lined two of the most common causes of anterior knee pain. There are many other causes, which a chartered physiotherapist can test for, but these are the two most common causes. The first is gluteal (buttock) weakness and the second is poor foot biomechamics. We outline here how to address both these issues.

  1. Gluteus medius weakness:

Your glutes or your buttock muscles control the lower leg during a step down or a squat. If poor gluteus medius strength is apparent a valgus strain may be noticed during a squat or a step down. A valgus strain is more commonly referred to as knock knees. Strengthening of the gluteus medius muscle group can help to reduce the pressure on the kneecap.

What can you do to redress the balance. (A) Strengthen (B) Stretch (C) Foam Roll. The attached exercise are commonly used to strengthen the glute medius.

(A) Strengthen

(i) Hip Abduction:

Slowly and controlled lift your upper leg up and down. You should feel the muscles on your side beginning to work. Do 15 reps x 2 times. 

 

 

 

(ii) Squat:

Stand with your feet hip width apart. Sit back and stop when your thighs are parallel to the floor. Return to the starting position using your buttock muscles. If you want some further feed back do this exercise in front of a mirror and make sure your knees aren’t turning in.

 

(B) Stretch

Many muscles function together to allow the knee to flex and extend (bend and straighten). Tightness in any of these muscular units can cause pain in the kneecap. These muscles include but are not limited to the IT band, quadriceps, hamstring and calf muscles. Below are some useful ways you can stretch these muscles at home.

(i) Quadriceps stretch:

In standing, bring your heel to your buttocks and hold this stretch for 20-30 seconds. You should feel the stretch on the front of your thigh.

 

 

 

 

 

(ii) Hamstring stretch:

Lying on your back. Lift your leg towards your chest. Place your hands behind the knee. Gently pull your leg towards your chest. Feel the stretch behind your thigh. Hold for 20-30 seconds.

 

 

 

 

 

(C) Foam Roll

Poor flexibility can be as a result of muscle tightness. Massage can help with muscle tightness, but this can also be reduced with foam rolling at home. Foam rollers can come in all shapes and sizes, some are flat and smooth, while others have bumpy components. Choose a foam roller which you are more comfortable with.

Below we’ve outlined how to foam roll the three major muscle groups; the glutes (buttock muscles), hamstrings and quadriceps (thigh) muscles.

(i) Glutes:

Begin by sitting on the Roller, both hands and heels planted firmly on the ground. To target the deeper piriformis muscle, place the ankle of that leg across the opposite knee. Gently roll body weight back and forth across the Roller – following the path of the muscle being massaged. To increase the release of the piriformis muscle, reach across body to hold crossed knee with opposite hand. Lean in toward that side of the buttocks while gradually pulling knee toward opposite shoulder into a piriformis stretch position. Continue rolling. Slowly return to neutral.

 

 

 

(ii) Hamstrings:

Begin by sitting on the floor behind the Roller, both thighs draped across the Roller. Keeping hands planted on the floor, lift buttocks up to roll back and forth along the length of the hamstring muscles. To increase the release of the right hamstring muscle, slowly stack left leg on top of right leg. Continue rolling with long sweeping strokes, working shorter repetitive strokes in areas of increased tightness.

 

 

 

(iii) Quadriceps:

Begin by lying across the Roller, elbows and forearms planted firmly on the ground. Gently pull with elbows and forearms to roll and release the quadriceps muscle. Control the pressure through controlling the amount of weight on the Roller. Make sure to keep abdominal muscles tight and back straight. To increase the release of the right quadriceps muscle, slowly stack left leg on top of right leg. Continue rolling with long sweeping strokes, working shorter repetitive strokes in areas of increased tightness.

 

 

 

 

 

 

  1. Pronated feet

The second common cause of anterior knee pain is pronated feet, also known as flat feet. A qualified physiotherapist in orthotics prescription can advise you if a custom made insole can correct your foot biomechanics. The mechanics of your feet impact on the mechanics of your knee. By correcting the foot mechanics, knee, hip and back position is also improved.

 

 

 

 

 

This is general advice, it does not constitutes as personalised medical advice. As advice from the internet is not always suitable for everyone it should be followed pain-free only. If you experience any problems or pain following these exercises, stop immediately. For a full assessment and a tailored treatment plan you should consult one of our Chartered Physiotherapists on 045 866075 or book online @ http://physiotherapyworks.ie/book-online/