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Why Does My Knee Hurt Going Downstairs? Common Causes and How Physical Therapy Can Help in Highlands Ranch and Greenwood Village

August 26, 2026

Leg injury after climbing stairs

Why Does My Knee Hurt Going Downstairs? Common Causes and How Physical Therapy Can Help in Highlands Ranch and Greenwood Village

If you’ve ever noticed that going down stairs hurts your knee more than going up, you’re not alone.

In fact, “knee pain going downstairs” is one of the most common reasons people seek physical therapy in Highlands Ranch, Greenwood Village, Lone Tree, Castle Pines, Centennial, and throughout the South Denver area.

The good news?

Knee pain on stairs does not automatically mean you need surgery, injections, or that your knee is “bone-on-bone.”

At Epic Physical Therapy, we help active adults, runners, golfers, and Medicare patients get back to walking, hiking, skiing, and everyday activities without being limited by knee pain.

Why Does My Knee Hurt Going Downstairs?

Walking downstairs places significantly more force on the knee than level walking.

Your body relies on your:

  • Quadriceps muscles
  • Glutes and hips
  • Ankles and calves
  • Balance and coordination

to absorb force and control your descent.

If these areas aren’t working together efficiently, the knee often becomes overloaded and painful.

Common Causes of Knee Pain Going Downstairs

Patellofemoral Pain Syndrome (Runner’s Knee)

Pain around or behind the kneecap is one of the most common causes of stair pain. It often worsens with:

  • Stairs
  • Squatting
  • Lunges
  • Sitting for prolonged periods

Knee Arthritis

Arthritis doesn’t always mean surgery.

Research supports exercise and physical therapy as first-line treatments for knee osteoarthritis.

Many people are surprised to learn that strength training and improved movement patterns can significantly reduce symptoms.

Meniscus Irritation

Meniscus injuries can cause:

  • Pain when twisting
  • Stiffness
  • Swelling
  • Difficulty descending stairs

Importantly, MRI findings don’t always correlate with pain, and many meniscus injuries improve without surgery.

Weakness and Reduced Load Capacity

Sometimes the issue isn’t damage.

It’s capacity.

If muscles surrounding the knee and hip aren’t prepared for the demands of daily life, stairs can become uncomfortable.

Good physical therapy focuses on rebuilding that capacity.

Pain Doesn’t Always Mean Damage

This may be the most important thing to understand.

Pain is complex.

Research shows that imaging findings such as arthritis, cartilage wear, and meniscus tears are common—even in people without pain.

Just because something appears on an MRI doesn’t mean surgery is inevitable.

Many cases of knee pain respond extremely well to:

  • Strength training
  • Activity modification
  • Balance work
  • Progressive loading
  • Physical therapy

Should I Rest My Knee?

Not necessarily.

Avoiding activity completely can create a cycle:

Less movement → Less strength → Lower capacity → More pain with everyday activities.

The goal isn’t to avoid movement.

The goal is to find the right amount of movement and gradually build tolerance.

When Should You See a Physical Therapist?

Consider getting evaluated if:

  • Knee pain has lasted more than 2–4 weeks
  • Going downstairs is becoming difficult
  • Walking or exercise has become limited
  • You are avoiding activities you enjoy
  • You’re wondering if you need an MRI or surgery

Physical therapy is recommended as a first-line treatment for many forms of knee pain.

Physical Therapy for Knee Pain in Highlands Ranch and Greenwood Village

At Epic Physical Therapy, we help people throughout:

  • Highlands Ranch
  • Greenwood Village
  • Lone Tree
  • Castle Pines
  • Centennial
  • Littleton
  • Englewood
  • Cherry Hills Village
  • South Denver

return to the activities they love.

Our approach includes:

  • Individualized one-on-one treatment
  • Strength and exercise programs
  • Manual therapy
  • Dry needling
  • Running analysis
  • Return-to-sport rehabilitation
  • Golf performance and TPI assessments
  • Balance training and fall prevention

We Accept Most Major Medical Insurance Plans

Epic Physical Therapy proudly accepts most major medical insurance plans, including:

  • Medicare (including Medicare supplemental plans)
  • Kaiser Permanente
  • Blue Cross Blue Shield (including Anthem plans)
  • UnitedHealthcare
  • Cigna
  • Medicaid (referral required)
  • First Choice Health
  • Optum
  • UHS
  • Worker’s Compensation Plans

If you’re unsure about your benefits, our team can help verify your coverage.

Same-Week Physical Therapy Appointments Available

You shouldn’t have to wait weeks to get answers.

Epic Physical Therapy offers same-week evaluations and convenient appointment times at both locations.

Schedule Your Appointment Online

Frequently Asked Questions

Why does my knee hurt more going downstairs than upstairs?

Descending stairs places greater forces through the knee and requires your muscles to absorb and control those forces. Weakness, arthritis, or irritation around the kneecap are common contributors.

Does knee pain going downstairs mean I need surgery?

Not necessarily. Many causes of knee pain improve with physical therapy and exercise.

Should I get an MRI for knee pain?

Not always. Imaging findings don’t always explain pain, and physical therapy is often recommended before advanced imaging.

Can physical therapy help arthritis?

Absolutely. Exercise and strength training are considered first-line treatments for knee osteoarthritis.

Schedule Physical Therapy for Knee Pain in South Denver

If knee pain is making stairs, walking, hiking, golf, or exercise difficult, we’re here to help.

Epic Physical Therapy provides expert physical therapy in Highlands Ranch and Greenwood Village with same-week appointments available.

We accept Medicare, Kaiser Permanente, Blue Cross Blue Shield, UnitedHealthcare, Cigna, Medicaid, and most major insurance plans.


Schedule Your Evaluation Today


🗓️ Ready to Feel Better?

Epic Physical Therapy helps active adults, athletes, golfers, runners, and Medicare-aged patients throughout South Denver move better, feel stronger, and get back to doing what they love.

Highlands Ranch Clinic
9200 W Cross Drive, Suite 420
Highlands Ranch, CO 80129
📞 720-458-0522

Greenwood Village Clinic
8200 E Belleview Avenue, Suite 420E
Greenwood Village, CO 80111
📞 720-572-4873


Book Your Appointment Online

Epic Physical Therapy proudly serves Highlands Ranch, Greenwood Village, Lone Tree, Castle Pines, Centennial, Littleton, Englewood, Cherry Hills Village, and the greater South Denver community.