Knee Pain When Climbing Stairs But Not Walking
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We do the research so you can find trusted products for your health and wellness. In chondromalacia, the cartilage under the kneecap softens and wears away. This can cause knee pain when climbing stairs, for example, but not at other times. It is also known as chondromalacia patellae. Share on Pinterest A description of symptoms and habits and a physical examination can help make clear the cause of chondromalacia. Chondromalacia may lead to a dull pain when bending the knee or when the knee straightens right after bending it. Activities that might cause pain include :
walking down hills or stairsclimbing stairsstraightening the knee while it is bearing weight
This is why the knees often hurt when a person is going up or down the stairs. This deeper movement means that the kneecap is forced to slide up and down over the femur more than usual. If the cartilage is worn down, or the kneecap isn’t sliding in its groove, a person may feel pain as the knees bend and straighten, and the bones rub on rough cartilage.
The pain may go away when walking, however, because the knees do not have to move as much. Squatting, kneeling, or sitting with the knees bent greater than 90 degrees may also cause pain with this condition. These activities all involve deep bending of the knee. Even a slight swelling of the cartilage can be enough to trigger pain during these activities.
Some people may also notice a cracking or grinding sensation after exercise or heavy use of the legs and knees. Symptoms of chondromalacia include:
pain in or around the knee, especially on climbing stairs, during intense activity, or after staying in one position for a length of timecrepitus, or cracking as you bend the knee
Common causes include injury, overuse, and misalignment. Many people are surprised to find that their cartilage is damaged because they have never directly injured their knees. However, chondromalacia can result from other factors, not only an injury or accident.
The most common causes include: Excessive use of the knees: This can result from running, jumping, or any activity that requires heavy use of the knees. Chondromalacia is often called “runner’s knee” for this reason. It occurs in people of any age and is common in young, active athletes. A kneecap that is out of alignment: If the kneecap is not in the proper position, the cartilage will not be able to protect it from rubbing.
Some people are born with a misalignment of the knee that can cause this issue. Weak muscles in the thighs or calves: The leg muscles help support the knee and keep it in place. If they are not strong enough, the knee may slip out of alignment. Even a slight misalignment can gradually wear down the cartilage and cause pain over time.
athletes and others who put strain on their knees through exercise and other activitiesadolescents, due to a temporary muscle imbalance as the body grows, which normally corrects over timewomen, as they tend to have less muscle mass around the kneepeople who have a previous knee injury, such as dislocationthose with a tight hamstring, flat feet, difference in leg length, or joint laxitypeople with patellar hypermobility, where the kneecap moves more than it should
It can also be a symptom of arthritis, It can be made worse by activities such as climbing stairs, squatting, jumping, cycling, skiing, running, sitting with the knees flexed for a long time, or a combination of these. Another cause is muscles that are not balanced.
- 1 Why does my knee hurt only when I climb stairs?
- 2 Why does my knee hurt but I can still walk on it?
- 3 Should I avoid stairs with knee pain?
- 4 How do you test for chondromalacia patella?
- 5 Can I ever squat again with chondromalacia?
- 6 Is climbing stairs bad for knee pain?
Why does my knee hurt only when I climb stairs?
Summary – Arthritis and chondromalacia patella commonly cause knee pain that strikes when you walk up stairs. Knee pain can also be caused by a ligament injury or a condition called patellofemoral pain syndrome. A healthcare provider diagnoses these conditions through imaging techniques, like X-rays and MRIs.
What is the best treatment for chondromalacia patella?
Treatment / Management – A trial of longstanding conservative management for at least one year should be the first line of treatment. This includes rest, activity restriction, and nonsteroidal anti-inflammatory medication, which is proven to be more effective than steroids.
- Rehabilitation with physiotherapy should focus on closed chain short arc quadriceps exercises and specific strengthening of vastus medialis obliqus, core muscle strengthening, and strengthening of hip external rotators.
- Quadriceps muscle strengthening with different exercises significantly reduces anterior knee pain in early cases of CMP.
Management of the patient with chondromalacia patellae is difficult, and there is no one specific form of treatment that is universally accepted as a standard of care. Medical management should be based on the physical exam findings. It can include patella stabilizing braces, physical therapy for quadriceps strengthening, orthotics that decrease pronation of the foot, and nonsteroidal anti-inflammatory medication.
The use of platelet-rich plasma (PRP) is sometimes advocated, but it is not the standard of care. PRP has not been shown to improve patient outcomes consistently. Likewise, prolotherapy has been recommended by some authors, but it is not the standard of care and has not been shown to improve patient outcomes consistently.
Operative Management Failure of conservative management will result in exploring alternative surgical options. Even though multiple effective options are available, care should be taken when recommending the best procedure, considering the patient’s age and severity of CMP.
- Each procedure has its own merits, indications, and limitations.
- Available options include patellar cartilage excision, shaving, drilling, proximal soft tissue, and distal bony patellar realignment surgery.
- The most effective and most straightforward surgery with avoidance of quadriceps fibrosis and dysfunction is a patellar tendon medial realignment with lateral release and reefing of the medial quadriceps expansion.
Arthroscopic Evaluation and Debridement: Indicated for diseased cartilage or chondral abrasion, fibrillation, or traumatized cartilage areas (Outerbridge grade II, III, and IV chondromalacia patellofemoral joint). Debridement is either mechanical or radiofrequency.
Arthroscopic or Open Lateral Retinacular Release Indicated for lateral patellar tilt and presence of tight lateral retinacular capsule and loose medial capsule. Patellar Realignment Surgery This is based on restoring the biomechanical force axis of the patellofemoral joint, which would improve its function; however, it would result in patellofemoral joint degeneration to a degree.
Indicated for severe symptoms refractory to conservative management, including physiotherapy. Various techniques have been described in the literature covering tibial tuberosity osteotomy, tibial tuberosity anteversion, and tibial tuberosity elevation.
Maquet (anterior tubercle elevation): Not more than 1 cm is elevated to avoid the risk of skin necrosis. Fulkerson (anterior-medialization): This is indicated in cases of patellar instability with the presence of an increased Q angle. Contraindicated in skeletal immaturity and in the presence of superomedial arthrosis ( It is recommended to perform an arthroscopic evaluation before surgery) Elmslie-Trillat osteotomy MPFL reconstruction Patellectomy: either partial or total patellectomy.
However, this procedure would be indicated only if a patient has excellent quadriceps function preoperatively and would be compliant to exercise regularly postoperatively. Total patellectomy is considered a radical procedure for managing CMP. It is associated with greater damage to the surrounding ligaments and quadriceps femoris.
Additionally, it changes the leverage effect of the extensor muscles. Several other complications have been reported in later stages after total patellectomy, such as instability of the extensor tendon and patellar tendon acute rupture. Hence partial rather than total patellectomy was usually performed in managing CMP.
Salvage procedures (Historical) Patellar resurfacing: the McKeever prosthesis initially had a beneficial long-term effect for cases of severe CMP with advanced patellofemoral osteoarthritis; however, this procedure was abandoned due to multiple complications such as patellar tendon lesions, secondary patella fracture, avascular necrosis, patellofemoral joint instability, and prosthetic loosening.
Other Treatment Modalities Cell therapy: Autologous chondrocyte implantation was first reported in 1994 for treating cartilage defects in knee osteoarthritis. In the last two decades, cell therapy for osteoarthritis has emerged as a treatment. Multiple reviewers consider CMP a mesenchymal disease; therefore, cell therapy would have a positive therapeutic effect.
Emerging modalities include autologous chondrocyte transplantation and injection of mesenchymal stem cells. Mesenchymal stem cells (MSCs): Intraarticular injections of MSCs from different sources were proven safe and clinically effective in treating chondromalacia patellar.
Why does my knee hurt but I can still walk on it?
1. Your Knee is Clicking or Popping – Whether your knee is clicking, locking, or popping, these are all indications that something is not quite right. In some cases, popping may be an indication of a ligament injury — such as an anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), or medial collateral ligament (MCL) tear.
Sudden, severe pain in the knee Pain that persists while walking The knee abruptly gives out, causing you to fall and feel unstable while walking Swelling within 24 hours after the initial injury
Another reason your knee may be popping is because of a meniscus tear, This can often occur along with a knee ligament injury and occurs when the medial meniscus tears. Similar to ACL, PCL, or MCL tears, a meniscus tear occurs from a single, sudden movement — such as sports injuries or twisting suddenly. In addition to popping, other symptoms include:
Knee pain Initial pain and discomfort — but still able to walk Worsening pain and stiffness Your knee giving out Knee catching or locking
Should I avoid stairs with knee pain?
If you live in a multi-story home or walk-up apartment, you know just how painstaking it can be to walk up and down stairs if you have arthritis in your knees. It may have gotten to the point of your avoiding the stairs altogether — or dreaming of moving to a one-story home.
Walking up and down steps causes pain in tender knee joints because of how your weight shifts between your legs as you climb. “Climbing stairs causes more force to go through the leg than walking does,” says occupational therapist Julie Dorsey, OTD, OTR/L, an Associate Professor of Occupational Therapy at Ithaca College in Ithaca, New York.
“That can irritate already inflamed joints.” Knee pain with stair climbing is so common that it can be one of the first clues that someone actually has osteoarthritis in the knee. In a 2014 study published in the journal Arthritis Care & Research, researchers reviewed the pain ratings of nearly 5,000 participants with or at high risk of osteoarthritis when walking, using stairs, in bed, sitting or lying down, and standing up.
- The activity that caused them to cross the threshold from “no pain” to “some pain” most often was going up and down stairs.
- Nee pain is most likely to first appear during weight-bearing activities that involve bending of the knee, such as climbing stairs.
- I’ve had a lot of patients who have tried to move to a one-story place just because of their knee pain, so it’s pretty prevalent,” says Deeba Minhas, MD, a rheumatologist at Michigan Medicine in Ann Arbor, Michigan.
“There are simple ways you can adjust your body mechanics to put a lot less strain on your joints.” However, there are a few important ways you can make using stairs a little easier on your joints — without forever swearing off stairs. Follow these strategies to make navigating stairs easier and less painful.
How do you test for chondromalacia patella?
Diagnostic Procedures – Since its first description by Budinger in 1906, chondromalacia patella has been of significant clinical interest because diagnosis is often difficult. The chief reason for this is that the aetiology is often unknown and the correlation between the articular cartilage changes and the clinical system is poor.
- Patients affected by chondromalacia patella are young, between 15 and 35 years old, and many are highly active and are often considerably disabled by the symptoms of aching behind the patella, recurrent effusion of the knee, knee instability and crepitus.
- The primary diagnostic approach for chondromalacia patellae is radiography with added arthrography.
Pinhole scintigraphy, part of arthrography, is also used to diagnose the condition. MRI is an effective, non-invasive method with the ability to increase the sensitivity and specificity of the diagnosis.
Can I ever squat again with chondromalacia?
38. What exercises should be avoided with patellar chondromalacia? – Those exercises which should be avoided with patellar chondromalacia include knee extension exercises with weights, lunges, lunges with weights, and significant squatting with weights.
Does chondromalacia patella show up on an MRI?
Abstract – Background: This diagnostic study was performed to determine the correlation between anterior knee pain and chondromalacia patellae and to define the reliability of magnetic resonance imaging for the diagnosis of chondromalacia patellae. Methods: Fifty-six young adults (median age, 19.5 years) with anterior knee pain had magnetic resonance imaging of the knee followed by arthroscopy.
The patellar chondral lesions identified by magnetic resonance imaging were compared with the arthroscopic findings. Results: Arthroscopy confirmed the presence of chondromalacia patellae in twenty-five (45%) of the fifty-six knees, a synovial plica in twenty-five knees, a meniscal tear in four knees, and a femorotibial chondral lesion in four knees; normal anatomy was seen in six knees.
No association was found between the severity of the chondromalacia patellae seen at arthroscopy and the clinical symptoms of anterior knee pain syndrome (p = 0.83). The positive predictive value for the ability of 1.0-T magnetic resonance imaging to detect chondromalacia patellae was 75% (95% confidence interval, 53% to 89%), the negative predictive value was 72% (95% confidence interval, 56% to 84%), the sensitivity was 60% (95% confidence interval, 41% to 77%), the specificity was 84% (95% confidence interval, 67% to 93%), and the diagnostic accuracy was 73% (95% confidence interval, 60% to 83%).
The sensitivity was 13% (95% confidence interval, 2% to 49%) for grade-I lesions and 83% (95% confidence interval, 59% to 94%) for grade-II, III, or IV lesions. Conclusions: Chondromalacia patellae cannot be diagnosed on the basis of symptoms or with current physical examination methods. The present study demonstrated no correlation between the severity of chondromalacia patellae and the clinical symptoms of anterior knee pain syndrome.
Thus, symptoms of anterior knee pain syndrome should not be used as an indication for knee arthroscopy. The sensitivity of 1.0-T magnetic resonance imaging was low for grade-I lesions but considerably higher for more severe (grade-II, III, or IV) lesions.
What exercises should you avoid with chondromalacia?
This means avoiding going up and down stairs and hills, deep knee bends, kneeling, step-aerobics and high impact aerobics. Do not wear high heeled shoes. Do not do exercises sitting on the edge of a table lifting leg weights (knee extension).
Is climbing stairs bad for knee pain?
Elevator go right, stairs go left, which do you choose? While taking the stairs is undoubtedly a benefit to your overall health, it does put stress on the knees, hips, and feet – especially going down. Patellofemoral pain syndrome is the most common cause of knee pain seen by doctors and is a pain that increases with stair climbing or squatting movements.