Knees hurt on stairs at 50? How should you look after them?

Knee pain on the stairs at 50 often has to do with the load the knee takes at each step, your body weight, your leg muscles, and doing too much or building up too quickly. While it hurts, rest the knee and ask a doctor or pharmacist for advice. Then reduce the load on your knees by holding the handrail, taking one step at a time, strengthening your leg muscles on at least 2 days a week, warming up before exercise, wearing supportive shoes and walking down hills slowly. As for crunching or clicking in a knee that does not hurt, the UK's NHS says that is normal.

Why do my knees hurt on the stairs at 50?

The NHS says knee pain has many possible causes. It is best not to guess the cause yourself; if you are worried, talk to a doctor. These are the common everyday factors.

Stairs add load to the knee

A 2010 study in the Journal of Biomechanics, which measured forces directly in 5 people with a sensor-equipped knee implant, found average peak forces on the knee of about 3.5 times body weight going down stairs and about 3.2 times going up, compared with about 2.6 times on level walking. Multi-storey homes, footbridges and train stations mean your knees take that load again and again every day.

Doing too much, too quickly

The NHS gives the example of pain after overstretching, overusing or twisting the knee. NIAMS, part of the US National Institutes of Health, says increasing the intensity of activity too quickly, training too often or for too long, and incorrect technique raise the risk of injury. A typical case is going back to hiking after a long break and spending the whole first trip going up and down.

Leg and hip muscles

The muscles of the thighs and hips take the load when you step up and step down. That is why the NHS advises adults to do strengthening activities that work all the major muscle groups, including the legs and hips, on at least 2 days a week.

Shoes and surfaces

NIAMS counts unsupportive shoes and not using the proper equipment among the risk factors for injury, and notes that running creates forces of two to three times your body weight on the legs.

How should I start looking after knees that hurt on the stairs?

When the pain has just started

While it hurts, rest the knee and ask a doctor or pharmacist for advice. The NHS advises not to stop moving a painful joint completely. For more detail on the first few days, see Stiff fingers on waking, sore knees after new exercise: why?

Using stairs with less strain

• Hold the handrail every time.
• Take one step at a time, without rushing.
• While it hurts, use the lift or escalator for a while, then return to the stairs as it improves.
• Carry less up the stairs at once; make more trips instead.

Strengthen the muscles that support your knee

The NHS advises adults aged 19 to 64 to do strengthening activities that work all the major muscle groups on at least 2 days a week, and at least 150 minutes of moderate activity a week, spread over 4 to 5 days or every day. Its strengthening examples include yoga, pilates, tai chi, lifting weights, resistance bands and exercises that use your own body weight.

The NHS advises speaking to a doctor first if you have not exercised for some time or have health conditions or concerns.

Body weight and stairs

The forces on the knee on stairs are measured as multiples of body weight, and for joint pain the NHS advises people to eat a healthy, balanced diet and exercise regularly. Keeping your weight at a healthy level is therefore another factor that affects your knees every time you use the stairs.

I love running and hiking, but my knees crunch. Should I worry?

The NHS says painless clicking in the knee is normal. What matters is whether the sound comes with other symptoms. The NHS lists a knee that locks, gives way or painfully clicks as a reason to get advice right away.

None of the sources used in this article names any particular food for knee noises. What they recommend for runners and hikers is the way you exercise, covered in the next section.

What to look out for

For noises in other joints, see Cracking, popping joints: should you worry, what to eat?

How can I run and hike without overloading my knees?

Before you set off

• Warm up and stretch before exercise, which MedlinePlus lists among the ways to help prevent sports injuries.
• Wear running shoes or hiking boots that are well made, fit well and have good cushioning.
• Increase distance and climbing gradually; NIAMS warns against increasing intensity too quickly.

On the way down

• A 1999 study by Schwameder and colleagues in the Journal of Sports Sciences, in which 8 men walked down a 25-degree ramp, found that using hiking poles reduced several of the forces acting on the knee joint by about 12 to 25% compared with walking down without poles.
• Take shorter steps, slow down and stop for breaks on long, steep descents.

Surfaces and rest days

• NIAMS counts running or jumping on hard surfaces among the risk factors for injury, so where you can, run on a smoother, softer surface such as a track rather than concrete.
• Alternate running days with cycling or swimming, since NIAMS says training too often or for too long raises the risk of injury.
• If a movement hurts, stop rather than pushing through.
• On long hiking days, take water and snacks with you.

When should I see a doctor about knee pain?

Book an appointment

• Knee pain has not improved after a few weeks (NHS)
• Joint pain is stopping you doing normal activities or affecting your sleep (NHS)

Get advice right away

• Your knee is very painful
• You cannot move it or put any weight on it
• It is badly swollen or has changed shape
• It locks, gives way or painfully clicks
• You have a high temperature with redness or heat around the knee

Go to the emergency department straight away

• Very bad joint pain after a fall or injury (NHS)
• You cannot walk or put weight on the joint

If you want to use a painkiller, ask a pharmacist or doctor first, and do not use any medicine on your own for long periods.