Fighting Gravity.

January 20, 2013 10:24 PM

What's going on with my knee? (YANMD)

I'm a 38 year-old male. Recently, I've been having periods of a dull ache in my right knee. I know I need to see a doctor, but something seems strange to me. My office and classroom(s) are on the fourth and third floors of buildings with no elevator, so during the week I'm walking up about 15 to 20 flights of stairs a day. And this causes me no problems at all. What causes problems, sometimes to the point where I need to pause for 20 seconds before continuing, is when I go down the damn things. This seems counter-intuitive to me -- why no pain going up, but pain going down?

As another data point, I ride an exercise bike for 30-45 minutes four to five time a week. Not only do I not have any pain or discomfort, but if anything Mr. Knee stays pain-free when I'm not slacking off on my exercise routine.

tl;dr -- Knee hurts when I go down stairs, not when I go up them or actually ride a bicycle for 45 minutes. What gives?

posted by bardic to health & fitness (11 answers total)

I (late-20s female) was having trouble with my one knee because of a weak ankle. My PT had me do strengthening exercises on my knee and it helped a lot. Any old injuries make you land funny?
posted by DoubleLune at 10:27 PM on January 20

I have worn down the cartilage in my right knee, and it feels fine going up stairs, but painful going down. I suspect this is because, as you indicated in your title, gravity is working against me.

Going down, you lower your entire body weight onto the joint, while going up the stairs, you are using a great deal of muscle to pull your leg, and the rest of your body, up the stairs. If you have strong quads, from biking for example, you would be much better at lifting your body weight with these mighty quads.

It's the difference between pressure on the joint and using your muscles to support your body weight.

IANAD
posted by blurker at 10:32 PM on January 20

It's probably a patella or other tracking issue since you say exercise corrects it. Super common in our sessile world and super fix-able. A PT will give you a bunch of exercises which will help and you can do lunges and squats at home with good form once you plateau on the PT exercises. I shoot for doing lunges/ squats/ quad/ glute exercises a couple days a week for a half hour or so and I'm good. Also stretching hamstrings and calf muscles.
posted by fshgrl at 10:42 PM on January 20

I had runner's knee and it was so much harder going down the stairs than up. It resolved itself after a ton of rest.
posted by discopolo at 10:44 PM on January 20

You sound like me! The Dr. diagnosed runner's knee and gave me exercises to do but it turned out just stretching my IT band totally resolves it. Now I always do IT band stretches after any exercise.
posted by MonsieurBon at 11:40 PM on January 20

Iliotibial Band issues, aka Runner's Knee, aka ITB is very common and notorious for whipping you going down stairs, not up.

Try stretching your hip flexors and abductors, and lying on your side and doing a foam roller up and down the outside-side of your leg (roller between leg and ground), and some strengthening exercises

Google around, there's tonnes on it. I'd bet money it's ITB.
posted by smoke at 1:39 AM on January 21

A friend is an orthopedic surgeon, and he tells me it's totally normal for going down to be harder on joints than going up.
posted by jon1270 at 3:03 AM on January 21 [1 favorite]

No idea the cause, but I have a knee that's the same way, especially when I've been more couch-potato-ish. Down is the worst - extra worst when I've accidentally hiked up quite a ways.

I live in Seoul and acupuncture+physical therapy helped, after seeing a "sports medicine" doctor, all covered mostly by insurance.
posted by nile_red at 6:04 AM on January 21

If you'd like to read an electromyography study on which muscles are used in walking up and down stairs: here.
posted by d. z. wang at 6:46 AM on January 21

Down is bad. Yep. But do cheer up, you aren't getting younger, and it will get worse! Bwahaha.
Lunges: VERY good.
posted by Goofyy at 8:43 AM on January 21

You didn't mention where the pain is - is it at the front of your leg or the back?

For what it's worth, all my knee pain disappeared after a week of doing low bar back squats (look em up and look for mark rippetoe's instruction on it). This was pain in the front of my knee, though.
posted by spacediver at 9:44 AM on January 21