Knee Pain When Climbing Stairs, Squatting, or Walking: 7 Common Causes and How to Treat Them
By Anthony El Asmar, DPT, DO, MSc – Osteopath & Physiotherapist in Lebanon
Knee pain is one of the most common musculoskeletal problems affecting people of all ages. It can develop gradually without a clear injury or appear suddenly after sports, exercise, or an accident.
Some patients experience pain when climbing stairs. Others notice discomfort when squatting, walking long distances, standing up from a chair, or exercising.
But why does your knee hurt, and how can you identify the cause?
As an osteopath and Doctor of Physiotherapy practicing in Beirut and Lebanon, I assess patients with knee pain related to joint disorders, tendon problems, sports injuries, muscle weakness, and altered movement capacity.
Understanding the possible causes is the first step toward choosing appropriate treatment.
1. Patellofemoral Pain Syndrome (Runner's Knee)
Patellofemoral pain is one of the most common causes of pain around or behind the kneecap.
Despite its nickname, runner's knee does not affect only runners.
It can also occur in people who spend long periods sitting, climb stairs frequently, perform repetitive squats, or suddenly increase their exercise intensity.
Common symptoms
Pain around or behind the kneecap
Discomfort when climbing or descending stairs
Pain during squats or lunges
Symptoms after prolonged sitting
Pain during running or jumping
Why does it happen?
Patellofemoral pain is usually multifactorial.
Contributing factors may include changes in training load, reduced muscle capacity, sensitivity of structures around the knee, and individual movement characteristics.
It is not necessarily caused by a kneecap being “out of place.”
Can physiotherapy help?
Exercise therapy targeting the hip and knee muscles is a central part of treatment.
Education, load management, and gradual return to activity are also important. Manual therapy may be used as an additional intervention when clinically appropriate.
2. Knee Osteoarthritis
Knee osteoarthritis is a common condition, particularly among middle-aged and older adults.
It involves changes within the joint that may be associated with pain, stiffness, and reduced function.
However, the severity of changes visible on an X-ray does not always correspond directly to the amount of pain experienced.
Common symptoms
Pain when walking or climbing stairs
Stiffness after periods of inactivity
Difficulty standing up from a chair
Reduced knee mobility
Occasional swelling
Discomfort during prolonged activity
What is the best treatment?
For many patients, first-line management includes:
Progressive strengthening exercises
Regular physical activity
Aerobic conditioning
Weight management when appropriate
Education about the condition
Strategies to manage painful activities
Some patients may also benefit from medication or other medical interventions.
Knee osteoarthritis does not automatically mean that surgery is necessary.
Many people can improve their symptoms and maintain good function through appropriate conservative management.
3. Meniscus Injuries
The menisci are two crescent-shaped fibrocartilaginous structures inside the knee.
They help distribute loads and contribute to joint function.
Meniscal problems can occur following a twisting injury or develop gradually as part of age-related changes.
Common symptoms
Pain along the inner or outer knee joint
Discomfort during twisting movements
Pain when squatting deeply
Swelling
Clicking or catching sensations
Difficulty fully bending or straightening the knee
Not every clicking knee has a meniscus tear, and not every meniscus tear requires surgery.
Can a meniscus injury heal without surgery?
Some meniscal injuries can be managed successfully with rehabilitation.
Treatment depends on the type of tear, location, symptoms, functional limitations, and whether the knee has true mechanical locking.
A knee that becomes genuinely locked and cannot fully straighten requires prompt medical assessment.
4. Patellar Tendinopathy (Jumper's Knee)
Patellar tendinopathy commonly affects people involved in jumping, running, or sports requiring repeated acceleration and deceleration.
It involves pain associated with the patellar tendon, which connects the kneecap to the shinbone.
Common symptoms
Pain just below the kneecap
Discomfort during jumping
Pain during squatting
Symptoms during running or sports
Localized tenderness around the tendon
What causes patellar tendinopathy?
The condition is often associated with a mismatch between the load placed on the tendon and its current capacity.
Sudden increases in training intensity, jumping volume, or exercise frequency may contribute.
How is it treated?
Treatment generally focuses on progressive tendon-loading exercises and careful management of training demands.
Complete rest is not always the best solution.
The objective is to progressively restore the tendon's ability to tolerate physical activity.
5. Ligament Injuries: ACL and MCL
Knee ligaments help stabilize the joint during movement.
Two commonly injured structures are the:
Anterior cruciate ligament (ACL)
Medial collateral ligament (MCL)
These injuries often occur during sports, sudden changes of direction, twisting movements, or direct impacts.
Possible symptoms
Sudden pain after an injury
Swelling
A sensation of the knee giving way
Difficulty walking
Reduced range of motion
Instability during movement
Does every ACL injury require surgery?
No.
Treatment decisions depend on the patient's age, activity goals, degree of instability, associated injuries, and response to rehabilitation.
Some patients can be managed without surgery, while others benefit from surgical reconstruction.
Regardless of the treatment pathway, structured rehabilitation is essential.
A recent knee injury accompanied by substantial swelling, inability to bear weight, or instability should be medically assessed.
6. Iliotibial Band-Related Knee Pain
Iliotibial band syndrome is a common cause of pain on the outside of the knee, particularly among runners and cyclists.
It is often associated with repetitive knee movement and changes in training load.
Common symptoms
Pain on the outer side of the knee
Discomfort during running
Symptoms that increase with distance
Pain when running downhill
Tenderness around the lateral knee
What is the treatment?
Management may include:
Temporary adjustment of running volume
Progressive strengthening
Training-load modification
Gradual return to running
Assessment of relevant movement and training factors
The iliotibial band does not necessarily need to be aggressively stretched or “released.”
A rehabilitation program should focus on the patient's overall capacity and activity demands.
7. Referred Pain From the Hip or Lower Back
One of the most important aspects of clinical reasoning is recognizing that pain felt in the knee does not always originate from the knee itself.
Some hip disorders can produce pain perceived around the thigh or knee.
Certain lumbar spine conditions may also contribute to symptoms extending into the leg.
Signs that another region may be involved
Knee pain associated with lower back discomfort
Pain extending from the hip toward the knee
Tingling or numbness
Weakness
Knee pain without clear local findings
Symptoms influenced by spinal or hip movements
In these situations, examining only the knee may miss an important contributing factor.
A complete musculoskeletal assessment may need to include the hip, lumbar spine, and neurological system.
Why Does My Knee Hurt When Climbing Stairs?
Climbing stairs requires the knee and surrounding muscles to manage substantial forces.
The quadriceps muscles play an important role in controlling knee movement, while the hip and ankle also contribute to the task.
Pain during stair climbing can occur with several conditions, including:
Patellofemoral pain
Knee osteoarthritis
Patellar tendinopathy
Meniscal disorders
Other joint or soft-tissue problems
The location of the pain, associated symptoms, and clinical examination help determine the likely cause.
Pain during stairs does not automatically mean that the knee is being damaged.
In many cases, appropriate strengthening and gradual exposure to activity can improve tolerance.
Why Does My Knee Hurt When Squatting?
Squatting places increasing demands on the knee as the joint bends.
Pain may occur because of reduced load tolerance, joint sensitivity, tendon-related problems, or other musculoskeletal factors.
A painful squat does not necessarily mean that squatting is harmful.
Depending on the condition, rehabilitation may begin with:
Partial squats
Supported squats
Sit-to-stand exercises
Modified squat depth
Progressive strengthening
The goal is to gradually restore comfortable and confident movement.
Should I Stop Exercising If I Have Knee Pain?
Not necessarily.
For many non-traumatic knee conditions, complete inactivity can contribute to reduced muscle strength, lower exercise tolerance, and decreased confidence in movement.
Instead, activity may need to be modified temporarily.
For example, someone with painful running may tolerate cycling, walking, or carefully selected strengthening exercises.
The appropriate level of activity depends on the diagnosis, symptom severity, and individual circumstances.
A gradual and individualized return to exercise is often preferable to prolonged avoidance.
When Should You Seek Medical Attention for Knee Pain?
Seek prompt medical assessment if you experience:
Significant swelling following an injury
Inability to bear weight
Visible deformity
A locked knee
Fever with a hot, swollen joint
Sudden severe pain
Progressive neurological weakness
Significant redness, warmth, or unexplained swelling
A hot, swollen joint accompanied by fever may indicate a serious condition requiring urgent medical evaluation.
For persistent but non-urgent knee pain, a musculoskeletal assessment can help identify likely contributing factors and appropriate treatment options.
How Is Knee Pain Diagnosed?
A comprehensive assessment is essential because different knee conditions can produce overlapping symptoms.
During an evaluation, I consider several components.
1. Medical History
Understanding the onset of symptoms, previous injuries, activity levels, and aggravating movements.
2. Pain Location and Behavior
Determining whether pain is located around the kneecap, inside the joint, along the tendons, or elsewhere.
3. Range of Motion
Evaluating knee bending and straightening.
4. Muscle Strength
Assessing the quadriceps, hamstrings, hip muscles, and other relevant muscle groups.
5. Orthopedic Testing
Using appropriate clinical tests when ligament, meniscal, or other structural involvement is suspected.
6. Functional Assessment
Evaluating activities such as:
Walking
Squatting
Stair climbing
Single-leg balance
Running or jumping when appropriate
7. Assessment of Other Regions
Examining the hip, ankle, or lumbar spine when the presentation suggests their involvement.
Imaging may be useful in selected cases, but an MRI is not automatically necessary for every patient with knee pain.
Can Osteopathy Help Knee Pain?
Osteopathic treatment may be appropriate for selected patients with musculoskeletal knee pain.
However, treatment should not rely exclusively on manual techniques.
Depending on the diagnosis and clinical findings, management may include:
Joint mobilization
Soft-tissue techniques
Therapeutic exercise
Progressive strengthening
Movement rehabilitation
Activity modification
Patient education
Return-to-sport planning
For conditions such as patellofemoral pain and knee osteoarthritis, exercise-based rehabilitation is particularly important.
Manual therapy may be considered as an additional tool when appropriate, rather than a replacement for active treatment.
Why Choose Dr. Anthony El Asmar for Knee Pain Treatment in Lebanon?
Patients searching for the best osteopath or physiotherapist in Beirut or Lebanon should look for a practitioner who combines clinical experience, a detailed assessment, evidence-informed treatment, and individualized rehabilitation.
Dr.Anthony El Asmar, DPT, DO, MSc, is an osteopath and Doctor of Physiotherapy with more than 13 years of clinical experience in musculoskeletal assessment, manual therapy, and rehabilitation.
He also teaches osteopathy and manual therapy at the university level.
His clinical approach focuses on understanding the patient's condition rather than applying the same treatment to every individual.
Depending on the clinical presentation, treatment may combine osteopathic manual therapy with physiotherapy-based exercise and rehabilitation.
The objective is to help patients improve movement, restore function, and return to their normal activities with greater confidence.
Frequently Asked Questions About Knee Pain
Why does my knee hurt when I go upstairs?
Pain when climbing stairs can occur with patellofemoral pain, osteoarthritis, tendon-related disorders, and other knee conditions. A clinical assessment helps identify the likely cause.
Can knee pain come from the hip?
Yes. Some hip disorders can produce referred pain around the knee. This is one reason why a complete musculoskeletal examination may include the hip and lower back.
Can an osteopath treat knee pain?
Osteopathic treatment may help selected patients, particularly when combined with appropriate exercise, education, and rehabilitation. Treatment depends on the diagnosis.
Do I need an MRI for knee pain?
Not always. Many knee conditions can initially be evaluated through a clinical examination. Imaging is considered when it may clarify the diagnosis or influence treatment decisions.
Is walking good for knee osteoarthritis?
Walking is generally a beneficial form of physical activity for many people with knee osteoarthritis. The amount and intensity may need to be adjusted according to symptoms and individual capacity.
Who should I consult for knee pain in Beirut?
A qualified physiotherapist or osteopath experienced in musculoskeletal assessment can evaluate many common knee conditions. Significant trauma, suspected fracture, serious instability, or other warning signs may require medical or orthopedic evaluation.
Knee Pain Treatment in Beirut and Lebanon
Whether you experience knee pain while walking, climbing stairs, squatting, running, or performing daily activities, understanding the cause is essential.
Knee pain does not always mean that something is permanently damaged, and many common knee conditions respond well to appropriate conservative management.
Anthony El Asmar, DPT, DO, MSc provides individualized osteopathic and physiotherapy-based assessment and treatment for musculoskeletal conditions in Lebanon.
Therapy by Anthony El Asmar
Clinic locations: Achrafieh • Dekwaneh • Jezzine, Lebanon
Areas of clinical practice: Knee Pain • Shoulder Pain • Neck Pain • Lower Back Pain • Sciatica • Sports Injuries • Musculoskeletal Rehabilitation
Book your knee assessment to better understand your symptoms and determine an appropriate treatment and rehabilitation plan.
About the Author
Anthony El Asmar, DPT, DO, MSc is an osteopath, Doctor of Physiotherapy, and university lecturer with more than 13 years of clinical experience. His clinical work focuses on musculoskeletal pain, osteopathy, manual therapy, clinical reasoning, and functional rehabilitation in Lebanon.