Knee Pain While Climbing Stairs or Squatting? What a Physiotherapy Assessment Looks For

Does your knee hurt when you climb stairs, get up from a chair, squat at the gym or walk downhill?

It can be tempting to assume that your knee is “weak” or that something inside the joint is damaged.

But knee pain can have several possible causes, and the activity that triggers the pain is only one part of the picture.

Pain around the front of the knee, for example, can sometimes become noticeable during activities such as stair climbing, squatting, running or prolonged sitting. These movements are also commonly used during clinical assessment because they place greater demand on the knee.

The right starting point is therefore not to guess the diagnosis.

It is to understand where the pain is, when it occurs, what changed before it started and how your knee is functioning.

At O2Revive, Hinjawadi:

We Assess First. We Recommend Only What You Need.

Why Does My Knee Hurt While Climbing Stairs?

Climbing or descending stairs places more demand on the knee than level walking.

If your knee is currently sensitive to load, you may notice symptoms particularly when:

• Going upstairs

• Coming downstairs

• Getting up from a low chair

• Squatting

• Lunging

• Running

• Jumping

• Walking uphill or downhill

• Sitting with the knee bent for a long time

These symptoms do not automatically point to one specific diagnosis.

Possible contributing factors may include:

• A sudden increase in physical activity

• Starting or increasing running

• More squats or lunges at the gym

• Reduced strength or exercise capacity

• Changes in training frequency

• Previous knee injuries

• Reduced tolerance to repetitive loading

• Changes in hip, knee or ankle movement

• Tendon-related irritation

• Joint-related conditions

• Age-related changes in some individuals

The same symptom can have different explanations in different people.

That is why an assessment matters.

Does Knee Pain While Squatting Mean Something Is Damaged?

Not necessarily.

Pain during a squat tells us that the knee is currently sensitive during that movement.

It does not, by itself, tell us why.

A physiotherapist may want to understand:

• Where exactly you feel the pain

• At what depth of the squat it begins

• Whether reducing the depth changes the symptoms

• Whether the pain occurs with bodyweight or only with added weight

• Whether one knee behaves differently from the other

• Whether your symptoms change with foot position

• Whether you have swelling

• Whether the knee feels unstable

• Whether the pain began after an injury

The squat can therefore be useful as an assessment movement, not simply something that must always be avoided.

Why Did My Knee Pain Start Suddenly After Gym or Running?

Sometimes knee pain appears after a clear injury.

At other times, there is no single incident.

Instead, the body may have experienced a change in workload.

For example:

You were running 5 km once a week and suddenly started running four times a week.

You returned to the gym after several months and immediately restarted heavy squats.

You added badminton or football on top of an already busy training week.

You increased your running distance and speed at the same time.

In these situations, the issue may sometimes involve the knee being exposed to more demand than it is currently prepared to tolerate.

This does not mean exercise is harmful.

It means the amount, intensity and progression of exercise may need to be reviewed.

Should I Stop Exercising If My Knee Hurts?

Not automatically.

The appropriate response depends on the cause and severity of your symptoms.

For some people, completely stopping activity may not be necessary.

Instead, rehabilitation may involve temporarily modifying the exercise and gradually building capacity again.

For example, depending on the assessment, this might mean changing:

• Squat depth

• Weight used

• Number of repetitions

• Running distance

• Running frequency

• Jumping volume

• Training days

• Exercise selection

Exercise is also a core component of management for conditions such as knee osteoarthritis, with NICE recommending therapeutic exercise tailored to the individual, including strengthening and general aerobic exercise.

The key word is tailored.

Doing random knee exercises is not the same as following an appropriate rehabilitation plan.

When Should You See a Physiotherapist for Knee Pain?

A physiotherapy assessment may be useful if your knee pain:

• Keeps returning

• Has lasted for several weeks

• Is gradually getting worse

• Limits stair climbing

• Makes squatting difficult

• Affects running or gym activity

• Stops you from playing sport

• Causes you to change how you walk

• Is associated with recurring swelling

• Makes the knee feel unstable

• Appeared after a change in training

• Improved temporarily but returned when activity increased

The earlier question should not necessarily be:

“Which treatment do I need?”

A better question may be:

“What is causing my knee to struggle with this activity?”

What Does a Physiotherapy Assessment for Knee Pain Look At?

A knee assessment usually involves more than checking the painful spot.

Depending on your symptoms, a physiotherapist may look at several areas.

Your Symptom History

You may be asked:

• When did the pain start?

• Was there an injury?

• Where exactly is the pain?

• Does the knee swell?

• Does it click?

• Does it lock?

• Does it give way?

• Which activities make it worse?

• What makes it feel better?

• Have you had knee pain before?

Your answers help guide the physical examination.

Your Knee Movement

A physiotherapist may assess how well your knee bends and straightens.

They may also look for:

• Pain during movement

• Stiffness

• Swelling

• Differences between sides

• Movements that reproduce your symptoms

Strength

Strength around the knee can be important for activities such as:

• Squatting

• Running

• Stair climbing

• Jumping

• Getting up from a chair

Depending on the problem, strength around the hips and lower leg may also be assessed.

Functional Movements

Instead of assessing the knee only while you are lying on a treatment table, your physiotherapist may ask you to perform movements related to your symptoms.

These may include:

• Squatting

• Single-leg squatting

• Step-ups

• Step-downs

• Walking

• Lunging

• Running

• Jumping

For some types of kneecap-related pain, squatting and stair activities are specifically useful in reproducing and assessing symptoms. (Orthoptics Australia)

Hip and Ankle Movement

Your knee works as part of a larger movement system.

Depending on your symptoms, an assessment may also consider movement and strength at the hip and ankle.

This does not mean every knee problem is caused by the hip or foot.

It simply means the whole movement pattern may be relevant.

Your Training Load

For active adults, this can be particularly important.

A physiotherapist may ask about:

• Gym frequency

• Running distance

• Recent increases in training

• Sports participation

• Exercise technique

• Recovery days

• Previous injuries

• Changes in footwear or training surface

This information can help identify whether your symptoms appeared after a significant change in physical demand.

Do You Need an MRI for Knee Pain?

Not every person with knee pain needs an MRI.

Imaging can be useful in particular situations, but it should not automatically be the first step for every painful knee.

For example, NICE advises that osteoarthritis can often be diagnosed clinically in appropriate patients without routine imaging, unless there are atypical features or another condition is suspected. (Nice)

Whether imaging is appropriate depends on your symptoms, history and clinical examination.

An assessment can help determine whether further medical investigation may be needed.

What Might Physiotherapy for Knee Pain Include?

Treatment should depend on what the assessment identifies.

Depending on the individual, knee physiotherapy may include:

• Education about the problem

• Activity modification

• Individualised strengthening

• Hip and knee exercises

• Mobility work where appropriate

• Movement retraining

• Gradual loading

• Balance or control exercises

• Guidance on squatting or running

• Return-to-sport progression

• Manual therapy where appropriate

• Home exercises

• Progress reviews

For patellofemoral pain, clinical guidance places particular emphasis on exercise targeting the hip and knee, while other interventions may be added when appropriate. (Orthoptics Australia)

The goal is not simply to make the pain disappear for a few hours.

The rehabilitation plan should help you gradually tolerate the activities that matter to you.

Why Does Knee Pain Sometimes Keep Returning?

A common pattern is:

Pain → rest → pain improves → return to full activity → pain returns

Rest may reduce symptoms temporarily.

But if the underlying activity demands have not changed—or the knee has not gradually rebuilt its capacity—the same problem may return when normal activity resumes.

A rehabilitation plan may therefore involve gradually increasing what the knee can tolerate.

For one person, the goal may be comfortably climbing office stairs.

For another, it may be squatting at the gym.

For someone else, it may be returning to running, badminton, football or cricket.

The goal matters because rehabilitation should prepare you for your actual life.

Knee Pain Among Active Adults in Hinjawadi

Hinjawadi has a large population of young professionals who balance desk-based work with evening gym sessions, running and recreational sport.

A typical week may involve:

Long work hours → limited movement → gym → weekend badminton or football → back to desk work

Sometimes physical activity changes dramatically between weekdays and weekends.

If knee pain appears during stairs, squats, running or sport, simply avoiding the painful activity forever may not be the most useful long-term approach.

An assessment can help determine what your knee currently tolerates and how activity may need to be progressed.

The O2Revive Approach to Knee Pain Physiotherapy in Hinjawadi

At O2Revive, we do not assume that everyone with knee pain needs the same strengthening routine.

We follow THE O2REVIVE METHOD:

ASSESS

Understand your pain, injury history, movement, strength, activity levels and goals.

PERSONALISE

Create a rehabilitation plan based on what the assessment identifies.

TREAT

Use appropriate physiotherapy and progressive rehabilitation strategies.

REVIEW

Track how your knee responds and modify the programme as your capacity improves.

This matters because someone wanting to walk without pain has different demands from someone preparing to return to running or heavy squats.

The treatment plan should match the person, not just the body part.

When Knee Pain Needs Urgent Medical Attention

Most knee pain does not require emergency care.

However, seek urgent medical assessment if:

• You cannot move the knee

• You cannot put weight through the leg

• The knee is badly swollen

• The knee has changed shape

• The knee repeatedly locks or gives way after an injury

• The knee becomes hot and red and you also have fever or feel unwell

These symptoms may require medical evaluation rather than self-treatment. (nhs.uk)

Frequently Asked Questions

Why does my knee hurt when climbing stairs?

Stairs increase the demand placed on the knee. Pain may have several possible causes, including kneecap-related pain, changes in training load, tendon problems, joint conditions or other factors. An assessment can help determine what is relevant in your case.

Why does my knee hurt during squats?

Squatting increases load through the knee as it bends. Pain during squatting can occur for several reasons, so the location of the pain, training history, strength and movement pattern should be assessed before deciding what treatment is needed.

Should I stop doing squats if my knee hurts?

Not necessarily. Depending on the problem, you may be able to temporarily modify squat depth, weight or volume rather than stopping completely. An assessment can help determine what is appropriate.

Can physiotherapy help knee pain?

Depending on the cause, physiotherapy may include strengthening, movement retraining, progressive loading, activity modification and education to help improve function.

Is knee pain always caused by weak muscles?

No. Strength may be one factor, but knee pain can have several contributing factors. Your activity levels, training changes, previous injuries, joint condition and movement demands may also matter.

How many physiotherapy sessions will I need?

There is no fixed number.

The frequency and duration of physiotherapy depend on the condition, assessment findings, goals and how you progress.

Can I continue going to the gym with knee pain?

Sometimes activity can continue with appropriate modifications. However, persistent, worsening or unexplained knee pain should be assessed before repeatedly training through it.

Knee Pain on Stairs or During Squats? Assess It First

If your knee keeps hurting during stairs, squats, running or gym activity, you do not necessarily need to stop everything you enjoy.

But repeatedly ignoring the problem or trying random exercises may not address why it keeps returning.

The better starting point is understanding:

What movement triggers the pain?

How much load can your knee currently tolerate?

Has your activity recently changed?

What does your knee need to return to normal activity?

At O2Revive, Hinjawadi:

We Assess First. We Recommend Only What You Need.

Move Better. Feel Better. Revive.

This article provides general educational information and does not replace an individual medical or physiotherapy assessment.