Will Knee Pain When Climbing Stairs Ever Get Better?

Okay, today we’re off to my equivalent of the mailbag, the comment section.

I got this one recently:

I have been dealing with patellofemoral pain syndrome for nearly 1 year. At the beginning I could not walk more than 2-3 km, I needed to rest to go on, could not run, and was scared to cycle. Now 1 year later there is no limited walking for me, I can run 8 km and there’s no problem with cycling but stairs are still a serious problem.
At the beginning I was doing squat, quad exercises etc. and these exercises were terrible for my knees and I stopped doing these. I started to walk 10-15 thousand steps every day and cycle 30 minutes 3-4 times a week as you said. When I use the stairs I feel pain.
So my knees feel okay now and I wonder whether I am gonna feel exactly normal in the future maybe 1 more year later. I mean, do I need to follow the same path further or could you suggest anything else for me?

First of all, I try to avoid suggesting things or giving advice. I’m not a doctor or physical therapist. But I can give you a few things to think about, and perhaps others on this site may want to chime in as well. I’m fortunate to have a pretty smart readership.

Second, congratulations! You may not think so, but you’ve made good progress in one year. You can run eight kilometers (about five miles for those of us in the U.S.), you can walk considerable distances apparently, and your knees handle cycling well. This is all very, very positive. I know, sometimes in the midst of what can be a long healing process, it’s easy to get discouraged. But you should take a moment and feel good about how far you’ve come.

Now, what comes next? This is always difficult, especially when it feels like you’ve reached a plateau. You don’t want to accidentally overstress your knees and move backwards. If you just continue to do the same things, but ramp up the intensity a little, will your knees heal to the point where you can feel comfortable on stairs again?

Maybe. Maybe not. The truth is, it’s just about impossible for me, or anyone, to guess based on the information you’ve supplied. Patellofemoral pain syndrome, I’m convinced, is a bogus, non-diagnosis. It doesn’t describe whatever is ailing your joints. It’s just your doctor’s fancy way of saying, “You have general knee pain that has no clear underlying cause.”

So what might you consider doing?

Well, you could stay on your current course, but start to slowly build up the intensity, especially of the cycling. Cycling builds strong leg muscles, which may be useful for navigating those stairs. Also it may thicken the cartilage under the kneecap; triathletes were found in a study to have thicker cartilage under the patella. I think cycling is the most likely reason (pure conjecture on my part, but I doubt it’s because of the swimming, and am skeptical about running having that effect either).

Or you might consider trying to do leg exercises, but in a completely different way. I wouldn’t do full-load squats if they bothered my knees. No way! But if you can get access to a Total Trainer, it allows you to do exercises at less-than-full body weight. That could enable you to build up your ability to better handle squatting (and stair climbing), but slowly. And, as I’ve written, with a little creativity, you can rig up something that will let you do squats in a way that doesn’t stress your knees too much. I did! See here.

Best of luck!