Knees
What exercises help with knee pain, including on stairs
Pain on the stairs is a common way activity-related knee pain shows up. When that pattern is osteoarthritis, NICE says to offer therapeutic exercise such as local muscle strengthening. A Cochrane review found land-based exercise reduced knee pain compared with not exercising.
This isn’t a workout to push through. It watches how your body responds and adjusts as it goes.
Before you start
This is general movement information, not a diagnosis. Stop and get the knee assessed if it locks, gives way, swells, will not take your weight, or the pain followed a twist or a fall. Stop and speak to a clinician if a movement brings on sharp pain, dizziness, or symptoms that travel down an arm or a leg, and seek urgent care for any loss of bladder or bowel control or numbness around the saddle area.
This is the version everyone gets. Yours is different.
Start your first sessionStairs are a clue, not a diagnosis
NICE says osteoarthritis is recognised clinically in people 45 or over who have activity-related joint pain, with either no morning stiffness or stiffness that lasts no longer than 30 minutes. Climbing stairs is activity. It does not, by itself, prove osteoarthritis, and this page cannot tell you why your knee hurts.
What to offer when it is osteoarthritis
For all people with osteoarthritis, NICE says to offer therapeutic exercise tailored to the person. The examples it names are local muscle strengthening and general aerobic fitness. It also says joint pain may increase when exercise starts, and that regular, consistent exercise is beneficial for the joints.
A Cochrane review of land-based exercise for knee osteoarthritis found pain lower by about 12 points on a 100-point scale and physical function better by about 10 points, right after the programmes, compared with not exercising.
Why the sequence is mostly strength
A knee that complains on stairs is being asked to control a step. Sit to stand is that pattern, done slowly from a chair. A shallow chair pose and a straightening hold train the thigh. A side-lying clamshell trains the hip that keeps the knee from dropping inward. None of this is a promise about your stairs. It is the kind of exercise the guideline names.
The sequence
- 1
One knee toward the chest · 30 to 60 seconds each side
Bends the knee with no weight on it, so you can see what range is comfortable before you load it.
- 2
Seated knee straightening · 10 slow holds each side
The thigh muscle controlling the last part of straightening, which is the work a step asks for.
- 3
Clamshell · 30 to 60 seconds each side
Side-lying work for the muscle on the outside of the hip that helps the knee track.
- 4
Heel raise · 30 to 60 seconds, lowering slowly
The calf controls how a step loads the knee. The slow lowering is the useful half.
- 5
Shallow chair pose · 30 to 60 seconds
A small squat. Less depth if the knee complains. The knee stays in line with the middle of the foot.
- 6
Sit to stand · 8 slow repetitions
The same pattern as a step, done from a chair so you can control the lowering.
Work only in a range that stays tolerable. NICE notes that pain can rise when exercise starts, and that consistent exercise is still what it recommends for osteoarthritic joints. Sharp pain, giving way or swelling is a reason to stop and get the knee seen.
That sequence was written for everyone with this. Yours would be built around your answers.
Start your first sessionWhat the research says
NICE NG226 (2022) says to diagnose osteoarthritis clinically in people 45 or over with activity-related joint pain and either no morning joint stiffness or morning stiffness lasting no longer than 30 minutes.
The same guideline says to offer therapeutic exercise tailored to the person for all people with osteoarthritis, for example local muscle strengthening and general aerobic fitness, and to advise that joint pain may increase at the start while regular consistent exercise remains beneficial for the joints.
Fransen et al., Cochrane review in the British Journal of Sports Medicine (2015), found land-based therapeutic exercise reduced knee pain by about 12 points per 100 and improved physical function by about 10 points per 100 immediately after treatment, compared with non-exercise controls.
Sources
- 1NICE NG226, osteoarthritis in over 16s (2022), recommendation 1.1.1
Osteoarthritis is diagnosed clinically in people 45 or over with activity-related joint pain and either no morning joint-related stiffness or morning stiffness lasting no longer than 30 minutes; prolonged morning stiffness is listed as an atypical feature.
- 2NICE NG226, osteoarthritis in over 16s (2022), recommendations 1.3.1 and 1.3.3
Offer therapeutic exercise tailored to the person for all people with osteoarthritis, and advise that joint pain may increase when starting it while regular consistent exercise remains beneficial for the joints.
- 3Fransen et al., exercise for osteoarthritis of the knee, Cochrane systematic review (British Journal of Sports Medicine, 2015)
Land-based therapeutic exercise reduced knee pain by 12 points per 100 and improved physical function by 10 points per 100 immediately after treatment, with benefit sustained for at least 2 to 6 months after formal treatment ended.
Common questions
What exercises help with knee pain?
For osteoarthritic knees, NICE recommends therapeutic exercise such as local muscle strengthening, not a single stretch. A Cochrane review found land-based exercise reduced knee pain compared with not exercising. Sit to stand, a shallow squat and a straightening hold are that kind of work.
What helps knee pain when climbing stairs?
Stairs are activity, and activity-related joint pain is part of how NICE describes osteoarthritis in people 45 and over. The exercise it recommends is strengthening and general fitness, tailored to the person. Sit to stand practises the same up-and-down pattern with a chair for control. This page cannot say why your knee hurts on stairs.
Should I rest a painful knee?
NICE says joint pain may increase when therapeutic exercise starts, and that regular consistent exercise is beneficial for osteoarthritic joints. Rest is not the recommendation. Stop and get assessed if the knee gives way, locks, swells, or will not take your weight.
Is stretching enough for knee pain?
Not on the evidence used here. NICE names local muscle strengthening and aerobic fitness as the examples of therapeutic exercise. Stretching the neighbours of the knee can be comfortable, and the strengthening page linked below is the other half.
When should knee pain be checked?
Get the knee seen if it locks, gives way, swells quickly, will not take your weight, or the pain followed a twist or a fall. Morning stiffness that lasts longer than 30 minutes is an atypical feature in the NICE osteoarthritis description and is worth mentioning.
This is the version everyone gets. Yours is different.
Start your first sessionAlso called what exercises help with knee pain, exercises for knee pain on stairs, knee pain climbing stairs exercises, what to do for knee pain when climbing stairs, gentle knee exercises at home, exercises for activity-related knee pain. Movements are drawn from the clinically authored Vinys library. This page is general movement information, not medical advice, and it is not a diagnosis. How the method works.