This will be somewhat technical, so feel free to take your time. If you experience knee or lower back pain when you climb stairs, the following information could be very helpful for you. The purpose of this post is to break down the technique of stair-climbing in order to promote harmonious and efficient movement patterns, built on a foundation of good leverage.
In terms of what moves your body from one step to the next, there are two main actions performed in stair climbing: hip extension (where you pull the thigh back and down, away from your torso) and knee extension (where you straighten the leg at the knee joint). Of course, when you move the other leg forwards to the next step, you are flexing at the knee and the hip, but the actions that actually move your body up the staircase are extension and extension. You straighten the knee, and straighten the hip, and this moves your body through space. It is easy not to think in these terms, because as we move forward we think of the leg that is moving forward, but of course it is the leg that remains on the ground that propels our body forwards and in this case upwards, and it is in the action of this leg that we see either efficient or inefficient movement patterns expressed.
For the sake of simplicity, you can think of it this way: extension occurs when a joint opens, and flexion occurs when it closes. For whatever reason, many of us rely more on knee extension than deriving power from the hips and buttocks, which is to our detriment. Many of us have weak buttocks, relative to our thigh muscles, but as to why this is? There are many theories, ranging from too much sitting, to too much imbalanced sports-playing, to tightness in the hip flexors, to anxiety, to haste, to the tendency we have to forget about the parts of our bodies that aren’t on the front of us. Out of sight, out of mind, perhaps?
One may feel too heavy to climb stairs, or too unfit when confronted with a tall staircase, but it is not actually an issue of size, though it may be one of fitness and function. We have a tendency to think that if we were lighter, things would be easier – but relative weakness and joint dysfunction can occur at any weight. Athletes talk about your power-to-weight ratio, which may be good or poor; to improve this you can focus either on getting stronger or lighter, and I would always choose strength. Strength is a relatively predictable and reliable consequence of structured training, whereas lightness is always at best a maybe.
And if you focus on improving strength, function and leverage, you don’t need to just wait and hope that losing weight will fix all your problems, you can sink your teeth into something tangible - you can work on improving your movement patterns, body awareness and muscular strength. This gives you something to do while you are training. Training then becomes something, it’s not just random movement time, and step-ups become a more obviously practical exercise.
If you think about stair-climbing, it is remarkably common for us humans to just pitch the torso forwards at the hips, shortening the hip flexors, and after placing our foot on the next step, we basically extend the knee to press our body onwards and upwards. As pictured to the left, the hip joint moves very little, and so it becomes a knee-dominant movement pattern. Relative to the hip, the knee is a very small joint, and if you can imagine practicing a one legged, full bodyweight knee extension – it’s actually a very difficult and problematic exercise, even if your thigh muscles are strong.
Also, as indicated by the arrow, when you are leaning forward, force from the interaction between your thigh and the ground drives up into the lower back, as opposed to dissipating through the body. Climbing stairs in this way can lead to excessive pressure in the knees and lower back, which can manifest as pain.
If, however, you climb stairs with a hip-dominant movement pattern, you bear the weight of the body through two joints, and the primary mover becomes the large and muscular hip joint, as opposed to the relatively unstable knee joint.
You will observe in this picture that the back remains vertical. This means the forces from the thigh don’t just press into the lower back, they dissipate through the torso. Also, you’ll notice that the shin is more vertical, and this reduces stress in the knee joint and the demand placed on the front-thigh muscles, the quadriceps. Ultimately, you are relying more on the muscles of the buttocks and hamstrings, which can provide you with significantly more power, even if at first, you feel weaker because you are relying on muscles that aren’t used to working like this.
This exercise has now become a hip-dominant movement pattern. Even though the knee is still working, because of the vertical position of the shin and the increased range of motion of the hip, the buttocks will power your movement much more than they did before, taking pressure away from the knee and lower back. And when this movement is powered by the larger buttocks, and the knee acts as a kind of assistant-joint, it means the weight of your body is borne fairly over two joints, with the larger one taking on most of the work.
For the purposes of this essay, the ankle is not terribly relevant, other than to mention that our tendency with our knee-dominant movement patterns is to place only the ball of the foot on the next step, which is only a small portion of the foot, and does not provide us with as much leverage or stability as we can get if we place the entire foot on the step and apply force through the heel. Of course there might not be enough room for your entire foot, but if the foot is flat, and you are pressing through the whole thing, you increase stability, and therefore your capacity to apply leverage.
So – to reduce stress and pain in the knee, the best way to climb stairs is this – keep your body upright, try not to lean forward, place your entire foot on the next step, apply force through the heel, and focus on pulling your heel backwards behind your body as you straighten your leg to move your body up the staircase.
Focusing on driving the heel down also helps to engage the buttocks. As you do so, set your intention to extend the hip before extending the knee, if you can. In reality, the joints move almost simultaneously, but focusing more on the hip will take pressure away from the knee.
If you can, hold onto the hand-rail. Another dynamic that keeps us leaning forwards while climbing stairs is the fear of falling backwards. Do not allow yourself to fall backwards down a staircase! Be patient, and as safe as you can.
As you fatigue, as the muscles of the buttocks fatigue, the old movement pattern will start to re-emerge. Which is totally okay, this is simply what happens when muscles get fatigued - you automatically rely on other muscles. This is why we train - to build up strength, power and endurance over time, so that we can become better at moving.
For those of you who would like a slightly deeper degree of detail – when you place your foot on the step in front of you, try not to let your knee collapse inwards. If your knee collapses inwards, this is because of a lack of strength through the hip in terms of external rotation, which also comes down to the muscles of the buttocks. If you can keep the knee pointing forwards, aligned with the toes, or even a little out to the side, this will help to improve stability of the knee and further activate the muscles of the buttocks.
The same is true with squatting – if you experience knee pain, keeping weight on your heels and pulling the knees away from each other, rather than allowing them to collapse inwards, is likely to help minimise discomfort by increasing the participation of the buttocks in completing the exercise.
Initially, you might not be able to climb stairs this way. If your hips/buttocks are weak, this will certainly be more fatiguing than the movement pattern you are used to – which you have been practicing for years. But over time, if you can strengthen your hip and hamstring muscles, you will find that applying leverage through the buttocks and hip makes for a much stronger action, and you become more resistant to fatigue, because you are not relying solely on the muscles of your thigh to get you up to the next step. You are distributing that workload more evenly through your body.
If you feel the need to work on the strength of your buttocks by themselves, or if you are simply curious, it is worthwhile working hip lift/glute bridge exercises into your training sessions. They will help to improve strength and muscular awareness in your buttocks and hips.
Over time, you can challenge yourself to develop more strength by attempting the same stair-climbing technique on higher steps or benches. The higher the step, the more you are required to take your hip through a greater range of motion, and the more you learn to active – and derive power from – the buttocks. Also, you can practice step-up exercises holding onto weights, or carrying a heavy backpack, or something of the like.
In my experience training a variety of individuals mostly in the wide age range of 40 to 70, this is a very effective fix for many cases of knee pain that occur while ascending stairs. It will not accommodate for all causes of knee pain, nor will it start to fix your problems right away, but as your buttocks strengthen, and as you become more familiar with the movement, you will give your body a chance to adapt and recover. Of course, for many people, descending stairs is actually more difficult. But whatever your pain or dysfunction might be, it is worth investigating these movements thoroughly, while bringing your awareness and patience to the task at hand.
If you have any questions, please post them below and I will try to respond in a helpful manner.
Update! February 2017. I have made a companion video to this post, if you have found this to be a helpful read, and yet you remain curious, please check it out here.