Knee Pain During Squats, Running or Stairs: Where Should You Look?
Your knee feels fine most of the day.
Then you squat.
Or run.
Or walk down a flight of stairs.
And suddenly, there it is again.
Knee pain during exercise is incredibly common, but that doesn't mean you should simply accept it as part of being active. It also doesn't mean there's necessarily something structurally "wrong" with your knee.
For runners, lifters, CrossFit and HYROX athletes, and active adults, knee pain can be influenced by more than what's happening directly at the knee.
The better question isn't always:
"What's wrong with my knee?"
Sometimes it's:
"What is making this particular movement difficult for my knee to tolerate right now?"
Why Does My Knee Hurt When I Squat?
A squat asks your entire lower body to work together.
Your ankles need to move. Your knees need to bend. Your hips need to contribute. Your muscles need to produce and control force. And your body needs enough capacity to tolerate whatever load you're asking it to handle.
If your knee hurts when you squat, there are several things worth considering:
How much weight you're using
How deep you're squatting
Your current training volume
Ankle mobility
Hip strength and control
Quad strength
Your stance and squat variation
Previous injuries
How quickly your training has progressed
Your overall recovery between workouts
That doesn't mean every person with knee pain has a mobility restriction or weak muscle somewhere. It means context matters.
If you can perform a bodyweight squat comfortably but develop pain with a heavy barbell, that's useful information. If your knee hurts during a deep squat but feels fine with a slightly reduced range of motion, that's useful too. Rather than labeling the movement as "bad," we can start looking at what changes the symptoms.
What About Knee Pain While Running?
Running presents a different challenge. Instead of producing force through a controlled repetition, your body is repeatedly absorbing and producing force over hundreds or thousands of steps. Your knee may tolerate a two-mile run perfectly well but become painful at mile five. Or maybe you were running three days a week without a problem, increased your mileage or speed work, and suddenly your knee started bothering you.
That doesn't necessarily mean running damaged your knee. Sometimes the issue is simply that training demand increased faster than your current capacity to tolerate it.
When evaluating knee pain in a runner, we may want to consider:
Recent mileage changes
Running frequency
Speed or hill work
Strength training
Previous injuries
Recovery between runs
Hip and lower-extremity strength
Ankle and foot function
Running mechanics
Footwear changes
The goal isn't to identify one body part to blame. It's to understand the combination of factors that may be influencing your symptoms.
Why Does My Knee Hurt Going Up or Down Stairs?
Stairs can expose knee symptoms even when other daily activities feel completely normal.
Going upstairs requires your leg to generate force to move your body upward. Going downstairs requires your muscles to control your body as you lower yourself. Both increase the demand placed on the knee compared with level walking. That's why someone may say: "I can walk all day without a problem, but stairs bother me every time." Again, that's useful information. It tells us something about the type and amount of load your knee currently tolerates. Rather than simply avoiding stairs, squats, or running indefinitely, the goal is to understand why those higher-demand activities are provoking symptoms and determine how to progressively rebuild tolerance.
Don't Forget About the Ankle and Foot
The knee doesn't work in isolation. Your foot, ankle, knee, and hip all contribute to how you move. For example, ankle dorsiflexion—the ability of your ankle to move forward over your foot—is part of a normal squat, stair descent, and running stride. If that motion is limited, your body will still find a way to complete the task. The strategy may simply look different. This doesn't mean a stiff ankle automatically causes knee pain. It does mean that if someone repeatedly develops knee symptoms during movements that require significant ankle motion, the ankle is worth evaluating too. We talk more about this relationship in Rooted: The Source of Pain — Ankle & Foot, where we look at why symptoms farther up the leg can sometimes make more sense when we evaluate how the entire lower extremity is moving.
It's Not Always About Stretching
When something hurts or feels tight, stretching is often the first thing people try.
You stretch your quads.
Then your hamstrings.
Then your calves.
Maybe your hips.
And sometimes that feels great.
But if the knee pain keeps returning every time you squat or run, doing more stretching may not address what is actually limiting you. Mobility matters, but so do strength, control, training load, recovery, and your ability to tolerate the demands of a specific activity. As we discuss in It's Not a Stretching Problem — It's a Movement Problem, the goal isn't simply to become more flexible. It's to have the mobility, strength, and control necessary for the things you want your body to do.
Does Knee Pain Mean I Need to Stop Exercising?
Not necessarily. There are certainly situations where an injury requires rest, medical evaluation, or temporary restrictions. But knee pain doesn't automatically mean you need to stop moving altogether. Often, we can learn a lot by determining what your knee can tolerate.
Maybe:
Running hurts, but cycling doesn't.
Deep squats hurt, but squatting to a box feels fine.
Heavy squats hurt, but lighter loads don't.
Downhill running bothers you, but flat running doesn't.
Walking is comfortable, but running isn't.
Split squats feel better than bilateral squats.
Those differences aren't just workarounds. They're information. Temporarily modifying an activity can allow you to continue training while you address the factors contributing to your symptoms.
Depending on the situation, that might mean adjusting:
Load
Volume
Range of motion
Exercise selection
Running mileage
Running intensity
Training frequency
The goal isn't to find increasingly creative ways to ignore pain. The goal is to maintain as much meaningful activity as possible while progressively improving what your knee can tolerate.
When Should Knee Pain Be Evaluated?
Consider having your knee evaluated if:
Pain keeps returning with the same activities
You're regularly changing your workouts because of your knee
Running mileage is becoming increasingly limited
Squatting consistently causes symptoms
Stairs are becoming difficult
You notice swelling
Your range of motion has changed
You feel instability, locking, or catching
Symptoms aren't improving despite reasonable modifications
Knee pain is beginning to affect normal daily activities
A significant traumatic injury, inability to bear weight, substantial swelling, obvious deformity, a locked knee, or significant new weakness or neurological symptoms warrants prompt medical evaluation.
What Does a Movement-Based Knee Evaluation Look At?
At Pillar Health Co., the goal isn't simply to find the painful spot and treat it.
We want to understand what your knee is having difficulty tolerating and why.
Depending on your symptoms and goals, an evaluation may include:
Knee range of motion
Hip strength and control
Quad strength
Ankle mobility
Foot and ankle function
Squat mechanics
Single-leg movements
Running-related movements
Previous injury history
Current training volume
The specific exercise or activity that produces symptoms
If squatting causes your pain, we want to see how you squat.
If running is the problem, your running history and training load matter.
If stairs are the only thing that bothers you, that matters too.
Your treatment plan should reflect what we actually find rather than assuming every person with knee pain needs the same treatment.
That may include a combination of hands-on treatment, chiropractic care, soft-tissue techniques, mobility work, progressive strengthening, rehabilitation exercises, and modifications to your current training.
Our Chiropractic Care & Sports Rehabilitation approach is built around helping active people stay active while improving their ability to tolerate the movements and activities that matter to them.
Your Knee Doesn't Exist in Isolation
Knee pain can be frustrating—especially when you're still able to do most things but one particular movement keeps bringing it back.
You don't necessarily need to stop squatting.
You don't necessarily need to stop running.
And you don't necessarily need to accept that your knees are "just bad." Sometimes the most useful thing we can do is look at the whole movement, understand the demands you're placing on your body, and identify what changes your symptoms.
That's also a central part of how we approach Sports Chiropractic: Why Athletes Are Turning to Chiropractic Care for Performance and Recovery: looking beyond the location of pain to consider movement, strength, training demands, recovery, and the goals of the individual athlete.
If knee pain is interfering with your workouts, running, or everyday activities, a movement-based evaluation can help identify what may be contributing to it and determine how to keep you moving forward.
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