Which ligament in the knee is most painful when climbing stairs?

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From the Guidelines

The patellofemoral ligament is most painful when climbing stairs, particularly in individuals with patellofemoral pain syndrome. This condition is characterized by pain around or behind the patella, especially during activities that load the patellofemoral joint like climbing stairs, squatting, or jumping 1. The pain occurs because the patellofemoral joint is subjected to significant force when the quadriceps muscle contracts to straighten the knee during stair climbing. Key factors to consider in managing patellofemoral pain include:

  • Delivering knee-targeted exercise therapy, with supportive interventions as required 1
  • Education should underpin all interventions, adjusted to reflect the needs of the person 1 Treatment typically includes rest, ice, anti-inflammatory medications, and physical therapy focusing on strengthening exercises. Proper footwear with good support and temporarily reducing activities that cause pain are also important. The pain occurs because repetitive stress creates inflammation and degeneration of the joint tissues over time. In terms of specific exercises, knee-targeted exercise therapy has been shown to be effective in managing patellofemoral pain 1. It is essential to note that the management of patellofemoral pain should be individualized, taking into account the person's specific needs and circumstances.

From the Research

Knee Ligament Pain When Climbing Stairs

  • The ligament in the knee most associated with pain when climbing stairs is related to patellofemoral pain syndrome (PFPS) 2, 3, 4, 5, 6.
  • PFPS is characterized by pain in or around the anterior knee that intensifies when the knee is flexed during weight-bearing activities, such as climbing stairs 4.
  • The pain of PFPS often worsens with prolonged sitting or descending stairs, and the most sensitive physical examination finding is pain with squatting 4.
  • While the studies do not specifically mention a particular ligament, they suggest that the pain is related to imbalances in the forces controlling patellar tracking during knee flexion and extension, particularly with overloading of the joint 2.
  • Risk factors for PFPS include overuse, trauma, muscle dysfunction, tight lateral restraints, patellar hypermobility, and poor quadriceps flexibility 2, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Management of patellofemoral pain syndrome.

American family physician, 2007

Research

Patellofemoral Pain.

Physical medicine and rehabilitation clinics of North America, 2016

Research

Patellofemoral Pain Syndrome.

American family physician, 2019

Research

Patellofemoral pain syndrome.

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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