‘Good goes up, bad goes down’: What this simple stair rule means for knee pain

‘Good goes up, bad goes down’: What this simple stair rule means for knee pain

Orthosurgeon Dr Kshitij Soni recently explained how people with knee pain can use stairs while putting less strain on the affected joint. In a video, he shared a simple mnemonic to remember the technique: “good goes to heaven, bad goes to hell.”

“For bad knees, remember this mnemonic whenever you have knee pain and you have to climb stairs,” he said on Instagram.

“What it means is, when you are going upstairs, always use your good knee first, and when you are climbing downstairs, use your bad knee first. What it does is, it decreases the load that stair climbing puts on your knees, and your knee pain will not be aggravated because of stair climbing.”

But does this technique actually reduce the stress placed on a painful knee? According to Dr Gaurav Prakash Bhardwaj, Director – Sports Injury, Joint Preservation & Replacement Surgery, PSRI Hospital, the technique can help reduce the load on a painful knee, although it does not address the underlying cause of the pain.

Why should your stronger leg lead while going upstairs?

“Yes. The often recommended rule, ‘good leg up, bad leg down,’ can help to reduce the load on a painful knee,” Dr Bhardwaj tells indianexpress.com.

When climbing upstairs, the leading leg has to help lift the body’s weight onto the higher step. Using the stronger or less painful leg first allows it to take on more of this work.

“When going upstairs, the leading leg is the stronger leg, and it can take more of the body weight and push the body upward,” he explains.

Why is going downstairs harder on painful knees?

“Normally, going down stairs puts more stress on the knee as the muscles around the knee have to slowly control the drop of the body,” Dr Bhardwaj explains.

This involves what is known as an eccentric contraction, where muscles remain active while lengthening to control movement. The process can increase compressive forces within the knee, particularly around the kneecap.

“You have to use force to lift your body up to get up the stairs but for many people with knee arthritis or knee pain going down the stairs is more painful and makes you feel more unsteady,” he says.

That is why placing the painful leg down first can be useful. “When you are coming down, putting the painful leg down first can decrease the amount of force and control that is required from that knee,” Dr Bhardwaj says.

Should you avoid stairs if you have osteoarthritis?

“Individuals with mild, stable knee pain can often safely use stairs if they are careful and their symptoms remain manageable,” Dr Bhardwaj tells us.

In fact, completely avoiding stairs and other forms of movement may have its own downside. “If you never take the stairs, you may also lose muscle strength over time,” he adds.

However, there are situations where stairs should not simply be pushed through. Dr Bhardwaj recommends limiting stair use and seeking an orthopaedic evaluation if you experience significant knee pain, swelling, repeated knee buckling or instability.

“The amount of stair activity you should do depends on the severity and cause of the knee problem,” he says.

How to climb stairs if your knees hurt

Dr Bhardwaj recommends several other precautions:

Use the handrail: “It is good to use the handrail, it supports and takes the load off the knees,” he says. Holding the railing can provide additional stability and reduce some of the load placed on the knees.

Take one step at a time: If the pain is significant, you don’t necessarily have to use an alternating step pattern. “Those with great pain may use the stairs one step at a time, bringing both feet to the same step before going to the next,” Dr Bhardwaj explains.

Wear supportive footwear: Shoes that provide adequate support can make movement more comfortable and improve stability.

Avoid sudden twisting: Take your time on the stairs and avoid abrupt twisting or pivoting movements, which can place additional stress on the knee.

Consider a walking aid if needed: For severe pain, a walking aid may sometimes be appropriate, but Dr Bhardwaj says this should be recommended by an orthopaedic specialist or physiotherapist based on the individual’s condition.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.