Stairs, Squats, and Getting Off the Floor Shouldn't Be the Hard Part of Your Day.
Hip and knee pain rarely arrives all at once. It starts as a twinge on the stairs, an ache at the bottom of a squat, or a long walk that turns sore by the end. You work around it, and one day you notice you've been working around it for a year. You don't have to.
Sound Familiar?
If any of these resonate, you're not imagining it, and you're not stuck.
In the knee
- Going down stairs hurts more than going up
- Kneeling, or pushing back up off the floor
- Standing up after you've been sitting a while
- A long walk that turns into an ache by the end
- Stiffness or puffiness the morning after a busy day
- Squatting, running, or lunging you've quietly stopped doing
In the hip
- Getting in and out of the car
- Sleeping on that side, or waking when you roll over
- A deep ache in the groin or the side of the hip after walking the dog
- The first few steps after you stand up from a chair
- Putting on socks and shoes
- An ache in the bottom of a squat or late in a run
These aren't signs of weakness. They're signs that your body needs a smarter approach, built around how you actually move and train.
Why It Keeps Coming Back
Knee pain in active adults is usually a capacity problem rather than damage, and the knee is often where it hurts, not where it started. The hip above it and the ankle below it decide how much force it takes on each step, which is why the stairs are usually the first thing to complain.
Hip pain tends to show up somewhere other than the hip: the groin, the outside of the thigh, or deep in the glute. The pattern people describe most is stiffness in the first few steps after sitting, which points to lost range rather than damage.
Both are treated the same way at Fortitude & Freedom Performance Therapy in Waukee, Iowa: find the real driver, restore the range the joint is missing, then load it rather than rest it. In Iowa you can start physical therapy without a physician referral.
Hip and knee pain usually settles down on its own. That's the part that makes it so easy to live with, and it's also the reason it returns. The pain fades when the demand drops, so a quiet week feels like progress. The tissue is no stronger than it was, so the next busy week starts the cycle again.
That is also why treating the sore joint on its own disappoints people. Work on the knee alone and you're working on the loudest joint in the chain, not always the one that set it off. It runs the other way too: a hip that can't control the leg usually shows up as a knee complaint long before it shows up as a hip complaint.
Most flares have a change behind them, and it's rarely a dramatic one. A new job on your feet, a house with more stairs than the last one, a fresh program, a big landscaping weekend. The tissue is asked for more than it has been trained for, and it complains.
The joint above and the joint below
Hip control changes what the knee absorbs. Ankle range changes what the knee absorbs. Both of them are quiet, neither of them hurts, and either one can keep a knee irritated for months.
How I treat hip pain without pulling you out of the gymStrength that quietly faded
Single-leg strength drops first and fastest, and nobody notices, because daily life lets you share the work between two legs. Stairs and curbs don't. That's why they're usually the first thing to hurt.
Read the runner's knee version of thisA change in volume you didn't count
In most cases I can find something in the four to six weeks before the pain started. It's almost never the thing people expect, and finding it changes the plan.
Read why squatting starts so many of theseWorking around it
Limping, avoiding that side, skipping the stairs. Every workaround protects the sore joint and loads something else instead, which is how one ache becomes two. The ache above the kneecap is a common second stop.
Read about the ache above your kneecapHow I Treat This
I treat the hip and the knee as one chain rather than two separate joints. Every visit is one-on-one with me in my gym in Waukee, and the plan is built to keep you moving while the tissue catches up. Individual results may vary.
A full chain exam: hip, knee, ankle, and trunk, plus the change in your week that came before the pain
Hands-on work to restore the range the joint is missing
Dry needling for the guarded muscles around the hip and knee, where it fits the case
A progressive strength plan that loads the tissue instead of resting it
Single-leg and step-down work, because stairs and curbs are where this shows up
Training changes so you keep walking, running, or lifting through the plan
How This Usually Goes
Knowing the shape of the plan up front makes it far easier to stick to, especially through the middle stretch that does the real work.
- 1
Visit one
A full exam of the hip, knee, ankle, and trunk, plus a walk through your last two months. We find the driver and the change that came before the pain, and you leave with something to do that day.
- 2
The first few weeks
Calm the irritated tissue and restore the range you're missing, using hands-on work and dry needling where it fits. Loading starts right away at a level you can handle, because waiting costs you strength.
- 3
The middle
Load goes up steadily, and single-leg work carries most of it. This is the least interesting phase and the one that decides how well it holds.
- 4
The end
Back to the stairs, the trail, or the barbell, with a maintenance dose of the two or three things that matter and a plan for adding volume without repeating the pattern.
Who This Is For
Waukee, Iowa, and the Des Moines metro around it. People who want the stairs, the trail, or the barbell back.
- Anyone whose knee complains on the stairs, the curb, or the way up off the floor
- Anyone whose hip aches after a walk, a long drive, or a night sleeping on that side
- People on their feet all day whose job changed before the pain did
- Runners and lifters from gyms around Waukee, Clive, West Des Moines, and Urbandale
- Parents and grandparents who want to get down on the floor and back up again
- Anyone who has already tried rest, stretching, and waiting it out
Read More
Knee Pain From Squatting
Why it hurts, and how to keep lifting through it.
Read MoreRunner's Knee Treatment
The modern fix for patellofemoral pain.
Read MoreQuadriceps Tendonitis
The ache just above your kneecap.
Read MoreHip Pain in Active Adults
How I treat it without pulling you out of the gym.
Read MoreDry Needling for Knee Pain
How it works, and when it's worth trying.
Read MoreDry Needling
What a needling visit actually involves.
Read MoreCommon Questions
Do I need a referral to see a physical therapist in Iowa?
No. In Iowa you can start physical therapy without a physician referral, so you can book directly and be seen. Some insurance plans ask for one before they pay, which is a separate question from whether you're allowed to be treated. Check with your plan.
Should I rest a sore hip or knee?
Complete rest usually backfires. It lowers the demand, so the pain fades, and it lowers your strength at the same time, so the pain returns when normal life resumes. Adjusting what you do and how much is far more useful than stopping. I'll tell you which parts to keep.
Why does going down the stairs hurt more than going up?
Going down asks the muscles around the knee to control your body weight while they lengthen, on one leg, repeatedly. It's a higher demand than going up. That's why it's often the first thing to hurt and one of the best things to train.
Can hip pain cause knee pain?
The two are closely linked, and it's common to feel it in one place while the driver sits in the other. That's why the exam covers the hip, the knee, and the ankle together rather than only the joint you point at.
Do you take insurance?
This is a hybrid practice. We accept Blue Cross Blue Shield and TRICARE alongside cash pay. Coverage details differ by plan, so check with your plan, and our team can walk you through the options when you get in touch.
Does dry needling help hip and knee pain?
It's useful for the guarded muscles around the hip and the knee, which are hard to reach any other way. I use it as a window that lets the strength work start sooner, never as the treatment on its own.
Where can I get treatment for hip or knee pain near me in Waukee?
Fortitude & Freedom Performance Therapy is in Waukee, Iowa, and treats people from Waukee, West Des Moines, Clive, Urbandale, Ankeny, and the wider Des Moines metro. Visits are one on one in a fully equipped gym, and Iowa does not require a physician referral to start.
Medical Disclaimer
This content is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician, and reading it does not create a patient relationship. Talk to a qualified health professional about your own symptoms before you act on anything here. If you have severe, sudden, or worsening symptoms, seek medical care right away.
Let's get the stairs back.
Tell us what hurts and what you want to get back to, and our team will set you up with Jake.
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