After 60: not running, not heavy squats – the gentle stair habit physiotherapists say protects your knees

The stairwell in Margaret’s block smells faintly of polish and yesterday’s rain. At 7.30am, while her neighbours scroll the news, she grips the rail and climbs. One floor, then down. Two floors, then down. Her slippers whisper on the concrete, a quiet metronome for a body that hit 68 last spring. She is not “getting her steps in”. She is training the one thing her physio begged her not to ignore: the way her knees handle stairs.

Six months ago, she avoided them. The slightest descent sent a rusty ache through the front of her joints. She started planning routes around lifts and escalators, even in her own house. At a check‑up in a community physio clinic, a therapist asked a blunt question: “Can you walk up and down a flight of stairs without hanging on for dear life?” She laughed, then hesitated. That pause changed the appointment. It also planted a simple, gentle habit that now lives between her first cuppa and the weather forecast.

Why physios care more about stairs than sprinting after 60

Most everyday knee pain after 60 is not shredded cartilage and doomed joints. It is a mix of slightly frayed tissue, stiff ankles and hips, and muscles that have quietly lost strength because chairs and cars won the day. Running and heavy squats ask a lot from all of that in one go. Stairs ask just enough. They mimic real life: getting on a bus, climbing to bed, stepping off a kerb that dips more than you expect.

Physiotherapists talk about load tolerance rather than “good” or “bad” movements. Your knees tolerate walking on the flat, then a small step up, then a controlled step down. Each level is a nudge, not a shock. Stairs, done gently and regularly, sit right in the sweet spot for most older adults: they wake your thigh muscles, challenge your balance, and ask your cartilage to bear weight in a way it was built for. No barbells. No Lycra. Just risers and rails.

Look at people who slip into knee trouble and you often see the same story. They stop using stairs because they hurt. Then the muscles that protect the joint – quadriceps, calves, the deep hip stabilisers – get weaker. The joint feels less supported, so stairs hurt more. Avoidance becomes a loop. The physios I spoke to want to break that loop with something small enough that people actually do it. A stair routine is cheap, precise and woven into the day. That precision is the trick.

The gentle stair routine a UK physio teaches for “over‑60 knees”

Here’s the method one London physio uses with patients who wince at steps but still want to stay mobile. Find a short, sturdy flight of stairs with a rail. Wear shoes you trust. Start with up only: step up one or two flights at your normal walking pace, using the rail lightly for balance, not to haul yourself. Walk back down in the lift or on the flat corridor if you can. Rest. Repeat 3–5 times.

After a week or two, if your knees complain less the next day than they did on day one, you begin to add controlled descents. That means taking your time on the way down, soft bend in both knees, heel to toe, rail there “just in case”. Many people rush the descent and jab the joint. Slow wins. You’re teaching your thigh muscles to act like a quiet shock absorber again, not a rigid brace.

Treatment rooms are full of people who went too hard too soon. Soreness around the kneecap that eases in 24 hours is fine; a hot, swollen joint that sulks for three days is a sign you overshot. The rule this physio repeats: you should be able to chat while climbing and feel the same or better by the following evening. If stairs bite sharply, buckle your knee, or pain shoots below mid‑shin, that’s not your cue to power through. It’s your cue to pause and get tailored advice.

“Stairs are brilliant because they scale. One floor twice a week is a start. Four floors most days is real training. The joint doesn’t care what it’s called; it notices the pattern,” says a Bristol physiotherapist who specialises in older adults.

• Start with climbs only; save descents for later.
• Use the rail for balance, not as a winch.
• Aim for 3–5 short bouts rather than one epic effort.
• Judge progress by next‑day comfort, not heroics.
• Stop and seek help if swelling, locking, or giving‑way appear.

How a “stair habit” quietly protects your knees

Think of your knee as a hinged door that relies on strong, well‑oiled hinges above and below. Stairs don’t just nudge the knee itself. They ask your hips, ankles and feet to share the load. Each step recruits your glute muscles to control your pelvis, your calves to steady your landing, and your core to keep you upright. That spreading of effort is what protects a joint over time. It’s load shared, not load dodged.

Inside the joint, movement feeds cartilage. With each step, fluid is squeezed in and out like a sponge, bringing nutrients and whisking away waste. Long spells of sitting starve that process; gentle, repeated loading revives it. You won’t regrow worn surfaces, but you can create a kinder environment for what’s left. The habit matters more than the height of the stairs.

There’s also a confidence layer. Many over‑60s fear stairs because a fall would be serious, so they cling to lifts and escalators even when they don’t strictly need to. A regular, deliberate stair routine, started in a safe, well‑lit place, teaches your balance system that steps are familiar again. You learn how your knee feels on the third riser, not just the first, and that knowledge shrinks anxiety. Pain often follows fear; reduce one and the other can soften.

Let’s be honest: nobody does hour‑long gym programmes forever. Five minutes of focused stairs before the news, or after hanging the washing, sneaks in under your brain’s “Ugh, exercise” radar. And knees care deeply about those tiny, repeated decisions. You don’t need a Fitbit. You need a staircase you trust and a plan you’ll keep.

Making stairs safer and kinder on older knees

The “just use the stairs” advice can sound flippant if your building has harsh concrete steps and a flickering light. Physios who prescribe stair work fuss over details. They look for grippy edges, solid rails, and somewhere to sit if you misjudge your effort. At home, small tweaks make a big difference: brighter bulbs, a second handrail, contrasting tape on the lip of each step so your eyes and joints agree on where the floor ends.

Technique matters too. Point your knee roughly over your second toe rather than letting it cave inwards. Place your whole foot on the step, not just the toes, and press from the heel as you rise. Keep your gaze gently ahead rather than glued to your feet; your spine and hips follow your eyes. These tweaks sound fussy until you feel the load shift from the sore front of the knee to the big muscles above and behind it.

Not everyone should launch into stairs tomorrow. If you’ve had a recent joint replacement, uncontrolled blood pressure, or use a walking aid for more than short indoor distances, you need a tailored plan. Stairs might come later, after flat‑ground strength and balance work. There’s no medal for rushing. The point is not to prove a staircase wrong. It’s to keep the option open for when you need it.

“I tell my patients: your future independence is hidden in boring things like stairs and chairs. If we keep those easy, the rest of life feels bigger,” says a Manchester physio who runs an over‑60s knee class.

A simple starter plan you can test this week

Step	What to do	Why it helps
1	Pick one safe staircase with a rail and good light	Reduces fear and avoids trips while you learn the habit
2	Climb 1–2 flights, 3 times, every other day for 2 weeks	Gently loads knees and thighs without overdoing it
3	Add slow descents when climbs feel easier and pain settles by next day	Trains control and confidence going down, the bit most people fear

From “bad knees” to better days

Relief is part of the story; options are the rest. When stairs feel less like a threat, you notice knock‑on effects everywhere. Getting on the bus without hunting for the lowest step. Choosing the park path with that small hill instead of the flattest loop. Saying yes to a friend’s terrace pub because the steps no longer loom. A tiny, repeatable stair habit buys you small freedoms that stack.

Knees also love variety. Mix your stair routine with short walks, sit‑to‑stands from a firm chair, and gentle calf raises at the kitchen worktop. None of this looks glamorous, yet together it nudges muscles, cartilage, and confidence in the same direction. One tiny routine beats a perfect plan you never start. The stairs are already there. They’re waiting every time you pass them.

FAQ:

• Won’t stairs just wear my knees out faster after 60? For most people, the opposite is true. Gentle, regular stair work helps keep muscles strong and cartilage nourished. Sharp, heavy impacts are the problem; controlled steps are usually a friend, not a foe.
  
• How much knee pain is “OK” when I start? Mild ache around the joint that eases within 24 hours is generally acceptable. Swelling, heat, locking, or pain that lingers for several days means you should scale back and get professional advice.
  
• What if I don’t have stairs at home? Use a single step, a low kerb, or a sturdy aerobic step in a hallway. The same up‑only, then gradual down‑training principle applies.
  
• Can I do this with arthritis or after a knee replacement? Often yes, but the dosage and timing matter. Many physios use stair work in arthritis and post‑surgery rehab, yet it should be introduced under guidance, especially in the first months after an operation.
  
• Is stair climbing enough exercise on its own? It’s a powerful piece, particularly for knee and heart health, but not the whole puzzle. Aim to add some general walking, simple strength work for hips and ankles, and activities you enjoy so the habit sticks.