However, sustained or repetitive contraction of the back and posterior pelvic (buttock) muscles may irritate hip, back or pelvic (sacroiliac joint) pain, due to the compression of the underlying joints. In a forward lean position, those with a shallow hip socket (hip dysplasia) will also experience greater forces on the back edge of the socket.2
Soft tissues such as muscles and tendons can also become fatigued and/or painful due to this sustained forward lean position, combined with the work of pushing up stairs. Back, buttock and hamstring muscles in the back of the thigh, or the hamstring tendon attachment at the sitting bone (ischium) may become painful.
Sciatic nerve pain climbing stairs may also occur when you have sciatica, deep gluteal syndrome, or piriformis syndrome. This is because the nerve is on more stretch when the body is leaning forward and the hip is bent. Also, as the muscles are working harder, they are hugging a little tighter around the nerve as it runs through the buttock. So, if the nerve is irritable or sensitive, you might feel the buttock pain in stair climbing more than during walking on the flat.
Twisting forces across the pelvis when climbing stairs
Stairclimbing can be more difficult and painful in the later stages of pregnancy. The action of stair climbing means that one leg is moving forward while the other is moving back. This creates some torsional or twisting forces across the pelvis, which can be harder to control when the pelvic ligaments are more relaxed in later pregnancy.
If you’ve been having pain over the sacroiliac joints (posterior pelvic pain) or pubic symphysis (the joint at the front of the pelvis), you might find walking up stairs is more challenging than walking on the flat, and sometimes painful.
High steps mean high hip flexion
Most normal stairs do not result in enough bend at the hip to bring it close to the end of its range of motion. However, if you are stepping up a large step in the garden for example, or at the gym, the hip might reach a position of deep flexion – where the thigh and the pelvis come close together.
Repetitive motion into this position may irritate joint related conditions such as osteoarthritis, femoroacetabular impingement syndrome (hip impingement, FAI, FAIS), hip dysplasia or labral tear.
Unaccustomed activity – Too Much-Too Soon
Across the causes above, you will have read ‘if you are not used to steps’ a number of times. Musculoskeletal pain will often occur simply when you do too much, too soon. Suddenly taking up high box step-ups at the gym or swapping to taking 4 flights of stairs at work, when you usually take the elevator, may result in sore muscles. But it might also result in aggravation of pain around the hips and pelvis, because of the challenges of stair climbing outlined above.
If you are unsure why you have hip pain walking up stairs, a consultation with a Hip Pain Professional, a professional that knows hip and pelvic pain, may be of benefit.
Why different areas of your hips might hurt going up stairs
Hip pain walking up stairs can occur in a number of different locations around the hip and pelvis. The area of pain can provide some clues as to what structures or conditions may be underlying the symptoms.
Front of hip pain walking up stairs
Pain at the front of the hip when climbing stairs is most commonly related to the hip joint structures or the soft tissues (muscles, tendons, bursae) at the front of the hip.
Less commonly, this pain can be referred from the lower back.
Much less commonly, the pain may be related to a bony injury due to trauma (e.g., a fall – bone fractures) or overload in those with osteoporosis or in endurance athletes.
If the reason for your hip pain is not clear, a thorough assessment with a health professional who knows hips, like a Hip Pain Professional, is recommended.
Common conditions associated with front of the hip pain when walking up stairs
Common hip joint related conditions causing pain at the front of the hip include:
Common soft tissue related conditions causing pain at the front of the hip include:
- Iliopsoas or hip flexor related pain – related to the iliopsoas muscle, musculotendinous junction or tendon
- Iliopsoas impingement after total hip replacement – due to pressure of the tendon against the underlying prosthesis
- Iliopsoas bursitis (inflammation of the bursa)
Possible causes of pain at the front of the hip walking upstairs
Factors that often contribute to pain at the front of the hip walking upstairs include:
- the relatively hard work of climbing stairs for the hip flexors – lifting the leg higher
- not controlling knee or hip position – a ‘knee in, hip shifted out to the side’ position may irritate structures within the hip joint, due to the changed loading.
- a really high step and/or a lot of forward body lean may result in compression (impingement) at the front of the hip joint.