Training guide
A step-down is a slow single-leg lowering off a step: standing on one leg, you bend that knee and hip to lower the other heel to the floor, tap it, and straighten back up. Start on a low step or the bottom stair, keep your knee over your middle toes and your pelvis level, and do 2 sets of 8 slow reps on each leg.
Step-downs train your thigh and hip to control your knee, for stairs, downhills and sport. The step's height sets how hard they are on your knee: lowering off a step loaded the kneecap more than stepping up onto it, and a higher step more than a lower one, so they come after step-ups.
This guide shows the forward and lateral step-downs, step height, knee control, where they fit with knee pain, what they do for your glutes, the step-down tests, and how many.
Stand on one leg on a low step, the other leg free in front. Bend the standing knee forward over its toes and sit your hips back a little, lowering the free heel to the floor over about 3 seconds, tap it, and straighten back up. The lateral step-down lowers the free foot beside the step instead.
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In 20 healthy adults, lowering off a step loaded the joint behind the kneecap more than stepping up the same step, and a higher step more than a lower one. A higher box also made knee control worse. Start at about 10 cm or the bottom stair and build towards 15 to 20 cm (our editorial heights).
Because they load the kneecap more, step-downs come after low step-ups, not before. Hip and knee exercise helps kneecap pain, but no trial has compared step-downs with step-ups.
The knee travelling forward is part of the move: blocking it in a squat shifted load onto the hips and lower back. The fault to fix is the knee drifting inwards, which a stiff ankle makes more likely.
From a 15 cm step, glute activity was low to moderate. Step-downs train control of your hip and knee; loaded step-ups, hip thrusts and squats build the glutes.
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2 sets of 8 slow reps on each leg from a low step, building to 3 sets of 8 to 10, 2 or 3 times a week: our editorial starting point. A kneecap pain trial used 3 sets of 10, three times a week, inside a hip and knee programme.
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A step-down is any slow single-leg lowering off a step. In the forward step-down, the one on our 3D figure, the free heel reaches forward to tap the floor; in the lateral step-down the free foot lowers beside the step, as in the clinical test; in the backward one it lowers behind you. "Eccentric step-down" means the same move with the emphasis on a slow lowering.
Peterson, Patrick and Poliquin step-downs are coaches' names for the forward step-down with the knee travelling well over the toes. The Poliquin step-up is its mirror.
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The standing knee bends to roughly 45 to 60 degrees (studies set the step height to reach that bend), the hip bends, the ankle bends as your shin moves forward, and your pelvis has to stay level on one leg.
The front of your thigh (the quadriceps) controls the lowering, working while it lengthens. The side of your hip (the gluteus medius) holds your pelvis level and, with the gluteus maximus, keeps your knee from drifting in; your calf steadies the foot.
From a 15 cm step, gluteus maximus activity was 8 to 13% and gluteus medius 19 to 27% of a maximal effort, and women worked nearer their maximum than men.
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Those figures are EMG (electromyography: electrodes measuring how hard a muscle works over a few reps), which shows effort in one session, not what a muscle builds over months.
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Steady balance on one leg, as the move page asks, and comfortable low step-ups, as our step-up guide teaches.
A stiff ankle makes the knee drift in and the hip drop: limited ankle bend was the clearest difference between people who moved well and less well in the lateral step-down, in healthy women and in soldiers with kneecap pain. Older adults go downstairs nearer their maximum strength than young adults, so a low step-down is real training for them. Kneecap pain is typically worse on stairs and when squatting.
In 20 healthy adults, lowering off a step loaded the joint behind the kneecap more than stepping up the same step, and a higher step loaded it more either way. The paper doesn't make clear which kind of step-down it measured. In another 20 adults, with the step set so the knee bent to 45 degrees, the forward step-down put more stress on the kneecap than a forward or a lateral step-up (13.8 against 11.2 and 11.5 megapascals). Both studies estimated the loads with models, and we read only the second one's abstract.
In the same 20 people, a step-down from the low step was in the lowest of three tiers of load on the tendon below the kneecap, and one from the high step in the middle tier. The two papers on these people give the step heights differently, so we don't quote them.
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In 20 adults, the step-down and the single-leg squat were the most demanding tasks for the hip and the step-up the least, with a half step-down in between. We read only the abstract.
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Bodyweight step-downs from a 15 cm step drew 8 to 13% of a maximal effort from the gluteus maximus and 19 to 27% from the gluteus medius in 34 adults, and the authors wrote that "None of the subjects generated sufficient EMG activity for strength gains". Another study found 13 to 14%. In reviews, lateral and crossover step-ups reached far more (79 to 113%), and step-downs gave "small excitation in males and moderate excitation in females".
In 9 people with a strain gauge on a normal ACL (anterior cruciate ligament), step-downs strained it about as much as step-ups, with no significant difference between the four exercises tested.
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In a review pooling studies of healthy people, walking down stairs loaded the kneecap no more than walking up (2.8 against 3.2 times body weight). An exercise step-down is a slow lowering on one leg, so the stair figures don't transfer to it. We read only the abstract.
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In 20 people at least a year after ACL reconstruction, lateral step-downs from a 15 cm box showed more pelvic drop and more of the thigh drifting in than from a 10 cm box, and worse movement scores.
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In 14 healthy adults at the same 60 degrees of knee bend, the step-down had more hip adduction (the thigh drifting in) and the single-leg squat more of the knee buckling inwards, though people's hip and knee angles still tracked together across the two.
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Steps from our move page ("Bend the standing knee forward over its toes, reaching the free heel forward and down until it just touches the floor"; "Keep the standing knee in line with its toes"). The 3-second lowering follows our step-up and hiking workouts; the step height and where to end the set are editorial.
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The movement on the figure: Patrick step-down
We have no 3D demo of the lateral version, so the figure shows the forward step-down; the standing leg does the same job. The set-up follows the clinical lateral step-down test (Piva 2006); the tempo and step height are editorial.
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The movement on the figure: Patrick step-down
No 3D demo for these; the forward step-down demo shows the standing leg.
Stand facing away from the edge and lower the free foot behind you. It's another way to vary the move; nobody has compared it with the forward or lateral version.
Lower only part of the way, then come back up. In one lab study it was less demanding for the hip than a full step-down and more than a step-up, so it's a natural step between them.
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Hold dumbbells at your sides and go back to a lower step. Coaches load step-downs with dumbbells, kettlebells or a barbell, though Catalyst Athletics notes they're used more for knee care than as a main leg strength exercise.
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About 10 cm, or the bottom stair with a hand on the rail. Raise it a few centimetres at a time towards 15 to 20 cm, the height the clinical tests use, once every rep keeps your knee over your toes and your pelvis level. That's our editorial progression; the Chartered Society of Physiotherapy's step exercise uses a step of about 12 to 18 cm.
In 20 healthy adults, a higher step loaded the joint behind the kneecap more than a lower one, and a step-down more than a step-up from the same step. A step-down from the low step still loaded it less than a lunge or a single-leg squat to 60 degrees.
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Movement scores were worse from 15 cm than from 10 cm after ACL reconstruction. If your knee starts to cave in, the step is too high for now.
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Raise the step before you add weight. When you add dumbbells, drop back to a lower step and build up again, as our step-up workout does (editorial).
Low step-ups, 8 each leg, and step-ups, 3 sets of 8 to 12 each leg (our step-up workout); the forward step-down, 2 sets of 8 slow reps each leg from a low step (our step-up workout, editorial), building to 3 sets of 8 to 10 (our knee guides, editorial); then skater squats and pistol squats, 3 sets of 5 to 8 each side (our pistol squat progression). The Poliquin step-up is the step-down's mirror: 2 sets of 8 slow reps per side (its move page's dose).
Keep the middle of your kneecap over your second or middle toes as you lower. An NHS trust leaflet puts it as "make sure your knees stay in line with your feet".
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That's part of a step-down. In a squat, blocking the knees from moving forward cut the load at the knee a little but raised the load at the hip about tenfold. More forward travel does raise kneecap stress, so with a sore kneecap a little less travel and a lower step is a sensible short-term change.
A hip that drops on the free-leg side is one of the faults raters look for, and poor ratings went with more pelvic drop measured in 3D. Hands on your hips help you feel it.
Limited ankle bend went with the knee drifting in and the hip dropping in the lateral step-down, in healthy women, healthy adults and soldiers with kneecap pain. These were snapshots, not trials. If your heel lifts or your knee can't travel forward, add knee-to-wall rocks, 10 slow rocks per side daily (the move page's dose).
In 40 women with kneecap pain, only the hip and quadriceps strengthening groups reduced how often the knee caved in during step-downs. In 34 young women whose knees caved in, 8 weeks of hip and trunk strengthening reduced the thigh drifting in during the step-down. Adding movement-control training to strengthening gave no clear extra benefit in 34 women with kneecap pain.
How your knees line up when you stand is a separate question; our knock knees guide covers it.
An international consensus says "Combining hip and knee exercises is recommended to reduce pain and improve function in the short, medium and long term", in preference to knee exercises alone. It doesn't name step-downs.
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In 42 women with kneecap pain, 4 weeks of hip and knee strengthening plus movement training that included step-downs, 3 sets of 10 three times a week by video call, cut pain by 3.7 cm more on a 10 cm scale than stretching. The step-down's own share can't be separated.
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From the same step, a step-down loads the kneecap more, which makes it the harder, later exercise, not the better treatment.
Start with low step-ups, stepping down with the working foot first, and add step-downs from a low step once step-ups are comfortable. NHS inform's advice for stairs is to "lead with your problem leg when going downstairs", and one NHS trust leaflet brings the step-down in at its third stage. Our runner's knee, front of knee pain and knee pain on stairs guides bring them in at their later stages.
Pain from 0 to 2 out of 10 is fine, and up to 5 is acceptable if your knee is back to its usual level by the next morning; for tendon pain just below or above the kneecap, keep it to 3 or less. Sharp, catching or giving-way pain, or new swelling, means stop. That's our knee guides' rule.
NHS inform's kneecap pain exercises keep pain within 0 to 5 out of 10.
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A step-down from a low step was a low tendon load in healthy adults. With jumper's knee, follow our jumper's knee guide's stages and keep the pain to 3 or less.
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Lowering-focused training after ACL reconstruction grew the quadriceps 23.3% against 13.4% at a year, and after a knee replacement it helped people go downstairs, but both trials used motorised machines, not step-downs. Step-downs come in at your surgical team's stage, usually from the bottom stair holding the rail; our ACL surgery and knee replacement guides have the stages.
You stand on a 20 cm step with your hands on your waist and do 5 slow step-downs while an observer scores five things: using your arms, leaning your trunk, your pelvis dropping, your knee drifting in (2 points if it crosses your second toe) and wobbling. A score of 0 or 1 is good, 2 or 3 medium, and 4 or more poor.
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Agreement between raters, scored as kappa (0 is chance and 1 perfect agreement), was 0.67 in the original study, 0.40 to 0.65 between physiotherapists rating 22 people with kneecap pain, and 0.59 to 0.81 in a review of 16 studies, which also found no agreed way to run the test.
In the forward version you tap the heel in front. Raters agreed well (kappa 0.80) in 26 women, and fairly to well across 142 physiotherapists, and poor ratings went with more pelvic drop in 92 healthy adults.
In the two prospective studies that used one, it didn't: forward step-down reps didn't predict kneecap pain over 2 years in 114 young women, and lateral step-down quality didn't predict Achilles pain in 70 recruits. For the related single-leg squat, a study of 306 young athletes found higher odds of leg injury but concluded the test "is not sensitive and specific enough to be used as a screening tool", and in 880 elite female players it predicted ACL injuries no better than chance.
Film yourself from the front on a low step and watch your knee, pelvis and trunk. It's feedback for your training, not a diagnosis (editorial).
Start with 2 sets of 8 slow reps on each leg from a low step (our step-up workout), building to 3 sets of 8 to 10 each leg (the dose our knee guides use). Both are editorial starting points.
They sit inside the sourced doses we found: a kneecap pain trial's 3 sets of 10, three times a week; one NHS trust leaflet's step-down "8 to 12 times, three times a day" at its third stage; another trust's step exercises at 8 to 12 reps, resting 60 to 90 seconds and repeating the set 2 to 3 times; and NHS inform's "maximum of 2 sets of 15", building up from 2 or 3 reps.
Lower over about 3 seconds, as our step-up and hiking workouts do (editorial).
Stop 2 or 3 good reps short, and as soon as your knee caves in or your pelvis drops (editorial).
About 60 to 90 seconds, or work the legs in turn (editorial); the trial rested a minute between sets.
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2 or 3 times a week on days that aren't back to back (editorial); the trial used three times a week.
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Count step-downs with squats, lunges and step-ups towards about 10 hard sets a week for your thighs, though from a low step they're light work for the glutes.
Slower lowering first, then a higher step a few centimetres at a time, then the lateral version, then dumbbells on a lower step (editorial).
Lower over about 3 seconds; tap the floor, don't land on it.
Keep it over your middle toes; lower the step if it keeps drifting.
Stand tall with your hands on your hips, and strengthen the side of your hip with the moves below.
Tap the heel without putting weight on it, then rise on the standing leg.
Go back down a few centimetres: control got worse from a higher box.
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Often a stiff ankle: add knee-to-wall rocks.
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Knee-to-wall rocks, 10 slow rocks per side daily, and the standing wall-press hip abduction, 3 to 5 holds of 5 to 15 seconds each side twice a day (their move pages' doses); lateral band walks, 2 sets of 10 steps each way, and single-leg glute bridges, 8 each side for 2 rounds (our knee control warm-up); wall sits, 30 seconds for 2 rounds, and single-leg stands, 2 holds of 30 seconds each leg (our knee strengthening workout); single-leg calf raises on the same step, 2 sets of 10 to 15 each leg (our step-up workout). The hip hitch has no 3D demo: stand side-on on the step on one leg, let the free side of your pelvis drop a few centimetres, then lift it level with the side of your standing hip, 3 sets of 15 slow reps each side 3 times a week (its move page's dose, from a runners' trial), starting with 2 sets of 10.
3D demoKnee-to-wall ankle rockBeginner · A wall
3D demoStanding wall-press hip abductionBeginner · A wall
3D demoLateral band walkBeginner · A band
3D demoSingle-leg glute bridgeIntermediate · No equipment
3D demoWall sitBeginner · A wall
3D demoSingle-leg standBeginner · A wall
3D demoSingle-leg calf raise from a stepIntermediate · A step + A wallThe step-up workout has step-downs at 2 sets of 8 slow reps each leg on the bottom stair; the knee strengthening workout and the knee control warm-up at 8 slow reps each side for 2 rounds; the hiking workout's descents at 2 to 3 sets of 8 slow reps each leg, lowering over 3 seconds; and the pistol squat progression starts with them at 3 sets of 8 slow reps each side.
A 30-minute step-up workout at home or in the gym: step-ups, split squats, step-downs and calf raises on one step, with the height set to your level.
30 minBeginner9 movesA wall, A stepA 25-minute session for knees that don't currently hurt: thigh and hamstring strength, single-leg control, then an optional full-range block with knees over toes.
25 minBeginner13 movesA bench or box, A wallA 20-minute warm-up that trains your knees to track over your toes: side-hip strength, squats and lunges with alignment practice, balance and quiet landings.
20 minBeginner10 movesA wall, A bandA 35-minute strength workout for hikers: step-ups, lunges and calf raises for climbs, slow step-downs for descents, single-leg hinges, carries and balance.
35 minBeginner13 movesA wall, A stepBuild to a pistol squat: ankle and balance prep, step-downs, skater squats, box and counterweight pistols, then the full one-leg squat.
25 minIntermediate8 movesA wall, A stepLow step-ups first, then step-downs from a low step once those are comfortable, within our knee pain rule. Our runner's knee guide has the plan.
Follow your surgical team's stages. Step-downs usually start from the bottom stair holding the rail.
Going downstairs asks older adults for 42% of their maximum strength, against 30% for young adults. Machine strength training improved older adults' stair descent but couldn't make higher steps easier, and we found no trial of step-downs for stairs or falls. The NHS asks older adults to do strength and balance activities on at least 2 days a week; start on the bottom stair with a hand on the rail.
Hold a rail or a wall while you learn. With a history of falls, numb feet or dizziness, stay within reach of something solid, as our single-leg stand move page advises.
Strength training is fine in pregnancy if you did it before; start anything new gently. With pelvic girdle pain, skip step-downs if stairs hurt and do sit-to-stands instead, as our step-up guide suggests for step-ups (editorial).
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Our muscular dystrophy workout leaves out step-downs because they put more strain through weakened muscles. Follow your neuromuscular team.
If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise. The American Heart Association says these need immediate medical evaluation.
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For chest pain that comes on suddenly and doesn't go away, feels tight or like squeezing, spreads to your arms, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headedness or breathlessness; arm pain that comes on suddenly with pressure, heaviness or squeezing across your chest; severe difficulty breathing, or a chest that feels tight or heavy; someone who faints while exercising; palpitations that don't go away, or come with chest pain, shortness of breath or feeling faint; or a headache that starts suddenly and is extremely painful, especially while lifting or straining. The NHS says a bleed on the brain may be more likely when lifting something heavy. Don't drive yourself to A&E.
A pop or tearing feeling at the front of the knee, then you can't straighten it or lift the straight leg, there's a dent above or below the kneecap, or the kneecap sits higher or lower than the other: go to A&E or an urgent treatment centre, or get help from NHS 111. A torn quadriceps or patellar tendon does best repaired soon; our patellar tendon rupture guide explains.
Get advice from NHS 111 if your knee is very painful, you can't move it or put weight on it, it's badly swollen or has changed shape, it locks, gives way or clicks painfully (painless clicking is normal), or it's hot and red and you have a high temperature. NHS inform adds a knee that swells straight after a twisting injury to that list. See a GP if knee pain doesn't improve within a few weeks. In the US, your doctor or urgent care.
Call 999 or go to A&E if you heard a crack, the joint or limb has changed shape or points at an odd angle, it's numb or tingling, or the skin looks blue or grey or feels cold. Get help from NHS 111 (in the US, urgent care) if it's very painful, very swollen or bruised, very stiff, or you can't put weight on it or walk more than a few steps.
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Ask for an urgent GP appointment or get help from NHS 111 for a headache that's triggered or made worse by coughing, sneezing, bending down or exercising.
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Speak to your GP first if you haven't exercised for some time or have medical conditions or concerns, as the NHS advises. Get advice before hard or straining work if your blood pressure is uncontrolled (140/90 or higher at a clinic, or 135/85 at home), or you have heart disease or chest pain when you're active, a pacemaker or defibrillator, diabetic eye disease, glaucoma, a hernia, recent eye or tummy surgery, or you're pregnant, as our breathing guide lists.
With controlled high blood pressure, the American Heart Association considers low- to moderate-intensity strength training with proper breathing safe: breathe out as you lift.
Not as a rule. In a squat, blocking the knees from moving forward cut the knee's turning load (from 150 to 117 newton metres) but raised the hip's from 28 to 303. More forward travel does raise kneecap stress in squats and lunges, so with a sore kneecap less travel is a fair short-term change.
UK advice differs: the Chartered Society of Physiotherapy's knee video says "Do not let the knee go past the toes" and the NHS knee exercises for runners give similar advice for squats, while the NHS strength exercises page says of mini-squats "Aim to get them over your big toe".
Coaches load them with dumbbells, kettlebells or a barbell, and they're the first rung of our pistol squat progression. Step height and load make them as hard as you need, though no trial has tested them in healthy athletes.
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No trial has compared them. From the same step a step-down loads the kneecap more, which makes it the harder, later exercise, not the better treatment.
Not shown. In the two prospective studies that used one, it predicted nothing, and screening with the related single-leg squat was poor.
From a 15 cm step, glute activity was low to moderate, and the authors judged it too low for strength gains. Loaded step-ups, hip thrusts and squats build the glutes; our glute guide covers them.
We found no study showing step-downs work the VMO (vastus medialis obliquus, the inner quad) on its own. Women with kneecap pain used more of it than women without in step-ups, step-downs and lunges alike.
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The lowering-focused trials used motorised machines; no trial has tested step-downs after surgery. Follow your surgical team's stages.
Stand on one leg on a low step. Bend the standing knee forward over its toes and sit your hips back a little to lower the other heel slowly to the floor in front, tap it, then straighten back up. Keep the knee over your middle toes and your pelvis level.
The front of your thigh controls the lowering, and the side of your hip keeps your pelvis level and your knee from caving in. Glute activity from a low step is low to moderate.
Start low, about 10 cm or the bottom stair with a rail, and build towards 15 to 20 cm a few centimetres at a time. A higher step loaded the kneecap more and made knee control harder in studies. Those heights are our editorial starting point.
They're a common part of kneecap pain programmes, which work, but they load the kneecap more than step-ups. Start with low step-ups, add step-downs once those are comfortable, and keep within our knee pain rule. Our runner's knee guide has the plan.
Neither: they're steps on the same ladder. From the same step, a step-down loads the knee more and asks more of the hip, so step-ups come first. No trial has compared them for knee pain.
Yes, that's normal: blocking the knee from moving forward shifted load onto the hips and back in squats. What to avoid is the knee caving inwards. With a sore kneecap, a little less forward travel and a lower step help.
Both work the same muscles. The lateral version is the one clinicians use as a test, and the forward one is our 3D demo. Start with whichever you control better, at the same low height.
You stand on a 20 cm step and do 5 slow step-downs while someone scores your arms, trunk, pelvis, knee and balance. Raters agree only moderately, and it hasn't been shown to predict injury, so use it as practice feedback, not a verdict.
They work the side of your hip and your glutes lightly, which helps knee control, but they aren't a glute builder. For glute size, loaded step-ups, hip thrusts and squats do more; our glute guide covers them.
Start with 2 sets of 8 slow reps on each leg from a low step and build to 3 sets of 8 to 10, 2 or 3 times a week. That's our editorial starting point. One kneecap pain trial used 3 sets of 10 three times a week, and NHS trust leaflets use 8 to 12 reps.
Easier: a lower step, a hand on a rail, or lowering only part of the way. Harder: a slower lowering, a higher step a few centimetres at a time, the lateral version, then dumbbells on a lower step, then skater and pistol squats.
Yes, when your team says so, usually from the bottom stair holding the rail. The lowering-focused training that helped after ACL reconstruction and knee replacement used machines, not step-downs, so follow your team's stages. Our ACL surgery and knee replacement guides have them.
Exercise education, not a personal prescription, and clinical review of these guides is pending. Check with a GP before starting hard training if you have a heart condition, chest pain, dizziness or breathlessness when active, and stop for sharp or increasing pain. Health disclaimer.
