What causes knee pain when squatting? Plus, 5 tips to avoid it

Squatting with poor form can put pressure on the knees rather than the thighs and glutes. Twisting your knee during a squat or sinking too low to the ground is particularly hard on your knees. If you feel pain in your knees when doing squats, you may need some conditioning to work out any weaknesses, imbalances, or tissue that’s stiff or damaged. 

While squats are great for strengthening the lower body, they’re not safe for everyone. If you have a condition that affects your knees, you should talk with a physical therapist to find out if you should do squats. They can also give you some ideas on alternative exercises for strengthening your glutes and thighs.

In this blog post, we’ll talk about some of the most common causes of knee pain when squatting and share five tips to help you avoid aggravating your knee pain.

Common causes of knee pain when squatting

Knee pain when squatting can be caused by an overuse injury, poor technique, muscle weakness or imbalances, or other injuries and medical conditions. The location of the pain and the intensity can give you some clues about the potential cause. Patellofemoral pain syndrome is a common condition known as runner’s knee or jumper’s knee. You would notice pain in and around the front of the knee. With patellar tendinitis, you would feel pain in the front of the knee near the bottom of the kneecap. 

A sprained knee and other types of acute injury can cause intense pain when squatting. This usually happens when the knee is twisted or hit with force. If you have sudden, intense pain in your knee when squatting that doesn’t go away, it could be a sprain. Sprains can also cause swelling and make it hard to walk or put weight on your knee. An old knee injury may cause pain and irritation when squatting, especially if your knee was never fully rehabilitated.

With arthritis and degenerative conditions, you might notice popping sounds or grinding sensations when you move your knee as well as swelling or weakness. Your pain may be most noticeable in the morning.

To review, here are some common causes of knee pain when squatting: 

• Patellofemoral pain syndrome

• Patellar tendinitis

• Meniscus injuries

• Muscle weakness and imbalances 

• Poor biomechanics and technique

• Arthritis and degenerative conditions

• Previous injuries and inadequate rehabilitation

5 tips to prevent and alleviate knee pain

Whether you’re doing squats for exercise or reaching for items in your kitchen cabinet, you should always practice good form. Keep your hips, knees and ankles aligned and never let your buttocks sink lower than your knees. If you’re squatting for exercise, squatting against a wall may help you build up your quadriceps, buttocks and core muscles to reduce your pain over time. With mild knee pain from an imbalance or overuse injury, some conditioning and exercise can help resolve the issue. Try to get some cardiovascular exercise every day and fit in a couple of strength workouts every week. Make sure you always warm up, cool down and stretch.

Try the following techniques to alleviate knee pain when squatting:

1. Master proper squatting technique — Stand with your feet shoulder width apart and your toes pointing straight ahead. Press your heels into the floor as you exhale and lower down, extending your arms out for balance. Squat until your thighs are parallel to the floor or as close to this as you can get without discomfort. Try to keep your back in a straight, neutral position. 

2. Build lower extremity and core strength progressively — Add some core exercises to your routine and do wall squats to build up strength in the lower body. Start with 10 wall squats three times per week. Stand with your back to the wall. Your heels should be about 18 inches away, at shoulder width, toes pointing straight ahead. Exhale as you lower down and rest your back against the wall. Engage your abs and press your heels into the floor. 

3. Modify activities during painful periods — Make sure you aren’t pushing your body past your limits. Ease up on activity and rest if you feel discomfort. Consider doing exercises that aren’t as painful, or focus on low-impact cardio. Ask your physical therapist about knee-friendly exercises.

4. Address mobility limitations — If your knee pain prevents you from squatting, explore other ways to reach items close to the ground. Try holding on to something like a wall or countertop for support. Or it may be less stressful on your knees to sit in a chair when you need to reach something low. 

5. Use appropriate supportive equipment when necessary — If you have a chronic condition that affects your knees, you might need to wear a brace for added stability. If you have flat feet or high arches, you may need shoes with extra support.

How can physical therapy help with knee pain when squatting?

Physical therapists are experts in the kinds of musculoskeletal conditions that can cause knee pain when squatting. Your PT can do a thorough assessment of your current abilities and your walking style. Based on your assessment and your treatment goals, they can create a personalized treatment plan integrating natural treatments and exercises. Your PT can also advise you on ways to manage your pain and modify activities to be less hard on your knees.

Sore knees can get in the way of important life activities like playing with your kids or going to the gym. At KC Rehab, we help our patients take control of their health so they can keep doing the things they love. You don’t need a referral to make an appointment, and treatments may be covered by your insurance.

Are you ready to try a different approach to managing your knee pain? Contact our team today to schedule an initial appointment.