Knee Pain When Squatting
Many people complain of knee pain when squatting or that they have sore knees after doing squats.
- Does this mean that squats are bad for your knees?
- Should you avoid squats because your knees hurt?
- Should you continue squatting through the pain?
After reading this post you will have a better idea of what might be contributing to your knee pain when squatting and how you can adapt your workout program accordingly.
This article will refer to a concept called load tolerance, something that I refer to a lot in my posts. If you are unsure about what this term means, then I highly recommend you go and read my post on Load Tolerance, before reading on any further.
This post will follow a similar school of thought to another of my posts, Are Deadlifts Dangerous?
Are Squats Bad for Your Knees?
The answer isn’t as simple as yes or no. Squats place a force (or a load) through your knees. The amount of force placed on them varies depending on the type of squat that you do and the amount of weight that you lift.
For example, an overhead squat will place more force through the knees than a front squat, which in turn places more load than a back squat.
Is More Load Through the Knee a Bad Thing?
No, not if increased slowly over time. Think of it a bit like exposure to the sun. Gradually spending more time each day in the sun will usually result in you getting a nice tan. Alternatively, going out for a full day in the sun on your first day of your holiday will likely lead to sunburn and extremely sensitive skin.
This concept is similar when it comes to placing a force through your knees. If you go to the gym and suddenly increase the weight that you lift, you will also increase the load that you place through your knees. This can result in a sensitivity in the tissues around your knees. Continue to squat through the pain and your sensitivity will persist and potentially worsen.
However, if you gradually increase the weight that you use, the tissues around your knee will have time to slowly adapt. This will result in a knee that can tolerate higher loads placed upon them. Going forwards you will be less likely to experience pain when squatting.
As a quick side note, sensitivity doesn’t mean damage, it just means something is sore and angry. With the right approach the sensitivity can settle, and you can start progressing again with no lasting damage.
Why are Your Knees Sore When Squatting?
The reason that most people experience knee pain when squatting is that the load that they are placing through the tissues in their knees exceeds that which they are currently able to tolerate.
Continuing to squat with knee pain can exacerbate the sensitivity and therefore further reduce the load you can tolerate.
There are other reasons for knee pain. However, in the absence of a traumatic injury most types of pain around the knee can be explained by this concept of load tolerance.
If you are concerned or are in any doubt, please seek out medical advice or a local physiotherapist for their opinion.
What Should you Do if you Experience Knee Pain when Squatting?
- Rest
Initially you will need to reduce the forces that you are placing through the sensitive area of your knee. This will allow your knee pain to settle. The simplest way of doing this is to reduce the amount of time you spend squatting.
However, complete rest is not the right answer. The problem with complete rest is that, whilst it may allow the sensitivity to settle, it can also lead to the muscles around your knee deconditioning. This will generally result in less load being tolerated as a result.
See the post on Load Tolerance for a more in depth description of this concept (with infographics to help visualise this easier).
This becomes a problem when you start squatting again. A weight that you were previously able to lift without pain may now be more than you can tolerate. This would result in your sensitivity flaring up again.
- Reduce the Weight You Are Lifting
Instead of complete rest, you need to consider relative rest. This means that you don’t stop squatting, instead you just reduce the weight you are lifting. By reducing the weight lifted, you reduce the load placed through the sensitive area.
You need to aim for a weight that you can currently tolerate. It might take some trial and error to find. Generally, to avoid another flare up, it is best to start off lighter and build up to find the suitable weight.
- Change Your Exercise Selection: Hip vs Knee Dominant Exercises
Earlier in this post, I alluded to the fact that different types of squats place a different load or force through your knees.
You can think of the exercises that you can choose as fitting into a spectrum. These range from hip dominant exercises to knee dominant exercises.
All types of squats and deadlifts share the forces through the hips and the knees. Depending on the mechanics of the lift, the ratio of force shared between the hips and the knees changes. This can be used to our advantage to train around knee pain.
This picture illustrates the exercises on the spectrum of hip dominant to knee dominant.
Thank you to Tony Comella for giving me permission to use the image above. You can find more from him here.
If you are currently unable to do front squats due to knee pain, then you can choose another exercise on the left-hand side of the scale.
You may still be able to still be able to choose another form of squat, either a low bar squat or a high bar squat (different variants of a back squat).
This would be less of a knee dominant exercise, so would place less force through your knees, hopefully reducing the force to one you can now tolerate.
Given that you have only moved a couple of steps to the left, you might need to combine choosing a different squat type with reducing the weight that you lift.
This might feel frustrating, like you’ve taken a step back. The good news is that the chances are you can still lift heavy in other ways.
- Try a Hip Dominant Exercise
Why not pick the exercise furthest on the left that is the most hip dominant exercise? The Romanian deadlift will only place a small proportion of force through your knees, as most of that force will be placed through the hips. This should mean that you are still able to lift as heavy as you were lifting previously.
Can you see why this might be a much better option than resting completely and allowing your muscles to decondition?
Squat Technique for Knee Pain
There is a lot written about the intricacies of the squat technique and whether this is good or bad for your knees. I am not going to go into that here. Everyone moves slightly differently, and no one is perfectly symmetrical, so aiming for perfection is unlikely to be achievable for everyone.
What I will discuss is the fact that some techniques place a larger force through certain areas of the knee. Remember, more force isn’t necessarily a bad thing. However, whilst your knee is already sensitive, that same technique might exacerbate your pain. Adjusting your technique, might allow you to tolerate squatting again at the same time as the painful area of your knee is settling.
- Squat Depth
The deeper that you squat, the more force that is placed through the front of your knee. If the front of your knee (or anywhere else around the knee) cannot tolerate that force, then there is a way we can adapt it.
It is likely that the top part of the squat is painless and only becomes sensitive at a particular depth. Performing a ‘box squat’ is a good solution. Place a surface behind you that is at an appropriate height. When you squat down to the surface you should be at a shallow enough depth that you experience no pain.
You can then start to increase the weight you use in this shallow depth without exacerbating the sensitivity in your knees. The box squat is also great because it provides a safety net behind you so that if you start to fatigue or lose balance you can just sit back down again.
- Knees Over Toes During a Squat
The further forwards that your knees move over your toes during a squat will increase the force through the front of your knees. To understand the physics of how this works, read my post Knee Pain Going Down Stairs.
There are ways of adapting your squat to avoid your knee moving forwards over your toes. Examples include:
- Wall squat
- TRX Squats
- Spanish Squats
All of the above allow you to lean back into the squat without falling backwards. The force placed through the front of the knee is reduced leaving you free to strengthen the muscles around your knees without exacerbating your pain.
- Knee Valgus During a Squat
This refers to when your knees drift in during the squat. It is generally considered that this isn’t the most efficient way to squat. Others suggest that this could be bad for your knees. I will not debate that here.
For the purpose of this article I bring it up to talk about the forces around the knee. The inwards movement of your knees during a squat (knee valgus) will increase the force on the inside of your knees.
If you are experiencing pain on the inside of your knee when squatting, then you might need to address this in the short term to allow the sensitivity to settle.
By concentrating on pushing your knees out during a squat, you will help to reduce the force on the inside of your knee. This can bring you knee into a position that you are able to tolerate.
These are Only Short Term Changes to Your Squat
All the measures that you can take to reduce your knee pain when squatting should be short-term measures. They should be utilised long enough to allow your knee pain to settle. Once your knee pain has settled, you should look to gradually expose your knees to more force.
Too many people forget to progress their exercises again once their pain has settled. Understandably they are fearful that squatting with heavy weights will result in their knee pain coming back. But this doesn’t have to be the case.
Remember the principles of load tolerance. By gradually exposing your knees to higher forces, you will allow sufficient time for the tissues around your knee to adapt. This will result in you being able to tolerate more force the next time.
If you progress your squats so that your knees can tolerate high loads without pain, you will have a robust and resilient body as a result. This will leave you less likely to get injured and more likely to be able to enjoy all the other activities that you love to do.
Have You Found 'Knee Pain When Squatting' Helpful?
Are you inspired to start learning more about how strength training could benefit you as an older adult?
Click below to access some free resources to help you to take your first steps.
Related Articles:
Guide to Correcting the Squat Butt Wink – The Barbell Physio
12 Responses
Lots of helpful tips!
This is so informative. Thank you for sharing! I’ll definitely be referencing this again!!
Thank you, I really appreciate it.
This is some really great information. I never really had a problem with squats, at last not before my accident. My legs, knees and ankles were always pretty strong and limber. Now, my discomfort comes from my right ankle, but I’m working on it!
When I used to teach group ex classes years ago, I noticed that so many people do squats incorrectly. That often led to back and knee pain. Having someone teach you how to do it correctly is a big help
Glad to find your blog. At 57 I definitely fit into the demographic. I am definitely guilty of avoiding squats due to knee issues. I’ve been through PT for my knees I think 5 times (and about the same for my back). At least I finally found the root cause of all my joint issues– I had acromegaly and have now had surgery and am in remission. My joints are much happier! I do need to challenge myself and add weighted squats to my fitness routine. Even on bent-over rows I use a band around my knees to remind myself to push them out, and if I lift too heavy my left knee turns in and causes knee pain afterward. Something to keep working on.
I’m glad you managed to find the cause and that you are doing better now. It is worth trying to find someone who can help to give you the confidence to push yourself out of your comfort zone in a safe environment.
Great info, especially the comparison of knee vs. hip dominance.
I am very careful when squatting. I try to keep the weight low. I don’t want to risk hurting my knees.
I would recommend stating to lift heavier, especially as a runner. You should be looking to strengthen your quads, which you can’t do with low weight. Speak to a good personal trainer who can help to give you the confidence to start increasing the weight you use.
The first thing I thought when I read the title was, ‘they’re doing it wrong’. I guess that’s the (very) short answer. Lots of good information here. I’ll be bookmarking this one!
Actually there’s not a lot of evidence to suggest that poor form will result in pain. If you’re already in pain then your form might make your pain worse.