04-01-2015

“My Knees Hurt When I Squat”

“My knees hurt when I squat.” This is a common complaint, and one I have heard many times as a personal trainer. Because their knees hurt, people end up not doing squats at all, when in fact, squats can help you get stronger and actually decrease knee pain!

Today we are going to talk about why your knees hurt when you squat, and what you can do to fix it. 

How To Squat Without Knee Pain

Okay, if you’ve had a knee injury in the past, then yeah, that might be contributing to your knee pain (and you should see your PT or doctor to discuss whether you should or should not do certain exercises). However, most people have muscle imbalances and weaknesses that are causing this knee pain.

One of the main culprits is not engaging the core (or simply not having core strength) during the squatting motion. As you squat, you should be hinging at the hips and moving backwards as if sitting into a chair. If you don’t, your torso will lean forward, and your knees will be at an awkward angle, causing most of the load to be on your quads…which leads to the knee pain.

Here’s great info from trainer Kevin Yates:

When you lack proper core and hip strength muscle imbalances often result in the quadriceps and lower back over working. This is one of the main reasons for knee pain during squatting.

Movements like squatting and lunging are not bad for your knees and they don’t cause injuries.

Muscle imbalances are the real problem.

One of my favorite trainers, Tony Gentilcore, has a great post about fixing your squat and avoiding knee pain. His tip, box squats, was something I practiced regularly with my clients.

Basically, you set up a box or bench behind you in the squat rack. Your goal is to squat back and touch the box with your butt before coming back up (do not actually sit on the box and then come up, you are just tapping the box).

Tapping a box or bench helps you with that movement of sitting backwards. Your weight should be on your heels and not your toes during a squat. I’ve talked about squat tips in the past, and how you can improve your form. I’ve mentioned putting a plate under your heels. Why? Because if you have a muscle imbalance or tightness, your heels might be coming up during the squat movement. Elevating your heels a bit helps you get deeper and keep the weight in your heels.

From Tony Gentilcore:

If squatting hurts your knees—and you’re not suffering from an injury—it’s because you’re making your knees do more of the work than the hips. Learning how to utilize the hips during a squat is important if you want to make them more joint-friendly. Box squats can do that.

Squats and lunges are not bad for your knees! That’s a myth similar to that of running being bad for your knees and cracking your knuckles leading to arthritis. Squats and lunges, if anything, help improve your knee health. Start working on your core strength to take the pressure off your quads and knees.

One more thing before I move on to talking about your quads…if you’re having trouble sitting back into your squat, try doing front squats and goblet squats. Since the weight is in front of your body as opposed to on your back, it will make it a bit easier for you to sit back into the squat. I talked about that in this post about squatting tips.

Moving on…another thing that might be causing your knee pain is quad weakness. If your knees hurt during walking lunges or after running, this might be why. In order to fix this, you just need to work your quad muscles a bit. Focus on exercises like the split squat, and progress to a reverse lunge. Avoid doing any forward movements like (duh) forward lunges or walking lunges…just until you build up your strength.

Here’s one of my first YouTube videos showing the split squat.

Similar with the squat, you should be going straight down NOT forward. If you are moving forward as you’re performing this you will probably feel that knee pain. Cues to repeat to yourself are: chest up, shoulders back. Your front heel should stay planted on the floor – if you come up on your toes, step your back leg further back/away from your front leg. 

My dad had knee pain during running and leg exercises, but once he started doing more split squats, his knee pain disappeared. He now runs 3 miles most days! Progression ideas for this exercise (once you master the split squat) would be: reverse lunge, front foot elevated split squat, rear foot elevated split squat, step-ups, and walking lunges.

***Remember though, please talk to your PT or doctor if knee pain is something you have regularly dealt with. Of course there could be some underlying issue that is not as simple as a muscle imbalance or lack of strength.***

Do you squat regularly? Have you ever felt knee pain?

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01-29-2015

How To Squat Deeper

I’ve written about proper squat and deadlift form, but today we’ll talk about how to work your way into a deeper squat. (I’ve also written about how it’s not necessary to squat all the way down – in fact, it can lead to injury if you’re not ready for that).

However, it’s important to work on mobility if you want to perfect your squat form and get a bit deeper each time. When I first started lifting, I’d have a bench under me and I couldn’t even squat to the bench! Usually, not being able to get low enough has to do with lack of flexibility – probably in your ankles or hips. PS – if you want to work on ankle flexibility and dorsiflexion, try this exercise. My PT had me do this for my shin splints during half marathon training and it really helped. For me, a tight Achilles and lack of dorsiflexion is/was causing tight calves which leads to shin pain.

Anyway, let’s get into a few things you can do to work on your squats. Let’s start with the warm-up:

How To Squat Deeper

Warm up your hips and glutes.

This seems like a no-brainer, but I’ve seen people show up to the gym and just start squatting. Yikes. Take 10 minutes to warm up before you hit the squat rack. First do some cardio to get your heart rate up, then start doing dynamic stretches for your hips, like lunges (where your knee is on the floor and you move forward to stretch the hip, but then come back up, then go back into it, etc. so it’s dynamic, not just you holding a stretch). Do side lunges as well to hit it from a different angle. Do a few static standing lunges to warm up your quads and glutes –  nice and slow.

Roll out your calves.

In order to get your calves ready, do the drill above, and foam roll your calves. If you have a partner, take a wooden stick/pole (some gyms have them some don’t, if not just use the foam roller) and ask them to roll it over your lower calf, closer to your Achilles. They’ll be able to apply pressure in different areas you may not be able to if you foam roll yourself. You want to get the blood flowing in these areas and get them loose, especially if dorsiflexion is what is causing you issues with squatting.

Okay let’s move to the actual squatting:

Set a bench or box behind you.

You won’t be doing box squats (which is a specific technique different than regular squats), but you’ll just be squatting down and trying to tap the bench with your butt. If you can’t get down that low, then you know you’ve got some work to do. This also gives you a starting point. Once you ARE able to tap the bench, you know that you’ve been improving and are getting better at squatting.

Put plates under your heels.

I had clients who would start with 25 lb. plates (thicker) and work their way down to just a 5 lb plate (very thin). Putting plates under your heels helps with the dorsiflexion issue, since now your heels are elevated and will give you a bit more range of motion. As I was reading a forum about this, I saw some opinions about this being impractical because “you’re supposed to be squatting with heels planted and driving through the heels.” Yes, that is true, but if you don’t have the range of motion how will you do this? As with anything else, this tip is a way to help you to progress to that level, similar to how using an assisted pull-up machine helps you progress to a pull-up.

Anyway, got side tracked, use a certain plate for 2 weeks, then try to use one that’s thinner, and work your way down. Obviously, you need to be working on mobility during this time as well. Simply using plates won’t improve your dorisflexion. Make sure you’re actively foam rolling your calves and Achilles and doing drills like the one I linked to above. Here are more drills from trainer Tony Gentilcore (scroll down a bit). My PT had recommended doing that drill whenever possible throughout the day, but a minimum of 2-3 times a day.

Do front squats.

Front squats require you to have the barbell on the front/meaty part of your shoulders. If you don’t have access to a barbell, you can do goblet squats instead. You’ll find that with front squats you will probably be able to get a bit deeper than with back squats. This is because of the angle of your hips and back during the squatting. 

squat-torso-positionPhoto Source

Throw these into your routine and focus on your depth. As always, make sure you’re keeping your core tight and “chest up, shoulders back.”

Start light.

Don’t be embarrassed if you’re only squatting the barbell to start. I started there too. It’s better to use light weights as you fix your mobility than try to do 100 lbs. and have awful form that will lead to injury. Use light weight and really focus on the exercise. Feel yourself bracing your core and going through the motions. Go nice and slow to determine how low you can get and get a tiny bit lower each week. Throughout the weeks, you’ll not only gain flexibility but you’ll also be able to start increasing your weight load bit by bit.

Are you able to do squats no problem or did you have to work your way up to them? They’re a great exercise when done properly!

How do you warm up before a lifting session?

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