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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