KNEE PAIN AND SQUATTING, WHAT SHOULD YOU DO?



Q – “My knee(s) hurt when I squat. Does this mean I should stop squatting altogether?”



Simple answer: NO!


This is a very common question, and sometimes statement, made by patients, friends, and most people who have an interest in following or returning to physical activity.


Although some “particular” forms of squatting may cause discomfort, this does NOT mean that squatting, in it of itself, is bad for you. Rather, it is likely that the pain is caused by poor squat technique/form or an underlying anatomical issue that leads to excessive stress on the knee.


Let’s dive into these two possibilities.



Issues with proper form



I think it’s rather self-explanatory when you think of how much poor form can negatively impact someone’s response to an exercise.


We (KC Performance) have been fortunate enough to have witnessed hundreds of squats throughout our training careers, and through numerous and careful observations, have seen recurring compensations that clients/patients demonstrate when squatting.


Some of these compensations are:

+ Knee Valgus (knees collapsing towards the midline of the body)

+ Excessive Anterior Weight Shift (knees going too far forward past the toes, causing the heels to rise up)

+ Excessive Lumbar Extension (lower back arching past its natural form )


These are just a few of the common issues we see when we ask people to perform a squat, regardless of if they experience pain or not (this is part of our evaluation process).


A quick and simple way to eliminate pain would be to simply improve your technique (ASAP)! This seems simple, yet there may be an underlying reason as to why your body is moving the way it is.


And this leads me to my second possible issue which is, “Anatomical Restrictions”.



Anatomical Restrictions



This is where things get interesting!


If a patient still demonstrates some compensation patterns even after being corrected by an expert trainer, the source of their poor form/exercise pain is most likely due to some muscular or soft tissue restriction, joint dysfunction, or how your bones have developed throughout the years.


If the problem is muscular/soft tissue in nature, then implementing SMR techniques (self-myofascial release) can be extremely helpful when needing to “turn down” muscle tone in certain areas in order to restore proper balance between both agonist & antagonistic muscle groups (when one muscle is stretching, its opposite is shortening 😉).



Self-myofascial release techniques include:


+ foam rolling

+ using a massage ball

+ self-massage

+ cupping

+ using a roller

+ and much more



On the other hand, if the problem is related to joint dysfunction, then adding joint mobilization techniques can help restore proper arthokinematic (joint movement).


This will allow for the successful completion of a given movement ( in this case, the good ol’ squat).


Band distraction techniques, mobilization with movement, or passive accessory joint mobilizations can also be very helpful when trying to regain the proper joint mobility.


These techniques must be performed by a qualified therapist such as osteopaths and/or physiotherapists. This method can help reduce the chances of “impingement” from occurring and thus freeing your pain-free range of motion.



Finally, a patient may experience pain during a squat due to their bone structure. This is commonly referred to as “structural limitations”.


Contrary to a functional limitation (like muscle and joint tightness), a bone structure limitation cannot be changed, regardless of mobility or soft tissue work performed. Instead, these structural limitations must be respected during training by potentially changing the depth and stance of a patient’s squat.


Due to differences in body structure, not everyone can (and should) squat past a parallel position. Changing the patient’s stance may be an easy solution to improving their squat while eliminating (or significantly reducing) pain.



And there you have it!
It’s most likely not the squat ITSELF that’s causing you pain,
but HOW you’re squatting



Our recommendation when experiencing pain during ANY exercise is to get it assessed.


A proper evaluation can help you reduce your pain, improve your form, and save you from potential injuries!


Any questions or concerns, don’t hesitate to reach out to Integral Performance Physio.