Squats are challenging enough without having to deal with knee pain. In this article, we will be taking a look at possible causes of knee pain while squatting and ways in which you can prevent or treat them.
There are two main causes of knee pain; technical issues (bad form, too much weight etc.) and there are knee-related issues (arthritis, muscle imbalances etc.). If you don’t know the cause, then addressing technical issues first is a good idea. If the pain persists, then speaking to a specialist is your best option.
This article will take you through the many causes of knee pain and give you a good idea of how to fix it.
Knee Pain While Squatting
According to Classic Rehabilitation Inc, over 100 million Americans suffer from chronic pain, with knee pain being the second most common cause . Now, most of these people are probably not exercising regularly, but it is important to realise just how common chronic pain can be.
Feeling your knee hurt while you are squatting can be a worrying experience, particularly if it occurs while you’ve got a heavy barbell on your back. Finding the root cause of your knee pain is important, and while you will need a professional to interpret a medical cause, you can do some initial tests to see if it is a technical issue.
What Could be Causing Your Knee Pain?
As stated in the introduction, there are two main causes of knee pain. The most common cause is a technical issue with the exercise itself. The other cause is down to the knee itself or the muscles that surround it. We will take a quick look at both:
There are a number of reasons why the squat itself could be causing your knee pain. Here are some common causes:
- Too much weight – If you are attempting to lift more than your body can handle, it can cause you to overcompensate. This can mean putting too much strain on your body. You may feel this in your lower back, your hamstrings, your quadriceps, or even your knees.
- Bad technique – If you are not performing squats properly, then this can lead to knee pain. Excessively leaning forward can put pressure on the knees. People with long femurs may find it difficult to squat past parallel. It is a misconception that everyone should be squatting “Ass to Grass”.
- Fatigue – If you have performed too many reps, or have trained too often in a week, then you may be overly fatigued. Which can affect how your muscles perform and your technique, both of which may cause knee pain.
- Incorrect footwear – Wearing inappropriate footwear can really mess up your technique and hurt your knees. For example, running shoes with a lot of cushioning can be quite unstable, causing you knee pain as your legs try to brace themselves. Squat shoes can be great for a high-bar squat but are not suited to low-bar squats. If you perform squats with a low-bar stance, then squat shoes could cause knee pain .
A knee injury is a likely cause for knee pain while squatting, though most knee injuries will be felt in your normal life. Not just during a squat.
- Arthritis – Inflammation of the knee joint (arthritis) is a common cause of knee pain. Though, most people with arthritis would be aware of knee pain while walking or climbing stairs.
- Tendonitis – This is an overuse injury which could be caused by excessive exercise. This doesn’t have to be squatting-related. If you are a runner or play sports, then these could cause tendonitis.
- Cartilage tears – Another injury that is often caused by running or contact sports, but a cartilage tear is more likely to be caused by a fall or banging into someone/something.
- Sprained or strained ligaments – These types of knee injuries are caused by twisting your knee rather than banging into someone or something.
How to Avoid Knee Pain While Squatting
Avoiding knee pain is all about managing your levels of risk. Trying to hit a new personal best while wearing high heels is an example of a high-risk strategy. Here are three ways to lower your risk of knee pain while squatting:
Focus on Technique
A good, solid squatting technique is your best way to reduce the risk of knee pain. Not only can you reduce your risk in the short term, but by strengthening your legs through a full range of motion, you are reducing your long-term risk of developing knee pain in the future.
Good technique isn’t just about getting the basics right. It is also about setting up the barbell correctly, wearing the right clothing/footwear, and, as we will see below, programming properly.
One of the most frustrating things for a personal trainer or coach to see is someone walking into a gym with no plan. Squatting 60kg, then adding on two more plates to raise the weight to 100kg, then adding two more plates again and failing.
Where is the programming? Building strength is all about marginal gains over time. You can’t just throw on as much weight as possible. This will almost certainly lead to bad technique or failure. Either of which can cause knee pain or worse.
Follow a sensible program, and don’t overdo it!
Have your Knee Checked by a Doctor
Look, if your knee is hurting whenever you climb the stairs, then don’t walk into a gym and start squatting. Walk into your doctor’s office and get yourself an appointment. Many knee injuries require an MRI scan. They also require professional rehabilitation.
Don’t be stubborn here. If your knee is hurting and it isn’t technique-related, then you almost certainly have some form of injury. Ignoring the problem will not lead to it going away. It will just get worse.
How to Get Rid of Knee Pain
If you’re already experiencing pain from squats it may well be too late to implement the aforementioned advice (although keep it mind for the future). Here are some things that might help eliminate pain and aid your recovery.
Thanks, captain obvious! But seriously. The knee is a complicated joint and bears the weight of your body almost 24 hours a day. Do not expect to be relieved of your knee pain any time soon if you continue to train. Depending on the severity of the pain, you may want to give your leg sessions a miss for a couple of weeks, or skip the gym all together while you recover. Speak to your Doctor!
Get a Knee Pillow
Research  comparing the effects of preoperative skin traction and knee pillows on pain relief in patients with proximal femoral fracture found that, “use of pillow under knee was associated with a reduction in pain similar to the traction method and had fewer complications.”
While I certainly hope you haven’t fractured your femur, this paper suggests that elevation of the knee during sleep by means of a knee pillow should relieve you of some pain and hopefully aid your recovery.
Feeling pain in your knee while you are squatting is either an indication that your squat is bad or your knee is bad. You can easily fix one, while the other needs professional help. The first thing you should do is immediately lower the weight or perform bodyweight squats. Get your technique perfect. If you still feel pain, then see a professional.
References  https://classicrehabilitation.com/knee-pain-statistics-and-causes/  https://barbellrehab.com/weightlifting-shoes/