Over the past few decades, the squat has become synonymous with many gym and fitness programs. You’ll have no doubt seen people trying all sorts of squat exercises, from heavy back squats, modified box squats, single leg squats to deep prolonged squats. No matter how many different variations you come across, there is one common thing that almost everyone who engages in squat based exercises will complain about at some point. “I get knee pain when I’m squatting!”
People report all kinds of pain during and after squatting exercises. From pain at the front of the knee, pain on the inner knee, pain at the back of the knee and all manner of popping clicking and cracking.
So why does squatting hurt your knees?
There can be many reasons why you might be getting pain in your knees when squatting. Some of these include, improper knee positioning, using too much weight for your strength capacity, poor knee control during the movement, or a joint issue within the knee. Often you will hear recommendations to reduce knee pain when squatting such as “you just need to improve your technique,” “reduce the weight,” “do a proper warm-up,” or “push your knees apart.”
Ultimately, you may be able mitigate or reduce your knee pain when squatting in the short term, but long term it is common for the knee pain to return.
Pain is your body’s alarm system, letting you know that what you are doing is causing it undue stress or damage. So, if you are experiencing pain when squatting, it is likely having a negative effect on the function of your knees.
At Functional Patterns, we take the position that no exercise should cause pain, and if it does, there is likely a reason. We believe that the exercises you do should be making you move and feel better, not worse.
Let’s look at some of the evidence around knee pain and squatting.
A study that assessed elite weightlifters for 6 years (1), found that 51% of them reported knee pain that lasted many weeks. These athletes were regularly completing squat-based movements as part of their training. They also found that a lot of these athletes kept training despite the pain. For an athlete having to perform, this may be a necessary evil, but for anyone looking to train in a way that helps their body function better, pushing through pain is never the answer.
With regards to these athletes, it is easy to think, “well they are probably lifting very heavy weight, which is probably what is doing the damage.” That likely contributes, but it’s not the whole picture.
Another study (2) has found that unfortunately, even deep body weight squats, that are recommended by many fitness and yoga gurus, can cause a greater chance of developing osteoarthritis in the knee in later life.
Although it may have been common for these athletes, it is not normal, nor necessary for your knees to hurt during or after squatting. On top of this, do we want to be engaging in an exercise that can potentially cause great degeneration on our body that shows up later in life?
If squats cause your knee to hurt, it’s time to look for a better option to strengthen you lower body.
At this point you may be asking yourself, I want to get stronger legs, how do I squat without my knees hurting? It seems clear that although completing squats may improve the strength of your leg and glute muscles, the benefit may in fact be outweighed by the long-term negative effect of the squat exercise itself.
However, do not despair, we have some advice to help you out.
Think about how the human body came to develop. Each one of the muscles in our body has evolved to help move the body in a highly specific and complex manner. At Functional Patters, we recognise that there are four main movements which the human body is very good at. These are walking, standing, running, and throwing. We also observe that when people become more proficient at these movements, their muscles become stronger and the overall movement better. On top of this, most movements that we do as humans generally are derived from these four mains functions, be that going up or down steps, getting in and out of a car, getting up and down from a chair or doing work related activities.
So, if our movement involves so much more than just squatting up and down, and our muscles are capable of so much more, we suggest that you seek to train your body in a way that better reflects the big four movements.
On reflection of this information, we like to ask a simple question. If the squat likely only makes you better at squatting, and the chance that it causes pain is so common, surely there is a more intelligent way of improving our lower body strength?
Yes, of course there is! When you account for what is required of your body to walk, stand, run, and throw with excellent movement, then pain will likely no longer be an issue.
How do you get started with improving these movements? Check out our 10 Week Online Course and give yourself the head start to be able to improve your strength and functional without the knee pain!
https://functionalpatterns.com/products/the-10-week-online-program
References
1. Stone, M. H., Fry, A. C., Ritchie, M., Stoessel-Ross, L., & Marsit, J. L. (1994). Injury potential and safety aspects of weightlifting movements. Strength & Conditioning Journal, 16(3), 15-21.
2. Zhang, Y., Hunter, D. J., Nevitt, M. C., Xu, L., Niu, J., Lui, L. Y., ... & Felson, D. T. (2004). Association of squatting with increased prevalence of radiographic tibiofemoral knee osteoarthritis: the Beijing Osteoarthritis Study. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 50(4), 1187-1192.
