Squatting correctly should not cause knee pain. However, people who squat incorrectly and those with a knee injury or knee condition may experience knee pain when squatting.
Many people squat regularly as part of their workout routine or during everyday tasks.
In this article, learn about the causes of knee pain from squatting, how to treat it, and how to prevent knee pain in the future.
Possible reasons why a person might experience knee pain from squatting include:
Squatting incorrectly
If people are not squatting correctly, they may experience knee pain. Performing this movement incorrectly can put pressure on the knees rather than the thigh muscles and glutes.
We cover how to squat correctly later in this article.
A person who continues to experience pain after adjusting how they squat should visit their doctor to check for any underlying knee problems.
Spraining the knee
Twisting the knee awkwardly while squatting or receiving a blow to the knee may cause a sprain.
Sprains are painful and can cause swelling. These injuries can make it painful to squat and do other exercises that involve the knee. A person with a sprained knee may also find it hard to walk or put any weight on this joint.
Patellofemoral pain syndrome
Patellofemoral pain syndrome can cause pain around the kneecap and in the front of the knee, making it painful to squat.
Anyone can develop patellofemoral pain syndrome, but some people refer to it as “runner’s knee” or “jumper’s knee” because it often affects individuals who do a lot of sport. Any injury to the knee may also cause knee pain when squatting.
Tendonitis
Tendons connect the muscles to the bones. Tendonitis of the knee can happen if a person strains or overuses the tendons around the knee, causing them to swell.
Tendonitis is more likely to occur as a result of repetitive movements, particularly if these exert a lot of force on the tendon. People often make repetitive movements while playing sports or working in a manual labor job.
Arthritis of the knee
Arthritis causes the joints to become painful and inflamed. Different types of arthritis can affect almost any of the joints in the body, including the knee.
Cartilage is the flexible, firm tissue that surrounds the joints and enables them to move smoothly. Osteoarthritis develops if this cartilage breaks down.
People with knee osteoarthritis may experience pain and swelling around the knee and feel as though the joint is stiff.
Osteoarthritis is most common in people over the age of 65 years.
Rheumatoid arthritis is an autoimmune condition that affects joints all over the body. The immune system attacks healthy tissue surrounding the joints, causing pain, swelling, and stiffness.
Post-traumatic arthritis can happen after an injury to the knee that damages the joints or ligaments. If an infection spreads to the knee, it can cause infectious arthritis of this joint.
Tendon or cartilage tears
A severe injury or sprain can cause the cartilage in the knee to tear. People may need to wear a knee support during physical activity after a cartilage tear.
A patellar tendon tear is one that occurs in a tendon of the knee, which can happen due to a blow, jumping, or a weakened tendon.
Symptoms of a patella tendon tear include:
- difficulty walking
- buckling of the knee
- a moving kneecap
- pain and tenderness
- an indentation under the kneecap
The type of treatment will depend on the size of the tendon tear. Physiotherapy may sometimes be sufficient, but surgery is usually necessary.
Iliotibial band syndrome
The iliotibial band, or IT band, is tissue that runs the length of the upper leg from the hip to the knee. When a person bends their knee, the IT band moves to support it.
If the IT band becomes inflamed, it can rub on the outer knee and cause pain, especially during movements that involve the joint, such as squatting. IT band syndrome often affects runners. People who do not stretch properly before exercising also have a higher risk of sustaining this injury.
Warming up properly before exercising can help prevent injury. Warming up the body is especially important in older adults, as muscles become less flexible and can tear more easily as people age.
To warm up, use movements that mobilize the joints and increase the flow of blood and oxygen to the muscles, such as marching on the spot. Stretching the legs before and after exercise can also help lower the risk of injury or strains.
To squat correctly:
- start in a standing position
- keep the feet shoulder-width apart
- while exhaling, bend the knees and lower the buttocks as though going to sit down
- hold the arms out to maintain balance
- ensure that the heels remain planted on the floor
- keep the buttocks above knee level and only go as low as is possible without causing discomfort
- keep the thighs parallel to the floor
- keep the back in a straight, neutral position
- make sure that the hips, knees, and toes are all pointing forward
- inhale and return to a standing position by pushing down into the heels and keeping the buttocks tight
The Arthritis Foundation recommend that people who are experiencing pain when squatting do squats against a wall. Using the wall for support can help people strengthen weak or injured muscles and reduce pain over time.
People can do squats against a wall using the following steps:
- stand with the back flat against a wall
- keep a distance of roughly 18 inches between the back of the heels and the wall
- plant the feet shoulder-width apart
- exhale and lower the buttocks as though going to sit down
- do not let the buttocks sink lower than the knees
- tense the abdomen and keep the back flat against the wall
- inhale and use the heels and leg muscles to stand back up
The Arthritis Foundation advise people who are experiencing pain when squatting to do 10 wall squats three times a week. Anyone with a medical condition that could affect their ability to exercise should speak to a doctor before making changes to their fitness routine.
People can use the R.I.C.E method for relieving pain in the knee. The R.I.C.E method involves:
- Rest: Rest the knee and avoid bearing too much weight on it.
- Ice: Apply a towel-wrapped ice pack to the knee for 20 minutes at a time.
- Compression: Place an elastic wrap or bandage around the knee to help prevent swelling.
- Elevation: Whenever possible, prop the leg up so that the knee is higher than the heart.
Over-the-counter drugs, such as ibuprofen, can help reduce pain and swelling.
Although people may need to avoid exercising or doing more squats, gentle movements or stretches can reduce stiffness and keep the joint mobile.
If people are still experiencing knee pain from squatting or other activities after giving the knee time to heal, they should see a doctor.
They may need to work with a physiotherapist to improve the condition of the knee. In severe cases, surgery might be necessary. The time that it takes for the knee to recover will depend on the type of injury or condition affecting the knee.
People who squat as part of their workout or during everyday activities should ensure that they are correctly performing this movement to prevent knee pain.
It is often possible to relieve pain by bandaging the knee, applying a cold compress, resting or changing activity, or taking pain relievers.
If people continue to experience pain in the knee during or after squatting, they should visit a doctor to make sure that there is no underlying condition causing this symptom.