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Knee Pain When Squatting

This is one of the most common aches and pains I come across when coaching TRU FIT training sessions. "My knee hurts when I squat."

Why do I get knee pain when I squat?

A lot of people get that pain deep in the front of their knee or around the patella (the knee cap) and more often than not, the reason for this is for poor muscle engagement, poor form and poor mobility.

How can we fix this?

We can fix this through a combination of different methods:

  1. Soft Tissue Therapy/Sports Massage - Using soft tissue therapy techniques like sports massage and cupping therapy, we can help reduce the tension in the quad muscles and relax the muscles around the knee joint, reducing stress on the joint. Massage is also a great was to help reduce inflammation around a joint. This in turn will also help reduce pain and help increased blood flow and therefore recovery. Cupping therapy is also a great way to help stretch the connective fascial tissues around the quad and knee joint itself, again, in turn, reducing tension and pain in the knee joint.

  2. Muscle Activation - A lot of the time the knee can be put under undue stress from the quads as other major and minor muscles groups are not activating correctly throughout the squatting movement. My first point of call would be to look at hamstring/glute activation and strength. If the hamstrings and glutes are unable to activate correctly throughout the squatting movement people will have a tendency to lean forward and have more weight in the front of their feet and therefore loading the quads and knees. Activating the hamstrings and glutes enables people to correctly load the mid/back of the foot correctly and therefore balancing the load between the quads, hamstrings and glutes. Activating smaller muscle groups e.g. the adductors and abductors can also help stabilise the knee joint throughout the squat ensuring the correct tracking of the knee.

  3. Correct Form - There are several steps to squatting correctly to ensure proper form, but one of the major mistakes people make is initiate the squatting movement by bending the knees. This automatically loads the quads and adds stress on the knee joint. Two of the main verbal cues, I give to people when squatting is to think about making sure their weight is evenly distributed throughout the feet (sometimes the queue of 'weight in the heels' helps people distribute the weight more evenly) and the first movement I ask them to think about is to stick their bum out a fraction before bending the knees. Again, this helps to activate the glutes and hamstrings and load more of the mid/rear of the foot to help reduce weight and stress on the quads and knees.

  4. Ankle and Hip Mobility - All of the points and vital and super important when squatting however, the last thing that often gets overlooked is ankle and hip mobility. Without the ankle and hips being able to flex and extend effectively, hitting the correct positions in the squat can become incredibly difficult. Lack of ankle and hip mobility will again lead to weight being distributed more in the front of the foot as you may not be able to keep the heels on the ground in the bottom of the squat. Regular stretching and massage through the ankles and hip joints can really help people hit the correct positions in the squat and therefore load the lower body correctly, avoiding overloading the knees. - The Air Squat

I hope this helps some people understand their knee pain when squatting in more detail and if you need help fixing your knee pain or would like to talk to someone in more detail about your knee pain, then please get in touch. We would love to help. Jack TRU FIT