Today I’d like to talk to you about squats with knee pain.
I guess we all know that the barbell back squat is probably the most effective lower-body exercise, if not the best exercise bar-none (no pun intended).
Often cited as “The King of All Exercises”, we are aware that we should all be performing squats on a regular basis.
However, I have often heard people say that they avoid squatting because it hurts their knees, and in truth if you’re not squatting correctly you are at risk of serious knee pain or even injury.
So, I’d like to discuss why you potentially have knee aches and pains due to squatting, whether you should avoid performing squats altogether if you have “dodgy” knees, and of course the solution to all your squatting problems.
First The Squatting Battle of the Sexes
I must admit it pains me sometimes to watch people squat in the gym, whether it’s the humble bodyweight squat or the loaded back barbell squat (or any other variety for that matter).
Many of the squatting techniques that I see are the main reason for knee pain.
I’m also going to go out on a limb here and say that unfortunately it’s mainly the guys who seem to completely massacre this superb lower body movement.
I’ve spoken a number of times previously about how the last few years of women training in the gym seems to be extremely focused on the “booty”.
The girls will perform a wide variety of exercises specifically targeting the glutes, but whenever they squat it’s always with perfect form.
However, when it comes to the men I typically see a barbell loaded with at least double the amount of weight it should have, followed by a few half-hearted attempts at quarter squats, if that.
The male ego is a weird and wonderful thing, and it is often on display in the gym environment, but when it comes to the barbell squat – guys, you need to stop writing cheques that your quads, glutes and hamstrings can’t pay.
Now don’t get me wrong, it would be pretty unfair of me to completely stereotype here, and I’ve often seen guys squat superbly, and a woman with the most awful technique I’ve ever witnessed.
But, in the main, when it comes to squatting – Ladies, you win hands-down.
Are Squats Bad For Your Knees (& Do They Cause Knee Pain)?
Firstly, let me say that I’m not looking to offend anyone here, but I feel I need to be blunt.
I’ve occasionally been asked (or told) whether squatting hurts your knees.
My reply is usually, “Squatting doesn’t, but what you’re doing does.”
All-to-often I see someone attempting a squat and they manage to pull off some type of hybrid exercise, which includes the lower body portion of a push-press, a good morning, and a calf raise.
For argument’s sake let’s name this exercise the “Push Morning Raise”
So, no squats will not hurt your knees, but a push morning raise will absolutely annihilate them.
Okay, possibly a bit harsh of me, but I just want to get my point across.
There’s a couple of myths about squatting that I want to dispel straight away.
We are typically told that when squatting that the knees should never go past the toes.
With that said, if you’re allowing your knees to move too far forward you will usually find that the heels come off the floor (calf raises anyone?)
As soon as your heels come off the floor you will place a huge amount of undue stress on the knees, and this is where the “knee pain from squatting” myth is born.
The idea is to keep your shins more vertical (they’ll always move forward slightly when you squat, but just don’t do it excessively), which allows your heels to stay flat on the floor.
I cannot recall where I first heard this, but you should always push through your heels when squatting. Imagine you’re on a sandy beach and you’re trying to push your feet as deep into the sand as possible – that’s how you squat.
As long as your heels stay flat on the floor, you’ll take the stress off your knees, and more of the load of the barbell (or your bodyweight) will be placed onto your hips.
This is extremely important, as your hips are a far larger joint than your knees, so they should be taking more of the “strain”.
The other myth that I typically hear is that squatting below 90 degrees is extremely bad for your knees (hence the final part of the “new hybrid exercise”, the lower portion of the push press and the good morning).
If you squat through a full range of motion, which will involve you going slightly below 90 degrees, this is actually far healthier and will help to make your knees stronger.
Pure and simple – If you aren’t suffering from a pre-existing injury, and you find that squatting is giving you knee pain, then your knees are taking more of the load/doing more of the work than your hips.
Do yourself a favour and allow the larger joint of the body (the hips) to do more of the work.
Should You Avoid Squatting if You Have Knee Pain?
Whether you should avoid squatting or not obviously depends on the severity of your knee pain.
So, if you’re in excruciating pain then you should avoid exercise altogether and immediately book an appointment with your Doctor, who may refer you to see a specialist.
However, if you’re someone who only feels knee pain whenever they squat, and not at any other time, this is evidence that you are squatting incorrectly.
Therefore, you need to first hone your technique in order to start squatting with perfect form.
This will include keeping your shins as vertical as possible so your heels stay flat on the floor. You will also need to ensure that your hips are taking more of the load than your knees, and that your feet are in the right position.
I also want to clarify when I talk about “load” this also includes bodyweight squats, as your lower legs, glutes, and hips are still supporting the entire body when you perform them.
So, how do you achieve perfect form and squat without knee pain?
The Solution to Squatting Without Knee Pain
Ladies and Gentlemen (and potentially more gentleman, as the majority of ladies seem to have this sorted), I present to you:
The “Box Squat”
The box squat will automatically allow you to perfect your squat technique, while also keeping your shins more vertical, thus meaning your heels will stay on the floor.
I’ve included a couple of videos below, which I think cover the box squat technique very well, although I’m not 100% satisfied with either explanation (but I’ll settle for 99.99%).
For me, a box squat should involve squatting down and your backside literally just brushing the box behind you, a very gentle touch, and then reversing the motion back into a standing position.
However, both Movement Rx and Mark Rippetoe appear to advocate actually sitting back on the box before rising back up again.
Who am I to argue with the many years of expertise of these guys and gals?
Okay, I want to clarify a few points on technique (from my point of view) before you fire away.
The box height will typically be determined by your own height, although about 14-15 inches works best.
Many people will use a bench to box squat, but please be aware that most gym benches are usually around 17-18 inches in height.
The main thing you want to achieve, in terms of the box height, is that you want to ensure that you’re squatting just below 90 degrees.
Your toes should be pointing outwards (so not straight ahead) at an angle of approximately 15-30 degrees, and you want to ensure that your knees stay in line with your toes throughout the movement.
If your knees start pointing inwards or outwards when performing any type of squat, you are probably putting more pressure on your knees than your hips once more.
Finally, never just fall or drop onto the box, as though you’re plopping onto your couch at home.
Slow and controlled on the way down, feel your butt against the box, and then reverse the movement back into a standing position.
The best way to master perfect box squat technique (or any squat for that matter) is through practice.
My suggestion would be to hit the box squat twice a week with a few days rest in between each session.
Your first session should be contained to bodyweight box squats, and aim for 2-3 sets of 10 reps.
The second session, add weight (even an empty barbell will suffice) if you feel you can and perform 2-3 sets of 6-8 reps.
I would suggest for the weighted version that you keep it extremely light until you feel you have mastered the technique.
How To Box Squat
Box Squat Technique With Knee Tendonitis
So, there you have it. You can squat without knee pain, as long as your form is correct.
Squatting definitely doesn’t cause knee pain, but the technique you are using is usually to blame.
The most common problem where knee pain arises “due to squatting” is pushing the knees and the shins too far forward, thus allowing the heels to come off the floor, and therefore making your knees take more of the load than your hips.
I certainly don’t think you have to avoid squatting unless you have severe knee pain.
The solution is to start performing box squats, which will allow you to master perfect squat technique.
I would love to hear from you and see what you think of the box squat.
So, please let me know in the comments section below.
Thank you for reading.