Why do my knees hurt when I squat? 4 Tips for athletes to avoid knee pain [in 2022]
Lets talk knee pain during squatting. It should be simple right? The knee just bends and then it straightens (and a very small amount of rotation, but who’s counting?). Figuring out the cause of knee pain should in turn be so easy to understand, we think….
Truth is, knee pain can be VERY complex and often times multi-factorial, meaning that it is caused by multiple things. The only time knee pain is really simple to understand is in the case of trauma to the knee. In this case clinical diagnostics and imaging can pinpoint exactly what the issues is. In non-traumatic cases this is almost always not the case.
In non-traumatic cases the knee itself is often NOT the source of the pain although that may be where you feel all the pain.
What do I mean by that? If your read below you’ll find out what I mean…
Weakness in your hip abductors & (2.) Weakness in your hip external rotators
This is by far the most common issue I see with patients who have knee pain during activities like squatting, running, jumping etc.
Everyone knows about the infamous glute max (your big booty muscle), but in reality it’s not the most important in regards to improving knee stability. The lateral (side) hip muscles pictured on the left (gluteal medius/minimus) and your deep hip external rotators play a much larger roll in the position of the knee during things like running, jumping, squatting etc. As you can see in the picture, when you have weakness in these muscles the pelvis shifts and will thus cause the knee to shift as well. This creates abnormal tracking of the patella (knee cap) and can create inflammation and pain.
If either (or both) of the these muscles groups are weak they will create excessive rotational forces through the knee that will thus make the patella (knee cap) ride in a less than ideal position, which can create PAIN under the knee cap!
3. Weakness in your foot or congenitally flat feet.
Just like the deep hip muscles play a huge role in stabilizing the knee, the foot plays equally as pivotal of a role! If your feet are over pronating (going flat) too much during repetitive activities it can leave your knee susceptible to multiple issues! Having strong arch supporting muscles can absolutely be a game changer for those who knee pain.
Another option for acute knee/foot pain or a congenitally flat foot can be getting a supportive foot orthotics. My favorite that I use for my patients are made by vasyli medical and can be found here.
4. Your squat form could use some help…
Last but certainly not least, poor technique or form will leave even the most elite athletes with pain. This may seem obvious but sometimes its hard to catch tiny flaws with the human eye. Using things such as a slow motion video recoding can be very beneficial when finding flaws in running or jumping/landing techniques. If your healthcare provider isn’t doing this they are doing you a disservice. Do yourself a favor and find someone who investigates the whole problem.
For a good visual on squat form check out our latest YouTube video here!