While squatting is a part of exercise routines, you might not realize how often you end up in a squat throughout a normal day. Picking up toys, lifting a box, or playing sports can all leave you in this position. You may experience some occasional discomfort with a squat, but when you notice it consistently hurting your knees, it could be a sign of problems with the joint or even things like an injury from a car accident that requires a chiropractor.
Why Your Knees Hurt When Squatting
Knee pain during squats can be frustrating and make it difficult for you to exercise or perform everyday tasks. There are several potential reasons why your knees might hurt when squatting, and the specific cause will often be determined by where the pain is located and how it feels. Let’s explore some of the most common causes of knee pain during squats and what each one could mean for your overall knee health.
Patellofemoral Syndrome
One of the most frequent causes of kneecap pain when squatting is patellofemoral syndrome, often referred to as “runner’s knee”. This condition typically causes pain at the front of the knee, near or around the kneecap (the patella). Patellofemoral syndrome occurs when the cartilage under the kneecap becomes irritated because of overuse or misalignment. Activities like running, jumping, or repetitive squatting can make this issue worse.
Symptoms of patellofemoral syndrome:
- Pain at the front of your knee
- Discomfort during activities like squatting, kneeling, or climbing stairs
- Pain that gets worse with prolonged sitting or standing
Patellofemoral syndrome can happen because of muscle imbalances, poor alignment of the kneecap, or trauma to the area. In many cases, correcting your form and strengthening the muscles around the knee can help alleviate this condition.
Patellar Tendonitis
Patellar tendonitis is another common cause of knee pain during squats, especially for athletes and people who live a more active lifestyle. This condition, also known as “jumper’s knee,” occurs when the patellar tendon—the tissue that connects the kneecap to the shinbone—becomes irritated or inflamed.
Symptoms of patellar tendonitis:
- Pain and tenderness at the base of the kneecap
- Swelling in the knee area
- A burning sensation in the knee
- Stiffness in the knee, especially after activity
This condition often results from overuse, particularly in activities that involve repetitive jumping or heavy impact on the knees. Rest, ice, and physical therapy can help reduce inflammation and improve tendon strength in your knees.
Osteoarthritis
Osteoarthritis is a degenerative joint disease that can cause knee pain when squatting because of the wear and tear on joint cartilage. This condition is more common in older adults but can affect anyone with a history of joint injury or overuse.
Symptoms of osteoarthritis:
- Swelling and stiffness in the knees
- Popping or cracking sounds during movement
- Weakness or instability in the joint
- Increased pain after periods of inactivity
Squatting can make the pain caused by osteoarthritis worse because the movement puts too much pressure on the already weakened cartilage, leading to pain and inflammation.
Sudden Knee Injuries
Any injury to the knee, such as a ligament tear, meniscus injury, or fracture, can also cause localized pain during squats. If you’ve recently experienced an impact or twist to your knee, like from a car accident or slip and fall, you may notice swelling, bruising, and difficulty bearing weight on the affected leg.
Symptoms of knee injuries:
- Sharp pain or throbbing around the knee joint
- Swelling or bruising
- Limited range of motion or instability
- Pain that gets worse with weight-bearing activities
It’s important to seek medical attention for knee injuries to avoid long-term damage and to heal properly.
Iliotibial (IT) Band Syndrome
Iliotibial band (also known as the IT band) syndrome can cause pain on the outside of your knee, especially during activities that involve repetitive bending and extending of the leg, like squatting. The IT band is a thick strip of connective tissue that runs along the outer thigh from the hip to the shin, and when it becomes tight or inflamed, it can make your knees hurt when squatting.
Symptoms of IT band syndrome:
- Pain on the outer side of the knee or hip
- Tightness in the upper thigh and hip
- Worsening pain with running, squatting, or cycling
Stretching, foam rolling, and strengthening your hip muscles can help alleviate IT band syndrome.
Bacterial Joint Inflammation
Though less common, bacterial infections in the joint (also known as septic arthritis) can cause knee pain after squats. This type of joint inflammation is serious and typically presents with additional symptoms like fever, fatigue, and even loss of appetite.
Symptoms of septic arthritis:
- Sudden, intense pain in the knee
- Redness and swelling
- Warmth around the joint
Septic arthritis requires immediate medical attention to prevent joint damage and further complications.
Poor Squatting Form
Even if your knees are otherwise healthy, performing squats with poor form can lead to significant knee pain over time. Squatting with your knees caving inward (known as knee valgus), not engaging your core or glutes properly, or leaning too far forward can put excess stress on the knees.
Common signs of poor squatting form:
- Knees extending too far over your toes
- Uneven weight distribution (like favoring one leg)
- Not sitting back into the squat properly, which places more pressure on the knees
Over time, squatting with poor form can also place stress on the knees which causes significant pain.
Preventing Knee Pain
Even with no underlying condition, squatting without proper form can cause pain in the knees. The first thing to do to prevent pain is to ensure you are doing squats properly.
- Begin by standing with your back flat against a wall, feet about shoulder-width apart. Place your heels a foot away from the wall and keep your knees in line with your heels.
- Take a deep breath, squatting as you exhale, scooting down as far as you can without dropping your bottom below your knees. Your knees should stay in line with your heels at all times.
- When you are ready to stand again, engage your core muscles and flatten your back against the wall. Inhale as you slowly rise to your original standing position. You should be pushing from your heels, not the balls of your feet, to engage the right muscles in the back of your legs.
TIP: Try practicing in front of a mirror at first so that you can check your form!
In addition to practicing squats, there are other ways you can reduce knee pain in your daily life.
Here are a few ideas:
- If you feel discomfort, ease up on your level of activity. Overuse is a common cause of pain in many parts of the body, and rest can help.
- Incorporate stretching into your daily routine to help improve any imbalances and increase flexibility.
- Keep your muscles and bones strong with exercise by gradually increasing your activity over time.
- Properly warm up and cool down from any exercise or athletic activities.
- Add strength training into your routine, targeting the leg muscles.
- Consider wearing orthotics to help align your legs or compensate for flat feet and high arches.
While squatting is a part of everyday life, you shouldn’t power through the pain. Instead, try to make reasonable changes that can help, and if they do not work, it may be time to talk to your Snellville doctor.
How to Alleviate Knee Pain During Squats
If you’re experiencing knee pain during squats, there are several steps you can take to find relief:
- Rest and ice: If your knee pain is due to overuse, take time to rest and apply ice to the area to reduce inflammation.
- Strengthen supporting muscles: Focus on strengthening your quadriceps, hamstrings, and glutes, a suite of muscles that provide support for your knees.
- Stretch regularly: Stretching your quads, hamstrings, and IT band can also improve flexibility and reduce strain on your knees.
- Use proper form: Always prioritize correct form when squatting to avoid unnecessary stress on your knees.
Treating Knee Pain
When knee pain doesn’t go away despite basic home remedies, it’s time to explore professional treatment options. Seeking the expertise of a chiropractor or healthcare professional is a great next step, especially if your pain is impacting your daily activities or exercise routines. Here’s an overview of what you can expect during treatment and the various approaches available to alleviate knee pain.
Chiropractic Care
If basic home remedies are not helping your pain, visiting a chiropractor is the next step. They’ll begin by discussing your symptoms, any injuries, and your overall health with you. Be sure to tell them about your pain, including when it started, if it’s consistent or intermittent, what makes it better and worse, and what changes you may have made to your physical activity.
Along with these questions, your chiropractor will perform a physical exam to evaluate your range of motion, swelling, grinding, and any other symptoms. You may be asked to bend your knee, walk, or move your knee into other positions to see how you respond. Chiropractors may also perform chiropractic adjustments to your spine and joints and reduce tension in your knees. They may also use techniques like myofascial release to improve mobility and relieve your pain.
Physical Therapy
Most pain felt during squatting can be addressed by a non-invasive form of treatment like physical therapy. You will be given certain exercises to perform aimed at strengthening the muscles that support your knee, focusing on the quadriceps, hamstrings, and hip abductors. For example, those with patellofemoral syndrome will work towards preventing inward movement of the knee during a squat. Strengthening the surrounding muscles can improve stability and reduce strain on the knee joint.
In some situations, your physical therapist may recommend custom orthotics, which are shoe inserts that promote better alignment of the feet, knees, and hips. Poor foot alignment can also contribute to knee pain by putting additional stress on the joint. Orthotics can help to correct this by distributing your body weight more evenly and encouraging you to engage in proper posture during movement.
When Surgery Becomes Necessary
While most knee pain can be managed with non-invasive treatments, there are certain situations where surgery may be required, especially if you have significant structural damage in the area.
- Arthroscopy: A minimally invasive procedure, arthroscopy involves inserting a small camera (attached to a thin tube) into the knee joint to diagnose and repair minor damage. Arthroscopy is commonly used for issues like torn meniscus cartilage or loose fragments of bone.
- Knee Realignment Surgery: In more severe cases, a procedure like realignment may be necessary to reposition the kneecap and relieve pressure on the cartilage. This type of surgery is typically recommended when the pain is caused by structural abnormalities in the knee joint.
Both procedures come with varying recovery times, but arthroscopy tends to have a quicker healing period compared to more invasive surgeries like realignment. However, your recovery still depends on factors like the extent of damage, your overall health, and the success of physical therapy after you’ve gone through surgery.
The recovery time for knee injuries will vary widely depending on the cause of the pain, the severity of any damage or injury, and the type of treatment. Some people will recover quickly by simply resting at home and managing their pain, while others will require ongoing physical therapy to work on imbalances at the source of the pain. If surgery is required, recovery could take months.
AICA Atlanta for Knee Pain and More
It is important that you always follow the advice of your doctors and avoid putting too much stress on an injured knee in order to return to your full level of activity. At AICA Atlanta, our team will work with you to create a recovery plan that meets your needs. Whether you need non-invasive treatments like chiropractic adjustments and physical therapy or require more intensive procedures, our team will work with you to restore your knee health and get you back to your normal activities as quickly and safely as possible.