Learning to squat with knee pain can be pivotal in unlocking knee osteoarthritis pain relief. Chronic knee pain is typically caused by muscle asymmetries, stiffness, thoughts about pain, and more. The good news is, almost all of these are able to be fixed and you will be able to squat again. You squat countless times per day and have been since the caveman era. It is actually NORMAL to be able to squat without chronic knee pain. Here are the reasons why you need to learn how to squat with knee pain.
Squats can be one of the most painful movements with knee osteoarthritis, chronic knee pain, and/or following a total joint replacement. But, squats are one of THE if not THE most important movement that you do during daily life.
Most of our ancestors depended on the deep squat! Our bodies are meant to squat but why do people start to develop pain with this movement?
There are many reasons we as humans have developed knee pain when squatting, that we are going to look at in this post.
Learning to squat with knee pain can be frustrating. Squats can feel awkward and I’ve even had some people describe it as embarrassing when trying to squat down to pick something up in public.
If you are feeling this way, I want you to know that you are not alone. This is why I want to tell you the 5 ways you can learn how to squat with knee pain so you gain more confidence and hopefully less pain!
5 ways to learn how to squat with knee pain
The chronic knee pain you may be feeling when squatting could be for many different reasons. And likely it is actually from a combination of these reasons below.
These may be things that you have not heard of before but the idea is to highlight things you need to work on. Not all of these ways may apply to you and that’s okay!
Choose at least the top 2 to begin working on. Once you improve in these areas, you should be able to find powerful knee pain relief.
Lesson #1: Squat Form
Try this experiment to test your squat form.
Stand up from where you are and try to do a squat, bend down and stand up how you usually would.
Think about how it feels:
- Do you have any pain?
- Do you have difficulty squatting lower?
- Does it feel awkward or just not right?
Now, stand in front of a chair. Squat down to sit down and then stand back up. Does it feel any different? Does it feel better?
For most of the people I do this with, the squat dramatically changes from when you have a chair behind you to when you are free squatting. This video below explains this exact situation and what to do instead.
In summary of the video above, when the knees bend first during a squat, they tend to take most of the load. This is one the of the most common problems I find when people squat with knee pain.
Now try to squat again, think about bending the hips first NOT the knees. You can even take your hands and physically push your hips back like in the video.
How does this feel? It’s okay if it feels weird at first or if you feel like you are going to lose your balance backwards (please do in front of a couch or bed if you do 😁 )
This is typically one of the first things I look at when seeing someone reporting knee pain with squatting. This tends to be one of the most common problems that leads to joint pain, especially with increased knee bend.
This test can also be turned into an exercise and can be a great way to teach your body how to squat properly again. Practice using your hips when you are doing anything squatting related (up/down from the toilet, in/out of car, up/down from chair, picking something up, etc).
Practice makes perfect.
This can make a world of difference to knee osteoarthritis pain and is arguably one of the most important lessons to learn.
Lesson #2: Overcome your pain with your thoughts
This may sound a little voodoo at first, but I wouldn’t be putting it in here if it didn’t work!
Especially when dealing with knee arthritis, I see quite a few people that have pain with squats because they are expecting it. Now I know this sounds crazy but it’s true.
If you are anticipating pain when you have to get in the car, bend down to sit on the toilet, or when you have to squat down to a chair- you will likely have pain.
Don’t get me wrong, the pain is real when you have it. But sometimes you can further convince our bodies that the squat is a potentially dangerous movement if you expect pain every time we do it.
If you think “Man, this is going to be painful” then your mind thinks that’s actually what you want to happen!
Your words are very powerful especially when trying to squat with knee pain. If you don’t believe me, I would highly recommend checking out the video below with Marisa Peer, a world renowned psychologist. She states: “First you make your beliefs, then your beliefs make you.”
If you start trying positive self talk, you may actually be shocked at the results.
If each time you go to squat, you tell yourself some variation of “I can do this” you may start to notice you feel more confident in the movement.
This idea is worth entertaining, I promise.
But this is not something that will likely lead to immediate change in pain. It does take some discipline to start looking at your knee pain in a more positive and optimistic light. But when you do, you may notice a drastic difference.
Lesson #3: taking care of stiffness
“I just want to be able to squat like everyone else” is something I hear from clients all the time.
When I bend down into a deep squat to demonstrate during a session, I hear “Man I wish I could do that”.
Well guess what, YOU TOTALLY CAN!
In order to regain squat depth like in the cave man picture at the beginning of the article, you have to make sure your joints are free how they need to.
Joint stiffness can have a significant impact on your ability to squat.
With stiffness being one of the leading symptoms of osteoarthritis (learn what the other 3 common symptoms are here!) your joints can be holding you back from getting down into a lower squat.
There are a few ways to relieve joint stiffness and regain mobility. But it’s not only the knee that you need to be focused on.
The four main joints that limit squatting ability are typically knees, hips, ankles, and/or spine (upper and/or lower back). This is why it is so important to look at all of these when figuring out where you need to work on most. I’ve heard physical therapists are great at this 🙂
When you try to squat with knee pain, your ankles may be the primary limiter. You may also be surprised at how limited they are in range of motion.
That is why I included this video below so you can see if your ankles are the culprit- and if they are, what to do about it.
Lesson #4: Strong hips are key
If you are having knee pain when squatting, your hips may be a huge part of the problem.
Think about the movements you typically do day-to-day. Like walking forwards, getting up and down from a chair, going up and down the stairs, etc.
If you notice, all these movements are in a forward direction. Likely, you rarely spend time deliberately moving side to side or backwards.
This is important because when you are constantly moving forwards, your thigh muscles do most of the work. The problem with this is that your hips and the backs of your legs tend to get neglected.
Now add walking as primary form of exercise and thus you have more forward movement.
Take this example. A client I met with was very active walking, occasionally running, and riding his bike. But, he started to develop knee pain that just wouldn’t go away. Upon assessment, he also had knee pain when squatting. Taking a look at his training, he was primarily all in one direction, forwards.
This is a very common scenario which is why it is being addressed here.
Variety in movement is crucial to keeping well-rounded, strong legs. When you were younger, likely you got your variety of movement from sports (which you can still do with arthritis!), playing with friends, and the increased willingness to try new activities.
But as we tend to get older, these activities may seem less desirable due to pain, weakness, or fear of injuring yourself.
It can be difficult to achieve this variety, especially when dealing with pain because you may be unsure if the exercises you are picking are good for your joints. This was the trap the gentleman above was falling into.
The answer to this problem: add variety. This can include:
With the gentleman in the scenario above, I added some lateral movements to work his outside hip muscles and some other exercises to help strengthen the back of his legs. His knee pain when squatting slowly started to go away once he were able to regain strength. This created a well rounded knee joint, getting support from all sides!
If you are feeling unsure of which exercises to start with, I created a free 5 day arthritis friendly workout challenge can show you exactly how to move without flaring up your knee pain!
You will get 5 days of workouts that will help add variety to your training and show your knees some love.
Lesson #5: Improve your balance
Now what does balance have anything to do with learning how to squat with knee pain? Actually, way more than you think!
Part of decreasing knee pain involves being comfortable shifting your weight backwards. Also your ability to stabilize yourself moving sideways a and backwards is vital too.
Your balance skills may surprise you. Even if you aren’t falling over the place your balance may not be as great as you think.
When you have appropriate balance, your muscles are all working together as a team. This team is successful when each muscle is doing its job. When we have pain, and/or a strength or mobility deficit, your team may start to experience some dysfunctions. These dysfunctions can then lead to increased joint pain because it alters how your joint accepts stress.
If your balance is better on one leg than the other or if you feel as though your balance is “off”, this could be contributing to your pain.
To test your balance I want you to try this test in the video below. It is a little harder than it looks!
If you are looking to squat without knee pain it is so important that your balance is good. It is important that once you master the basics of balance (can be found here) then you progress to higher level activities like this one.
If it is hard for you to do, don’t worry! It’s actually a good thing because now you know a potential reason why you may be having knee pain when squatting.
This ultimate balance challenge can give highlight any potential balance deficits and asymmetries. Keep in mind, this is only one test, but it’s an important one.
If you notice balance impairments, begin working to improve your balance. It will actually help your squat.
Adding support when you are squatting can also help to prevent compensations that may be going on. Here are some examples of how to modify squats.
There are a few different ways you can learn to squat with knee pain. Commonly, pain originates from a combination of things and it is unlikely pain is coming from one singular thing- especially if you have started to experience gradual pain without any injury.
The most important thing is to know that knee pain when squatting is not normal and can be fixed.
There have been many people who have been dealing with knee pain for months and/or years thinking it’s because of age or getting older.
These reasons are important to think about when looking at why your chronic knee pain is occuring.
The longer you try to ignore this pain, it will likely continue to get worse.
If you are dealing with knee osteoarthritis and are looking for ways you can build stronger legs without having to worry about if you are doing the right exercises, hop on over and grab the Knee Osteoarthritis Exercise Guide!
One of the most common things I hear is that people avoid exercise because they are in pain and not sure if what they are doing will cause more damage.
Resting is one of the worst things you can do, especially for chronic knee pain and osteoarthritis. It’s time to take action and get control over your knee pain with squats.
Disclaimer: This post is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Kuhn and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Move Well Age Well, LLC and Dr. Alyssa Kuhn, PT, DPT are not liable or responsible for any advice, course of treatment, diagnosis or any conclusions drawn, services or product you obtain through this video or site.