Squat Series #1: Prevent Knee Pain with Squatting

Love it or hate it, the squat is a staple movement of most exercise programs. It is also one of the most common exercises to get wrong. And it’s no surprise, considering how many moving parts and muscle groups are required; glutes, quads, hamstrings, calves, ankles, core, knees, even your shoulders and lats—all are required to execute a ‘perfect’ squat. 

In this squat series, we will take a deep dive into some of the most common form issues seen with the squat–chances are, you’ll see them too! Just as a note, we will be discussing the basic and unweighted squat movement, and not the barbell squat; the barbell squat is a more advanced movement with its own set of rules. If you’re interested in learning more about how to properly barbell squat, you check out this article here. 

In this first article in the squat series, we will discuss knee issues with squatting and how to alleviate discomfort and avoid straining this very important joint. 

Knees are a controversial topic in the fitness industry. When squatting, is it okay for your knees to travel over your toes, or not? Should your knees be in line with your toes or is it okay for them to be wider than your stance? Etc, etc. Everyone has – that will affect your squat stance and movement; these variations include the length of your femur and the depth and size of your hip sockets, among others. One thing is certain though: your knees should not hurt when you squat. 

In some cases, a physiotherapist or doctor may be the only professionals who can tell you the exact source of your pain, especially if you’re dealing with an injury or an overuse issue. But in the case that your knee pain is the result of poor form, there are some steps that you can take to reduce your or your client’s discomfort:

1. Find your natural squat stance. For many people, the most comfortable stance is feet slightly wider than hips with toes pointed out slightly. This might not be true for you though–try squatting without weight and see what feels the most comfortable and that gives you the most depth. 

2. Sit, not hinge. Sitting’ into a squat and focusing on glute engagement will help take some of the load off of your knees. Cue your client (or yourself) to imagine sitting on a bench. The hips and butt should be pushed towards the back of the room. And don’t be afraid to accessorise! Use a bench or a chair so that your client touches their glutes to a bench or chair behind them at the bottom of the squat movement; this will help to engage the glutes and also guide them towards getting their thighs parallel to the floor (which is an important aspect of squat technique!). 

Another modification that you might find helpful is the hack squat. In this variation, you place a foam roller or a yoga ball between your client’s back and the wall. Ask them to step away from the wall, pressing their backs against the ball or foam roller, and squat as if they are sitting on a bench. This may take some trial and error, but this variation forces your client to “trust” the ball or foam roller and to engage their glutes. Their legs at the bottom of the squat should form a 90 degree angle (but no deeper, especially if your client suffers from knee pain). 

3. Grip the floor with your feet. A strong base of support is a squat essential! I will often cue clients to imagine pulling a piece of paper apart on the floor with their feet while they squat (and deadlift!). An active base of support will help to take the weight off of your joints, preventing injury. If you have trouble ‘activating’ your feet, try squatting without shoes (if your gym will allow it). 

4. Related to the point above–your footwear is important! The shoes that you squat in should be flat and have very little cushion. Too much support and cushion may put your joints at risk. 

5. Loosen up the calves. If you or your client have a problem going to depth without your heels lifting up and your knees hurting, try foam rolling your calves before each squat session. 

6. Use accessories! Your kneecaps should be in alignment with your second toe as you squat–are yours collapsing inwards? If you find that your knees start caving in at the bottom of the movement, try using a resistance band looped around your legs above your knees and focus on ‘pressing’ the knees out and keeping them stable through. Alternatively, you can put a ball or pilates ring in between your knees while you squat to ensure that your legs stay stable–it’ll also help to engage ‘knee protective’ muscles such as your adductors. 

We hope these tips help to alleviate your knee pain! Are there any that we missed? We’d love to hear from you!

Wishing you all the best on your journey to optimum health!

Written by Theresa Faulder, Master’s in English, Certified Personal Trainer and Infofit fitness blog writer.