10 Minute Tip 13: Anterior Knee Pain From Squatting | Why It’s Happening & How To Address It
Knee pain from squatting happens due to a variety of factors. Squat frequency, intensity, volume, and technique all play a part in anterior knee pain. Here we are going to address technical considerations of the squat and knee pain to assist in reducing it.
From a technical point of view, the acuteness of the knee angle at the bottom of the squat may be a contributor to anterior knee pain.
There are a variety of things that may increase the acuteness of the knee angle including:
Depth
Bar Placement
Eye Gaze
Tension
Balance
Torso Position
Footwear
In this episode of the PRS Podcast we discuss why these factors influence knee pain and how to address them to reduce knee pain from squatting so you can continue squat comfortably and get stronger without injury.
Resources mentioned in this episode:
If you’re enjoying our podcast, please leave us a review on Apple or Spotify.
Join our Facebook Community for free form checks, live Q&As & more: https://www.facebook.com/groups/PRS.Barbell.Mastery
Got questions or guests you'd like to hear on the show? Submit them here: https://forms.gle/7Vu2HmgHoeQY9xM59
Get in touch with the show!
Email: podcast@progressiverehabandstrength.com
Rori IG: @rorimegan_prs
Alyssa IG: @alyssahope_prs
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:04] Welcome back to the Progressive Rehab & Strength podcast. I'm your host, Dr. Rori Alter, with my lovely co-host, Dr. Alyssa Haveson. We're clinical coaches here at Progressive Rehab & Strength, and we are back for our first podcast recording of 2023. So this is super exciting. We recorded a bunch in 2022 to get us through January, and here we are recording some new podcasts for you. So we're going to start with a ten-minute tip Tuesday. So if you're listening to this when it airs, it's Tuesday. Happy Tuesday, everyone. And in these ten-minute tips, we set a timer for 10 minutes. We talk about a topic, common questions, or experiences that you have in powerlifting, barbell training and injuries and progress, and all those things. So in today's Ten-Minute Tip, we will discuss modifying the squat for knee pain. So we're going to set a timer for 10 minutes, and we're going to talk about knee pain in the squat and what you can do about it. All right, here we go. Are you ready, Alyssa? Timer Three, two, one, go. Alyssa, why do the knees hurt when we squat?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:01:20] Usually, it's not the knees. But typically, when we see knee pain during the squat, it's related to the knee angle and how the knee moves. And the knee is often not the culprit of what's going on. And these aren't as quote-unquote as many people say bad. We have to look at the position of the knee throughout the range of motion and how the joints and the knees move while someone is squatting. So, Rori, I'll let you go into what will affect knee angle and movement. But those are the two big pieces of it.
Dr. Rori Alter, PT, PRSCC, SSC: [00:02:07] Yeah, that's a crucial part of knee pain in a squat. And I think you touched on it when you said it's not the knees hurting. If you're experiencing knee pain, you connect the experience of pain to the knee. But as Alyssa said, it's really about how we're moving and how our movement affects the knee. And we've had multiple podcasts on pain barbell training and the pain experience and all that stuff. So again, it's not ever just technique or how you're moving. It's a combination of your own painful experiences and beliefs around pain, with whatever might be going on at the physiological or biological level in the knee, possibly, and also how we're moving. So technique or the stress on the joint and our recovery. Our program volume, intensity, and all those things. It's all these things combined. But in this Ten-Minute Tip, what we're going to be talking about are the technical components of the squat that affect the experience of knee pain in the squat. And when you said it's not usually the knee, it's our movement and how we're moving through space to position the knee joint, plus all the muscles, ligaments and tendons, and joint structures, how they're being moved and affected by movement and load throughout the motion.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:43] And so typically anterior knee pain, or medial or lateral anterior or knee pain, is going to be affected most by having a deeper knee angle. So a more acute knee angle. That's because our knee is sliding more forward when we get that angle. Our thigh and calf are approximating closer. So it's just more stress and more closure on the knee. And that can stretch the anterior structures of the knee. So the quadricep muscle ligaments and all that stuff and the joint capsule put pressure on the front of the knee. And that can cause some knee pain. And then the deeper we go or the deeper the knee angle is, it can also put compression on the posterior aspect of the joint or inside the joint. So what we want to talk about is modifying the squat to open the knee angle a little bit more. So we're not causing as much pressure over time, accumulated with our training stress. So again, it's not simply the knee position. It's the knee position under stress accumulated over time in our training, right?
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:05:15] Yeah. And just to be completely clear, with everything we're talking about, I know that there are some ideas out there that knees moving forward or knees being past your toes is bad or squatting below parallel is bad, like these things aren't bad for your knees. So we have to look at the type of squat we're doing and how someone is moving.