You know that familiar feeling when you lower yourself into a squatting position and you’re already bracing for what’s about to happen – the knee pain while squatting.
As you come out of the squat, you feel the pinch and the dull ache coming from your knees. You wish you could find an effective solution for preventing knee pain and possibly causing yourself a knee injury.
Knee pain when squatting is a frustrating and limiting issue for many individuals trying to reach health and fitness goals, and yet it’s a common occurrence.
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According to classicrehabilitation.com, knee pain is the second most common cause of chronic pain. One-third of all people who exercise regularly report that they experience knee pain, and 20% of women suffer from squatting knee pain during their exercise routine .
To put these figures in context, let’s take the number of women in the U.S. in 2020, which was reported at 167 million. If 10% of those women exercise (16.7 million) and 20% of them experience knee pain, this means roughly 3.3 million women are experiencing knee pain regularly.
It’s understandable with these statistics why so many individuals would be looking for ways to prevent knee pain and avoid injury.
In this article, we examine the causes of knee pain and how you can prevent it during your workout routine.
Understanding knee pain during squatting
Knee pain can occur for several reasons, ranging from poor technique and muscle imbalances to underlying knee conditions or injuries. It is important to differentiate between temporary discomfort due to incorrect form and long-term or chronic issues that require medical attention. By identifying the cause of your knee pain, you can take appropriate measures to address it effectively.
Causes of temporary discomfort
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Incorrect form during physical activity accounts for the majority of sharp knee pain. Proper form is important to prevent knee injuries as follows:
Pain at the back of the knee
Caused by a hamstring strain or tear when you overextend the the muscles at the back of your thigh. Anterior knee pain will be felt when you squat, kick or run. Swelling is also a common symptom, preventing you from straightening your knee. This can affect your balance and coordination, making it more difficult to come out of a squat.
Pain at the side of the knee
Caused by iliotibial band syndrome or a meniscus tear. Iliotibial band syndrome is when the iliotibial band, a thick band of tissue that runs from your hip to your knee, becomes tight and rubs against the outer side of your knee.
Incorrect squatting form, such as knees caving in (valgus collapse), excessive forward lean, or uneven weight distribution, can increase stress on the iliotibial band (ITB). Performing squats frequently or with high volume can lead to overuse of the ITB, especially if there’s already existing tightness or inflammation.
A tight IT band combined with weak hip abductors (like the gluteus medius) can lead to improper knee tracking during squats. This misalignment increases friction and tension on the ITB, where it crosses the knee joint.
If you want the best chance of preventing a meniscus tear, the answer is to maintain the health of the iliotibial band. Since it is tissue, you can use a carnosine-based gel, like CarnoSport, to help with recovery and reduce inflammation. The scientific proof that carnosine – a naturally occurring compound in the body – provides a strong antioxidant and anti-inflammatory effect has been around since 1938. Applied as a gel before and after workouts, it acts as a supportive therapy to prevent injury to key muscle structures around the knee.
Locking of the knee joint
This is associated with the incorrect distribution of body weight during exercise. This “locking” is not typically a true mechanical lock but rather a sensation of stability or tightness.
During a squat, especially in the standing phase, there is a co-contraction of muscles around the knee joint. The quadriceps, hamstrings, and calf muscles all work together to stabilize the knee. This co-contraction can create a sensation of locking or tightness, which is actually a form of dynamic stabilization of the knee.
However, an incorrect squatting technique counters the body’s natural stabilization forces and can cause an unnatural twisting of the knee cap and joint. If you experience severe pain or the actual locking of the knee during exercise, you must seek professional help to prevent further injury.
Patellofemoral Pain Syndrome
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Also known as runner’s knee or jumper’s knee, this condition causes pain around the kneecap and in the front of the knee. Squatting can exacerbate the discomfort associated with this syndrome.
A common symptom is a popping or clicking sound when you bend your knee. Something that makes this pain worse is weak leg muscles, so its imperative that you don’t abandon your exercise routine. Instead, you adopt exercises that focus on muscle strength.
According to hipkneeortho.com, the cartilage under the knee gets irritated and damaged due to repeated stress or friction. Not only do you feel this pain when squatting but also when you climb stairs or kneel.  This condition makes your knee more prone to injury and inflammation.
Prevent the effects of PPS with supportive therapy
One approach to prevention is the use of a carnosine-based gel, like CarnoSport. Chemipower, in conjunction with the scientists at Tartu University, has harnessed the muscle recovery and anti-inflammatory properties of carnosine. Building on groundbreaking scientific discoveries, they developed a topical gel that provides all the benefits of carnosine but avoids side effects like digestive irritation.
Using a product like CarnoSport before and after exercise will accelerate muscle recovery and decrease inflammation in the surrounding tissues, preventing swelling. This, together with the correct form, will reduce pain in the front of the knee.
If you lose your balance with too heavy of a load during squatting, you can suffer a mild knee sprain or even a catastrophic quadriceps or patellar tendon rupture.
The patellar tendon is a strong, flat, fibrous band located at the front of the knee. It connects the bottom of the patella (kneecap) to the top of the tibia (shinbone). The patellar tendon is also involved in the knee-jerk or patellar reflex, a reflex action that doctors test with a reflex hammer during a physical examination to assess the nervous system.
Heavy squatting primarily targets the quadriceps and gluteal muscles. If these muscles are disproportionately strong compared to the stabilizing muscles around the knee. It can lead to an imbalance in forces around the joint, putting extra strain on the tendons.
Causes of chronic discomfort
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According to arthritis-health.com, people living with chronic knee pain can benefit from an exercise program that strengthens the muscles around the knee cap and joint.
A perfect storm
However, the squat position brings a great deal of discomfort and pain to sufferers. Underlying knee problems such as arthritis are often diagnosed when sufferers have too much weight, putting excess pressure on the knee. This, in combination with lifting heavy objects, provides the perfect storm for the stabbing pain felt in the knee area.
Ensure correct form while squatting to minimize stress on the knees. This includes keeping the knees in line with the feet and not letting them extend far beyond the toes. Begin with bodyweight squats or shallow squats, gradually increasing depth as tolerated.
Knee arthritis, particularly knee osteoarthritis, involves the gradual breakdown and eventual destruction of cartilage, which is the smooth, rubbery connective tissue that covers the ends of bones where they meet to form a joint.
In the early stages, you may not experience anything more than a ‘twinge’ when doing squats. As the surface of the cartilage becomes more rough, it increases joint friction. Once the knee cartilage is sufficiently damaged or worn down, bone involvement is common, with bones rubbing directly against one another.
The action of squatting causes the friction to increase, and as the synovial fluid, which is the lubricating fluid for the knee, is depleted, swelling and inflammation become pronounced.
Joint, ligament and tendon health are of utmost importance as this condition progresses and a gel like CarnoSport has the benefit of supporting the health of these structures. It’s scientifically proven and used by athletes who compete in the international arena in powerlifting and marathons.
Whether your discomfort and pain during squatting are caused by temporary or long-term knee issues, the road to pain relief is the same. Beginning with a proper squatting technique and ending with supportive therapies that increase the muscle, joint, tendon and ligament health around the knee.
Proper Squatting Technique
One of the most crucial aspects of preventing knee pain during squats is using proper technique. Here are some guidelines for squatting correctly:
- Stand with your feet shoulder-width apart.
- Keep your back straight and your core engaged.
- Lower yourself by bending your knees and hips as if sitting back into an imaginary chair.
- Ensure that your knees are in line with your toes and do not extend beyond them.
- Maintain a neutral spine position throughout the movement.
- Push through your heels to return to a standing position.
Knowledge is power
Knee pain during any exercise is frustrating and limiting. However, with the knowledge you have gained in this article, you are well on your way to understanding not only the causes but the symptoms of pain in the different areas of the knee. This will help you to put corrective measures in place for the prevention and treatment of knee pain during squatting.
The effectiveness of carnosine as a supportive therapy for increased health of the supporting structures of the knee are well documented and can bring much-needed relief of inflammation and decrease the ravaging effects of an imbalance in PH levels within the muscles surrounding the knee.
By using these simple techniques and including carnosine as part of your workout routine, you can save your knees from bad squatting form, unnecessary injuries and degeneration.