How to Manage Knee Pain While Squatting
Knee pain while squatting is one of the number one reasons you will hear someone claim as the reason they don’t squat.
Seeing as this is one of the best movements you could be doing in the gym, and not to mention a basic human movement pattern we all should be capable of, I hate to see someone avoid squats outright due to fear of pain and injury.
As with most of my articles involving pain and injury I’m not going to give you a laundry list of “rehab exercises“. On that same front I’m not going to give you movements that are “like squatting” I’m giving you the real deal. These are all bona fide squat variations, specifically meant to make squatting as comfortable as possible for those with knee pain.
Here’s the strategies you can implement to manage your knee pain while squatting.
1. Switch to Low Bar Squats
This might sound like an odd recommendation at first. What does bar position have to do with knee pain?
Due to the lower bar placement in a low bar squat you won’t get as much forward knee travel in this variation as you would with either a high bar squat or a front squat. For most individuals this limited forward knee travel abates some of their pain symptoms. This isn’t an instant fix for your knee pain, just a small quality of life adjustment that can hopefully make squatting more tolerable.
Additionally…don’t get this twisted that forward knee travel is either A. Bad for your knees or B. The cause of your knee pain. It’s not. Too many internet sources quote “your knees going past your toes” on certain exercises as the reason to why you have knee pain. This is incorrect and outdated. While thankfully slowly starting to die, this is still a narrative that exists and is readily pushed, and I don’t want you coming off this article thinking “Coach Matt said my knees can’t go past my toes“…they can, and your knees won’t explode if you do so…promise.
2. Start With Box or Pin Squats
This is one of the few instances in your life where you’ll hear me say “quarter squatting is okay“.
If you are having extreme difficulty squatting due to knee pain start with either box or pin squats. The idea here is we find a depth you can squat to without an instance of knee pain. For many individuals they will be able to squat to around a quarter/half squat position before their knee pain really sets in. Once you find your range of motion that you can squat to pain free that will be your starting point.
(Note: Slight discomfort and stiffness is okay and honestly expected. You can discern good “pain free” reps if your workout starts off slightly stiff and uncomfortable but gets more bearable as you go. If your pain is only increasing with every rep and set, you need to adjust the box/pins height)
Moving forward, as opposed to progressing the weight on the bar you are going to attempt to progress your range of motion. Maybe you start with quarter squats and after two weeks of progress you lower the box/pins an inch or two. If you can squat to that depth pain free for the next two weeks you’ll repeat the process. The goal being to eventually work your way down to about a parallel depth box or pin squat. This can take a long time (I’m talking weeks to months). Be patient with the process.
Also…you may be tempted to slap on heavier weights with this variation due to the decreased right. Fight back your ego in this case, the whole point of the exercise is to get you back to a full ROM squat. Don’t worry about the load on the bar so much as progressing your ROM overtime.
3. Progress to Load Managed Tempo Squats
Once you’ve got a handle on pain free squatting to around a parallel box, the next variation you’ll want to try are long tempo squats, specifically on the eccentric portion of the lift (Eccentric: Lowering, in the case of the squat this is the “sitting portion” of the movement).
Tempos are great because they are what you can use to get back to your true “normal” squat again.
Moving slowly through your squat does 2 things for us. First and foremost it tends to be much more comfortable when dealing with pain to tempo through a range of motion than it is to full send it. You may find with a smooth 5 second tempo squat that you don’t feel any pain at all compared to if you just drop right into the squat.
Additionally because you are tempoing this is going to force load off the bar keeping your ego in check. The whole goal here being with these tempos that you neve exceed a load on the bar than which causes you pain. This may very well mean you are doing tempo squats with just the bar, or with little 5lb plates on the end. Again, this is okay. You have to be patient.
4. Slowly Decrease Tempo + Increase Load Over Time
Alright so you’ve crushed a bunch of box squats and tempo squats and all you want to do is get back to your normal squats again?
Here’s how you do it.
Over the course of multiple weeks slowly start to decrease the tempo of your squats while increasing the overall load. For example you may have started with a 6-0-0 tempo squat for around 3 weeks. The next 3 weeks you can go down to a 4-0-0 tempo squat, then 2-0-0 tempo squat, and finally a “normal” squat.
Over the course of those weeks and with each subsequent drop in the tempo, try to increase the weight in very small increments as you go. Again the golden rule here being, you can only increase load on the bar if it DOESN’T cause an instance of pain. If you have the patience to stick to that rule overtime you will get yourself back to normal pain free squats again.
Where most people screw this up…myself included…is they let their ego get ahead of them. They are making great progress for 6 weeks or so and then they load up more weight than they are ready for the pain comes back, and they basically have to restart the progress all over again. Speaking from experience it’s much easier if you skip that altogether.
5. BONUS: Knee Sleeves + Knee Wraps
Just like belts don’t do anything to prevent lower back injuries, knee sleeves/wraps aren’t going to do anything to prevent knee injuries.
That being said they can act as great little security blankets that increase your perceived comfort/decrease your perceived pain while squatting. They are at least worth the shot.
If all else fails when you get good at wrapping knee wraps, the pain of cutting off all circulation to your lower legs can replace your actual knee pain…