Physical Modification When Experiencing Pain
Physical modifications include:
- Modifying your lifting technique
1. Modifying your training load
Quite often powerlifters get pain while preparing for a competition. This is when the training load is at its peak levels.
You could be experiencing knee pain during this time because the load has exceeded your adaptability. In other words, your ability to recover and adapt to the training stimulus.
If we think of the pain this way, then we should find ways to reduce the load. For example, if you start having knee pain at 100kg, try 90kg, or 80kg. If that is no good, then try adjust the sets and reps. If you are still having knee pain, then adjust the tempo, such as doing a 3 second eccentric and a 3 second concentric.
You can see here that there is a systematic way of modulating your load to see if you can avoid knee pain when squatting. As you can imagine, this works very well for people that only have knee pain at certain loads.
If you still have pain regardless of the load, then you should start looking at modifying the exercise selection.
Check out my article on whether powerlifting will destroy your body in the long-term.
2. Modifying your exercise selection
When making modifications to your exercise selection, this could be small or large.
There is likely something you can do without pain, and that is something you can work to build on while letting your body recover.
3. Modifying your lifting technique
- What we do at the hip
- What we do at the foot
- What we do with our core
Knee Pain After Squats
Squats can be regularly performed with or without the help of weights and are a great form of exercise. However, you need to use caution while performing squats as they can cause knee pain if performed incorrectly. For that reason, squats have gotten a bad name in recent times. However, they are not a bad form of exercise and you need to learn to perform them in a proper manner to minimize and even eliminate knee pain after doing squats.
Squats Bring Serious Benefits
Targeting your quadriceps, calves, hamstrings, adductors, glutes, and hip flexors, squats are an amazing way to strengthen your lower body. In terms of athletic performance, squatting can make you stronger in activities like biking and running. If youre looking to improve your speed and strength, Selena Samuela, a Peloton Tread instructor, suggests adding an explosive element like a jump squat to the mix.
Not only can squatting add power and stability to boost your athletic performance, but youll notice the difference in your everyday life, too. Simple, routine tasks like getting out of bed, picking up a heavy bag of groceries, and walking up a steep set of stairs may not seem very challenging, but they can all be made easier and safer by regularly doing squats.
Autumn Calabrese, a BeachBody trainer and certified personal trainer, explains this benefit further. We sit down and stand up constantly, a lot of times we do this with some form of weight in our hands, Calabrese says. Strengthening these muscles makes daily life easier. Youll be less likely to get injured, too.
But thats not all. Squats are also helpful for burning fat, strengthening your knee, hip, and ankle joints, and boosting your core strength, which can help ease lower back pain and make twisting and bending easier.
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How To Fix The Problem
If you were unable to control your knee during the single leg squat test, we just uncovered a possible cause of your pain: poor coordination. In order to fix this problem and decrease any pain, you need to start by improving knee stability.
The first type of exercise I want to introduce to you is called reactive neuromuscular training or RNT. First introduced by physical therapists Michael Voight and Gray Cook, RNT exercises are designed to help improve movement quality by teaching the athlete to feel for how it is moving .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 wont 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 isnt an instant fix for your knee pain, just a small quality of life adjustment that can hopefully make squatting more tolerable.
Additionallydont get this twisted that forward knee travel is either A. Bad for your knees or B. The cause of your knee pain. Its 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 dont want you coming off this article thinking Coach Matt said my knees cant go past my toesthey can, and your knees wont explode if you do sopromise.
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Do Squats Cause Knee Problems
Squats are beneficial exercises as a total body exercise. For beginners the Ball Squat can help ensure you are using the appropriate form. If you ensure that your knees do not pass your toes while you perform this exercise then with practice, eventually you will be able to stop using the ball.
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The Takeaway For Knee Pain When Squatting
I hope this was able to help you pinpoint what exactly might be causing your knee pain during squats.
As I always emphasize, its absolutely vital that you pay close attention to how exactly you perform your exercises in order to prevent injuries overtime and to progress faster. I personally could have prevented a lot of injuries and set backs had I applied this when I first started lifting.
And if youre looking for a complete evidence-based program thats fully equipped with in-depth tutorials for each and every movement…
…then click the button below to take the free body type analysis quiz I have up in order to discover what program is best for you:
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How To Squat Without Pain
If youre making any of the above form mistakes, I want you to go back to the basics so you can re-educate your muscles to work synergistically as you squat. You can even start at home and add more challenge with weights or a resistance band around your thighs.
Chair Or Bench Squats
Start by using a bench or a chair to practice the hip hinge and transferring your weight to your hamstrings, glutes, and quads without using your lower back. Make sure to keep your back stable. You can hold weights as you progress. You can also use a lower bench or chair to practice getting into a deeper squat.
Wall Squats
I really love the wall squat variation because its hard to do this exercise wrong. Make sure your knees are right above your feet, your core and glutes are fully engaged, your back is not rounding or over-arching that you can see a clear anterior pelvic tilt.
I notice that when my core is engaged, my back just naturally goes back into normal alignment. You can add a resistance band or hold a plate in front of you. This is a great quad, glutes and core strengthening exercise.
I hope you found this post helpful
Make sure to also check out these posts:
How Do You Fix A Sore Knee When Squatting
Many physical therapists recommend that you lean against a wall when squatting if you have arthritis in the knee. Taking some of the pressure off the knee may help. However, they also recommend that if the knee pain after squats and lunges feels heightened, you should not continue with these exercises.
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Weak Glute Medius Muscles
Another potential cause for knee valgus is having weak external hip rotators. The muscles responsible for external hip rotation is the glute medius
In the squat, your hips need to maintain a certain level of external hip rotation. This is the action of your leg rotating out to the side as you descend into the bottom. The wider you squat, the more external hip rotation that is required.
Make a note if youre a wide-stance squatter because were going to return to this later.
If the demand for your external hip rotators is too great, your glute medius will fatigue and fail to do its job properly. As such, the entire leg will start to rotate inward, which can also look like your knees caving.
In order to address weak glute medius muscles, there are specific exercises that will help you increase strength in this area. Ill give you these exercises in the next section.
some lifters also find their knees cave if they have a leg length discrepancy that causes them to squat uneven.
Progress To Load Managed Tempo Squats
Once youve got a handle on pain free squatting to around a parallel box, the next variation youll want to try are long tempo squats, specifically on the eccentric portion of the lift .
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 dont 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.
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Prevention And How To Squat
Warming up properly before exercising can help prevent injury. Warming up the body is especially important in older adults, as muscles become less flexible and can tear more easily as people age.
To warm up, use movements that mobilize the joints and increase the flow of blood and oxygen to the muscles, such as marching on the spot. Stretching the legs before and after exercise can also help lower the risk of injury or strains.
To squat correctly:
- start in a standing position
- keep the feet shoulder-width apart
- while exhaling, bend the knees and lower the buttocks as though going to sit down
- hold the arms out to maintain balance
- ensure that the heels remain planted on the floor
- keep the buttocks above knee level and only go as low as is possible without causing discomfort
- keep the thighs parallel to the floor
- keep the back in a straight, neutral position
- make sure that the hips, knees, and toes are all pointing forward
- inhale and return to a standing position by pushing down into the heels and keeping the buttocks tight
The Arthritis Foundation recommend that people who are experiencing pain when squatting do squats against a wall. Using the wall for support can help people strengthen weak or injured muscles and reduce pain over time.
People can do squats against a wall using the following steps:
People can use the R.I.C.E method for relieving pain in the knee. The R.I.C.E method involves:
Over-the-counter drugs, such as ibuprofen, can help reduce pain and swelling.
Letting Your Weight Shift Forward
Stand up tall, then shift your weight to the right the left forward now backward. Any shift too far to any of these sides causes imbalance and dysfunction. When weight is shifted too far forward, pressure builds in the knee causing pain from squatting.
The Fix: Sit Back
Drive your weight throughout the entirety of your foot and sit back to ensure your weight does not travel forward. You should be able to comfortably wiggle your toes without losing balance.
Now, you may struggle with ankle stiffness that restricts your ability to sit back. You can experiment with a wider squat stance and/or pointing your toes out at a 45-degree angle.
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Are Your Knees Caving In The Squat Bad
Onto the million-dollar question, should you be concerned if your knees cave in the squat?
Squatting with your knees caving isnt something that is going to cause pain or injury today, tomorrow, or next week. But, if you continue to squat in this way, its definitely something that will come back to hurt you in the long-term.
The most common issue that arises when you have knee valgus is patellofemoral syndrome. In other words, general knee pain at the front part of the knee. As well, knee valgus can causeiliotibial band syndrome, which is pain that occurs on the outer side part of the leg. In rare circumstances, aggressive knee caving while squatting heavy can cause ACL tears.
Also, as Ill discuss later, one of the main reasons why your knees are caving in the first place is because of a glute weakness. So if your knees are caving, then its a sign that youre probably not lifting as much weight as you could, which should be concerning if youre a strength athlete.
The knees caving can also cause IT band pain when squatting, which we discuss in our other article.
In order to assess whether knee valgus is something that you should focus on fixing right away, there are two factors to consider:
Why Low Bar Squats Hurt Your Knees And How To Fix It
When you execute the low bar squat correctly it should not hurt your knees at all.
In fact, with correct progression and technique, no squat variation should hurt your knees.
Most pains associated with the high bar squat, low bar squat, overhead squats, front squats, etc. are due to incorrect technique first & foremost, and seconded by incorrect progression.
After you hone your technique make sure you progress appropriately by using our free beginner program.
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Reason #: Valgus Knees During Squats
This next reason your knees could be causing pain when you squat is pretty easy to spot.
Take a look in the mirror as you squat. Are your knees staying more or less pointed straight forward? OR, are they starting to point in towards each other?
If the second situation is the case, valgus knees could be the cause of your pain. This improper positioning can be caused by a variety of issues, including weak gluteus medius muscles and internally rotated hips.
Image by www.childrenshospital.org
Having a knock-kneed form could set you up for something a lot more serious than some pain with squats. Valgus knees can make you more prone to serious issues like ACL or PCL tears .
To address valgus knees, try exercises like those I suggest in this article outlining different exercises to target the gluteus medius. These moves will help wake up those glute muscles that will help fix valgus knees and encourage better balance all along the lower body
Knee Pain During Squats No More: How To Squat Properly
First, assume the squat stance practiced when correcting mistake #1. Keep your feet about shoulder-width apart and feet slightly turned out. If your ankle mobility is limited, taking a wider stance may help.
Next, screw your feet into the floor, driving your feet into the ground to engage the right muscles.
Keep your chest up, take a deep breath in to brace your core, and initiate the movement by unlocking the hips back then bending the knees and lowering the hips at the same pace. Keep your knees above your ankles, weight spread throughout the entirety of your foot .
Descend as low as is challenging but not painful. Once in the bottom of the squat, drive through your heels to stand. Viola! You are now squatting without knee pain.
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Fix Your Knee Pain In The Squat With Rich Borgatti
Knee pain and tightness during the Squat and downhill running is a common problem with strength and endurance athletes. In this video we will teach you how to Assess and Correct one of the main causes.
Lets be clear, knee issues are always a combination of both STABILITY and MOBILITY. You cant separate the two and we are going to show you some unique active mobilization strategies to correct not just the mobility problem but to also encourage proper stability and sequencing.
The pattern that we identify here is one in which Rich has lost proper rotation of his Tibia on the right side and also has very restricted adductors and Vastus Medialis and Sartorius on the same side. This could have very possibly come from a ton of volume during his Spartan Race training and races or from something as simple as driving too much in the car and overusing the right foot.
There are numerous other patterns and causative factors for knee pain in the squat which we will write about in future articles. The point of this article is not to give an exhaustive understanding of how to approach all of the possible causes of knee pain but rather to give a better understanding of one common pattern and some strategies to address this.
Brad Cox from Acumobility works on Rich Borgatti from Mountain Strength CrossFit in Winchester MA. Here is the full video showing both assessments and corrections:
How to Fix Knee Pain in your Squat from Brad Cox on Vimeo.
Assessments:
HIP MOBILITY ASSESSMENTS
Calf