I am often asked about knee pain when squatting or doing lunges. When I ask the person to perform a squat or lunge, I usually find that their knees cave in or the knees wobble during these movements. This instability puts a lot of force in the knees which can cause damage and result in pain.
Below are a few recommendations which may help. However, if you’re in pain, I recommend seeing a doctor or therapist to ensure there is no damage to the knee, particularly, if the pain is getting worse or the pain doesn’t go after resting it for a few days.
Assuming it is safe for you to continue, I advise you work your way down this list in this order
1. Limited ankle mobility – this is a very common problem.
An easy way to test this is to do a squat with small plates underneath the heel of your feet. If you can perform the squat with better form, or get lower depth, you need to look at your ankle mobility. I do not recommend using plates underneath your feet during training as this does not solve your problem and could make the problem worse.
- Stand with one leg in front of the other near a wall for support
- Bend your front leg until you can feel a stretch in the calf, ensuring your knee travels in line with your toes.
- Hold this stretch for 2 minutes.
- After two minutes, without moving your body, push the ball of your feet into the ground for 10 seconds
- Then try to lift the balls of your feet off the ground for 10 seconds.
2. Groin restriction – this is when you have tightness on the inside of your legs.
An effective way to do this is using a frog stretched.
- Get on the ground supporting yourself on your elbows and knee
- Elbows should be shoulder width apart and knee width should be the same as they would be at the bottom of the squat
- Slowly push your hips back while keeping your back straight until you can feel a stretch
- Hold this for 2 minutes
- After two minutes, without moving your upper body, you want to try to pull your legs further apart for 10 seconds. This will also help you with step 3.
3. Abductor weakness – these are the muscles that lift your leg up sideways
A good exercise to strength theses muscles is the side lying leg raise.
- As the name suggests, you will need to lie on your side
- Slowly raise your leg – emphasis needs to be on getting your leg as high as possible in a controlled manner
- Try these with your leg at different angles (relative to your body)
- Do at least 3 sets of 15 reps on each leg
4. Technique – once you have the required mobility (step 1- 3), now it’s time to squat
I would suggest having someone assess your technique such as a personal trainer in your gym – there’s usually no charge for this. Alternatively, you could get a friend to assess you or filmed it on your phone (ideally from several different angles) so you can assess yourself.
Below are some of the things you need to look out for when squatting to avoid knee pain:
- Do not allow knees to cave in and ensure there is no knee wobble/sideways movement
- Heels stay in contact with the floor throughout the movement
- Weight should be distributed evenly on both feet
- Different stances to see if this helps with the above three points
- Screwing your feet into the ground – right foot clockwise and left foot anti-clockwise. Your feet shouldn’t move but it means the ankles and knees are less likely to collapse
- Box squats – these can put less pressure on your knee