Can You Do Squats if You Have Bad Knees?

 

The basic squat is such a great exercise for so many reasons:

 

 

Of course, doing a squat involves sinking down into the knees, which can cause pain for some people. Many people with knee problems—from pain to arthritis—can still squat but with care and modifications.

 

If you’re uncertain about squatting and knee health, the best person to ask is your doctor. For clients, insist they talk to their doctors about safe exercises for their specific knee problems.

 

 

When we talk about pain in the knee area, we could be talking about many different things. We could be referencing pain in the knee joint, for instance. This joint connects the femur (thigh bone) to the tibia (shin bone). It makes it possible to flex and extend the lower leg.  

 

Sitting directly on top of the knee joint is the patella, also known as the kneecap. The kneecap connects the quadriceps tendon with the patellar tendon. We might experience pain in the kneecap if we bump it into a piece of furniture, such as the leg of a table or desk. It’s also possible to break the patella. In fact, roughly 1% of all broken bones are a fractured kneecap (1).

 

There are also other soft tissues in the knee area. They include the collateral ligament and articular cartilage. So, if someone says that they are having knee pain, they could be talking about pain in any one of these areas.

 

 

Most people refer to knee pain or poor mobility as having bad knees, but this means a lot of different things. Some of the most common causes of knee pain are injuries, repeated stress, and osteoarthritis associated with aging (2).

 

 

Knee pain can result from both long-term overuse of the joint and acute injuries. A common overuse injury is tendonitis. The tendons are connective tissue linking bones to muscles. Knee tendons can become inflamed and painful. Athletes are particularly vulnerable, but anyone who is active throughout the day may develop tendonitis.

 

Acute injuries to the knee occur suddenly. Anyone can develop these injuries, which include torn cartilage, especially the meniscus, torn ligaments, and strains or sprains of the ligaments or muscles around the knee.

 

 

Arthritis occurs when cartilage in the joint wears away. Bone rubs on bone, resulting in inflammation and pain. Everyone gets some degree of arthritis as a natural part of aging. This is called osteoarthritis. Arthritis may develop earlier or be worse in people with frequent injuries or who engage in certain physical activities regularly.

 

 

Problem knees can also result from issues in other parts of the body. For instance, a tight IT band pulls on the knee, causing pain. This is particularly common in distance runners. Pain or injury in the hips or feet may force you to move the knee in a way that causes pain and damage over time.

 

 

If you or a client has some knee issues, but your doctor gives you the go-ahead, proceed with caution. According to the Arthritis Foundation, a good way to start and to take pressure off the knees is with a wall squat (3). Resting your back against the wall forces good form too.

 

You can also make squats safer for bad knees by reducing the range of motion. Squat only as deep as you can go without pain. If you feel pain, shorten the range of motion.

 

 

Pain during squatting may have several causes, most often injuries, but poor form can also cause pain. Squats are not inherently dangerous, but bad form is. If you have a client complaining of knee pain during squats, stop and evaluate before they cause damage.

 

If you can’t rule out bad form as the cause, be sure they see their doctor for an evaluation. They could have an injury that requires rest or treatment.

 

 

One in five U.S. adults has chronic pain according to a 2022 study (4). Results of this study, which were published in the journal Pain, also indicate that one of the most common places to experience chronic pain is in the knee area.

 

In the medical field, pain around the kneecap is called patellofemoral pain syndrome. Less formally, it is also referred to as runner's knee or jumper's knee.

 

Knee pain can have numerous causes. Among them are:

 

 

 

Any of the above conditions can cause pain in the knee while squatting. But there are other causes as well, some of which relate to how this exercise is performed.

 

One of the main causes of sore knees during a squat is improper form. If you lean too far forward, for instance, this places more stress on the knee area. It can also lead to pain if you allow the knee to extend beyond the toes while squatting. 

 

Pain during squatting may be caused by a structural or functional misalignment in the knee area. So, every time you squat, it creates more stress on the joint or soft tissues surrounding it. 

 

Knee valgus is an example of structural misalignment. Also known as knock knees, this condition exists when the knees rotate internally. The opposite of knee valgus is knee varus, also commonly referred to as being bowlegged.

 

Dysfunctional alignment in the ankles or hips can also contribute to knee pain when doing a squat. Since all these joints are connected, if one is out of line, it can negatively impact the others.

 

 

If you feel knee pain when squatting, stop the exercise immediately. If the pain is not severe, it may go away simply by allowing the knee to rest. Take a day or two off from lower body movements and give the area time to recover.

 

If you experience symptoms that suggest that the knee pain is serious, such as pain that is severe or getting worse, seeing a doctor is recommended. Diagnostic tests can help determine the cause of the pain. Once this is established, a plan can be created to help the knee recover.

 

This plan might involve physical therapy or, if the injury is severe, it may even require surgery. The healthcare provider can help determine the best course of action based on the exact injury and its severity.

 

 

Fortunately, there are several things you can do to keep a squat from creating knee pain. Options include:

 

 

Good form, wall squats to start, and limited range of motion are all important ways to make squats safer for bad knees. Here are some other modifications and variations to try:

 

 

 

Recovery from surgery or an injury, and a doctor’s orders are all good reasons to avoid squats entirely, if temporarily. A squat is an efficient strength move, but it’s not the only effective one. What can you do instead of a squat? Try these alternatives to avoid knee pain or making an injury worse.

 

 

Squats are great for the glutes, but you can use these exercises to build strength in this big muscle group without stressing the knees:

 

 

 

To target the quads and hamstrings try these exercises:

 

 

 

Squats are not just about legs and glutes. They also strengthen and improve mobility in the hip flexors and the hip joint. Glute bridges and hip thrusters will help with this, as will deadlifts. You can also use resistance bands to do knee lifts, which strengthen hip flexors.

 

Add in some hip stretches, or yoga sessions, to really improve flexibility and mobility in these major joints. This will help stabilize the knees and reduce pain during all kinds of movements.

 

 

There is no simple answer to this question, unfortunately. If you have a client with a knee injury, pain, or arthritis or who has had knee surgery, urge them to talk to their doctor about this question. It really depends on the individual and the particular knee issue.

 

For many people, squats can actually reduce knee pain over time. If their doctor gives them the go-ahead, work slowly with these clients. Start with a small range of motion and no weights to build strength and mobility.

 

 

Personal trainers can help clients avoid knee pain during exercise by reinforcing proper form. This reduces stress on the knee joint while going through the movement’s full range of motion.