Whether it’s in a bodybuilding gym, crossfit, zumba, running group or any other form of fitness outlet, squats are the norm, that one exercise which almost everyone is familiar with. Some love them, some hate them, some brag about them and others are scared to do it. In my experience, the most often blamed exercise for knee pain is a squat. And what I always say to my clients is that “no exercise is dangerous, it is how you do it that matters”. Now there can be many reasons for knee pain in squatting. If you are getting pain in other movements like running, walking, stair climbing as well, your problem goes well beyond correcting form for squats.
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Correcting the form and tweaking the exercise is just one part of the equation. There may be other physiological reasons like Vitamin D or calcium deficiency which may lead to achy joints in general. If the pain persists, it is always good to go see a physiotherapist and get it checked. After all, “there is no perfect form but only what suits your body”. People have different hip structures and joint angles which make different stances more optimal.
In this article, what we are trying to do is to give you a quick step by step diagnostic series to find out a pain free variation to get you back in the game. Just try it out step by step and see what works for you.
Step 1: Basic Form Check
The most common error people make in squats is keeping their feet wide and pointed out like a duck. Although this is taught by many trainers because people get more ankle room, it also puts knees in an awkward situation where they have nowhere to go but to cave in towards each other putting unnecessary stress on the connective tissues of the knees. So, step 1 is doing 10 bodyweight squats with your feet straight, hip distance apart with your knees out. If you don’t get pain, voila! Now this is your new squat form, practice this with lesser weights for a few sessions.
If you still get pain, move on to step 2.
Step 2: The Wall to Nose Test
You may have failed step 1 but still remember the form: Knees out, feet hip distance apart with heels firmly planted on the ground during the entire movement. What you have to do now is stand 6 inches away facing a wall and perform bodyweight squats again. If you bend too much at the knee, your knees will hit the wall. If you bend forward too much, your nose will hit the wall. This will teach you to stay upright throughout the movement. If you don’t feel pain in this, all you have to do while squatting is staying upright (chest towards the wall you are facing). If you are currently doing barbell back squats, I’d recommend switching to goblet squats with a kettlebell or a dumbbell. Since it is more taxing on the core, you would not be able to lift that much weight which is perfectly fine.
If you still get pain, keep reading.
Step 3: The Chair Test
Take a chair which is slightly lower in height as compared to your knees. Now sit on the chair with the same stance as you squat. Once again, remember all the same form cues told in earlier steps. Now get up and sit down, repeat for 10 repetitions. Looks like a squat, right? This is called the box squat. If you don’t get pain in this, chances are that in your regular squat you are initiating your movement with your knees which is not optimal. Box squats will teach your body how to shift loading more towards your hips. Typically you can do squats with roughly the same weights in box squats as you can in a back squat/goblet squat. A couple of months of this and your body will get used to this type of loading and you can go back to regular squats without the box.
If you get pain in a box squat as well, try doing it from a higher chair/sofa and see if that works. You should be able to find a height which works for you to start with.
Step 4: Common Sense
If you still haven’t found a solution, don’t be scared. Take a few days off and try the chair test again with a high chair. If it still hurts, get a blood test done for any deficiencies and go to a physiotherapist. Don’t lose hope and never ever accept your condition to be so for the rest of your life. The human body is amazing at recovering from injuries and with right guidance, can do so on its own. In fact, physical rehab work has been found to be comparably effective to a knee surgery for even a torn meniscus. Make sure your doctor knows that at the end of it, you want to lift weights again and not be scared of it.
Honestly, if you are in this situation, you must have abused your knees in some form in the past. “Phrases like No pain, no gain only make sense on t-shirts and not in practical training”. So if it hurts while running, stop for a while and try and figure out what the problem is (And yes, running also has a proper technique which needs to be kept in mind). Knees typically are a victim joint meaning, they bear all the brunt which they shouldn’t when the body is pushed from both upstream (hips, lower back) and downstream (ankles).
Be smart about it while trying out pain free options (switching gradually to barefoot running, doing box squats for a while etc).
Work with a professional gym trainer from Urban Company, and give your body a chance to heal!
Pain Shishir Banerjee is a professional registered on UrbanClap and heads PSI fitness.