Types of knee pain (1) can vary depending on the cause, location, and pattern of pain being experienced. Pain can sometimes be experienced on the knee cap, beneath the knee cap, or somewhere on the side of the bones, and that pain can either be static, experienced in a specific part of the knee, or be radiating in nature.
Radiating pains often point toward nerve damage, but any pain that is strictly in the bone area could point towards bone weakness and sometimes patella fracture owing to a knee injury.
How Knee Pain Hinders Daily Life Activities?
Although experiencing knee pain does not sound like something serious, it can hugely impact how you go about your daily life. Knee pain is often accompanied by swelling, inflammation, and redness and can induce instability in walking making a person limp. Simple tasks such as walking the stairs can exacerbate the pain, and the movement of the knee joint (2) while climbing can worsen the pain as well as the pathological condition. People with severe conditions of knee pain can even become dependent on their caretakers for simple activities like walking, bending, and stooping over to pick up something.
Exercises that Report Knee Pain
Many people think that the leg muscles are supposed to be stronger to avoid injury and prevent knee pain. People have a notion that because orthopaedics often prescribe exercises with physiotherapists for different kinds of pains, knee pain would have a similar scenario too. But this is not the case. Some exercises (3) can worsen knee pains by weakening the knee caps. Movements like deep lunging, repetitive jumping, frequent use of stairs, running, squatting, and high-impact sports have the potential of damaging the ligaments attached to your knee joint. If the muscles are associated with the disease which is causing the knee pain, your glutes can experience stabbing pain as well.
IT Band Syndrome
IT Band Syndrome (ITBS) stands for Iliotibial band syndrome. It is a type of knee injury that happens due to frequent use of flexion and extension of the knees. The intensive and frequent use of the knee joint not only damages the joint structure and deteriorates the bones called the knee cap. The IT band located in the knee area becomes swollen or tightened, making the two bones meeting at the knee rub against each other, causing friction.
This type of knee injury is considered an overuse injury and can occur from activities as simple as running up and down the stairs. People who perform squats often develop lower body injuries if they are exercising at the wrong angle. Box squats are also a major reason behind the development of ITBS. Box squats involve carrying a very heavy weighted box which puts greater pressure on the knees. There are a few risk factors for developing ITBS (4). If a person has one of these risk factors, taking extra precautions can help prevent this syndrome. These risk factors include pre-existing iliotibial band damage or having an already tightened band, lack of flexibility in a person, osteoporosis or osteopenia, other bone diseases, weak body stature, sedentary lifestyle, knee injury, and excessive strength training.
ITBS can be diagnosed with the help of physical examination as well as radiological examination. If all the symptoms point toward this syndrome, it can be confirmed further with the help of an X-ray or an MRI scan. Physicians also tell ways to prevent this syndrome. If you have a sedentary lifestyle, make sure you do not keep your knee rested in the same position for more than 30 minutes. If you have bone diseases and a weak body posture, do not attempt exercises that put pressure on your knees with proper supervision. Avoid wearing improper shoes, especially heels for females because it directly increases the stress on the body on the knees. Besides, if you plan to increase your exercise stamina, make sure you do it slowly and steadily, otherwise, you might end up hurting your quadriceps muscles.
Patellofemoral Pain Syndrome
Patella is a bone in front of the knee joint, that covers the anterior portion of the tibia and fibula and also the posterior portion of the femoral bone. Any pain experienced in front of your knee or at the knee cap is called patellofemoral pain syndrome (5). People who play sports often or are physically active suffer from this problem more often and so this condition is called “runner’s knee”.
The pain related to this syndrome is not sharp. It is usually a dull pain that inhibits the regular movements of your body including squatting, kneeling, using stairs, and even running normally. People with this syndrome might not be able to sit with their bent knees for a longer period. The condition is often associated with bones and joint health only, but the muscles surrounding this area i.e., the quads, especially the hamstring muscles, are also important in this regard. Muscle imbalances and weakness due to electrolyte and mineral disproportion, overuse of the knee joint, and prior knee surgeries can trigger this type of syndrome.
Why Squatting Triggers Knee Pain? – Causes
Squatting is one of the few positions that are commonly practiced in our daily lives. It cannot be avoided because of its essential use in body posture. If you feel pain in this posture from time to time, you already have a condition that is inducing knee pain when squatting. The common causes of this knee pain are as follows:
A condition that is caused by the degeneration of the cartilage that surrounds the tips of the joints. This protective cartilage prevents friction between the bones but when the cartilage breaks down, this can lead to knee pain.
Bacterial Inflammation at the joint:
This type of inflammation most commonly occurs in the joints of the knee and the hands. It is also considered a type of arthritis that affects the synovial fluid in the joints.
It is a condition that results from inflammation in the tendons linked with the patella. These tendons get swollen and cause pain in the knee, and the condition is also known as jumper’s knee. (6)
The conditions mentioned above including patellofemoral pain syndrome and Iliotibial Band syndrome are both of the causes of knee pain associated with squatting. Severe trauma or injury involving the knee can cause meniscus tears and other joint-related problems. Previous surgeries can also cause improper healing in the joint area and present squats-induced knee pain.
Diagnosis of Squats-induced Knee Pain
The initial way to manage your pain is to try some home remedies, however, if none of them work and your pain in the knee persists, the best choice is to visit your doctor. The doctor will perform certain tests and also ask you questions to confirm a diagnosis. Firstly, the doctor will ask for your health history, which includes your family history, history of illness, and also your medication history.
The typical questions asked by the physicians involve the period of pain suffering, when it started, and how it was triggered. What type of movements cause more pain and what range of motion of the joint is comfortable, are also one of the few questions. If you have recently attempted new activities or new exercises, and have had any recent trauma or injury, you should inform your doctor about it. Changing the surface you play your sports on or adding more time to your duration of exercise can also be one of the questions essential for a proper diagnosis.
Your physical examination might include checking the range of motion of your knees, your ankle mobility, any signs of redness and swelling, and the consistency of pain when the physician touches your knee. Ankle mobility is very important to test the squatting mechanisms since it can affect your overall body posture. Last but not the least, your physician would make a differential diagnosis (7) by conducting a few radiological exams to detect the underlying cause, possibly an X-ray or an MRI scan. X-ray is important to look beneath the skin for any signs of injury or fractures, but when it comes to soft tissues like the tendons and the cartilages, MRI would be more helpful.
Treatment and Recovery for Knee Pain When Squatting
Half of the body weight is carried by the knee joints. If you do not have ideal body weight, your obesity can affect your joints and cause back pain. Lower back pains have also been noticed with this condition. The treatment of knee pain when squatting is essential for proper physical and physiological health.
A non-invasive and preferable way of treatment is physical therapy. After your diagnosis, if the condition is only mild to moderate, your doctor will refer you to a physical therapist. This physical activity is usually in reps and needs to be practiced at home once you learn them properly from the physiotherapy clinic. These exercises will include warm-up movements that will reduce friction in your knee joint and then will extend towards the muscles of your shin, hamstrings, and hip abductors so that complete rest does not hinder your muscle activity altogether. Any exercise of squat form will be avoided. Some of these exercises might be in a standing position, but if you have a sedentary lifestyle, (8) you can take better suggestions from your healthcare professional.
Structures in and around the knee have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that helps to heal these structures.
Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is required to heal and repair.
As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.
If the physio treatment is not enough, your doctor might recommend custom orthotics that involve the placement of certain devices in your shoes. This will help you move at the right angle with your feet and knee joints.
This is the last option to prevent your joints from deteriorating further and save you from a handicapped-like lifestyle. One procedure is arthroscopy (9) where a camera is used to invade your knee and look for the damage. Once the problem inside is, detected, the invasive cut is used to rectify the damage. The procedure is called realignment which is a more open surgery where the joint and the knee caps are repositioned to relieve the pressure of friction.
Prevention and Management of Knee Pain When Squatting
The initial way to manage this pain is the use of home remedies. If the condition has just begun, it can be ameliorated using adequate tips and techniques. Some of the home remedies (10) include:
This is an acronym for Rest. Ice, Compression, and Elevation. Rest is very important because your knee joint needs a break from all the activities it has been supporting you in. Avoid doing excessive physical movements that involve this joint and do not use stairs, instead use a lift. Ice is a typical temperature-changing technique to say goodbye to the pain. You can either use ice packs available from the medical store and apply them to the affected area from time to time, or you can simply roll ice cubes in a satin cloth to provide the cold effect.
Compression is intended to stop any swelling in that area that might occur from pain. Using tight bandages to wrap around the knee area in proper form will help. Elastic bandages are easily available at the drug stores but avoid wrapping too tightly as they can block the blood vessels and cause other complications. The last one is elevation; it is suggested to keep your legs including the knee above your heart. This will accelerate the blood flow towards the knee and pool more blood there which will increase the rate of natural healing by the body.
Hot water bottles and hot packs that consist of gels inside the bag are some pain management techniques. You can buy them at the drug stores and warm them up on a stove or an oven with the step-by-step instructions usually inscribed on the bottle or pack. Applying heat on the knee will have almost the same temperature change effect as the cold packs.
These include paracetamol but more effectively NSAIDs, like ibuprofen and naproxen that will reduce inflammation at the joint. If you are taking any other medicines already, make sure to consult your healthcare professional for possible interactions and proper medical advice before taking any medicine dose.
Consider getting a knee massage or doing one yourself on the knee. Doing a self-massage has now become easier by watching professional YouTube channels with thousands of subscribers. Massages have shown positive results when pain relief is intended. You can use oils like eucalyptus, peppermint, wintergreen, rose, and lavender, which are well known for their antispasmodic and relaxing effect.
Frequently Asked Questions
Why do my knees hurt when I squat?
Knee pain during squatting is usually caused by overuse of the knee joint and surrounding supporting structures. Hence, individuals who experience knee pain while they squat may be recommended to either carry less laid as they go in a squat position or try to lose weight. This will help lower the total weight on the knee, improve the uncomfortable symptoms and allow the joint to heal.
How do I get rid of knee pain when squatting?
Losing weight is one of the first recommendations made by a doctor for an overweight individual who is experiencing knee pain while squatting. Other recommendations that may be made more specific to the squats are that the overall range of motion of the knees as individual squats should be reduced. This help takes off the excess pressure from the knees. Another recommendation often made for this is to avoid carrying very heavy weights while going into the squatting position. This can promote excess stress and strain on the knees.
Is it OK to squat with knee pain?
While it may be permissible to squat while having mild knee pain, individuals should still try to be cautious and avoid putting too much weight on their knees. However, if the knee pain is more severe, it is best to consult a health physician to rule out any serious cause of the knee pain.
How long should knee pain last?
Knee pain caused by minor causes usually lasts for a few days, and the individual may experience improvement in symptoms just by taking rest. However, knee pain caused by serious conditions or injuries may take much longer to heal, and the individual may be required to rest for more than a few days.
Should you lock your knees when squatting?
It is not recommended to fully lock the legs while performing squats or other exercises like the seated leg press. This is because lockings will shift all the weight from the muscles directly to the joint, which can cause increased stress and acute injury.
Should you fully extend on squats?
While carrying out squats, the experts suggest against the full extension of knees. Instead, the individual is recommended to keep the legs slightly bent, as this promotes the overall loading and the time for which the quadriceps are being activated.
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