Pain on the outside of the knee while squatting is a common issue that can hinder daily activities and exercise routines. This discomfort often signals underlying factors affecting the knee joint’s mechanics. Understanding the potential causes and implementing strategies can help alleviate this pain and support long-term knee health.
Common Sources of Outer Knee Pain
Outer knee pain during squatting frequently stems from issues with the iliotibial band, meniscus, or patellofemoral joint. The iliotibial (IT) band is a thick band of connective tissue running along the outer thigh. When this band becomes tight, inflamed, or irritated, often from repetitive motion or improper mechanics, it can rub against the lateral knee, leading to pain and inflammation, especially during squatting. This condition is known as Iliotibial Band Syndrome (ITBS).
The lateral meniscus, a C-shaped piece of cartilage on the outer side of the knee, provides cushioning and stability. Tears or irritation can cause pain, particularly during movements that involve twisting or loading the knee, as seen in squatting. Patellofemoral Pain Syndrome (PFPS) involves pain around the kneecap. While often felt at the front, issues with the kneecap’s tracking can sometimes refer pain to the outer knee when the knee is bent under load during a squat.
Another source of outer knee pain is popliteus tendinopathy. The popliteus muscle, located behind the knee, plays a role in unlocking the knee joint and providing stability. Inflammation of its tendon can contribute to discomfort in the outer knee region during squatting movements.
Factors Increasing Pain Risk
Several factors can contribute to the development or worsening of outer knee pain during squatting. Improper squat form is a significant contributor. Errors like allowing the knees to collapse inward or outward, excessive forward lean, or insufficient hip hinging can place undue stress on the outer knee structures. When the hips, knees, or ankles are not properly aligned during a deep squat, the knee joint can experience severe strain, leading to repetitive friction.
Muscle imbalances also play a role, particularly weakness in the gluteal muscles (especially the gluteus medius), or tightness in the hip flexors or adductors. Weak glutes can lead to the knee not tracking properly and becoming overloaded, increasing strain during squats. Overuse or rapid progression, such as increasing squatting volume, intensity, or frequency too quickly, can overwhelm the muscles and tissues, leading to irritation and injury.
Inadequate warm-up or cool-down routines can heighten the risk of pain by leaving muscles tight and less prepared for squatting. Footwear and foot mechanics can also influence knee alignment and function. Unsupportive shoes or underlying foot issues, like overpronation, can alter the kinetic chain and affect how forces are distributed through the knee, contributing to outer knee discomfort.
Immediate Relief and Self-Care Approaches
When experiencing acute outer knee pain from squatting, immediate steps can help manage the discomfort. Resting the affected knee by reducing or temporarily stopping activities that aggravate the pain, especially squatting, is often the first recommendation. This allows irritated tissues time to recover and prevents further strain.
Applying ice to the outer knee can help reduce inflammation and pain. Ice packs should be applied for 15 to 20 minutes at a time, never directly to the skin. Gentle stretching of the surrounding muscles, such as the IT band, quadriceps, and hamstrings, can also provide some relief from tightness.
Over-the-counter pain relief medications, such as NSAIDs, can temporarily alleviate pain and reduce inflammation. Acetaminophen can also reduce pain but does not address inflammation. Use these medications as directed and consult a healthcare provider if pain persists or worsens.
Professional Guidance and Sustainable Recovery
For persistent or severe outer knee pain when squatting, seeking professional guidance is important for sustainable recovery. Consult a general practitioner, sports medicine doctor, or physical therapist if the pain is severe, accompanied by swelling, instability, pain at rest, or if self-care measures do not provide improvement. A healthcare professional can accurately diagnose the specific cause of the pain for effective treatment.
Physical therapy plays a central role in long-term recovery by addressing the root causes of the pain. A physical therapist can assess biomechanics, identify muscle imbalances, and develop a personalized treatment plan. This plan often includes targeted strengthening exercises for muscles that support knee stability and proper tracking, such as the gluteus medius, quadriceps, and core muscles.
Improving flexibility and overall hip mobility through consistent stretching of the IT band, hip flexors, and hamstrings is also a component of recovery. Correcting squat form under professional guidance is essential to prevent recurrence, ensuring proper knee alignment and engagement of the correct muscle groups. Once pain has subsided and strength has improved, a gradual return to squatting and other physical activities is advised to allow the body to adapt and strengthen without re-injury.