When squatting, many individuals experience discomfort on the outside of the knee, a common issue. This lateral knee pain often signals underlying conditions aggravated by squat mechanics. Understanding the structures involved and common causes is key to addressing the problem and managing symptoms.
Understanding Your Lateral Knee
The lateral knee involves several structures that facilitate movement and provide stability. The iliotibial band (IT band) runs along the outside of the thigh from hip to just below the knee, providing stability to the outer knee.
The lateral meniscus, a C-shaped cartilage on the outer knee, acts as a shock absorber, distributes weight, and enhances joint stability. The lateral collateral ligament (LCL) connects the thighbone to the lower-leg bone on the outside of the knee, maintaining outer knee stability.
The popliteus muscle, at the back of the knee, assists in initiating knee bending and contributes to stability. The biceps femoris, a hamstring muscle on the outside of the thigh, contributes to knee flexion, hip extension, and knee stability.
Common Reasons for Pain
Lateral knee pain during squatting can stem from several conditions. Iliotibial Band Syndrome (ITBS) is a frequent cause, occurring when the IT band becomes tight or inflamed. This irritation often arises from the IT band rubbing against a bony prominence on the outer thigh bone as the knee bends and straightens. Poor squat mechanics, such as knees collapsing inward, can increase this friction.
Lateral meniscus tears can also cause discomfort during squats. A tear in this C-shaped cartilage, often from twisting motions or overuse, can result in pain during weight-bearing activities. Individuals might experience pain, swelling, and limited knee movement.
A lateral collateral ligament (LCL) strain involves stretching or tearing of the ligament on the outer knee. While often caused by direct force to the inside of the knee, LCL injuries can also be exacerbated by squatting with heavy objects or landing awkwardly, causing pain and instability.
Patellofemoral Pain Syndrome (PFPS), also known as “runner’s knee,” causes pain around the kneecap. While typically in the front, pain can sometimes refer to the lateral side. Squatting increases stress on the patellofemoral joint, leading to discomfort, particularly with muscle imbalances or improper kneecap alignment.
Popliteus tendinopathy involves inflammation of the popliteus muscle’s tendon, causing pain on the outer back of the knee that worsens with weight-bearing knee flexion. Overuse or biomechanical issues can contribute to its development. Biceps femoris tendinopathy, an irritation of the biceps femoris tendon, can also cause lateral knee pain, especially during forceful knee bending or hip extension.
Initial Steps and Seeking Help
When experiencing lateral knee pain, immediate self-care measures can help. Resting the affected knee by limiting activities that cause discomfort is a first step. Applying ice to the outer knee for 10-15 minutes several times a day can help reduce pain and swelling. Compression with an elastic bandage can also help minimize swelling, ensuring it is snug but not too tight.
These steps alleviate acute symptoms. However, certain signs indicate the need for professional medical attention. If knee pain persists for several days without improvement, a doctor should be consulted. Swelling or inflammation that does not subside with rest and ice also warrants medical evaluation.
Weakness or instability in the knee, such as the knee giving way, indicates seeking medical advice. Difficulty bending or straightening the knee fully, especially if it limits daily activities, also requires professional assessment. Sharp, severe, or sudden pain, or if a popping or crunching sound was heard or felt at the time of injury, suggests a potentially more serious issue like a meniscus tear or ligament injury.
Preventing Future Pain
Preventing lateral knee pain during squats involves technique, strength, and flexibility. Proper squat form minimizes stress on the knee joint. This includes maintaining alignment where knees track over toes and avoiding inward collapse. Initiating the squat by sitting back, as if into a chair, helps load the glutes and reduces knee pressure.
Gradual progression of weight and intensity is important; increasing volume too quickly can lead to tendinopathy. Start with lighter weights or bodyweight squats, slowly increasing the load to allow adaptation and strengthening. Dynamic warm-ups before squatting prepare muscles and joints, enhancing mobility and flexibility.
Targeted strengthening exercises for hip and knee muscles are important for stability. Strengthening gluteal muscles (especially gluteus medius) and hip abductors improves lower extremity alignment and reduces knee stress. Exercises like clamshells, side-lying hip abductions, and glute bridges are beneficial. Improving quadriceps and hamstring strength also contributes to knee support and proper force distribution.
Flexibility and stretching also play a role. Addressing tightness in the IT band and hip flexors can reduce strain on the lateral knee. Stretches like the standing IT band stretch, pigeon pose, and quad stretches improve flexibility. Regular practice of these strategies helps maintain knee health and reduces lateral knee pain during squats.