Squatting is a fundamental human movement, but pain during a squat is a common concern. This discomfort often indicates an issue with movement patterns or an underlying physical condition. Understanding the causes of squat-related pain is key to addressing it effectively.
Understanding Squat Mechanics
A well-executed squat involves coordinated movement across the hips, knees, and ankles. During descent, hips hinge backward, knees bend forward, and ankles dorsiflex, lowering the body. The torso remains relatively upright, with weight distributed through the midfoot. This action engages major leg and hip muscles.
Squat depth varies, but ideally, hips descend at least to knee level or below, maintaining spinal neutrality. Proper alignment, like keeping knees tracking in line with toes, is important for joint health. Stance width and toe-out angle vary by individual anatomy, influencing comfort and movement.
Common Contributing Factors to Pain
Squatting pain often stems from mechanical issues or habitual movement patterns. Improper form is a frequent cause; deviations like knees caving inward, a rounded lower back, or shifting weight onto the toes stress joints and tissues. For instance, knees collapsing inward can strain the anterior cruciate ligament (ACL) and other knee structures. Excessive forward lean increases lumbar spine stress.
Insufficient mobility in key joints, particularly hips and ankles, restricts proper squat depth and mechanics. Tight hip flexors may limit hip range of motion, leading to compensatory lower back arching and increased spinal pressure. Limited ankle dorsiflexion can prevent knees from moving forward, forcing hip compensation or heel lift, disrupting balance and stressing the knees.
Muscle imbalances contribute to altered mechanics and pain. Weak gluteal muscles may lead to increased reliance on quadriceps or adductor muscles, potentially causing strain. Tight hamstrings can pull on the pelvis, affecting spinal alignment. Overuse, from too many repetitions or too much weight, can lead to soreness or localized irritation.
Specific Conditions Causing Pain
When pain persists or is sharp, it may indicate a specific underlying condition.
Patellofemoral Pain Syndrome (PFPS)
Patellofemoral Pain Syndrome (PFPS), or “runner’s knee,” causes pain around or behind the kneecap, worsening with squatting or climbing stairs. It arises from muscle imbalances, like weak thigh muscles or hip abductors, or improper kneecap tracking during knee flexion. Squatting can increase knee joint tension in individuals with PFPS.
Tendinitis
Tendinitis, an irritation of tendons, commonly affects the patellar tendon (“jumper’s knee”) or quadriceps tendon, causing pain below or above the kneecap. These conditions result from repetitive stress and overuse, manifesting as aching pain that intensifies with squatting.
Hip Impingement
Hip impingement (femoroacetabular impingement or FAI) causes a deep “pinch” in the front of the hip, especially at the bottom of a squat. This occurs when hip joint bones abnormally contact each other during deep hip flexion. Poor core stability and ankle stiffness can indirectly contribute by altering pelvic and hip mechanics.
Meniscal Tears
Meniscal tears, injuries to the C-shaped cartilage in the knee, can cause sharp pain, clicking, or a catching sensation during squatting. Deep or twisting movements can aggravate or even cause these tears, as the meniscus can get caught between the thigh and shin bones.
Muscle Strains
Muscle strains, such as those in the groin (adductor muscles) or hamstrings, cause pain in the inner thigh or back of the upper leg during or after squatting. Groin strains often result from overuse, improper technique, or sudden increases in training intensity.
Lower Back Issues
Lower back issues, including muscle strains or disc bulges, can cause pain during squats. A rounded or excessively arched lower back during squatting stresses the lumbar spine, potentially leading to discomfort or injury. Squatting with an existing disc bulge, especially with improper form or heavy weight, can exacerbate symptoms like sharp pain, numbness, or tingling down the leg (sciatica).
Strategies for Relief and Prevention
Addressing squat pain often involves adjusting technique and incorporating specific exercises.
Modifying Form
Modifying squat form is a key step. This includes experimenting with foot stance and toe-out angles to find a comfortable position aligned with individual anatomy. Adjusting bar placement or torso angle can alleviate stress on certain joints. Decreasing depth or slowing movement tempo can reduce joint impact and allow for better control.
Improving Mobility
Improving mobility through targeted stretches can address limitations contributing to pain. Hip flexor stretches, ankle mobility drills, and dynamic hip stretches increase range of motion, enabling a deeper, more comfortable squat. Sitting in a deep bodyweight squat, for example, can help establish a stable bottom position and improve mobility.
Strengthening
Strengthening specific muscle groups supports proper squat mechanics and reduces strain. Exercises targeting glutes, such as hip thrusts or glute ham raises, and quadriceps, like leg presses or lunges, enhance stability and power. Core strengthening exercises, including planks and deadbugs, are important for maintaining spinal stability during the movement.
Warm-ups and Cool-downs
Appropriate warm-ups and cool-downs prepare the body and aid recovery. A dynamic warm-up, involving low-intensity full-body movements and specific mobility exercises, primes muscles and joints for squatting. Examples include air squats, leg swings, and foam rolling. Adequate rest and recovery between training sessions are also important to prevent overuse injuries.
When to Seek Professional Guidance
While many instances of squat pain can be managed with self-care and form adjustments, certain signs indicate the need for professional evaluation.
Persistent pain that does not improve with rest or modifications, or pain that worsens, warrants attention. Sharp, sudden pain during a squat, or pain accompanied by noticeable swelling or bruising, should prompt a consultation with a healthcare provider.
Inability to bear weight on the affected leg, or symptoms like numbness, tingling, or weakness in the legs, indicate potential nerve involvement or more severe injury. In such cases, a physical therapist, sports medicine physician, or other medical professional can accurately diagnose the issue and recommend an appropriate treatment plan.