After the 2011 Reebok Crossfit Games Regionals, I elected to have bilateral ankle surgery to remove bone spurs from both of my ankles? Why? The spurs were impeding my ankle range of motion, preventing me from a full depth squat…or so I thought. Fast forward nearly 10 years of daily practice and my squat is still a work in progress, but night and day from where it was before. Through this experience, I now have a deeper understanding of squatting mechanics that allows me to share my knowledge with others. One of these areas is knee pain in the squat.
One of the most common questions I receive as a performance coach who works with aging athletes, “Is squatting bad for my knees?” Answer, “It depends.” What are the demands of the squat? How many squats are you doing? What is your technique? What is the anatomy of the individual? What is the load of the squat? All of these questions and more factor into my answer. When someone tells me their knees hurt when they squat, it takes about 10 seconds of watching them move for me to find the reasons why and it usually falls into one of two categories: 1. poor posture and/or 2. lack of technique.
When assessing an athletes posture, I look at the ribcage relative to the pelvis. In most athletes I work with, their ribcage is hyperinflated causing the back to overextend and the pelvis to tip forward. This leads to the athlete sitting into the squat and letting the bodyweight translate forward causing the tendons and soft tissue of the knee to receive the load. With enough reps or enough load, the knees get cranky.
The other common fault I see is in the technique of the athlete. Many are worried about letting there chest drop so they arch their back and they reach their butt back. Again, this leads to a negative outcome as the knee (and lower back) end up taking the burden of the load. Instead, when teaching a client the squat, I start have them feel their heels first. I also want them to be able to get their pelvis to neutral and to feel abs. Setting the athlete up in this position leads them to the next step: letting the knees flex forward. I know heresy! For an athlete to stay upright in a squat while using hamstrings and quads, the knees must flex forward. The difference in this squat however, the weight must stay back on the heels. This ensures the load stays dispersed through the muscles of the glutes, hamstrings, and quads. Not the knees and lower back.
Personally, I use the squat as a tool to teach clients simultaneous hip and knee flexion along with stabilizing the core, something that is essential for long term health of the knee, hip, and lower back. There aren’t many movements that can accomplish all of these things, and it’s time efficient as well. I wouldn’t consider the squat critical to activities of daily living, however the farther away we get from a full functional squat (sitting on heels, ass to grass and stable with knees over toes), we can assume the individual is starting to or has lost range of motion and control of the ankle, knee, hip, and lower back, all important in the long term health of the athlete. Especially if the individual is still active in recreational sports or lives an overall active lifestyle.
In general, if you are trying to squat on your own without much experience, I would stick to front loaded squats (goblet and zercher) or bias single leg movements like the split squat, step-up, or lunge. Single leg movements put much less technical demands on the core and legs and can in fact teach some basic control and understanding of how everything works together.
In the future, I will be breaking down the squat much more in depth and giving you my progression from taking the squat from an F to an A+ so stay tuned!
Ready to get rid of that nagging knee pain and overhaul your squat? Let’s get started! Click the link below to set up a free assessment and we will get you on the path to pain free squatting!