Knee Pain During Squats? Here's Exactly What to Do

Knee pain during squats affects millions of people and is one of the top reasons adults over 40 give up strength training. But in most cases, it's not the squatting itself that causes pain — it's how you're squatting, or a muscle imbalance that needs addressing. ## Common Causes of Squat-Related Knee Pain **1. Weak Glutes** If your glutes aren't firing properly, your knees compensate. Valgus collapse (knees caving inward) is almost always a glute weakness issue. **2. Tight Hip Flexors** Tight hip flexors from sitting all day prevent full hip extension, causing compensations that load the knee. **3. Limited Ankle Mobility** If your ankles can't dorsiflex properly, your heel rises and your knee tracks forward beyond your toes — increasing patellofemoral pressure. **4. Patellar Tendinopathy** Overuse of the patellar tendon causes pain just below the kneecap. Common in people who suddenly increase training volume. ## The Fix: A 4-Week Protocol **Week 1-2: Correct the Foundation** - Glute bridges: 3 sets × 15 reps (activate glutes) - Clamshells: 3 sets × 15 reps each side - Ankle circles and calf stretches daily - Elevated heel squats (weight under heels): practice squatting pain-free range **Week 3-4: Reload Progressively** - Box squats to a comfortable depth: 3 × 10 - Step-ups: 3 × 12 each leg - Romanian Deadlifts: 3 × 12 (builds posterior chain strength) - Full squats — only if pain-free, with careful attention to form ## Red Flags — See a Doctor If: - Swelling that doesn't resolve within 48 hours - Sharp pain that worsens during activity - Knee locks, clicks, or gives way - Pain after minor trauma *This is general guidance only. A physiotherapist can provide an accurate diagnosis and individualized treatment.*