Deep Squats & Knee Pain

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#1
Squats & Knee pain. How deep should you go? Will squatting deep hurt your knees? Why do your knees hurt? There's a lot of myths & misinformation on the subject. This post will give you more info.


The Knee
First go to wikipedia to get an understanding on how your knees work & the different ligaments. The following text was originally posted by Brent on StrongLifts.com. Brent is a weightlifter. You can check his training log on his website.

Brent said:
From a biomechanical standpoint, the patellar tendon isn’t at risk to injury until the shins start tilting forward at a considerable angle (i.e. weight is being pushed near the balls of the feet, not the heels), and the supportive ligaments (ACL, MCL, LCL) aren’t in danger of damage unless the knees don’t follow the toes, i.e. they drift inwards during the squat, you let the bar crash on you and let your feet shift on the way down, etc.

and what you and the physical therapists that you have been treated by are trying to say is basically, the limbs of the body are constantly at risk because the ROM that they have been built for is dangerous, and therefore you should consciously limit the ROM that you let your joints move through, which quite frankly does not make a whole lot of sense - how many babies and children should be going to the ER on a daily basis because of their daily activities? aren’t their joints as fragile, or even more fragile, than a trained athlete’s ?

also there are some schools of thought in PT which advocate full ROM squatting as part of a rehabilitation program

weightlifting is a sport that basically revolves around the ability to squat deep, and while it does have its fair share of athletes who damage their knees and backs, there are also many athletes who continue to compete into their 30s, 40s, and 50s in Master divisions … like other sports, i.e. football, wrestling, etc., there is a risk for injury when competing (in the form of “forgetting” to move a certain way, allowing the body to deviate from correct positions, etc.), but that risk can be minimized through good decision-making and recovery habits

of course, no one is saying that you as an individual have to change your squatting habits, if you really believe it’s not good for you, don’t do it, i’m only arguing that as far as athletic training (i.e. weight training in a controlled, regulated environment under good supervision) goes, deep squatting is a producer of good leg strength and health, not a damager
Another comment by galapagos, also knowledgeable:
galapagos said:
Totally agree. Most PTs haven’t done a single squat their entire lives(other than when they were a baby) and the only people they see injured are those that get injured squatting incorrectly, so obviously they’re gonna get biased. Olympic weightlifters routinely squat ATG, so there’s nothing wrong with it. In fact, as you squat below parallel, your knee ligaments are in a tighter position to protect your knees, compared to when you’re squatting parallel, when they are that their most relaxed. Also, the more you squat below parallel, the most hamstring and glute involvement there is, again protecting your knees from damage. Bottom line, squatting ATG is a perfectly natural human movement that should be encouraged.
This one by me
Mehdi said:
Squatting deep doesn’t hurt your tendons. Typically, it’s working a joint/muscle beyond the range of motion it was designed for that will hurt the tendon. Overstretch your biceps: you’ll tear it. Keep the lower leg stable, while rotating the upper leg: you’ll tear your acl tendon, etc…

You’re body was designed to squat deep. There’s nothing wrong with doing this. Chinese people have the habit of sitting in a bottom squat position for extended periods of time.

Keeping your knees healthy while squatting is all about technique:
-Increase the weight gradually
-Work on flexibility & mobility in hamstrings/hip joint if needed
-Don’t bounce at the bottom
-Keep your knees out
-et

PTs will advise you not to go full rom for two reasons:
-They fear you’ll injure yourself because you’re not using proper technique.
-They lack understanding of how the squat works & what correct technique is.

5 millions people are involved in weightlifting competition worlwide. They all squat deep. Their injury rate is lower than in any other sport like soccer, football,…

How Deep Should You Squat.
At least below parallel. I like to go low. Very low. I'm a big fan of the High Bar Olympic Squat. But feel free to squat with a high bar if you prefer. Whatever you do: squat below parallel. If you can't break parallel: stretch your hamstrings & adductors. Stretch also your glutes (pirfirmos/psoas), whatever stretch the whole thing. It's always good.

Now most people will struggle to break parallel. But others like me, especially smaller lifters, will have no problems breaking parallel & going very low. If you're one of these: stop when your butt tucks under. Ask someone to watch from the side or tape yourself. Going too low can lead to injury in your sacrum. This doesn't happen a lot as most people are rather inflexible, but it happens to some.


Why Your Knees Hurt When Squatting
Squats done properly are one of the best exercises to strengthen your knee joints. If you get knee pain from squats, you either did them wrong or you had a pre-existing problem.

The knee is made for stability. If your ankle or hip joint lacks mobility, the knee will have to overcompensate mobility. But because the knee is made for stability & not mobility, it gets injured. You can't force a joint to do a task that it was designed for. In this case: you can't force your knee to be mobile while it's meant to be stabile.

If you don't know what this means: plant your left foot on the ground & try to rotate your upperleg to the side This is how people typically get an ACL injury. If your hip or ankle lack mobility, the knee will have to be mobile & a similar things happen.

So: if your knee hurts: look at your ankle or hip. Don't search for the knee. Similar things happen for your other joints btw: if your lower back (stability) hurts, you got a problem at the hip (mobility), etc.


If you experience knee pain:
-Stop doing quarter/half squats
-Check your technique, knees out, push from the heels, don't bounce at the bottom, etc
-Check the joint above & below: ankle & hip.


More on Squat Technique
This is where it all starts: technique. Learn to squat correctly. You'll find that a) many people don't squat b) many people don't squat correctly. So educate yourself. These articles will help you:
-How You Can Avoid Knee Injuries from Squatting
-21 Tips To Improve Your Squat Technique
-Starting Strength: invest 30$ in this book once & you'll have a solid understanding on the Squat, Deadlift, Bench Press, Overhead Press, Power Clean. 30$ is cheaper than the costs of treating an injured back/knee.


And remember: you need to squat. If there's only one exercise you should do: it's the squat. I squat 3 times sometimes 4 times a week. I've done Smolov Squat routines. I always squat deep. In 10 years of strength training I experienced knee pain once. When I had snapping hip syndrome which is: a lack of hip mobility. Your knee hurts: check technique & check joints above/below. Good luck.
 
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Warboss Alex

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#2
awesome post Mehdi!

also, I liked the baby comment.. it's funny, instinctively as infants we know exactly how our bodies should work but as adults we try to use science to overrule our inherent instinct, and end up buggering up the knees.
 

mrRuckus

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#3
I've blown out the same knee twice. Once in softball, once in basketball. The other knee I'm not even sure what happened but some fat kid fell on it in 5th grade playing football and i couldn't really bend it for a few months and spent the summer playing nintendo and getting fat. If i remember right, i cracked my patella.

I've never had any knee pain whatsoever doing deep squats. It will feel a bit annoyed doing leg extentions(which i haven't done a rep of in years) or low rep leg presses, though.

My lower back or deep in my inner hip is where I sometimes feel some stiffness or soreness doing squats.
 

stronglifts

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#5
WBA & Quagmire: Thanks. This belongs in the sticky/faq.

mrRuckus said:
I've blown out the same knee twice. Once in softball, once in basketball. The other knee I'm not even sure what happened but some fat kid fell on it in 5th grade playing football and i couldn't really bend it for a few months and spent the summer playing nintendo and getting fat. If i remember right, i cracked my patella.

I've never had any knee pain whatsoever doing deep squats. It will feel a bit annoyed doing leg extentions(which i haven't done a rep of in years) or low rep leg presses, though.

My lower back or deep in my inner hip is where I sometimes feel some stiffness or soreness doing squats.
I agree with the leg extension. Heavy leg extension also gave me knee pain. Never had problems with the leg press (haven't done it since 5 years at least), but the problem is always the same with machines: if you don't position yourself correctly, you're at risk. I'd say move your feet more up or down & see how your knees react. Or drop them completely.

Inner hip is very very common (groin). A lot of people inner hips crack when they move their legs. Sometimes it crack too much & there you have it. As I wrote above: I had snapping hip syndrome & am still dealing with. Watch out with your groin, it takes very long to heal if it get injured.
 

Mr.Positive

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#7
I just recently started doing deep squats about a month ago. The are a LOT tougher than regular squats, what you see 99% of people in the gym doing all the time. A lot tougher, IMO.

Do you guys basically go down as far as you can go? I drop until my abs touch my quads and then come back up.

Unfortunately my squat numbers dropped since going deep, from 345lbs to 285lb...:(

EDIT: To add, I've had no knee pain at all. I was worried about this, so I started with very light weight.
 

Warboss Alex

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#8
Mr.Positive said:
I just recently started doing deep squats about a month ago. The are a LOT tougher than regular squats, what you see 99% of people in the gym doing all the time. A lot tougher, IMO.
Deep squats ARE regular squats.

Mr.Positive said:
Do you guys basically go down as far as you can go? I drop until my abs touch my quads and then come back up.

Unfortunately my squat numbers dropped since going deep, from 345lbs to 285lb...:(
You go down as far as is comfortably possible, yes.

Forget your non-deep squat numbers, they don't mean anything and you couldn't squat that weight.. you could just put the weight on your shoulders and go down a bit with it.

Soon your REAL squat will surpass your old 'fake' squat. :) And your physique will reflect this, as will your knee integrity.
 

Drum&Bass

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#9
Forget your non-deep squat numbers, they don't mean anything and you couldn't squat that weight.. you could just put the weight on your shoulders and go down a bit with it.
LOL was thinking the same thing.

why are people having a hard time with squats like there some kind of incredibly complex exercise that requires a huge discussion.
 

Mr.Positive

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#11
Warboss Alex said:
Forget your non-deep squat numbers, they don't mean anything and you couldn't squat that weight.. you could just put the weight on your shoulders and go down a bit with it..

Before I was squatting until my thighs were parallel to the floor, which was what I thought was a 'normal' squat. That's what you see most guys doing.

Going deeper than that is a lot tougher, it takes a huge amount more of effort to do a full, real, squat, IMO. But, what a great exercise! I have noticed a big difference.

Thanks for the tips guys!! I'll try a slightly wider stance too.

Hopefully, I'll get my numbers back up soon. :)
 

Drum&Bass

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#12
Squat Depth

there is an explanation online that says squatting to parallel is bad for your knees..completely idiotic. The only thing bad for your knees is having them drift past your toes.
 

spesmilitis

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#13

stronglifts

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#14
Drum&Bass said:
Squat Depth

there is an explanation online that says squatting to parallel is bad for your knees..completely idiotic. The only thing bad for your knees is having them drift past your toes.
Deep olympic squats & front squats involve the knees drifting past your toes.

It's simple: your elbows & knees are strongest when fully extended or flexed. But they are weak any position in between. That's why squatting below parallel is better on the knees than doing a half/quarter squat.
 

Kerpal

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#15
Is it even possible to squat deep without your knees going over your toes? I'm trying to imagine it but I can't, unless your shins are staying perpendicular to the floor, in which case you're not squatting as deep as possible.
 

spesmilitis

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#16
Kerpal said:
Is it even possible to squat deep without your knees going over your toes? I'm trying to imagine it but I can't, unless your shins are staying perpendicular to the floor, in which case you're not squatting as deep as possible.
Powerlifting, for some.
 

Kerpal

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#17
Yeah, I think powerlifters keep their shins perpendicular but their goal is to move as much weight as possible in a powerlifting competition, and I'm pretty sure in powerlifting competition you only have to go to parallel or 1" below. But if you're trying to squat as deep as you can, I'm pretty sure your knees have to go over your toes, which means your shins have to be at an acute angle to the floor, unless you have deformed legs or something like that.
 

stronglifts

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#18
Kerpal said:
But if you're trying to squat as deep as you can, I'm pretty sure your knees have to go over your toes, which means your shins have to be at an acute angle to the floor, unless you have deformed legs or something like that.
Exact knee position depends on the length of your thighs/lower legs.
 
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