Hey Team Victory! I personally know how frustrating knee pain can be, especially when you are trying to live an active lifestyle. It can be defeating when you go to your doctor and they seem to only be focused on that one little area around your knee where the pain is. It's like they don't get you. Today, I thought we would take a different approach...
Whenever someone walks into my office and they tell me their knee hurts when they squat my mind immediately jumps to two different areas. The hip and the ankle. But why? clearly this is a knee issue, right?
Your knee pain may not be a knee problem
Yes, your knee hurts when you squat. But, that doesn’t necessarily mean your knee is the problem! Two of the most common reasons for knee pain during a squat pattern are a lack of hip stability and decreased ankle mobility. When the hip or ankle have mobility/stability problems they put the knee in a compromising position which can lead to pain. For all of you nerds out there: it can change the Q angle and place an increased load across the knee joint.
How do you fix it?
I'm not in the business of blindly throwing exercises at people just for the sake of giving an exercise, it's why I don't have pre-printed exercise handouts in my office. I like to have a process like Assess-Correct-Re-assess. Here's how we do it:
- First, let's Assess: Perform 5 air squats (less if painful)
- Now let's Correct; Perform one of the awesome exercises below
- Then Re-assess: 5 more air squats and look for positive change; decreased pain, less stiffness, better knee position, "feels easier", etc.
- If you find change, boom! That's your homework!
Perform 5 slow and controlled air squats (less if it's painful). You may have a friend watch, record it with your phone, or just pay attention to how it feels (if and when there is pain or any other barriers).
Disclaimer: You can have your friend watch you squat and tell you everything you are doing wrong, or you can do what I do, and videotape yourself with your phone and save your friendships!
Do you have a "tight" ankle on the side of pain?
Often if we are lacking movement in a particular joint, we will make up for it somewhere else in the chain. If you want to squat and have a tight ankle, YOU WILL STILL SQUAT, but your body may have to go around that tight ankle to get you there. You may feel your toes rotating outward and pushing against your shoes, your ankle rolling inward, or it may feel like your ankle is running into a brick wall and you are falling backwards during an air squat. Try doing this ankle mobilization (Correction) to solve your tight ankle.
Now, after the ankle mobility drill Re-assess and perform 5 more air squats.
Did that change how your squat feels? Can you go deeper without pain, does it feel easier? Less barriers? Not falling backwards?
Is your knee pain coming from your hips?
When we have a lack of hip stability, a common finding is an inward collapse of your knee or an asymmetrical shift of your pelvis during a squat. How do I know if my knee is collapsing in? Well, there are a few different opinions out there regarding exactly where your knee (center of knee-cap) should be in relation to your foot during a squat, but we can play it safe and say; I would like to see your knee tracking over your mid foot or even over the outside edge of your foot. Try doing a suitcase carry exercise (Correction) to improve your hip stability:
Now, after the suitcase carry, Re-assess and perform 5 more air squats.
Now how does your squat feel? Can you go deeper without pain, do your hips stay level, are your knees staying over your feet?
- Assess: 5 air squats
- Correct: Ankle mobility drill or suitcase carry
- Re-assess: 5 air squats
- If either of those drills made your squat better, make that part of your squat prep.
Did you noticed an improvement in your ability to squat following either of those correctives? If so, then that is your new homework and should be incorporated into your warm up, especially before a squat day.
Of course, there are many factors that can lead to knee pain and this post is not all inclusive, just a few of the common reasons I see active people get knee pain. Hopefully you found a few tools to help you reach your squat goals. If you need some more help, go see a sports chiropractor or someone who will LOOK AT MORE THAN JUST YOUR KNEE TO TREAT YOUR KNEE PAIN!
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Victory Spine and Sport is a sports chiropractic clinic located in Camas, Washington close to Vancouver Washington. Dr. Henry blends chiropractic, sports medicine and physical therapy to provide our patients with a unique, active approach to chiropractic that our patients deserve.