The squat is a foundational human movement pattern used daily, whether standing up from a chair, picking an item off the floor, or performing an exercise. When this movement causes discomfort, it signals an underlying issue, either structural or mechanical, that is placing undue stress on the body’s joints or tissues. Pain during a squat is common and should not be dismissed, as it often points toward a breakdown in the kinetic chain. Understanding the source of the pain is the first step toward modifying activity and ensuring this necessary function can be performed safely.
Common Structural Causes of Squatting Pain
Pain often arises from a pre-existing condition within the joint structure that is aggravated by the pressure of squatting. The knee is a frequent site of discomfort, often manifesting as Patellofemoral Pain Syndrome (PFPS), which presents as pain felt beneath or around the kneecap. This condition is worsened by deep knee flexion, such as squatting below a 60- to 90-degree bend, due to increased contact forces on the cartilage. Tendon issues, such as patellar or quadriceps tendonitis, also cause localized pain resulting from repetitive strain and subsequent inflammation.
Discomfort originating in the hip joint is often described as a deep, pinching sensation in the front of the hip at the bottom of the squat. This is frequently associated with Femoroacetabular Impingement (FAI), a condition where abnormal bone shape causes premature contact during deep hip flexion. FAI can sometimes be related to a labral tear, which involves the ring of cartilage surrounding the hip socket, causing catching or sharp pain.
Squatting can also aggravate the lumbar spine, particularly if there is a history of disc irritation or facet joint issues. As the pelvis rotates backward in the deepest part of the movement, the lumbar spine flexes, placing increased shear and compressive forces on the intervertebral discs. This mechanical stress can exacerbate existing injuries, causing pain that may be localized in the lower back or radiate into the buttocks or legs. Pain that persists or radiates beyond the joint line suggests the underlying structural issue may be more significant than a simple muscle strain.
Identifying and Correcting Faulty Movement Patterns
Mechanical issues stem from poor technique or limited joint mobility, leading to excessive strain on certain tissues. One common pattern is knee valgus, where the knees collapse inward during the ascent or descent of the squat. This movement increases stress on the medial structures of the knee, including the medial collateral ligament and patellar tracking mechanism. Correcting this requires actively cueing the hips to “open” and focusing on maintaining the knees in line with the middle of the foot, often utilizing a resistance band around the thighs for external feedback.
Limited ankle dorsiflexion, the ability of the shin to move forward over the foot, is a major contributor to faulty mechanics. When the ankle cannot move adequately, the body is forced to either pitch the torso excessively forward or lift the heels off the ground to maintain balance. This forward lean shifts the stress away from the quadriceps and onto the hips and lower back, potentially leading to pain in those areas. Placing small wedges or weight plates under the heels temporarily can accommodate this mobility restriction, allowing the individual to squat deeper while maintaining a more upright torso.
The “butt wink” is characterized by a posterior pelvic tilt that causes the lower back to round into flexion at the bottom of the squat. This happens when the hips or hamstrings lack the necessary mobility to accommodate the depth. Consistent core bracing, using a “ribs down” cue to align the torso over the pelvis, helps stabilize the spine throughout the movement. Reducing the depth of the squat to the point just before the pelvic tuck begins is the most direct corrective action to protect the lumbar discs from excessive load.
Immediate Self-Care and Professional Consultation
When pain first arises during a squat, immediate self-care should focus on modifying activity rather than complete cessation. This involves temporarily stopping the heavy loading and high-volume training that aggravated the injury, while continuing to move within a pain-free range. For instance, switching from a barbell back squat to a box squat or a goblet squat can reduce the load and modify the joint angles to find a less painful variation.
Applying ice to the localized area can help manage acute pain, although its effect on long-term healing is debated. Gentle, pain-free movement is encouraged soon after the initial onset to maintain blood flow and mobility, an adaptation of the traditional RICE protocol. If the pain is minor and manageable, modifying the activity for one to two weeks should allow the irritated tissue to settle down.
However, certain “red flags” indicate that self-management is insufficient and professional medical guidance is necessary. These include pain that is sharp, stabbing, or unrelenting, especially pain that persists while resting or wakes a person from sleep. Joint instability, such as the knee “giving way” or buckling, or the knee locking and being unable to move freely, demands immediate evaluation. Furthermore, any pain accompanied by systemic symptoms like fever, chills, or unexplained weight loss necessitates prompt consultation with a healthcare provider.