The seven most common causes of knee pain are:
- Incorrect technique
- Too heavy
- Shoes or foot problems
Surprisingly it is not the ‘squat’ and definitely not ‘squat depth’. The squat can be the cause when you tick one or all of the above boxes. The depth can be the problem when not progressing properly or ticking some of the above boxes.
Weak quads, thigh/hip adductor or abductor, calf, hamstring muscles can all contribute to instability, incorrect alignment, certain muscles doing more work than others etc. For example, the knees might be caving in due to weak hip abductors which creates torque on the knees.
Instability can be a product of weakness but can also be a product of not training for stability. Instability during the movement can cause misalignment which in turn creates torque on joints.
Instability and weakness are some of the effects of inactivity. There are plenty of other side effects from inactivity that will contribute to a bad squat, like poor mind-muscle connection etc.
4) Incorrect technique
Not knowing how to perform the movement can produce excessive load on joints that can’t handle it, create misalignment, and will have plenty of other ramifications.
Training more than your recovery allows is one of the major contributing factors to knee pain, especially when some of the other boxes are also ticked. Combine overtraining, high reps, not enough rest, with bad technique, weakness, instability and you have a recipe for disaster. Knee surgery type of disaster.
6) Too heavy
Working out with more weight than one can handle. Not leaving the ego at the door. Not listening to the body. Training through pain while the body says no, the body says “There is something wrong” but the message is ignored.
7) Shoes or foot problems
The feet are our foundation, they are the lowest load-bearing part of our body, They are the base upon which everything happens. If you have issues in your feet then problems will travel up. I have a whole book of things I would like to say about shoes. I’m going to keep it short. Ordinary people wear soft squishy runners to do every-day people things, they wear shoes for tasks they’re not made for, people wear shoes for fashion, not comfort.
If you have excessive supination and pronation happening at the base of your load bearing system, then that is issue numero uno you need to address.
Do I need knee surgery?
I’m no doctor. But I will give my opinion. I believe that knee surgeries and replacements are becoming an all too frequent occurrence and are too easily prescribed. My opinion is that—and opinion is all that you should take it as, you form your own—a healthier approach is:
- Proper programming
… and squat! Squat deep.
Should your knees go past your toes when squatting?
The answer is. It depends on how deep you squat. But yes, if you squat past parallel then your knees will more than likely for the majority of people have to go past their toes to maintain balance. If the knees don’t go past the toes then the hips come back too far and create imbalance, which is usually paired by extending the arms to create a counterbalance. This action is usually paired with the shoulders coming low and hips staying high, which I call fake range.
Is squatting below parallel bad for your knees?
The answer is. Not if you progress to it appropriately and address flexibility and strength first. If you miss some or all of the attributes required for a good squat then squatting below parallel can be bad for your knees. Squatting below parallel should be the goal of every human being. As a race we’re all given the ability to squat deep when we’re born, then we live such a life where we ruin our ability to squat deep:
- Sit too much
- Don’t squat enough
- Become inactive
Where is your science to back this up? Stuff science, if you need science to back something this obvious up then there are bigger problems to address.
This is speaking from experience, not science, science can be manipulated to fit the required outcome. Science can be tainted and my writing can be as well. In the end it all comes down to you using common sense, discovering, learning, trying, analyzing, opening up, and understanding your body mechanics. But above all, invest time, time in research, time in experimenting, time in changing your mindset, time, time, time.
My experience is over a decade of training myself and people all over the world in private, group format, workshops, etc. The proof for me has been seeing the hard results.