Squats aren’t bad for your knees, squats done with bad form are bad for your knees.
But how you do your squats matters.
More often than not, it's not THE exercise you do that is "bad" but HOW you might be doing the exercise.
In fact, NOT learning, developing and improving at least some kind(s) of squatting in your training programs and day-to-day life could be putting your long term health and wellness, overall movement quality and your knees at risk.
We are, as humans, made to squat. It’s a fundamental and foundational pattern.
Sitting back on to the toilet or chair = a squat.
Getting up off of the toilet or chair = yup, that's squatting too.
Yet as important as the movement is (and as common as it should be in our everyday lives) it’s not uncommon to hear people either complaining of knee pain when squatting, or, expressing fear of squatting because they have “bad knees” or someone told them it would hurt their knees.
Blanket statements like “squats are bad for your knees!” or, “deadlifts will damage your back!” are ones to be explored.
Squats should be a staple in every program. The key is understanding there are dozens of squat variations and not every squat should (or will) look exactly the same. Everyone has their own set of abilities, genetics, anatomical structure, strength, experience and goals. Which means everyone will have their own squat based on these factors.
You can’t make your squat look like someone else’s unless you have their exact abilities, genetics, anatomical structure, strength, experience and goals
But you can find a pain free squat variation and techniques that work for YOU.
Where to start if you struggle with your squats or feeling pain with them
Check your form
Find your squat stance
Your most ideal squat stance is the one YOU can comfortably and safely perform without pain or restriction. The end. There isn’t a one size fits all stance and your squat will and probably should look very different than your gym buddy’s squat. It could be due to musculature and mobility, but most likely the difference is because no two hip joints are built the exact same and bony anatomy varies wildly from person to person.
Look at the difference in my squat if I use the “classic” stance - legs shoulder width apart, toes pointed straight ahead- compared to the stance I use - much wider with my feet externally rotated, or turned out. The stance on the left isn’t ideal for me, plus it’s very uncomfortable.
Here’s one of the many ways you can assess which hip with might work best for you. Get down your knees and elbows and rock your butt back towards your heels. Does your low back round? Go back to the beginning, but this time, try widening your knees a bit. Try again. Better? Still more rounding? Play around with finding a knee width position that allow you to get as close to your heels without rounding your back.
Same goes for your squat depth
Unless you're a competitive powerlifter- where your hips must drop below the knees - you don't need to hit a particular depth, especially not an ass to grass squat. The ideal depth s going to be the one that feels most stable for you, has the least amount of compensations and of course, is pain free.
Your depth, like your stance, is going to be largely determined by your anatomy. Some people will never be able to squat low to the floor and it's important to remember it's not always a mobility problem, and it's not a necessity.
Here's a quick four part assessment to help gauge squat proficiency, determine what depth is appropriate and to check for mobility and stability issues:
Feet shoulder width apart, toes facing straight and arms overhead. What does it look like? Heels coming up off the floor? Back rounding? Excessive forward lean?
Keep your arms up overhead, widened your stance and turn your toes out a little. Does it look better? Less rounding or leaning? Some people will be more successful in a stance like this as it gives them a wider base of support.
Arms still up, put your heels on some small plates. How's it look now? Deeper? Heels staying down? If yes, the lack of depth could be due to ankle mobility or structural restrictions.
Ditch the plates and hold a 5-10 pound weight out in front of you. What's it look like now? Deeper? This engages your anterior core and allows for more depth by giving your body more stability. If this noticeably cleaned your squat up, you most likely have a stability, not a mobility, issue.
But aren't deep squats worse?
Deep squats can have protective effects on the knees but only if done safely and correctly.
As we squat, different surfaces of the femur (thigh bone) and patella (kneecap) are placed under stress. The amount and type of stress changes over the course of the movement, dependent upon depth of the squat. And, different parts of the squat will have different effects on different anatomical structures; ligaments, cartilage, meniscus.
Shear forces - translatory forces caused by the (natural) rolling and gliding motion of the knee joint
Compressive forces- caused by the quadriceps and quad tendon as well as the patella tendon forming a strap in the front of the knee which compresses against the kneecap as you squat.
So although it would seem that deeper squats would be increasing the compressive forces, thereby increasing injury and wear-and-tear, there are many things not being taken into account here - like the effect the quad tendons have in contracting the quadriceps muscles or, the hamstrings and the calves bumping into each other.
And, research shows little evidence of cartilage damage in elite powerlifters and weightlifters - handling extremely heavy loads (and deep squatting) due to squatting long term. It’s also been shown that deep(er) squats will promote positive changes in cartilage thickness and the strength of tendons and ligaments.
It's in the beginning, or first half of the squat (0-90 degrees) where the most amount of damage and highest likelihood of injury is shown, especially when performed with poor technique.
This is also why using heavier weights and doing a partial, or quarter squat would be more “stressful” on the knees than deeper squats would be with lighter weights.
Look at your shin angle
Referencing the chart above, starting the squat descent by breaking at the knees first (as opposed to sitting the hips back) will place even more shear forces on the knee.
This is known as anterior or forward translation of the tibia (shin bone).
There will always be some forward movement of the knees - it's natural and not as big of a no-no as you might have been told- but if it's excessive to the point of you coming up on your toes, or, your squats have been causing you pain, it's something to address.
Think about aiming for a more vertical tibia.
Work on ankle mobility
Try these two drills if you have an inadequate amount of dorsiflexion (bringing the toes towards your shin) and stiffness, which can be one cause of your crappy squat patterning.
Wall ankle mobilizations
Start with your toes against the wall and bend your knee lightly to tape the wall while keeping your heel ON the floor. Slide your foot back a bit and repeat. Over time, work on moving your foot further away from the wall, while still keeping your heel down. Try 8-10 reps per side in your warmups before squatting.
Rocking ankle mobilizations
Get into a plank position and place the toe of one foot against the heel of the other. Rock back and drive your heel towards the ground. Not able to get your foot flat? Move your hands back closer to your feet and try again. Shoot for 6-8 reps per side.
And your hip mobility and strength
Weakness and dysfunction at the hips will effect the knee. A common faulty pattern with this is the knees caving inwards.
While a little knee movement is normal, again, it's something to clear up especially with newbies or, those experiencing knee pain, especially if it's excessive.
Sometimes this can be easily cleared up by thinking "knees out" or, imagining putting your kneecaps in line with your pinky toes. "Reach out to the corners of the room" can work too.
For some tactile feedback, try using a miniband above the knees and think about pushing the band out as you sink into your squat.
Adding exercises - both in your warmups and in your training program- to address the hips and glutes will help to take some of the brunt of work off of the knees and emphasize more posterior chain recruitment.
Create a more stable foot too.
Start from the beginning
Before you jump right to barbell squatting, what does your goblet squat look like?
Train in a pain free range of motion
Trouble keeping your neutral-ish spine position (which could impact how your hips and knees and feet react)? A box or bench can be used as feedback for how low to go and how you need to be sitting back, not sliding forward. You're better off getting strong in a position you can handle and then possibly working your way lower as you progress.
Lower the weight and decrease the volume
Are you doing too much too soon? If you are experiencing pain, it could be from going too heavy, too often for too long. Dial it back a bit and/or lower the weight for a bit. Hell, take some time off of heavy squats all together.
Change things up from time to time
Your stance, the load, the type of squat, the tempo, how often you do them.... you get the idea. Doing the exact same thing over and over and over again can lead to overuse injuries and aches and pains.
Look at the rest of your programming
What’s the overall balance of your training look like? What about other exercises that are known to make some knee issues worse, like walking or forward lunges? How much single leg work are you doing? Hip, hamstring and glute work? Are you following a program at all? Is your knee pain pain within the actual joint? Or, is it a hell of a lot of quadriceps soreness that won't go away?
Get assessed by a professional
Find a coach, a physical therapist or other medical professional who can look at your squat - and movement patterns in general - and help you determine where the problem might be coming from and how best to troubleshoot it. Don't be satisfied with treatment that only attempts to fix the pain and doesn't address what the root of the problem could be.