7 Important Factors Causing Sharp Knee Pain When Squatting

Squatting is a natural human movement and yet, as we age, it seems to become more and more difficult. 

This is largely down to the sedentary lifestyles most of us now lead, where we spend much of the day sitting.  The benefits of squatting are widely known and it’s now viewed as an important exercise for a healthy body. 

However, a common complaint with squatting is that of knee pain.

squat on heels

The most common cause of sharp knee pain when squatting is patellar tendinopathy. 

The patellar is a ligament that connects the patella to the tibia, and overuse can cause the tendon to wear and inflame, resulting in sharp pain just below the kneecap.  

However, whilst this condition is most commonly cited, it’s not exclusive to all knee pain.  Below are some other causes of knee pain which you may encounter when squatting.

What Causes Knee Pain When Squatting?

Poor Squat Form

Good squat technique can be subjective when you consider a person’s anatomy, such as the length of their femur bone, but there are some common mistakes that can cause and acerbate knee pain.

When squatting be sure to keep your chest and head up to discourage any forward leaning. 

If you do lean forward during a squat, this will transfer more of the weight load on your knees, placing more stress onto the tendons which can increase the chance of injury. 

During the concentric phase of the squat, push through your heels which will help to keep the weight on the ankle and hip joints and away from the knees.  This will also help with better alignment.

Load Management Error

Load management error is caused when someone squats without properly conditioning their body beforehand.

For example, they increase the weight load too much and too fast or simply try and incorporate high squat repetitions a number of times per week. 

heavy barbell back squat

This essentially means that their body, knees included, has not been able to properly adapt before making any changes.

Gradually increasing weight loads when squatting and working up to high volume workouts will allow your body to adjust to these alterations, helping to limit stress on the joints.

Patellofemoral Syndrome

Patellofemoral syndrome is a common condition that is caused by overuse of the patellar tendon that results in inflammation of the cartilage just behind the kneecap.

The inflammation happens when the kneecap is misaligned so that weight is bearing on one side or the other during activity. 

This impacts tracking of the patellar during knee flexion and extension and without proper treatment can cause other conditions such as arthritis.

Treatment typically comprises of ice packs to the area along with rehab work to strengthen the overall knee joint and muscles.

Meniscus Injury

The meniscus is a small piece of cartilage that helps to spread your weight evenly across the knee and acts as a shock absorber between the shin and thigh bones.

A tear to the meniscus is very common and typically happens during squatting if the lifter twists their knee under a heavy load. Signs indicating this kind of injury range from knee swelling to reduced range of motion.

Whilst a meniscus tear can heal on its own, sometimes it will require medical intervention by way of an MRI scan and further treatments.

To avoid this type of injury during squatting, proper form is essential. Avoid twisting the knees when you’ve un-racked the bar and keep your knees out. 

If you lose form during the squat, it’s not uncommon for the knees to fold inwards, this puts stress on the meniscus and can cause injury.

Iliotibial Band Syndrome

Iliotibial band syndrome, often referred to as IT Band syndrome, is caused by friction of the iliotibial band tendon as it crosses the knee causing pain on the outside of the knee. 

Even though a common injury in runners, it can be caused by squatting.

The IT band is connective tissue that begins at the hip and runs down to the outside of the knee.   The cause of pain is usually down to stiffness or inflammation which can result from poor squat form

Poor Ankle Mobility

Poor ankle mobility in squatting can inadvertently put more of the weight load onto the knees causing discomfort and pain. 

If this is the case, consider squatting with your heels elevated, this should only be a temporary solution whilst you work on improving ankle mobility.

Wide stance squatting with toes pointing outwards can also help as this decreases the level of ankle mobility.  This can also aid with achieving a deeper squat.

Weakness In The Quadriceps

If you have underdeveloped quads this can increase the strain placed upon the patellar tendon causing pain.

Does Squatting Damage The Knees?

When a squat is performed correctly it will not damage the knees and can be a beneficial exercise for overall knee health. 

However, squats can exacerbate underlying knee issues which should be addressed before undertaking the exercise. 

When people report knee pain either during squats or post training, it’s often due to the issues that the lifter is already suffering from as opposed to the exercise being the actual cause of their discomfort.

When knee pain is encountered during squats, it can be down to incorrect form. 

If the lifter notices pain shortly thereafter, it could be they suffered a knee injury whilst training – again this may be down to their technique. 

If you’re unsure of your technique, it would be worth seeking the advice of a qualified strength and conditioning specialist or personal trainer.

How Top Stop Your Knees Hurting When Squatting

The cause of your knee pain would determine the best method for aiding recovery and it’s not always to rest and reduce exercise. 

Indeed, in some instances it can be recommended to continue with training but to a lesser degree.  Below are a number of ways that could potentially help to keep knee pain at bay during squats.

Stretch And Warm Up

As the quads are one of the primary muscles activated during squatting, any tightness can result in knee pain due to a misalignment of the patella. 

hamstring warm up

This essentially impacts the tracking of the tendon during knee flexion and extension. 

Before squatting, it’s a great idea to undertake stretching to warm up the muscles which not only alleviates any tightness but can help to prevent injury during squats.

Alter Your Squat Stance

By changing the position of your squat stance, you can help to keep stress off of the knees.  Simply position your feet wider with your toes pointing outwards. 

squat stance

This is a much better foot placement to adopt as with wide stance squatting more of the weight is shifted from your knees to your hip adductors.

Incorporate Tempo Squats

Tempo squats are when you assign a set amount of time, usually 3 seconds, to complete each portion of the movement. 

A common format for tempo squats is the 3-0-3 (also known as the Denver squat).  This is where you squat down to a count of 3, with the zero indicating no pause, and ascend back up to a count of 3.


Correct squat technique is important to prevent any knee injuries and don’t be under the impression that squats can cause knee pain as regular correct squatting is hugely beneficial.

Please seek advice from a qualified medical professional to diagnose any knee pain you may have and subsequent treatment.

Leave a Comment