Knee Pain From Squats? Better Check Your Form

Knee Pain Ruining Your Leg Day?

Ever had a leg day ruined by a sharp pain shooting through your knee on squats or leg extensions? Knee pain is a multifaceted problem well known for causing extended breaks from the gym. However, have you ever wondered why it occurs? Is it due to the exercises you do in the gym or could there be other factors at hand?

Do Squats Cause Knee Pain?

Squats, specifically barbell back squats, have received a great deal of criticism as a principal knee pain cause. For one, this exercise allows for extremely heavy loading. Adding to that, it is highly accessible as it only requires a barbell, weight plates, and a squat rack, extremely common equipment nowadays. Even without a squat rack, a smith machine, which is a squat rack with a barbell integrated into it, can be used for squats. The use of heavy barbell back squats to grow the glutes and quads is thus very common in many leg day programs. However, it is the style of squatting that is often claimed to cause knee pain; squatting with knees over the toes.

Do Knees Over Toes Cause Knee Pain?

A squat described as “knees over toes” often relates to a squat with a deep knee bend, bringing the knee past the toes. When this deep knee bend is achieved, the knee joint is exposed to a great amount of mechanical forces, which has been suggested to cause injury and pain. However, not much evidence points to the deep knee bend position as being a principal cause of both short- and long-term knee injuries. Rather than injurious, good coaching and smart training with the deep knee bend position on leg extension exercises like the squat actually increase protection from injury and strengthen the lower limbs.

knee over toes squat

Do Other Leg Exercises Cause Knee Pain?

In a similar vein, other deep knee bending exercises have similar potential to cause knee pain. Deep lunges or single leg squats both expose the knee joint to similar mechanical forces as a barbell back squat would. Rather than blaming an exercise, other factors related to the exercise, such as the way it is executed or the variables in the program, should be scrutinised.

What May Be Hurting Your Knee During Leg Day

Several factors could be responsible for causing knee pain during leg day across leg extension exercises.

  1. Using too heavy a load
    Jumping up the loads too quickly and using an excessively heavy amount of weight can cause injuries, especially if the body is not used to it. Sudden injuries can take place when the soft tissues, such as muscles and ligaments, are unable to tolerate the load placed upon them.
  2. Performing too much volume
    Excessively high training volumes, especially when untrained or unacclimated, can increase the risk of a repetitive use injury. This often happens when programs keep adding more and more repetitions without considering the built-up fatigue.
  3. Training without sufficient recovery
    If the leg is still sore and unable to produce the same amount of force as it normally could, training at the same intensity would increase the risk of acute repetition failure and possibly injury.

Needless to say, if someone was already experiencing knee pain, attempting to train the injured leg at the same intensity while ignoring the pain puts them at greater risk of worsening their injury.

Working Around Knee Injuries And Pain

Working around knee pain can be difficult, especially for those without access to specific training equipment. The following are three strategies to negotiate this injury on leg day:

  1. Train using progressive range of motion in the pain-free ranges
    If the deepest knee bend position is painful, squatting or lunging through a pain-free partial range of motion until the previous range of motion is achieved is one way
  2. Use exercise variations that do not cause pain
    Other leg extension exercises aside from the barbell back squat, such as the leg extension machine, step-up, and reverse lunge are potential alternatives that can train the quads but reduce the strain on the knees.
  3. Use Blood Flow Restriction training
    Using a blood flow restriction cuff and the blood flow restriction training protocol for leg extension exercises can be a viable way to reduce load and knee stress while producing similar training results.

The Verdict On Knee Over Toes?

Overall, as long as the deep knee position is slowly developed and strengthened over time, it is unlikely that training in that position will guarantee a knee injury. Avoiding the common pitfalls mentioned in this article will make your leg day workouts much more enjoyable and bring you more results in the long term. If you already have existing knee pain from squatting or other leg exercises in the knees over toes position, rehabilitating the knee until the pain is gone or working around the knee pain should be your priority.

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