Why Does My Knee Hurt When I Squat? A Physical Therapist Explains

Knee pain with squatting is incredibly common, whether it happens under a heavy barbell, during a workout, or simply when getting down to the floor.

The good news? Pain during a squat doesn't automatically mean something is damaged—or that you need to stop squatting.

There are several reasons a knee can hurt during a squat. Figuring out why starts with a few surprisingly simple questions.

1. Where Does Your Knee Hurt?

The location of your pain doesn't give us a diagnosis by itself, but it can provide some useful clues.

• Around or behind the kneecap: Often associated with patellofemoral pain, one of the most common causes of knee pain with squatting, stairs, running, and lunging.

• Directly below the kneecap: The patellar tendon may be involved, especially in people who lift, run, jump, or play sports.

• Along the inside or outside of the knee: There are several possible sources, including the meniscus and other structures surrounding the knee.

• Above the kneecap: The quadriceps tendon can sometimes be the source.

The first gem: Pay attention to exactly where you feel your pain. "My knee hurts" tells us much less than "I feel a very specific pain directly below my kneecap when I get past halfway down." Those details matter.

2. Are You Actually Squatting Wrong?

Maybe—but probably not for the reason Instagram told you.

There isn't one perfect squat technique for everyone. Your anatomy, mobility, training history, goals, and the type of squat you're performing all influence what your squat should look like.

One of the most persistent myths is that your knees should never go past your toes. Your knees travel over your toes all the time—walking downstairs, running, jumping, and playing sports. Allowing your knees to travel forward does increase the demand placed on the knee, but increased load isn't the same thing as damage. A better question is:

Can your knee currently tolerate the load you're asking it to handle?

That's a much more useful way to think about knee pain.

If your knee is irritated, temporarily changing your squat depth, weight, or technique may reduce the demand enough to let you keep training while you build your capacity back up. The modification should have a purpose—not simply follow an arbitrary rule about what a squat is "supposed" to look like.

3. What Changed Before Your Knee Started Hurting?

This is one of the first questions we ask patients, and it's one you can ask yourself.

Think back 2–6 weeks before your knee started bothering you. What changed?

Did you:

• Start squatting heavier?

• Add another leg day?

• Increase your running mileage?

• Start playing basketball or another sport again?

• Return to the gym after taking time off?

• Suddenly start hiking or walking more?

• Combine several of these at once?

Your body adapts to the demands you consistently place on it. Sometimes knee pain shows up because those demands increased faster than your body's ability to adapt.

This changes the question from:

"What's wrong with my knee?"

to:

"What am I asking my knee to do that it's not currently prepared for?"

That's often a much better place to start.

4. Should You Stop Squatting If Your Knee Hurts?

Not automatically.

There are certainly situations where temporarily removing an exercise makes sense. But many times, we can modify the squat rather than eliminate it.

Try this:

If squatting hurts, reduce the weight and shorten your depth. Does that significantly reduce your symptoms?

If it does, you've learned something useful. Your knee may tolerate the movement just fine—it may simply not tolerate the current dose.

From there, other variables can be adjusted:

• Weight

• Depth

• Sets and reps

• Frequency

• Tempo

• Squat variation

The goal is to find a starting point your knee tolerates and gradually build from there.

For an active person who wants to squat, run, hike, or play a sport again, "just don't do that anymore" isn't much of a long-term solution.

5. What If Your Knee Hurts More as You Squat Deeper?

This is another useful clue.

As you squat deeper, the demands around the knee—particularly the patellofemoral joint—generally increase.

That's not inherently bad. Your knee is designed to handle load. But if the knee is currently irritated, a deep squat may exceed what it can comfortably tolerate while a shallower squat feels perfectly fine. This is why reducing squat depth can sometimes be useful during rehab.

It doesn't mean deep squats are bad for your knees. It means we're temporarily adjusting the dose while we work on increasing your capacity.

6. When Should You Have Your Knee Looked At?

If your knee pain keeps coming back, is getting progressively worse, or is starting to change how you exercise or move, it's probably worth figuring out why. You should seek evaluation sooner following a significant injury, especially if you experience substantial swelling, difficulty bearing weight, repeated giving way, or a knee that becomes mechanically locked. For everyone else, you don't necessarily need to wait until the pain becomes severe. Sometimes the easiest knee problem to solve is the one you've only been dealing with for a few weeks—not the one you've been modifying your workouts around for the last year.

The Bottom Line

If your knee hurts when you squat, remember these three things:

1. Location matters: Where you feel the pain can give us important clues about what's being irritated.

2. Load matters: Instead of assuming something is damaged, think about what changed and whether your current activity exceeds what your knee is prepared to tolerate.

3. You don't necessarily need to stop squatting: Sometimes changing the weight, depth, volume, or variation gives you a pain-free—or much more comfortable—place to start. The harder part is determining why your knee became sensitive in the first place and what needs to change to keep it from coming back. That's where an individualized assessment becomes valuable.

In Mission Viejo? Knee Pain With Squatting?

At Kinetik Performance & Rehab, we work with active adults and athletes who want more than being told to simply stop doing the activities that hurt.

We'll look at your knee, strength, mobility, movement, training history, and current workload to figure out what's contributing to the problem—and develop a plan to get you back to the things you actually want to do.

If knee pain is keeping you from squatting, lifting, running, or staying active, contact Kinetik Performance & Rehab in Mission Viejo to schedule an evaluation.