Knee pain · The Blog
A Doctor of Physical Therapy and lifter's honest answer.
Short answer: usually, yes. And in a lot of cases, squatting is part of what gets your knees better, not worse.
I know that's the opposite of what you've probably been told.
At 13, an orthopedic surgeon told me to never squat again. Stop soccer. Quit skateboarding. Too much impact, he said. I had chronic knee pain for years after that.
You know what eventually fixed my knees? Heavy squats. Loaded gradually, the right amount at the right time.
So let's talk about what the evidence actually says.
Pain and structure are not as closely tied as you might think. We want to believe that imaging like X-rays, MRIs, and CT scans are the gold standard for identifying the cause of pain and symptoms. The evidence says otherwise.
Our bodies are full of textbook abnormalities, but they don't always cause pain and symptoms. When researchers scan people with zero pain, they repeatedly find the same abnormalities that get blamed for patients' symptoms. We see it in the spine, the shoulder and the structures around it, the hip, the knee, and various other areas of the body.
It runs the other way too. Plenty of people in real pain get imaged and nothing textbook shows up to explain it. Most low back pain has no identifiable structural cause at all. In the knee, pain and what shows up on the X-ray line up poorly - plenty of painful knees look clean, and plenty of rough-looking ones never hurt. And for back pain, routine imaging doesn't improve outcomes, because the picture so often doesn't match the person.
The scan doesn't always match the symptoms. So if you're dealing with pain and you've had imaging done, don't just blindly accept those findings as the reason for your symptoms. And if squatting bugs your knees a bit, it doesn't automatically mean you're wrecking them.
The idea that deep squats destroy your knees doesn't hold up well. A review of the research on squat depth and knee loading found no evidence that deep squats, done with reasonable technique, harm healthy knees, and pointed out that partial squats loaded heavy can actually stress the joint more.
This is where the evidence is strongest, and it isn't just for arthritis. Loading the knee on purpose, at the right dose, helps across the problems lifters actually deal with:
Loading isn't the enemy. Done right, it's the treatment.
The question I ask every patient: how does it feel during and after? If it settles back down by the next day, you may be fine to keep progressing.
If pain is climbing day over day, you're seeing swelling, or you're losing progress in the gym, these are signals to do less. Don't just stop, modify. Here are a few ways to keep squatting without grinding through it:
The point isn't to avoid squatting forever. It's to keep a version of it in your training while your tolerance climbs back up.
Being told to stop squatting is one of the most common, and most damaging, pieces of advice lifters get. For most people with knee pain, the answer isn't to stop lifting. Oftentimes, it's the opposite. The more you can modify to stay active and keep loading it, the better it tends to feel.
Grab my free Traffic Light guide - it walks you through exactly how to read your pain and adjust, so you know when to push and when to pull back.
And if you're tired of being told to stop, book a free strategy call and let's talk.
All verified on PubMed; a few link to PubMed Central where that was the cleanest verified link.
Imaging "damage" is common in people with no pain (structure ≠ symptoms):
Pain is common without any explanatory imaging:
Squatting isn't inherently damaging:
Loading the knee helps, across conditions:
Book a free strategy call and let's build a plan that keeps you squatting.
Book a free strategy call