Hi, I’m Dr. Molly with Your Goals Physical therapy. Have you been trying to squat but you keep coming up against some inside knee pain that’s just limiting that whole idea, then this video is perfect for you.
So squatting is absolutely amazing, but it takes all the fun out of it, if it hurts and not muscle hurts but sore hurts, like this is damage, right? Muscle sore is kind of what you’re looking for at least to a certain extent.
But when that intensity of discomfort gets to pain, it takes all the fun out of doing the squats. If that’s something that you’ve been dealing with for a long time or several weeks, it can be disconcerting. You can be afraid that you’re going to need knee surgery. You could fall down that rabbit hole and think that you need to have a joint replacement or some other surgery because something else catastrophic has to be wrong with your knee because why would squats hurt?
Some people’s squats were just the last straw. Other things are bothering them but now that their squats have been impaired, they really just need to get back and figure out what is going on with their knee. In this video I’m going to talk about three main causes for inside knee pain, and then we’re going to talk about ways to stop that knee pain. In some cases you can start that process at home. So let’s get started.
What I mean by passive structures is we have ligaments and we have other parts of our anatomy that are fixed: bones, ligaments, our meniscus, those things don’t move on their own, they’re just there.
They are passive specifically relating to inside knee pain. I’m going to bring up my little model of a knee. So specifically when we’re talking about the inside knee pain, we can be looking at the ligaments that run right along the inside of that joint, that help keep these two bones together. This is a pretty basic model, but there are several that cross over this joint and any number of them could be slightly torn, a little annoyed. There can be several things that are going on with this, which could result in knee pain on the inside of that knee.
The other thing that’s on the inside of that knee is your meniscus. That is another very common reason that people will have knee pain while they squat. Your meniscus is a cushion between the two bones and depending on the bone structure, how close these bones are together, if you have arthritis, if you don’t, where that is, that meniscus can get torn causing pain.
So in terms of passive structures to figure out if that’s truly what is causing it, you would need to see somebody to kind of manipulate your knee to see what’s happening and what structures are actually damaged and to what extent. Because a minor tear may not even be the problem. A minor injury to your meniscus or that ligament you may not even really know about. So that might not be the cause. But again, these are some of the reasons that we do get knee pain.
Muscles can cause pain if they are being worked too hard or they’re very tight.
We’ve all had muscle spasms where a muscle really contracts hard which caused a lot of pain. In this example for a knee problem, what can happen (we’re just going to pick on the quads just because it’s kind of easy).
If you’re going down into that squat, we assume a baseline amount of strength to be into that position. So whether you’re talking about a bodyweight squat or something with a squat bar you’re assuming that there’s a certain amount of strength at some point that may not be true.
Everybody’s fitness level is different as you’re going down. If that quad does not feel that it is strong enough, you will get a very strong sense of a pull or a grab, a muscle spasm, sometimes people feel something very sharp, but it’s your body’s way of saying that is too heavy for me and that’s too much work. So you just get this, it’s a nondescript to us because you don’t understand muscle code. It’s your body’s way of saying that I don’t have the strength to do that activity.
Now, muscle length can also play a role in it because if a muscle like your hamstring is very, very tight and it pulls that bone slightly outta joint, now that can cause a lot of discomfort because things are not in their right spot as you’re trying to do the squat.
Anybody who’s done a squat realizes, especially if you’ve been sore from a squat, if you’re just doing body weight, it’s literally anything from your waist down to your feet can get sore because squats are an amazing workout, but they use all the muscles from your waist down to your feet.
If one of those muscles is not long enough, or not quite strong enough, it can add extra stress to the inside of that knee causing pain.
Now the last thing, the mechanics or the coordination of your squat, as I just mentioned, doing a squat is not a one joint motion. It takes everything from your hips down to your ankles.
It’s a lot of joints in there. If you’re adding a bar to your shoulder, or even if you’re holding weights in your hand, you’re now adding your entire body to that because depending on where your head is or your trunk is held, that can be extra stress on your knee because it all has to function in a very coordinated sense together.
If anything like your trunk is too far forward, if your hips are too far forward or too far back, if your ankles are turned in too much or too far out. Any of those things can affect the joint above it, which will affect the joint above it and vice versa, it could affect the joint below it and the joint below that. We are all one giant unit as we’re moving into this squat.
Depending on the type of squat you’re doing, it can be a very dynamic motion. Instead of just an easy smooth motion, even if you’re just doing a basic bodyweight squat or a squat down to a box and coming up, all those joints and all those muscles have a specific role that they need to play. If the muscle length or muscle strength around that joint are not equally coordinated, it can cause inside knee pain.
Those are the three main reasons why people can have knee pain. Now that is a lot of information and it’s kind of simplified and I did that on purpose because you can get mogged down in Meyer by all of this.
Anybody who’s looking through the internet knows how much information there is and how overwhelming it is to figure out what exactly is going on. I still get caught in this and I’m in the medical world. I had a kid that was sick this weekend and it was very weird symptoms, stomach ache and with no nothing else, just a little bit of a fever. You look at Dr. Google, and Dr. Google says this is appendicitis. So I’m calling the doctor.
The doctor’s like, well, you do have to come in and get checked because it could be. So you go in for the physical exam. Much to my shock, my kid has strep. Apparently one of the small random, down at the bottom symptoms of strep throat is random abdominal pain in kids. Who would’ve thought I wasn’t going to get there with Dr. Google. I would have never put strep throat on my diagnosis suggestions. I was dead set we were going in for CT’s and emergency surgery.
I say all that to say that it is very hard to self-diagnose. Some people are pretty good at it, but overall it is very hard to take a whole look at yourself and know exactly how equal your strength is on either side.
Understand muscle length, see all the coordination that’s involved in a dynamic movement such as a squat. It is far easier for you to come in and have somebody put their hands on you, be able to physically check the ligaments in your knee, physically check the meniscus without having to worry about waiting for an mri. These are things that can be checked manually. Then looking at strength and your flexibility and actually physically seeing you do a squat in person in real life.
There’s so much more information that you can get from one hour when you have a physical in-person visit, especially with somebody who specializes in this, than you can by digging through the internet. So if you’ve been dealing with this and you’re rightfully very scared that you may need surgery, instead of trying to decipher through all this, let me make this easy for you. I deal with so many knee problems with athletes that I’ve actually created a knee book, and so I will leave the link for that.
It’s “How Not to Let Your Knee Pain Derail Your Workout”. I will leave a link for that. It’ll be a little button and you can click that and you can get my best tips to getting you back to your workout despite this knee pain. The other thing that I’m going to leave a link for is, if this is the exact care you’re looking for.
If you’re tired of going through and being worried about this knee problem and you’re ready to just get rid of it and deal with the specialist who does nothing but help people get back to their favorite activities, I’m going to leave a button on the bottom that says, “ask about cost and availability”. You’ll fill out a quick little form and my office will get back to you.
There again, the medical field and dealing with aches and pains is very, very complicated. It is a lot easier when you can be in a room with somebody, ask specific questions and have them actually see when the pain starts and be able to give you a reason for that.
At the end of an evaluation with me, you will know the root cause of your knee pain and get a clear path with a very specialized program just for you. That’ll get you back to your squats without anything until we have a chance to talk. I hope you’re having a good day.
If you are still searching and would like something to help guide you, Then click the button below to get a copy of my e-book “How Not to Let Your Knee Pain Derail Your Workout’.
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