Knee Pain When Squatting Down or Kneeling: Causes and Treatments

What causes knee pain when squatting?

Does the idea of dropping something and having to bend over to pick it up make you groan? Maybe you experience outer or inner knee pain when you squat down to look in the oven or tie your shoe. 

Sharp pain in the knees from squatting down or kneeling is a common annoyance that may be a sign of an underlying condition. This pain may just be a nuisance or it can prevent you from enjoying your day, but the good news is that it can be corrected. 

 

Here are some of the most common causes of knee pain when squatting or kneeling:

Knee arthritis

Arthritis is caused by inflammation in the joints. Inflammation from arthritis can lead to pain, swelling, and stiffness. Any joint in the body can experience arthritis, but knee arthritis is one of the most common forms.

Knee arthritis can cause inner knee pain during everyday activities such as climbing stairs or walking. This disability may cause you to miss out on experiences with your friends and family or be unable to work.

The “wear-and-tear” arthritis causes in the knee occurs most often in people 50 years of age and older, though it may also occur in younger people. This form of knee inflammation is caused by the gradual degeneration of cartilage in the knee. As the cartilage wears away, it decreases the protective space between bones in the knee which leads to them rubbing together. 

The most common symptoms of knee arthritis are stiffness and swelling causing pain when bending or straightening the leg, pain that is made worse by vigorous activity or after a period of rest, and weakness in the knees that may lead to “locks,” creaks or clicking sounds, or buckling.

 

Runner’s knee

Runner’s knee is the informal term for Patellofemoral Pain Syndrome. This form of knee pain is felt around the front of the knee (the patella) where it connects to the lower part of the thigh (the femur).

Though it is most often associated with running, runner’s knee may also be caused by a structural defect or certain ways of walking. Examples of situations that can contribute to the development of runner’s knee include:

• Weak thigh muscles
• Tight hamstrings
• Tight Achilles tendons
• Poor arch support
• Excessive training or overuse
• Existing injuries

Pain from runner’s knee is felt when a person is active or after sitting for an extended period with legs bent. A feeling of rubbing or grinding, or a clicking sound at the kneecap, may also be experienced with runner’s knee and the kneecap may be tender to the touch.

 

Tissue trauma

Knee tissue trauma is caused by a sudden movement or direct force that strains the knee beyond its normal range of movement. This trauma results in the soft tissue of the knee being torn or strained. Soft tissue includes ligaments, muscles, tendons, and menisci.

Trauma that causes a knee injury is most often experienced by athletes, but it may also occur on intensive job sites, while chasing children or pets, or with other forms of activity.

The most common symptom of tissue trauma is an immediate sharp pain that may be followed by swelling. After the trauma has occurred, you may feel like your knee is close to “giving out” when you walk. You might have difficulty straightening your leg, have bruising, and/or experience stiffness around the trauma site.

 

Iliotibial band syndrome (ITBS)

Iliotibial band syndrome (ITBS) occurs when a tendon called the iliotibial band gets irritated or swollen from friction in the knee joint. The ITB stretches from the top of the knee to the top of the pelvic joint and creates friction when it tightens.

ITBS may occur in one or both legs. If it is experienced in both legs, it is called bilateral iliotibial band syndrome. This knee condition is most commonly experienced by basketball players, cyclists, hockey players, runners, skiers, and soccer players. 

Certain people may have an increased risk of developing ITBS including people with bowed legs or one leg that is longer than the other, people who have knee arthritis, and people who rotate their ankle, leg, or foot inward when they move. 

Symptoms of Iliotibial band syndrome include hip pain, knee pain when flexing or extending the knee, sensations such as a pop or click on the outside of the knee, and discoloration and warmth on the outside of the knee. At first, this pain will be felt at the onset of exercise and as it worsens, it will also be felt while resting.

 

What are the best treatment options for knee pain when kneeling or squatting?

Knee pain caused by activities such as kneeling or squatting may have you feeling discouraged, but there are treatment options available that can help alleviate your symptoms. Our expert pain doctors will work with you to identify the cause of your knee pain and then will develop an individualized treatment plan to address the issue.

The following are some of the best treatment options for knee pain experienced when kneeling:

Improvement of ankle flexibility

Lack of ankle mobility may be the source of some knee pains, and improving the ankle’s flexibility could be the only treatment some people need. When your ankles are restricted in their mobility, the next nearest joint will take over some of the load, causing inflammation of the knee.

It’s important to improve ankle flexibility not just to avoid or treat knee pain, but also to prevent pain in other joints of the body. As one of the lower weight-bearing joints, the ankles have a lot of work to do to help keep the body in motion effectively. 

People who have experienced an ankle sprain at any point in their lives may have limited ankle flexibility, poor mobility, and resulting knee pain.

 

Strength training exercises

Many different forms of strength training can help alleviate knee pain. With all of these exercises, it’s important to remember to warm up and cool down to prevent additional pain in the body.

Here are some of the best exercises for increasing strength, reducing friction, and helping address knee pain:

• Straight leg raises
• Wall squats
• Calf raises
• Step-ups
• Side leg raises

 

Periods of rest

Taking a break from rigorous workouts or normal day-to-day activities may be required to treat certain forms of knee pain. Resting allows the body to recover and heal the strain that is caused by repetitive movements. 

For minor injuries, a day or two of rest may be all that is needed to alleviate symptoms. More severe pain may require a longer recovery time. Taking rest days between especially difficult workouts can benefit your recovery in the long term.

If knee pain during exercise or daily activities plagues your life, our pain management doctors across Texas, Florida, and Orange County, California can work with you to develop an individualized recovery plan. 

 

Frequently Asked Questions

What does knee bursitis feel like?

Knee bursitis may cause a warm, tender, and swollen feeling when pressure is applied to the knee. Pain can also be felt while moving or even when resting. Knee bursitis is most commonly caused by jobs that require a lot of time spent kneeling on hard symptoms.

What are a few common symptoms of knee tendonitis?

Knee tendonitis or Patellar tendonitis is felt as pain between the kneecap and shinbone. This pain may only be felt during physical activity, but over time it will worsen and appear at all times of the day.

What happens if knee bursitis is left untreated?

If knee bursitis is left untreated, symptoms will gradually worsen over time. The bursa that lies over the knee cap may also become infected leading to additional pain, swelling, and fever.

Does knee bursitis require surgery?

Treatment for knee bursitis usually involves a combination of lifestyle changes, self-care practices, and treatments administered by a doctor that help alleviate pain and inflammation.