Your knee hurts when you squat because of muscle imbalances, tight hips, poor movement mechanics, weak glutes, patellar tracking issues, or early joint irritation. When the hips or ankles aren’t moving well, the knee takes on too much stress—causing pain in the front, outside, or inside of the knee. Most cases improve quickly with a targeted physical therapy plan that identifies your specific imbalance and restores proper movement.
Why Squatting Makes Your Knee Hurt
Squatting is something we all do every day—getting into a chair, picking something up, working out, or chasing kids around.
So when your knee hurts during a squat, it’s frustrating. It can make you feel limited. And if you’re active, it can make you nervous to even train.
At Next Level Regenerative Physical Therapy, this is one of the most common questions we hear:
“Why does my knee hurt when I squat… and is something wrong?”
The good news:
Knee pain with squatting is almost always fixable.
And it’s usually caused by something around the knee—not the knee itself.
Let’s break down the most common reasons you feel that sharp, tight, or achy pain.
Your Hips Are Tight or Not Activating Well
Your hips control the position of your knees during a squat.
If your hips are stiff or your glutes aren’t firing, your knees often:
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Move inward
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Track forward too much
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Twist or rotate
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Lose stability at the bottom of the squat
All of this puts extra pressure on the kneecap and surrounding tissues.
People with hip mobility issues usually feel:
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Front knee pain
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Pinching at the bottom of a squat
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Pain only on one side
If you want to learn more about hip-knee mechanics, visit our resource on Hip & Knee Pain
Your Ankles Don’t Move Enough
Ankle mobility plays a bigger role in squatting than most people realize.
When your ankles are tight, your heels lift or your knees shift forward. This forces the knee joint to take on more stress—and more load than it’s built for.
If you feel pain when you squat in:
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Running shoes
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Narrow stance
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Deeper squats
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Heels lifted
…it often points to ankle mobility limitations.
Your Kneecap Isn’t Tracking Smoothly
The kneecap should glide through a groove in the femur.
But when muscles around it pull unevenly—often due to quad dominance or weak glutes—the kneecap can track slightly off-center.
This causes:
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Pain in the front of the knee
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A feeling of pressure or grinding
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Pain going down stairs
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A “tight band” feeling around the knee
This is extremely common and responds well to hands-on treatment + targeted strengthening.
You’re Relying Too Much on Your Quads
If your glutes or core aren’t doing their job, your quads take over.
When that happens, your knee becomes the “hinge point” for the entire movement.
This often causes:
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Pain at the top of the knee
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Pain when standing up from a squat
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Pain after workouts or long days
Re-training your squat mechanics and building balanced strength can make a massive difference.
You Have Early Joint Irritation or Arthritis
Sometimes the knee itself is irritated—especially if there has been:
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Prior injury
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Sports overuse
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Cartilage wear
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Long-term stiffness
Even early arthritis can cause squat pain, but it’s important to know:
Arthritis in your knee does NOT mean you can’t squat or stay active.
In fact, movement is one of the best treatments.
Your Form Needs a Small Adjustment
Even tiny changes in squat form can change how much pressure goes into the knee.
Common form issues include:
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Knees moving inward
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Torso collapsing forward
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Feet too narrow or too wide
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Depth too fast, too deep, or too soon
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Not bracing before descending
A small tweak can often reduce pain instantly.
If you train regularly, our Sports Rehab team works with athletes and active adults at every level to fix this quickly.
A Previous Injury Never Fully Healed
Old sprains, strains, or meniscus irritation can flare up during exercises like squats—especially if the surrounding muscles haven’t regained full strength or balance.
Pain isn’t “random.” It’s your body telling you something isn’t moving the way it should.
So… Can You Fix Knee Pain With Squats? Absolutely.
At Next Level PT, we take a whole-body approach, not a “just strengthen your quads” or “stop squatting” approach.
Here’s how we help people stop knee pain for good:
Our 5-Step Approach to Fixing Knee Pain When You Squat
1. Identify the real root cause (hip, ankle, core, or knee)
We assess how each joint moves and look for imbalances.
2. Hands-on therapy to release tight tissues
We use advanced manual therapy to decompress the knee and restore mobility.
3. Corrective exercises tailored to your body
We rebuild balance in your glutes, hips, core, and knees—not generic “knee exercises.”
4. Improve your squat mechanics step-by-step
We teach you the right stance, depth, bracing, and movement pattern for your body.
5. Create a long-term plan to keep you pain-free
So you can train, lift, and stay active safely.
This is exactly why our patients see fast results—because we treat the body as a whole, not as separate parts.
When Should You See a Physical Therapist?
You should get evaluated if:
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The pain makes you avoid squatting
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You can squat but it hurts every rep
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Knee pain is worsening or spreading
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You can’t recover between workouts
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You hear clicking, grinding, or popping
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Your knee feels unstable
You do not need a doctor’s referral.
Final Thoughts
Knee pain during squats doesn’t mean something is “wrong” with you.
It just means something isn’t working together the way your body needs.
When you understand the cause—and treat it with a personalized plan—you can return to squatting with confidence and without pain. Click this video on proper squat form!
At Next Level Regenerative Physical Therapy, we help people move better, train stronger, and feel in control of their bodies again.