The WORST Squat For Knee Pain & What To Do Instead

Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)

It actually saddens me to see so many people misunderstand what both the issues behind knee pain often are and not understanding the impact of the exercises they are prescribing people (yes, exercise is a prescription). A recent example was a fitness pro who had their client both on a wedge AND was using bands to create a Spanish squat. Unfortunately, it was clear that this coach did not realize these are actually contradictory methods.

You see the whole point of using a wedge (we will discuss whether this is a good idea) is to help the knees to move more forward to create greater stress upon the patellar tendon. The whole point of a Spanish squat is to keep from painful knees having to experience more force by not having the shin translate forward. So, you can see, they are literally trying to do two OPPOSITE things.

Are these ideas individually even good? The research on wedge squats was only for patellar tendinopathy was for single leg training no more than 50-60 degrees of knee bend. So, it was for a very specific type of knee pain that is also a very generalized issue. What most don’t know is that a very basic strength training program of a leg press and squat was just as effective in reducing knee pain while having greater collagen turnover which makes for a more resilient knee.

We can see that a very basic strength training program can have positive impacts upon knee pain and that wedging doesn’t provide anything that is unique. This should be also considered in context of a lot of the research that said that the wedge squat did cause pain and encouraged lifters to just “work through it”. Such a strategy may not be practical for someone who is quite a bit of pain already and pain tolerance may not be high for a multitude of reasons.

Few have the important discussion that lack of ankle mobility also has a VERY significant role in knee pain. This is extremely important because the wedge takes away the need for ankle mobility. You quickly see understanding what the body needs as a whole impacts the better decisions we can make about which exercises we prioritize.

How about the Spanish squat, should you be using it? There are VERY select and few cases I would find this to be the case. People that may have fear or just building back to integrated movements after surgery may feel more comfortable doing a Spanish squat. However, we need not become reliant on such methods because they wont’ replicate what the knee endures in every day life. They are more like band-aides for a very select time in extremely specific cases.

In both wedge squats and Spanish squats there tends to be a lack of emphasis on hip abduction which is key for getting greater gluteal activation. This isn’t just about building a better butt, but following the great amount of research that show stronger hips can be a great help in improving knee pain.

What should you do instead? Josh does a great job of breaking down more important cues and progressions we can use to build squats that don’t cause knee pain and help our efforts to improve knee issues.

Don’t miss more information like this as we address common misconceptions and myths while giving you evidence based solutions in our upcoming Chronic Pain Masterclass. You can save on this great CEU 6-week online program with code “pain” HERE