How to Squat if You Have Patellofemoral Pain Syndrome

Before I went to the gym today, I put up a message on my Facebook fan page which just hit 7000 so thank you very much, and it is “if there were any specific videos that people wanted me to do.”

There were couple of questions that people asked and they wanted me to do videos on. For this one the question was: How can we help clients to squat if they have patellofemoral pain syndrome or lack cartilage in the knee? This was from Stephanie, so thank you very much Stephanie for the question.

How to Squat if You Have Patellofemoral Pain Syndrome?

There are 4 things that I am doing with my clients that have patellofemoral pain syndrome or are lacking cartilage in that knee joint. We will be using the Suspension Trainer to go through this. This ends up being really good because with the Suspension Trainer I can off load that knee when it comes to going through the exercise.

How to Squat  if You Have Patellofemoral Pain Syndrome?

CLICK HERE to watch the YouTube video.

#1 – Squatting Movement

When it comes to squatting movements, I want a vertical shin. If I use a Suspension Trainer, it’s easier to get into that vertical shin. That vertical shin decreases how much bend is in that knee.

Squatting with Vertical Shin

Squatting Movement with Vertical Shin

Now if Orsy moves her knees forward, you see her foot stays the same but now her knee is in a lot deeper bend. With that deeper bend, it puts more stress on the knee.

Squatting with Knees Forward

Squatting Movement with Knees Forward

Use the Suspension Trainer and work on keeping that shin vertical and that ends up being good for patellofemoral pain and any type of cartilage issue.

#2 – Progressive Squat

Getting them to start and just progress to the point where they have no pain in the knee and come back up. Coming down to the point before pain and coming back up and building that depth that they can do.

Progressive Squat

Progressive Squat

If I go deeper, it puts more stress on that patellofemoral joint and also puts more stress within that knee joint. But you want to work the muscles throughout that full range of motion because if I keep avoiding those ranges of motion, I end up losing strength in those ranges of motion. And I want to build strength in those ranges of motion because they decrease the stress on that knee joint and in the patellofemoral joint.

#3 – Hip Dominant Exercises

I would look at focusing in on hip dominant exercises and those could be like deadlifts or kettlebell swings. Those two are excellent exercises because you are still loading up that knee and you are isometrically working the muscles around that knee joint. We are still working that knee joint and we are still strengthening the muscles around the knee joint which is good and also with those hip dominant exercises we are working on strengthening the hip.

Now if you have a weakness or injury or pain in that knee, we want to do everything we can to strengthen up the hips because we are going to need them to do more work because the knee joint is injured or in pain.

#4 – What Your Client Is Doing Outside the Gym?

This one is almost always overlooked. It is about what your client is doing away from the gym or away from the exercises. And what they do outside of the gym will ruin everything that is done in the gym. If they are putting the knee in highly stressful positions, that will just irritate the knee and it really doesn’t matter what you do in the gym because it’s not going to help when it comes to recovery.

Your client needs to work on keeping that knee in low stress positions. A low stress position is keeping that leg straight because sitting at the desk with the knee bent progressively builds up stress within that knee.

If they are in a deep knee position for a long period of time that puts lots of stress on the knee. If they are doing lots of kneeling throughout the day, that is going to put the knee in a stressful position. It is very important, if they have knee pain or knee injury, that throughout the day they are doing everything they can to put the knee in a low stress position.

There you go. Give those a go with your client. Work on keeping that vertical shin which is important. Work on the progressive squat, the suspension works excellent for that. Thirdly look at the hip dominant exercises because you are still getting benefit from strengthening that knee but then you are also strengthening a joint that you need help with when it comes to protecting that knee and recovering from that knee injury or pain. And then fourthly, keep that knee in low stress positions throughout the day.

Lastly, head down below, hit “Like,” leave a question or a comment and I will get back to you. This is Rick Kaselj saying take care and good bye bye.

If you are looking for a specific program to help with patellofemoral pain then check out Patellofemoral Syndrome Solution, here:


Rick Kaselj, MS

P.S. – If you like this article, these might also help you out: