Here’s a series of questions you’ll want to consider before I give you my take.
-Do you have to squat to sit down on the chair? -Do you have to stand up a from squat when you stand up from the seated toilet bowl? -Do you have to squat to avoid overloading your back when picking stuff up from the ground? -Do to squat to get in and out of the car?
Yes, yes, yes, and yes. Squatting is really a fundamental movement we need in activities of our daily life. If we want to be independent, it’s not something we should give up easily. So if there’s no knee pain and if there’s no major structural issue, I’ll say squat because your life does literally depend on it. Having the necessary strength to bring you through daily life challenges will greatly decrease the chances of non-contact knee injury/ issues. Conversely, if the functionality is not maintained, one will gradually lose it over time to possibly find themselves stuck in a downwards spiral of increasing reluctance to use the legs and decreasing lower body strength and functionality. This spiral will likely continue until much is done to reverse that. If there’s knee pain, I ask the next round of questions.
-Why do you think you have it? Traumatic incident? Overuse? Deconditioning? Degeneration? Bad lower body movement patterns/ posture? -Is there structural damage? Or do you think there is? -What is the first intuitive thing you’ll naturally do when there’s knee discomfort? Is it helping you? -What do you think you should actually do more of in the bigger picture? If it’s not a traumatic incident, what do you think is common across various causes? It’s the lack of adequate maintenance. Maintenance in the form of conditioning with good “centering” of joints throughout movement is much needed. Like how you have to brush your teeth daily to maintain good oral health, mindful practicing of a sufficient amount of good centrated movement will go a long way in reducing the various causes for the knee pain.
And since the word “overuse” is often overused. It’s important to understand that true overuse of joint, in the presence of good centrated movement, is often safeguarded by the muscle and nervous system. Those will likely be the first to give, not the joints, to prevent true overuse. It is instead repetitive suboptimal mechanics (decentrated joint mechanics) that will cause issues in the joint and surrounding structure over time. If it is a traumatic incident, rehab and reconditioning is still a crucial part of regaining functionality. Unless the knee structures are deemed not suitable for any form of rehab and reconstruction/ replacement is the only option, often we will draw a full circle to come back to needing to move well and to move enough to build capacity and tolerance. That is why the first instinct to not move the knee when there is knee pain, may not be helpful. Movement is after all one of the most important components of rehab and reconditioning programs.
Instead of focusing on the knee pain, focusing on the pain-free range of motion and slowly progressing that range is the way to go. If there is knee pain in a deep squat, we don’t have to visit that deep a range of motion. We may instead work through with half squat to slowly condition the muscles around the knee and in the proximal joints to help support the knee. Through the pain-free range of motion, we may also help build awareness in joint centration and provide the body with much need opportunities to refine the activation and sequencing of lower body muscles for better and safer movement. Not to forget other well-targeted exercise variation will also be much beneficial if it is well-tolerate. At the end of the day, you have to practice certain things to be better at it. In order to go through our daily lives, which involves much squatting, we will need to work through with squats or other lower body variations. That will help us build and maintain the minimum strength required to help us support our lifestyle needs. The key here is doing it well (move well) and doing it enough. Squat more, as your life depends on it.
Progressing your quality of life,