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Why Your Knees Hurt When You Squat (and How to Fix It)

Why Your Knees Hurt When You Squat (and How to Fix It)

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Knee pain during squats and lunges isn’t just “getting older” — it’s usually a specific structure or control problem that can be identified and fixed.

In this episode, Craig Smith, PT, and pro volleyball player Alex Keicher break down the most common causes of knee pain and what to do for each one. They cover how to tell the difference between a joint issue, a tendon problem, or patellofemoral pain — plus why co-contraction and glute inhibition can make your knees feel tight even when nothing’s torn.

You’ll learn:

  • The key differences between knee joint, tendon, patellofemoral joint, and meniscus pain.

  • Simple self-tests to narrow down which structure is irritated.

  • The best interventions for each:

    • Traction for the joint

    • Cross-friction and load for the tendon

    • Isometrics or pain-free zones for patellofemoral pain

    • Heel lift and temporary extension limits for anterior horn meniscus irritation

  • How to fix “tight” squats caused by co-contraction and gamma-loop dysfunction.

  • How to reset glute activation and rebuild smooth movement patterns with sit-to-stand drills.

  • Craig’s four-step framework to eliminate knee pain and reload your system safely.

If your knees ache every time you squat, this episode gives you the roadmap to understand what’s really going on — and how to move pain-free again.

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Welcome to Past Your Prime – the podcast for active adults balancing training, rehab, family, and real life.Each episode, hosts Craig Smith (PT & coach) and Alex Keicher (pro athlete & busy dad) unpack real-world strategies for overcoming injuries, staying strong, and living pain-free—even when life gets chaotic.


💡 Learn more, access resources, and join our community:👉 ⁠pastyourprime.com⁠

Follow us on Instagram:📲 Alex – ⁠@spikerkeicher⁠📲 Craig – ⁠@craigsmithPT


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