Knee Pain Below During Squats: Causes and Solutions - Orthopedics

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Knee pain, particularly below the kneecap during activities such as squats, can be attributed to several underlying causes, especially when you have recently increased your physical activity level. Given your history of weight gain and the initiation of a new exercise regimen, it is essential to consider the potential stress and strain that your knees may be experiencing.

Possible Causes of Knee Pain Below the Kneecap
1. Patellar Tendonitis: This condition, often referred to as "jumper's knee," occurs when the patellar tendon, which connects the kneecap (patella) to the shinbone (tibia), becomes inflamed. This is common in individuals who suddenly increase their physical activity, especially with exercises that involve jumping or squatting.

2. Chondromalacia Patella: This condition involves the softening and breakdown of the cartilage on the underside of the kneecap. It can lead to pain during activities that put pressure on the knee, such as squatting or climbing stairs. Symptoms often include a grinding sensation or pain below the kneecap.

3. Iliotibial Band Syndrome: The iliotibial band is a thick band of tissue that runs along the outside of the thigh from the hip to the shin. If this band becomes tight or inflamed, it can cause pain on the outer side of the knee, which may also radiate to the area below the kneecap.

4. Meniscus Injury: The meniscus is a cartilage that acts as a cushion between your shinbone and thighbone. A tear in the meniscus can occur due to sudden twisting movements or excessive strain, leading to pain, swelling, and difficulty bending the knee.

5. Osteoarthritis: If you have a history of knee issues or if you are older, osteoarthritis could be a contributing factor. This degenerative joint disease can cause pain, stiffness, and swelling in the knee joint.


Solutions and Recommendations
1. Rest and Modify Activity: It is crucial to allow your knee some time to recover. Avoid activities that exacerbate the pain, such as squats or running, until the pain subsides. Consider low-impact exercises like swimming or cycling that do not put excessive strain on the knees.

2. Ice Therapy: Applying ice to the affected area can help reduce inflammation and alleviate pain. Aim for 15-20 minutes of icing several times a day, especially after activities that aggravate your knee.

3. Strengthening Exercises: Once the acute pain decreases, focus on strengthening the muscles around the knee, particularly the quadriceps, hamstrings, and hip muscles. This can help stabilize the knee joint and reduce pain. Consult a physical therapist for a tailored exercise program.

4. Stretching: Incorporate stretching exercises for the quadriceps, hamstrings, and iliotibial band to improve flexibility and reduce tension around the knee.

5. Footwear: Ensure that you are wearing supportive shoes that provide adequate cushioning and stability. Poor footwear can contribute to knee pain, especially during physical activities.

6. Consult a Healthcare Professional: If the pain persists despite these measures, it is essential to consult a healthcare provider or a physical therapist. They can conduct a thorough evaluation, possibly including imaging studies like X-rays or MRIs, to determine the exact cause of your knee pain and recommend appropriate treatment options.

7. Gradual Progression: As you return to your exercise routine, gradually increase the intensity and duration of your workouts. This will help your body adapt to the new demands and reduce the risk of injury.

In summary, knee pain below the kneecap during squats can arise from various conditions, particularly after a sudden increase in physical activity. By implementing rest, ice therapy, strengthening and stretching exercises, and consulting with a healthcare professional, you can effectively manage your symptoms and work towards a pain-free return to your fitness routine.