The physiotherapist speaks with an apologetic tone. “We have already attempted standard stretches along with cycling and swimming exercises. Now we should consider a different approach that some might question. Marc is 49 years old and shows discomfort even before changing position on the examination table. He has endured three years of persistent knee pain and undergone two MRI scans. He also purchased custom orthotic insoles but none of these interventions provided meaningful improvement. His previous medical advice strictly prohibited any deep bending movements. However this specialist now recommends that he perform squats.
Outside in the waiting room you will find the same situation repeated over and over. There are people who cannot run after their children or climb stairs without thinking about it first. Standing through an entire concert has become impossible for them. Most of them have been told that swimming helps protect the joints and that Pilates strengthens the body in a safe way. However some sports doctors & rehabilitation specialists are now saying something completely different. Their new recommendations go against all the careful advice that patients have been following for years. This shift in thinking challenges the traditional approach to recovery & fitness that has dominated medical guidance. The conventional wisdom about low impact exercise has been the standard recommendation for decades. Patients trusted this advice and built their recovery plans around these principles. Now they are learning that the methods they relied on might not be the best path forward after all.
It may sound strange, but the move that everyone told you to stop is back.
Why squats are suddenly being talked about again for knee pain
There is a quiet change happening in rehab clinics. Some doctors are finally saying what they’ve been thinking for a long time: avoiding squats forever might not be safe and might be making knees weaker. They watch as patients baby their legs, always stopping before the bend gets “too low.” This puts them in a semi-squat limbo that never really loads the joint.
The real enemy isn’t bending, it’s fragility for this new group of experts. In a lab, the knee doesn’t just bend and straighten. When you get out of the car, it twists. When you miss a step, it absorbs shocks. It locks and unlocks dozens of times a day. Training those movements, as long as it’s not too much, can be a way to protect instead of punish.
Sarah’s journey with squats and knee pain
Sarah, 38, is an office manager who stopped doing squats after she hurt her meniscus. Her doctor told her to keep doing Pilates and swimming. “Safe sports,” he said. Two years later, she could swim through a pool lane like a dolphin, but climbing the subway stairs still hurt her knees. She felt both strong and weak at the same time.
A friend suggested she visit a sports physiotherapist. The initial sessions felt almost insulting in their simplicity. She did half squats while gripping a doorframe and barely moved at all. Later she added light weights & removed her shoes while gradually squatting deeper between rest periods. After three months her knees weren’t perfect. But she realized she could now carry groceries up two flights of stairs without struggling on each step.
The role of controlled squats in strengthening knees
What changed wasn’t magic. It was the load, the direction, and the trust. There is a growing body of research that supports the same idea behind those personal stories. When done correctly, controlled squats can strengthen the quadriceps, glutes, and hamstrings, which all help keep the knee stable and take pressure off the joint surface. The cartilage doesn’t just wear away; it also reacts to pressure and movement, like a sponge that gets food when it is squeezed and released.
That’s where people disagree. Some doctors still follow the old belief that squats are bad for bad knees no matter what. Other people think the specific details are important. They consider factors like whether you use just your body weight or a heavy barbell. They look at whether you squat shallow or deep. They think about whether the movement causes pain or feels tolerable. The medical community has not reached agreement on this issue. This leaves patients confused between two different sets of guidelines.
Finding the right approach to squats for knee health
Some experts now support the controversial squat method. The squats that these people recommend do not look like a gym PR video. There is no screaming and no heavy bar and no heroic depth. It usually starts with a chair. You sit down and stand up. Then you control the way down. Then you hover just above the seat for two seconds before standing up again. That little pause is where the joint learns to handle stress without getting scared.
Some exercise programs include a wall for support or a countertop that you can grip with one hand. Position your feet slightly wider than hip width with your toes pointed outward a bit and distribute your weight evenly across each foot. Experiencing pain is acceptable but it should only be mild discomfort that disappears quickly once you finish the set. If the pain continues the squat should be modified to be smaller or slower or you should add support.
Physical therapy for the knee focuses less on performing complex movements & more on helping the joint regain confidence in its natural bending motion.
The importance of gradual progression
# The Right Way to Start Squatting for Knee Health
Physical therapists point out that the most common error people make is pushing themselves too hard right from the start. Someone reads that squats can help their knees and immediately jumps into doing three sets of 20 deep squats every single day. This is usually when the complaints start rolling in about how the exercise made their joint problems worse. Knees don’t respond well to sudden intense training. They need gradual improvement with specific targets and proper rest periods between workouts.
Let’s be realistic about this. Nobody manages to exercise every single day because life constantly interferes. Your job demands attention and your children need care. Some evenings you feel completely exhausted and even the thought of changing into workout clothes seems overwhelming. The most practical approach involves fitting in two or three brief exercise sessions weekly that last between ten and fifteen minutes each. These short bursts work best when you blend them into activities you already do. While you stand at the bathroom sink brushing your teeth you can perform a few squats. During those moments when you wait for water to boil you can practice chair exercises.
The goal is not about having thighs that look like those of a fitness influencer. It is about being able to get up off the floor without needing to negotiate with your body.
Trust and permission in knee rehabilitation
Dr. Léa Martin is a French sports doctor who treats runners & people who claim they hate exercise. She explains that squats are not the problem. The real issue is putting too much weight on your body without proper control. When done carefully and with gradual improvement a squat becomes one of the most effective exercises for teaching your knee to handle everyday activities again.
She has watched the backlash unfold. She has read the worried emails from patients who received conflicting information within days. She has talked to anxious coworkers who don’t know what to tell people anymore. This is why she takes a different approach. She breaks everything down into straightforward rules. These are rules that actually work in real life. They are not perfect rules designed for ideal situations that rarely exist.
Finding your own line with squats
# Understanding Knee Pain and Movement
There is no magic solution that emerges from all these stories. The situation creates stress. People worry that making one wrong movement will damage their joints permanently. At the same time there is pressure to treat the knee like any other body part that can tolerate stress when properly conditioned. When you are the person who needs to climb the stairs neither approach feels entirely right. The fear of injury often conflicts with the need to stay active. People receive mixed messages about protecting their knees versus strengthening them through use. This confusion makes it difficult to know what to do when facing everyday activities like climbing stairs. The reality is that knees need both protection and appropriate challenge to stay healthy. Finding the right balance between caution and activity requires understanding your own body and its limits.
It could be that the real change has less to do with squats and more to do with permission. You have permission to question a blanket ban you got ten years ago. You have the right to say no to an exercise that clearly makes your pain worse. You can ask your doctor, physiotherapist, or coach for a plan that changes depending on how well or poorly you’re doing. Bodies don’t follow rules; they respond to what you actually do.
The squat sits right at the center of this challenge. Poor form can aggravate an already irritable knee. But when you approach it with care it becomes a steady dialogue between your body and mind. You start asking yourself whether you can maintain the position, whether you can rise back up, and whether deeper ranges might become possible over time. You don’t need to fall in love with the exercise. What counts is rediscovering that your knees remain capable of adaptation rather than simply enduring whatever you throw at them.
