How to Squat Safely with Patellofemoral Pain Syndrome or Knee Cartilage Issues

Photo of author
Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Are you struggling with knee pain or an injury, but still want to maintain your squatting routine? If you have patellofemoral pain syndrome or lack knee cartilage, it can be challenging to find a way to squat without aggravating your condition.

In this article, we’ll explore four essential tips for squatting safely with knee issues, using the suspension trainer as an aid.

These strategies will help you strengthen your muscles, protect your knees, and continue your fitness journey.

1. Maintain a vertical shin:

When squatting with knee issues, it’s important to keep your shin vertical throughout the movement. A vertical shin helps decrease the bend in your knee, reducing stress on the joint.

Using a suspension trainer can make it easier to maintain this position. By offloading some of your weight onto the trainer, you can focus on proper form and minimize knee strain.

squat Patellofemoral

2. Employ progressive squatting:

To avoid putting unnecessary stress on your knee, start with a squat depth that doesn’t cause pain. Gradually increase the depth over time as your strength and flexibility improve.

It’s essential to work your muscles through their full range of motion, as avoiding certain ranges can lead to decreased strength and increased stress on the joint. The suspension trainer is an excellent tool for progressive squatting, as it provides support and allows you to control your depth.

3. Focus on hip-dominant exercises:

Incorporating hip-dominant exercises like deadlifts or kettlebell swings into your routine can benefit your knees. These exercises still engage the muscles around the knee joint isometrically while also strengthening the hips. Strengthening the hips is crucial if you’re experiencing knee pain or injury, as strong hips can help compensate for the compromised knee joint and aid in recovery.

4. Be mindful of your daily activities:

It’s essential to consider what you’re doing outside of the gym or your exercise routine. Activities that put your knee in high-stress positions can negate any progress made during your workouts.

To promote recovery and avoid aggravating your condition, try to keep your knee in low-stress positions throughout the day. Avoid sitting with your knees bent for long periods, kneeling, or engaging in activities that put undue stress on the joint.


If you’re dealing with patellofemoral pain syndrome or knee cartilage issues, these four tips can help you squat safely and effectively.

By maintaining a vertical shin, practicing progressive squatting, focusing on hip-dominant exercises, and being mindful of your daily activities, you can continue to strengthen your muscles and protect your knees.

Remember to always consult with a healthcare professional before starting any new exercise routine, and listen to your body to prevent further injury.

Website | + posts

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Leave a Comment