On a rainy Tuesday night, the waiting room of a busy physio clinic looks like a line for a concert that no one wants to go to. People hold on to ice packs, elastic bandages, and that little plastic bag of scans that always makes too much noise. A middle-aged man runs and rubs his kneecap through his jeans. A woman in heels at work scrolls through her phone while rubbing the side of her knee. A woman in leggings by the window does a discreet stretch with her eyes on the floor.
When the physiotherapist finally calls her in, he doesn’t suggest swimming or Pilates. He points to a low bench and says one word that makes everyone stop: “Squats.”
These squats are not at all like the ones you know.
Why a simple squat suddenly splits doctors
For years, the advice for knee pain sounded like a voicemail that played over and over: “Avoid impact, swim, and try Pilates.” Low load, low risk, low everything. It was comforting, but for a lot of people, it was completely useless. My knees kept hurting. Life stayed small every day.
A new group of experts is now pushing something that sounds almost crazy: targeted, deep, and sometimes slow squats, even for people who are already in pain. Not the “leg day” squats that gym bros do. Clinical, technical, and supervised squats that put stress on the joint instead of protecting it like fragile glass.
Some doctors think this is brilliant. Some people think it’s irresponsible.
Julia, 47, is an office manager, a former runner, and an expert at giving up on hobbies. After three years of patellofemoral pain and a depressing tour of “just rest it” advice, she ended up at a sports medicine clinic that uses a controversial method. No more swimming. No more “stay away from stairs.” Instead, a 12-week program that focuses mostly on a progressive form of squat.
She could barely bend to 30 degrees without hurting herself in Week 1. She was going down to a height close to a chair with a light kettlebell by week 8. Her pain score had dropped by more than half by week 12, and she walked up two flights of stairs one day without even thinking about her knees.
Her doctor was very happy with the result, but he still said, “I hate that they made you squat.”
The reasoning behind these squats is very simple and very upsetting for people who grew up with the “rest and protect” model. Joints need more than just rest; they also need weight. Not just when you lie on a table and squeeze a foam roller, but also when you walk, run, or do other things, the muscles around your knee need to be strong and work together. Cartilage likes to move, have blood flow, and change.
So, instead of telling people to avoid the movement that hurts, some therapists now teach it slowly and on purpose. A controlled squat puts stress on the quadriceps, glutes, and hamstrings in a way that can stabilize the knee and reset pain signals. Critics see the danger right away: if you push too hard or too fast, you could make everything worse. For supporters, the bigger risk is that millions of people will always have to walk carefully around stairs, chairs, and sidewalks.
The “controversial squat” protocol is taking over rehab rooms
The version that experts disagree on is not the quick, ego-driven gym squat. It’s more like a slow, supervised ritual. You stand with your feet about hip-width apart and your toes slightly open. You can face a wall or hold the back of a chair. Then, as if you were about to sit on a low stool behind you, bend your hips and knees so that your knees follow your toes without collapsing inward.
You only go as low as you can without sharp pain, hold for two or three seconds, and then slowly rise again. Some protocols use a small wedge under the heels or a slant board to change the angle and move the weight from the hips to the quads. *The goal isn’t depth or heroics; it’s accuracy under load.
When your knees haven’t been worked out in years, ten reps can feel like a whole workout.
This is also a place where people often get lost by themselves. They bend too quickly, chase the “burn,” or copy a TikTok video made by a 22-year-old with perfect cartilage and no medical background. Then the pain gets worse, and the message is, “Squats ruined my knees.”
In real life, things are usually less exciting and more boring. The load was moved too quickly, rest days were missed, or technique went out the window as soon as fatigue set in. Let’s be honest: no one does this every day with the same patience as a monk. That doesn’t mean you’re weak; it means you’re human.
Therapists these days give you “wiggle room” weeks, lighter days, and honest talks about what you can really stick to with work, kids, and that leaking kitchen sink.
Dr. Léa Marceau, a French sports doctor who helped design a knee rehab program based on progressive squats, says, “The squat itself isn’t the bad guy.” “The real problem is how much and how well it is given. A well-coached squat can be good for your health. A quick, copied squat from YouTube can hurt a joint that is already sensitive.
In the research and in clinics, a few shared ideas keep coming up around this new protocol. Most programs follow the same simple rules without making a big deal out of it:
- Start higher and smaller than your ego says you can: a shallow range, a slow tempo, and no extra weight at first.
- Use a pain scale: a little pain (3–4/10) is okay, but sharp or long-lasting pain is a sign of trouble.
- Don’t train every day; instead, do it two to three times a week so your tissues can get used to it.
- Do hip and ankle mobility exercises with squats so that the knee doesn’t have to do all the work.
- Not after three painful sessions, but after six to eight weeks.
Living in two worlds: should I protect my knee or train it?
Patients are stuck between two sets of instructions because the medical world is divided. One doctor says to never kneel again, and another says to sit deeply with a kettlebell. One physiotherapist swears by Pilates on the reformer, while another calmly gives you a barbell. This is infuriating for someone who just wants to climb stairs without having to deal with the universe.
People start to secretly try things out. A few quick squats in the kitchen while the pasta cooks. A bend in the middle of the office printer. Your knees hurt more one day and less the next, and the story you tell yourself about them changes a lot. Are they tired or just not trained enough? Are you fixing them up or breaking them?
Traditionalists say that a degenerative joint shouldn’t have to deal with compressive forces. They cite X-rays, age, weight, and surgical histories. They are worried that telling people to do squats will make them overuse them, especially if they don’t see a doctor afterward. On the other side, progressive doctors use data to show that properly loaded exercise can help some people feel better, work better, and put off or even avoid surgery.
They also point out a harsh truth: telling people to “avoid” bending their knees often makes them move less overall. Less walking, less socializing, and less self-assurance. The knee becomes both a reason and a prison. MRIs don’t show that emotional spiral, but it shows up everywhere else.
In the middle, there is a quieter truth: both sides are right and wrong at the same time. Not every knee can or should be pushed into deep squats, especially when it’s flaring up or after a new injury. Also, not every knee that scares you with an MRI is a ticking time bomb. Rules of the situation.
For some, the controversial squat is a way to slowly change the way they feel about their own bodies, one repetition at a time. For some people, it’s just too dangerous, painful, or triggering after years of failed treatments. Both answers are correct. “Are squats good or bad for knees?” isn’t the most interesting question. “What kind of squat, at what stage, for whom, and under whose guidance?” is. That’s when the argument gets serious and personal.
| Key point | Detail | Value for the reader |
|---|---|---|
| Load can heal, not just harm | Well‑designed squats strengthen muscles and calm pain rather than “wearing out” the joint | Offers hope beyond rest and passive treatments for long‑term knee pain |
| Progression beats perfection | Starting shallow, slow, and supported reduces risk and builds confidence | Makes squats feel accessible even if you’re scared of bending your knees |
| Personalization matters | Age, injury history, weight, and fear levels all change how a program should look | Encourages readers to seek tailored advice instead of copying random online workouts |
Questions and Answers:
If my knees hurt, are squats always safe?Not all the time. Some people do well with progressive squats, while others do not. Your diagnosis, how you squat, the weight, and how quickly you progress all affect your safety. Before you start adding weight or going deeper, it’s worth it to get at least one in-person assessment.
What kind of squat do people usually suggest for knees that hurt?Therapists often begin with a supported squat to a chair or box, with feet hip-width apart, a slow descent, a small range of motion, and a short pause at the bottom. A heel lift or slant board is sometimes used. Not how low you can go, but how much control and comfort you have.
Can I just do squats instead of my physiotherapy exercises?Not a good idea, I think. Squats can be a big part of a workout, but most good ones also include hip strength, core stability, and some kind of balance or walking work. Don’t think of squats as the whole cast; think of them as the main actor.
How much knee pain is “normal” when doing squats for rehab?A lot of doctors use a scale from 0 to 10 to rate pain and say that it’s okay to have pain between 3 and 4 out of 10 during the exercise, as long as the pain goes away within a few hours and doesn’t get worse the next day. If you feel sharp, catching, or getting worse pain, you need to stop and change what you’re doing.
What if I’m too scared to do squats again?It’s normal to be afraid of that, especially if you’ve been told for years that bending will hurt your knees. You can start even smaller, like doing “sit-to-stand” moves from a high chair, putting some weight on your hands on a countertop, or just bending your knees while holding on. A good physiotherapist will understand your fear and take their time with you.
