A Physical Therapist's Guide to Squatting With Less Pain and More Confidence
A Personal Note From My Experience
When I was a kid, my first real experience with squatting started at World Fitness in Milford, New Jersey, when I was training to get ready for football at River Dell High School.
Back then, there weren't nearly as many gyms, trainers, or resources available to teach young athletes how to properly lift. Like a lot of teenagers, I thought I was invincible. I was focused on getting stronger, adding more weight to the bar, and—if I'm being honest—trying to lift more than my friends.
Looking back, I was probably more focused on how much weight I could lift than how I was lifting it.
And, not surprisingly, I tweaked my back a few times.
Those experiences taught me an important lesson that has stayed with me throughout my career as a physical therapist:
Strength is important, but strength without good movement is not the goal.
Over the years, I have learned a lot more about how the body moves, how to train smarter, and how to help people build strength while protecting their spine. I have also learned that back pain during squatting is not simply about being "weak" or doing something wrong.
Many people struggle with squatting because they were never taught how to move efficiently.
My hope is that this article gives you some of the information I wish I had when I was first starting out in the gym—so you can train smarter, move with more confidence, and avoid some of the mistakes I made along the way.
Why Your Back Hurts When You Squat (and Why You Shouldn't Give Up on Squatting)
Have you ever bent down to pick up a laundry basket, reached into the bottom cabinet, lifted a grandchild, or tried to get up from a low chair—only to feel your lower back tighten or send you a warning signal?
Maybe you have even stopped squatting altogether because you are worried that you are "hurting your spine."
This is one of the most common concerns I hear from patients in physical therapy:
"My back feels fine most of the time, but every time I squat, my back starts bothering me."
The Squat Technique That Protects Your Back (and the Myth That Has Confused People for Years)
Before we talk about changing your squat, let's clear up one important idea:
There is no such thing as one "perfect" squat.
Your best squat depends on several factors:
A competitive powerlifter, a recreational gym-goer, and someone trying to pick up their grandchildren from the floor may all have slightly different-looking squats.
And that's okay.
The goal is not to make every person's squat look identical.
The goal is to create a squat that is:
From the Gym to the Clinic: What I Learned the Hard Way
When I first started lifting weights as a teenager, my goal was simple:
Lift more weight.
Like many young athletes, I believed that adding more plates to the bar was the best sign of progress.
What I didn't understand at the time was that the quality of the movement mattered just as much as the amount of weight.
I wasn't thinking about:
I was competing against my friends.
Today, as a physical therapist, I see the same thing happen with patients of all ages.
The problem usually isn't that someone is weak.
The problem is that they are asking their body to perform a movement without giving it the right tools.
Sometimes the biggest improvement doesn't come from lifting heavier.
It comes from moving better.
The Biggest Squat Myth: "Your Knees Should Never Go Past Your Toes"
If you have spent any time in a gym, chances are you've heard this advice:
"Never let your knees go past your toes when you squat."
This idea has been repeated for decades.
The original intention was to reduce stress on the knees. However, like many fitness rules, the advice became much more rigid than the evidence supports.
The human body does not move with a set of artificial boundaries.
Your knees are designed to move.
Your ankles are designed to move.
Your hips are designed to move.
When you force your knees to stay behind your toes, something else has to compensate.
Often, that compensation is a greater forward lean of your torso.
And when your torso leans farther forward, your hips and lower back may experience increased demand.
Research examining squat mechanics has shown that allowing natural knee movement can be an important part of performing a safe and effective squat. The appropriate amount of knee travel depends on the individual's anatomy, mobility, training goals, and comfort.
Studies by Fry and colleagues examined how limiting knee movement changes the forces experienced at the knee and hip during squatting. Additional biomechanical research by Schoenfeld has emphasized that squat technique should be individualized rather than based on one universal rule.
References:
Fry AC, Smith JC, Schilling BK. Effect of Knee Position on Hip and Knee Torques During the Barbell Squat. Journal of Strength and Conditioning Research. 2003.
Schoenfeld BJ. Squatting Kinematics and Kinetics and Their Application to Exercise Performance. Journal of Strength and Conditioning Research. 2010.
So, Should Your Knees Go Past Your Toes
The answer:
Sometimes.
For some people, allowing the knees to move forward creates a smoother, more comfortable squat.
For others, especially those with certain injuries or limitations, modifying the movement may be appropriate.
The better questions are:
The goal is not avoiding knee movement.
The goal is controlling movement.
Six Quick Squat Technique Tips for a More Comfortable Squat
Keep the Weight Close to Your Body
If you are lifting an object from the floor, keep it close.
Think about picking up:
The farther something is from your body, the more demand it places on your back.
A simple rule:
Close is easier. Far away is harder.
Let Your Knees Move Naturally
Stop thinking:
"My knees can't go forward."
Instead think:
"My knees should move in line with my feet."
Your knees should generally track over your second and third toes.
Avoid letting them collapse inward.
Controlled movement matters more than a specific position.
Start the Movement With Your Hips and Knees Together
Many people have been taught:
"Always push your hips back first."
While a hip hinge is important, an excessive hip-first strategy can create a very forward-leaning squat.
A good squat usually involves:
Think of sitting down between your feet rather than simply sitting backward.
Brace Your Core—But Don't Become a Statue
Your core provides stability during lifting.
A helpful cue:
Imagine someone is about to gently poke you in the stomach.
Create that gentle tension.
You don't need to:
Your goal is support, not rigidity.
Use Your Whole Foot
A strong squat comes from creating a stable base.
Think about keeping contact through:
Many people shift too far forward onto their toes or too far backward onto their heels.
A balanced foot creates a balanced movement.
Let Your Legs Help You Stand Up
When coming out of a squat, many people think:
"Pull myself up with my back."
Instead think:
"Push the floor away."
Your:
are designed to create this movement.
Let your legs do the job they were built to do.
A Simple 3-Minute Preparation Routine Before Squatting
If your back feels stiff before squatting, spending just a few minutes preparing your body can make the movement feel much better.
This is especially helpful before:
1. Hip Rockbacks (10 repetitions)
Start on your hands and knees.
Slowly move your hips backward toward your heels while keeping your spine comfortable.
Focus:
Purpose:
Helps prepare the hips for bending and squatting.
2. Deep Breathing With Gentle Core Activation (5 breaths)
Lie down or stand comfortably.
Take a slow breath in.
As you breathe out, gently tighten your abdominal muscles.
Purpose:
Helps your nervous system prepare for movement and improves awareness of trunk support.
3. Ankle Mobility Drill (10 repetitions each side)
Place one foot forward.
Keeping your heel down, gently move your knee forward over your toes.
Purpose:
Improved ankle motion allows the squat to happen with less compensation from your back.
4. Chair Squats (10 repetitions)
Sit down and stand up from a chair.
Focus on:
Purpose:
Practices the exact movement pattern used every day.
5. Supported Squats (5 repetitions)
Hold onto a countertop, railing, or stable surface.
Perform comfortable squats while focusing on:
Purpose:
Build confidence before adding resistance.
Tom's Clinical Insight
"Many people think they need to stretch more before they squat. Sometimes they do. But often what they really need is to teach their body how to coordinate the movement again. A few minutes of practicing the right pattern can be more valuable than spending 30 minutes trying to loosen every muscle."
The Bigger Picture
A comfortable squat is not about chasing perfection.
It is about building capacity.
Your body adapts to what you repeatedly ask it to do.
If you gradually expose your body to squatting—with good technique, appropriate loading, and consistency—you can often regain strength and confidence.
The goal is not just a better squat in the gym.
The goal is being able to move through life without fear.
When Back Pain During Squatting Needs Attention, How Physical Therapy Helps, and the Final Takeaway
When Should You Get Help for Back Pain During Squatting?
One of the most common questions I hear from patients is:
"How do I know if this is something I should just work through or something I should get checked?"
The answer depends on the situation.
Some soreness after trying a new exercise, increasing weight, or returning to activity is normal. Our bodies adapt when we challenge them.
However, pain that continues, worsens, or begins affecting your daily life deserves attention.
Consider getting evaluated if:
You should seek medical attention more urgently if you experience significant changes such as:
These symptoms are less common but important to address.
For most people, however, the biggest issue is not a dangerous condition.
The bigger problem is often that pain has caused them to lose confidence in their body.
And rebuilding that confidence is where physical therapy can help.
How Physical Therapy Can Help You Squat With Less Pain
Many people think physical therapy is simply about treating pain.
While reducing pain is important, the bigger goal is helping you understand why the pain is happening and what you can do about it.
A physical therapist looks at the entire movement system.
This includes:
Two people can have the exact same back pain diagnosis but require completely different solutions.
One person may need to improve hip mobility.
Another may need to build strength.
Another may need to gradually return to movements they have been avoiding.
This is why individualized treatment matters.
The Goal Is Not a Perfect Spine—It's a Resilient Spine
One of the biggest changes in modern back pain treatment is moving away from the idea that the spine is fragile.
Many people have been told things like:
While certain conditions require specific precautions, most people benefit from gradually restoring movement, strength, and confidence.
The spine is designed to move.
It is designed to handle load.
It is designed to adapt.
The goal of rehabilitation is not to create fear around movement.
The goal is to help your body become more capable.
The Mayo Clinic and current clinical guidelines emphasize remaining active and avoiding unnecessary bed rest for most cases of low back pain, while gradually returning to normal activities as tolerated.
Reference:
Mayo Clinic. Back Pain: Symptoms and Causes.
https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
Common Questions About Squatting and Back Pain
Not necessarily.
Pain is information, not always damage.
A painful squat may simply mean your body needs a different strategy, less weight, better preparation, or a gradual progression.
The answer is usually not avoiding the movement forever.
The answer is finding a better way to perform it.
No.
Appropriately performed strength training can actually be one of the best things you can do for your back.
Strength helps improve:
The key is matching the exercise and the load to your current ability.
The mistake is not lifting.
The mistake is doing too much too soon without proper preparation.
Sometimes.
But not always.
Imaging findings such as disc bulges, arthritis, and degenerative changes are common—even in people who have no pain.
This is why a complete evaluation considers more than a picture.
A good assessment looks at:
The person matters more than the image.
If squatting causes back pain, it does not mean your body is broken.
It means your body is giving you information.
That information can help guide you toward better movement.
The solution is usually not:
The solution is learning how to move with better control, gradually build strength, and restore confidence.
Remember my lesson from those early days in the gym:
I thought progress came from adding more weight to the bar.
Now I understand progress comes from building a body that can handle the demands you place on it.
Strength matters.
Technique matters.
Consistency matters.
But confidence matters too.
The goal is not just to squat more weight.
The goal is to move through life with less pain and more freedom.
"The strongest patients are not always the ones who lift the most weight. They are the ones who understand their bodies, train consistently, and are willing to adjust when something is not working. Good movement is not about perfection—it is about building a body you can trust."
References and Resources
Patient Education Resources
American Physical Therapy Association (APTA)
Low Back Pain Resources and Evidence-Based Practice Information
https://www.apta.org/patient-care/evidence-based-practice-resources/clinical-practice-guidelines
Mayo Clinic
Back Pain: Symptoms and Causes
https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
Clinical Practice Guidelines
Delitto A, George SZ, Van Dillen LR, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ.
Low Back Pain Clinical Practice Guidelines.
Journal of Orthopaedic & Sports Physical Therapy.2021;51(11):CPG1-CPG60.
https://www.jospt.org/doi/10.2519/jospt.2021.0304
Squat Biomechanics References
Fry AC, Smith JC, Schilling BK.
Effect of Knee Position on Hip and Knee Torques During the Barbell Squat.
Journal of Strength and Conditioning Research.2003.
Schoenfeld BJ.
Squatting Kinematics and Kinetics and Their Application to Exercise Performance.
Journal of Strength and Conditioning Research. 2010.
McGill SM.
Low Back Disorders: Evidence-Based Prevention and Rehabilitation.
Human Kinetics.
Tom Willemann