What should you do when an exercise hurts?

You do a squat, and your knee hurts. It hurts every time you squat. What do you do?

Whenever a client of mine comes up against an issue like this, the first step is simple.


I know that sounds simple. I know that sounds so simple that it’s almost insulting. But I have personally observed no less than 2 trillion people (yes, I’ve actually seen every person on Earth do things wrong 146 times) doing squats and other exercises with 1) no idea of proper form and 2) no idea which muscles they should be focusing on for proper strength development, muscle balance, and joint motion.

This is where having a friend with good eyes, a GoPro, or a solid personal trainer comes into play.

The first two options are great as long as you know what you’re looking for. If you don’t know what you’re looking for or your friend doesn’t know what he’s looking for, then the wisdom of the internet can help.

There are bulletin boards for fitness and weightlifting where folks get together to share videos of themselves doing exercises to make sure they’re doing things correctly. This is cost-effective though time consuming (and may be a little too “not private” for many people’s tastes).

Better still, you could learn what a motion should look like, then watch the video of yourself doing it. If you’re analytical, honest, and able to criticize yourself accurately, this is a great solution and one that I advocate very strongly.

The third option, having a personal trainer, is also a good option IF the trainer:
knows what s/he is looking for
can teach you what you should also be looking for
understands why it’s important to be looking for whatever they’re looking for

A trainer is no guarantee of good form. I’ve seen trainers running clients’ joints into the ground with complex exercises that are way beyond most people’s performance capacities. I’ve seen clients asked to do exercises like squats or deadlifts for endless sets with poor form and no attention to the wear and tear the dismal form is placing on the involved joints. Yes, you work up a sweat. No, it’s not good for you.

So if you get a trainer, make sure s/he knows what s/he’s doing.

How will you know if your trainer knows how to help you train through an injury (rather than “around”)? If you’re someone who has very little experience with exercise and don’t know good form and haven’t had enough experience with trainers to go by feel, you can use the following as a rule of thumb.

If you go through your first two sessions with a trainer and you don’t get at least one piece of detailed feedback on form on any exercise, your trainer doesn’t know what s/he’s doing. If during those two sessions you do a squat, and your trainer doesn’t spend at least a total of 5 minutes fixing your form or praising you for perfect form (and explaining why your form is perfect), your trainer does not know what s/he’s doing and will be setting you up for injury in the long term.

This week I had a woman with “elbow tendinitis” and numbness in her other hand. Her elbow hurt most during light dumbbell front raises. One look at her form during that exercise showed poor scapular positioning. Just cuing the proper form improved the elbow pain 75%. The rest seemed to go away after a little extra exercise for the posterior shoulder girdle. The hand? Immediate relief with strengthening/activation of her shoulder musculature.

A second example: I had a gentleman start training with me this week who had knee pain during squats. He was concerned that a past arthroscopic surgery had done permanent damage. A 30 second fix to get him to engage the correct muscles (his glutes) during the squat as well as two minutes of stretching removed the pain in his knee. How did I know what to do? I just had to see how bad his form looked.

So if an exercise hurts, don’t assume something’s busted in your body. Assume first that something’s busted in your form and make the appropriate correction.


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.