Have you ever encountered this awkward situation: after squatting down to pick something up or tie your shoelaces, your knees feel weak and your lower back has no strength when you try to stand up, and you may even need to hold onto something to slowly rise? This phenomenon of "soreness and weakness in the lower back and knees, with difficulty standing up from a squat" is, from the perspective of Traditional Chinese Medicine (TCM), often not simply a matter of "getting old" or "being tired," but rather a signal the body is sending. So, what TCM theories might underlie this?
Is Soreness and Weakness in the Lower Back and Knees, with Difficulty Standing Up from a Squat, Caused by "Kidney Deficiency"?
TCM often says that "the waist is the residence of the kidney." The kidney governs the bones and produces marrow, while the knees are the "residence of the sinews." When a person experiences soreness and weakness in the lower back and knees, with difficulty standing up from a squat, many people associate this with "kidney deficiency." Indeed, insufficient kidney essence leads to malnutrition of the bones and weakness in the lower back, which in turn affects the ability to stand and squat. But is this the only cause? Actually, it is not. Practicing TCM physicians often point out in clinical practice that this condition may also be related to "insufficient liver blood" or "dampness encumbering and obstructing." The liver governs the sinews; when liver blood is deficient, the sinews and vessels lose nourishment, and the knee joints feel stiff or sore during movement. When dampness pours downward and obstructs the meridians, the knees likewise feel "heavy," making it especially difficult to rise.
Why Is It Especially Difficult to Stand Up After Squatting? How Does TCM Explain This Movement?
Squatting down and then standing up may seem like a simple movement, but it actually requires the coordinated exertion of the muscles, sinews, and bones of the lower back, knees, and legs. From the perspective of the TCM meridians, the Foot Shaoyin Kidney Meridian, the Foot Jueyin Liver Meridian, and the Foot Yangming Stomach Meridian all pass through these areas. If kidney qi is insufficient, the lower back cannot provide adequate support; if liver blood is insufficient, the tendons of the knees lose elasticity; and if the spleen and stomach are weak, qi and blood generation is insufficient, and the muscles lack strength. Therefore, "difficulty standing up from a squat" may not be a single issue, but rather a manifestation of dysfunction across multiple zang-fu organs. Practicing TCM physicians mention in popular science education that clinically, middle-aged and elderly people commonly experience this symptom due to deficiency of the liver and kidney, while in younger people it is more often related to prolonged sitting, heavy dampness, or insufficient qi and blood.
Besides Kidney Deficiency, What Other Causes Can Lead to Soreness and Weakness in the Lower Back and Knees?
Soreness and weakness in the lower back and knees, with difficulty standing up from a squat, is not necessarily a "deficiency pattern." TCM emphasizes pattern differentiation; for example, "cold-dampness impediment obstruction" is also a common cause. If one remains in a damp environment for a long time or indulges in cold, cold-dampness invades the joints, leading to poor circulation of qi and blood, causing heaviness and distension in the lower back and knees, with an obvious sensation of the joints "locking" when rising. Similarly, "blood stasis pattern" — after prolonged sitting or trauma — stasis blood obstructs the meridians, which can likewise cause localized soreness, weakness, and lack of strength. Therefore, one cannot universally "tonify the kidney," but rather a practicing TCM physician must clarify the pattern type through inspection, auscultation and olfaction, inquiry, and palpation. If you have similar troubles, it is recommended that you consult a licensed medical institution and let a professional physician determine whether it is a "deficiency" or "excess" pattern.
How Can Daily Care Alleviate Difficulty Standing Up from a Squat?
Since soreness and weakness in the lower back and knees and difficulty standing up from a squat may involve multiple aspects, daily care also requires "targeted treatment." TCM believes that in terms of diet, one may appropriately eat more foods that tonify the kidney and fill essence, such as black sesame, walnuts, and mulberries; if there is a tendency toward liver blood insufficiency, goji berries and red dates can be added; if dampness is heavy, coix seed and adzuki beans are suitable for making porridge. In addition, gentle exercises such as Tai Chi and Baduanjin help promote qi and blood circulation and strengthen the lower back and knees. However, it should be noted that any conditioning method must be tailored to the individual. For example, moxibustion. But specific operations must be carried out under the guidance of a practicing TCM physician and should not be attempted blindly on one's own.
Summary: How Should We Properly Face Soreness and Weakness in the Lower Back and Knees with Difficulty Standing Up from a Squat?
Returning to the original question: with soreness and weakness in the lower back and knees and difficulty standing up from a squat, must one "take medicine" or "undergo physical therapy"? In fact, the core of TCM popular science education lies in "prevention being greater than treatment." If you only occasionally experience this symptom, it may be related to fatigue or improper posture, and attention to rest and adjustment of daily routines is sufficient. But if the symptom persists or worsens — for example, affecting daily walking — then one needs to be alert to whether there is an underlying problem. Practicing TCM physicians often emphasize that TCM conditioning is a process of "pattern differentiation and treatment determination," with no universal formula. Have you ever had a similar experience? Have you ever thought about using TCM knowledge to better understand your own body? Why not start today by paying more attention to the state of your lower back and knees — after all, a healthy body is the foundation for standing up.