Have you ever had this experience: after squatting down to tie your shoelaces or pick something up, when you try to stand, your knees and lower back suddenly feel sore and weak, as if you cannot muster any strength? This phenomenon of "soreness and weakness in the lower back and knees, and struggling to stand up after squatting" may, in the view of traditional Chinese medicine (TCM), be more than just simple fatigue. What bodily signals are hidden behind it? Today, from the perspective of TCM popular science, let us talk about this common complaint—without any commercial promotion, simply to help resolve the questions in your mind.
Why does TCM associate difficulty standing up after squatting with the "kidney"?
In TCM theory, it is often said that "the kidney governs the bones, and the liver governs the sinews." Soreness and weakness in the lower back and knees, and difficulty standing up after squatting, are often related to deficiency of kidney qi and liver blood. Specifically, the kidney stores essence, essence generates marrow, and marrow nourishes the bones; the liver stores blood, and blood nourishes the sinews and vessels. When kidney essence is insufficient, the bones lose nourishment, and soreness and weakness in the lower back and knees easily occur; when liver blood is deficient, the sinews and vessels lose nourishment, and joint movement may become stiff and weak. In the TCM meridian theory, Taixi point (located on the medial side of the foot, in the depression between the tip of the medial malleolus and the Achilles tendon) belongs to the Foot Shaoyin Kidney Meridian and is the yuan-source point of the Kidney Meridian. Yuan-source points are where the original qi of the zang-fu organs passes through and remains, and Taixi is especially closely related to the essence-qi of the kidney; therefore, when discussing soreness and weakness of the lower back and knees caused by kidney deficiency, this point is often mentioned. So, does all "soreness and weakness in the lower back and knees, and difficulty standing up after squatting" mean kidney deficiency? This requires syndrome differentiation. For example, prolonged sitting and excessive fatigue may also lead to poor circulation of qi and blood, thereby causing the same symptoms.
Besides kidney deficiency, what other causes can lead to this problem?
Many people automatically associate soreness and weakness in the lower back and knees with kidney deficiency as soon as they hear about it, but TCM emphasizes that "each person is different." For example, heavy dampness can also make a person feel heavy in the body, and when squatting down and standing up, the joints may feel as if they are "stuck" and difficult to move. In addition, insufficient qi and blood caused by spleen deficiency can likewise affect the nourishment of the limbs. Among points related to the spleen and stomach, Zusanli is relatively well known. It is located on the anterior-lateral side of the lower leg, 3 cun below Dubi, one finger-breadth from the anterior crest of the tibia. It belongs to the Foot Yangming Stomach Meridian and is the he-sea point of the Stomach Meridian as well as the lower he-sea point of the stomach. The Lingshu records that "when pathogenic factors are in the spleen and stomach, there will be muscle pain." Zusanli is one of the key points for regulating the spleen and stomach and is often used to understand the relationship between the generation and transformation of qi and blood and the loss of nourishment of the limbs. So, how can these situations be distinguished? If you also have aversion to cold and frequent nocturia, it may tend toward kidney yang deficiency; if you also have dry mouth and dizziness, it may tend toward kidney yin deficiency; if you also have body edema and a thick, greasy tongue coating, then dampness may be the culprit. Therefore, soreness and weakness in the lower back and knees, and difficulty standing up after squatting, do not have a single cause and require comprehensive judgment.
In daily life, what simple self-care methods can be tried?
Since the problem may originate from multiple factors, daily self-care should also address multiple aspects. For example, in the diet, some black-colored foods such as black beans and black sesame seeds may be appropriately included; in TCM, they are believed to help nourish kidney qi. At the same time, avoid maintaining a squatting posture for long periods, and stand up and move around every half hour to promote the flow of qi and blood. For people with heavy dampness, eat fewer cold, raw, greasy foods, and appropriately drink some coix seed water, which helps remove dampness. However, please note that these are only general suggestions. For specific individuals, it is better to consult a licensed TCM physician, such as a licensed TCM physician, who may provide more personalized guidance based on your tongue coating and pulse manifestations.
Why should one not blindly believe in traditional formulas that claim to "work in one move"?
Various traditional formulas for "standing up after squatting without difficulty" circulate online, such as relying solely on a certain herb or massage technique. But TCM conditioning emphasizes "treatment based on syndrome differentiation." If it does not match the syndrome, it may instead worsen the problem. For example, if a person with kidney yang deficiency mistakenly uses heat-clearing drugs, yang qi will become even more deficient; while a person with heavy dampness who blindly takes tonics will obstruct the expulsion of dampness. Therefore, for soreness and weakness in the lower back and knees, and difficulty standing up after squatting, the root cause must first be clarified before action is taken. Licensed TCM physicians often remind people that any conditioning method should be carried out under professional guidance, and self-experimentation should be avoided.
How can lifestyle habits be used to prevent this problem?
Prevention is better than conditioning and self-care. For soreness and weakness in the lower back and knees, and difficulty standing up after squatting, we can make some adjustments in daily life. For example, avoid sudden, vigorous squatting and standing movements; first bend forward slowly, then straighten up gradually, giving the joints a process of adaptation. Appropriately perform gentle stretching, such as the "cat-cow pose" in tai chi or yoga, which helps enhance the flexibility of the lower back and knees. In meridian theory, Yanglingquan is the he-sea point of the Foot Shaoyang Gallbladder Meridian and also one of the eight influential points, the "influential point of sinews." It is located on the lateral side of the lower leg, in the depression anterior and inferior to the head of the fibula. The Nanjing, Chapter 45 states: "The sinews converge at Yanglingquan." The strength of the sinews and vessels directly affects the flexion and extension of the joints; therefore, Yanglingquan is theoretically related to sinew disorders and impaired movement. In addition, maintain a regular daily routine and avoid staying up late, because staying up late consumes and damages liver blood, indirectly affecting the sinews and bones. These methods can all help improve the problem to a certain extent, but remember that they are not "targeted medicines," but part of long-term self-care.
Summary: What should we do about soreness and weakness in the lower back and knees, and difficulty standing up after squatting?
Finally, let us return to the original question: when you have soreness and weakness in the lower back and knees, and difficulty standing up after squatting, should you worry? In fact, this may be the body reminding you that you need to pay attention to the balance of the kidney, liver, spleen, and other zang-fu organs. Through reasonable diet, moderate exercise, and adjustment of daily routines, most people can feel improvement. But if you find that the symptoms persist or worsen, you may wish to consult a formal medical institution and let a licensed TCM physician perform syndrome differentiation and analysis for you. A licensed TCM physician can help you find the root cause through inspection, auscultation and olfaction, inquiry, and palpation. But in any case, the purpose of popular science is to convey knowledge, not to replace diagnosis and treatment. So, are you ready to start paying attention to the health of your lower back and knees today?