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Single-Leg Decline Squat Check
Also known as decline squat test.
Checks: How well the knee tolerates load through the kneecap tendon and the front of the knee
What this checks
This checks how the front of your knee copes with a controlled single-leg squat on a slight downhill slope. The slope increases the load on the kneecap and its tendon, so pain there points towards that structure being irritable.
Do not do this test if
you have had a recent significant knee injury, the knee locks, gives way or is very swollen, you cannot put weight through the leg, it is very painful at rest, or you feel unwell with the pain. See a doctor first if any of those apply.
How to do it
Step 1
Set up on a small slope
- Stand on a firm wedge or the bottom of a slope, about 15 to 25 degrees, with your toes pointing downhill.
- Have a wall or rail beside you for balance.
Step 2
Stand on the leg you want to test
- Shift your weight onto the test leg and lift the other foot just off the ground.
- Keep your trunk upright.
Step 3
Slowly bend the knee to about a quarter squat
- Lower under control, letting the knee travel forward over the foot.
- Go only as far as is comfortable, to roughly a quarter or half squat.
- Keep the kneecap tracking over the middle of the foot.
Step 4
Come back up and note the response
- Straighten back up under control.
- Note any pain at the front of the knee or just below the kneecap, and whether the leg felt weak or unsteady.
- Compare with the other leg.
What your result means
Likely normal
A negative result usually looks like this.
- You can lower and rise under control with no sharp pain.
- Any effort is felt evenly in the thigh, not pinpointed at the kneecap.
- Both legs feel similar in strength and control.
Possible problem
A positive result usually looks like this.
- Pain at the front of the knee or just below the kneecap during the squat.
- The knee rolls inwards or the hip drops because the leg cannot control the movement.
- Clearly weaker or more painful than the other leg.
Tips for a clearer result
Small things that make the test easier to read.
- Hold a rail lightly for balance so you can focus on the knee.
- Do it side-on to a mirror to watch the knee tracking.
- Stop if the pain is sharp or the knee feels like it will give way.
How to read this
A positive result may point towards kneecap-related pain or an irritated kneecap tendon at the front of the knee, but it cannot confirm it - several knee problems feel similar, and only a hands-on assessment can tell you for sure.
This is a guide, not a diagnosis. It cannot rule a problem in or out - a physiotherapist can. If your symptoms are severe, spreading, or you feel unwell, see a doctor.
Points towards
If your result points to a problem, these condition guides are a good place to start reading.
Reproduced your pain?
A positive result is worth getting looked at. Book an online assessment with an HCPC-registered physiotherapist, wherever you are in the UK.
Book an online assessmentNot sure what your result means?
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