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Proper squat form
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Proper squat form - February 3, 2005 7:15:00 AM
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Brandon@personalTrainer
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I belong to a site where weight lifters and body builders post. I have been trying to explain my position on squats. I believe in no deeper then parellep, they are saying that 90 is hard on the knees...the only way to squat is ATG (A ss to the ground). They say that the stress on the knee joint is less. I have a strong school background and have also been coached to stop at 90, no deeper....please can someone cofirm if I am right or wrong with some extra details. They even read articles or I should say abstract:D and take it as defense of their ideas.
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Re: Proper squat form - February 4, 2005 4:19:00 AM
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JLS_PT_OCS
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There is no reason to think that squatting deeper than 90 is hard on the knees.
Your biomechanics are important, but studies show better gluteus and hamstring activation lower than 90.
Also, the knee torque increases as the knee progresses further over the foot, so that's a consideration.
Retired competetive weightlifters have no higher incidence of knee arthritis than any other group. If squatting low is bad for your knees, someone should tell the middle eastern and asian populations (over 2 billion people), they regularly squat to ATG position when resting or standing in line...yet those populations have much lower rates of hip and knee arthritis than we do in the west. I'm not saying the squat is the reason, but it's definitely interesting to think about...
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Proper squat form - February 4, 2005 7:10:00 PM
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Brandon@personalTrainer
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hmmm, ok I trust in your education, but why have I always been told 90 degrees. Weight lifters dont go below parellel (90 degrees), this is one place that I was taught to only go to parellel. It is interesting to think about the asian cultures, my first thought was that asians are very lightly built but sumo wrestlers also drop low when warming up. That is body weight though, not additional foreign weight. I just dont understand why I have been told not to do it...I also a CSCS, and I am pretty sure they dont suggest deep squats?
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Re: Proper squat form - February 4, 2005 9:58:00 PM
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Alex Brenner PT MPT OCS
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I am not familiar with the evidence here but there is some anecdotal evidence to suggest that deep squats could be bad for the knees. If you look at the longevity of professional baseball catchers you will see that many do not last long at this position and many times have to give it up and play first base. My childhood baseball hero Dale Murphy had to give up catching early in his career because of knee pain and was moved to centerfield.
Personally, I run daily and have rarely had knee pain, however, if I squat down for longer than 1-2 minutes I get patellofemoral pain. This is the only time that I ever get this pain.
What do our resident experts (moderators of this forum) have to say about squat form?
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Alex Brenner, PT, MPT, OCS
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Re: Proper squat form - February 5, 2005 3:39:00 AM
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Brian Schiff, PT, CSCS
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Here is my two cents. I never advocate that my patients or clients squat below 90 degrees in their training. What do we know about the kinematics of this? Squatting below 60 degrees begins to add compressive force at the P-F joint that can be detrimental. The forces only increase with more depth and load (weight). So, what is to be gained from such repetitive loading?
I agree with ArmyPT in that the longevity of baseball catchers might tell us something about the nature of such activity. Maybe we should also contact NFL lineman and ask how good thier knees feel and hold up after maintaining such positioning for years.
The bottom line is what does function dictate. I do not know of many activities that require one to generate power from such a position aside from catching or playing line. At times, you may be required to rise from a chair/couch from a depth greater than 90 degrees but this is simply with your body weight and not done for 3-5 sets of a certain number of reps.
Most athletes do not function in these depths, so it does not make sense to train that way nor take the risk of knee problems. If you want more glute/ham activation, spend more time doing reverse hypers, glute ham raises or dumbbell lunges. This ATG squatting is a recipe for disaster in my opinion and I do not want to be the one to cause a serious knee injury, not to mention the added balance required not to fall backward with such a maneuver.
I will search some of the literature and see if I can pull up some specific articles on this. By the way, I'm pretty sure the NSCA does not currently advocate this ATG squatting.
Brian Schiff, PT, CSCS
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Re: Proper squat form - February 5, 2005 7:29:00 AM
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JLS_PT_OCS
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Good points, Brian and Army.
I think also it is important to see that achieving 90 degrees at the knee and achieving parallel femur position are two different things.
There's where biomechanics comes in.
I guess I am more interested in not arbitrarily stopping at 90 degrees without good reason, and less interested in doing ATG squats, which I also do not advocate.
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Proper squat form - February 5, 2005 10:09:00 AM
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Brandon@personalTrainer
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Hey thanks for posting...and brain I would love to see any links you find or qoutes. I have never heard that going deeper then 90 is advisable. I have tried to explain it to the others on the body building site, but they believe what they want. Their heros perform them, and I think they dont consider the size of said individuals. If someone can squat 800 lbs in good form, maybe 225 ATG is fine..but for a normal person to structure a leg program around that seems dangerous. I can see going deep without any weight maybe (asians) for range of motion and that at times your body may be placed into this position, but adding external weight doesnt make sense. I do however want to develop strength in the quads, therefore, I lift heavy but with slow progresion and in a non balistic manor.
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Re: Proper squat form - February 7, 2005 9:47:00 AM
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cneup
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There are some good articles written by Rafael Escamilla on squatting biomechanics - check them out on medline or pubmed.
The evidence shows that there are increased shear forces on the posterior horns of the meniscus and also increased patellofemoral compression forces. But then again . . how much is too much?? Squat angles in training should be determined by function and presence/absence of knee pathology rather than hard and fast "rules." For the general population full squats are probably not necessary - you can get great glut/ham strengthening with less PF forces using lunges with a reach to the floor and other assistance lifts (good mornings, deadlifts, reverse hypers etc).
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Re: Proper squat form - February 8, 2005 10:45:00 AM
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Randy Dixon
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I only found one reference that deals with this in a quick search, believe it or not. It was from Escamilla.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11528346&dopt=Citation
Effects of technique variations on knee biomechanics during the squat and leg press.
Escamilla RF, Fleisig GS, Zheng N, Lander JE, Barrentine SW, Andrews JR, Bergemann BW, Moorman CT 3rd.
Michael W. Krzyzewski Human Performance Laboratory, Division of Orthopaedic Surgery and Duke Sports Medicine, Duke University Medical Center, Durham, NC 27710, USA. rescamil@duke.edu
PURPOSE: The specific aim of this project was to quantify knee forces and muscle activity while performing squat and leg press exercises with technique variations. METHODS: Ten experienced male lifters performed the squat, a high foot placement leg press (LPH), and a low foot placement leg press (LPL) employing a wide stance (WS), narrow stance (NS), and two foot angle positions (feet straight and feet turned out 30 degrees ). RESULTS: No differences were found in muscle activity or knee forces between foot angle variations. The squat generated greater quadriceps and hamstrings activity than the LPH and LPL, the WS-LPH generated greater hamstrings activity than the NS-LPH, whereas the NS squat produced greater gastrocnemius activity than the WS squat. No ACL forces were produced for any exercise variation. Tibiofemoral (TF) compressive forces, PCL tensile forces, and patellofemoral (PF) compressive forces were generally greater in the squat than the LPH and LPL, and there were no differences in knee forces between the LPH and LPL. For all exercises, the WS generated greater PCL tensile forces than the NS, the NS produced greater TF and PF compressive forces than the WS during the LPH and LPL, whereas the WS generated greater TF and PF compressive forces than the NS during the squat. For all exercises, muscle activity and knee forces were generally greater in the knee extending phase than the knee flexing phase. CONCLUSIONS: The greater muscle activity and knee forces in the squat compared with the LPL and LPH implies the squat may be more effective in muscle development but should be used cautiously in those with PCL and PF disorders, especially at greater knee flexion angles. Because all forces increased with knee flexion, training within the functional 0-50 degrees range may be efficacious for those whose goal is to minimize knee forces. The lack of ACL forces implies that all exercises may be effective during ACL rehabilitation.
I personally don't have a problem with squattting below 90, power lifters do it all the time. I seem to remember some studies showing that partial squats actually place more stress on the knees. I'll have to see if I can find the references.
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Re: Proper squat form - February 10, 2005 10:04:00 PM
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Randy Dixon
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About the catcher's bad knees, I don't know much about baseball, but isn't the catcher's position usually up on his toes or the balls of his feet rather than on the back of his heels? This is going to make a huge difference on the biomechanical forces. It also has a different feel.
If you are on the balls of your feet, your knees will project out over your toes, it is very difficult to prevent this. If your weight is on your heels then it is very easy and natural to prevent this. Then force angles, particularly that of gravity, may become more important than knee angle. So maybe catchers bad knees are more of an indictment for the knee past the toe argument than the ATG argument.
I would also wonder about muscle tension versus ligamentous tension. When lifting weights you bear the load on your muscles (and of course the connective tissue) while I would imagine a catcher relaxes his muscles somewhat and lets the ligaments support his weight. I'm sure their is a better way of stating that. Somebody fix it for me.
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Re: Proper squat form - February 11, 2005 2:22:00 AM
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PTupdate.com
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Some points to consider:
1. As listed above, catchers and carpenters have a very limited life span with regards to the knees, and that is without adding a ton of weight to the shoulders!
2. The lateral meniscus can glide backwards up to 11mm in full flexion...think of the shear forces involved when doing a deep squat. Not to mention the impingement of the ACL in a narrow notch.
3. Asian cultures do squat a lot, BUT analysis of asian patellas usually show what is called a "squatters facet". Not sure if this is a genetic adaptation, or develops with time, but still reminds us of the sheer magnitude of the forces involved. This facet becomes engaged in the fully flexed position and permits more tolerable weight bearing.
Anthropological study also reveals that there is sometimes an extension of the articular surface on the anterior end of the posterior surface of the medial condyle in populations of habitual squatters. Labelled a Charles' facet, it has been considered to be formed by the compression of the medial meniscus in a flexed position of the knee joint.
John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
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John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: Proper squat form - February 11, 2005 5:18:00 AM
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JLS_PT_OCS
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John-
Great points, I hadn't heard about those types of changes, interesting.
I don't think, however, anyone is advocating squatting like a catcher with weights on.
At least to speak only for myself, I am advocating a position where the femur is parallel to the ground. That can happen at 90 degrees or at 110, depending on the biomechanics of the individual. I am more concerned with not arbitrarily stopping at 90, especially if you're not yet at femur-parallel position.
I think others have brought up, rightly so, the inherently non-functional state of a squat to 130 degrees or more at the knee. Specificity issues are likewise raised.
If taught properly, the squat is very safe, even done to 110 or so at the knee. If weight is on heels as Randy mentioned and biomechanics are good, then there you have it.
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Proper squat form - February 11, 2005 7:08:00 AM
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PTupdate.com
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You're right Jason, the 90-110 range is certainly not anything like a deep squat.
I guess the most important factor is just the use of common sense. If starting a squat program, start light and find how your particular anatomy handles the exercise. Progress weights into the target zone. If pain develops, either avoid the angle where the pain occurs, or begin to widen/narrow stance, or toe in/toe out to reduce the pain and mechanical compression.
One thing I would consider is the degree of dorsiflexion of the foot (true dorsiflexion). With the weight on the heels, at 110 degrees of knee flexion there is a fair amount of DF that is required. Those with a high subtalar axis, along with either tight soleus or equinus, will achieve the DF via pronation. The adduction of the talus will really force the tibia into IR, and that could put some major strain on the PF joint. Throw in the fact that most guys at the gym are wearing their crappiest shoes (no arch support or even mechanical support) and the problem could get compounded.
John Duffy, PT OCS
[URL=http://www.PTupdate.com]www.PTupdate.com[/URL]
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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Re: Proper squat form - February 11, 2005 8:51:00 AM
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JLS_PT_OCS
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Good points again John on some biomechanics issues.
I often have to experiment with a lot of different form modifications to find a safe and comfortable squat style for difference people.
I have found no one that could not safely squat to at least nearly parallel who was under 65 yrs of age. (after that I have found a few...)
Learning to squat properly is a big part of a patient's rehab for a variety of problems.
I don't save it for athletes or weightlifters...
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Proper squat form - February 16, 2005 4:45:00 AM
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treybien
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A quote from the great Mel Siff about squats
"The full squat is probably the most maligned exercise of all, often being regarded as a major hazard for the knee. This bad reputation seems to have arisen in 1957, when Karl Klein of the University of Texas at Austin addressed the 4th annual meeting of the American College of Sports Medicine on the dangers of squatting. When he published his research in 1961 the alleged dangers of the squat gained many supporters over the years. This view has not changed significantly since then, despite the fact that scientists have shown the Klein's experimental method was seriously flawed and that modern studies have failed to confirm his findings. Any dangers of the full squat are due to faulty technique rather than the exercise itself such as
-bouncing passively or relaxing in the lowest position
-rotating or tilting the knee inward
-descending too rapidly and stopping very suddenly
-relaxing or flexing the lumbar spine
-squatting unevenly with more force on one leg than the other
-squatting with unstable shoes or on a soft or slippery surface."
from Mel Siff, Facts and Fallacies of Fitness (2003)
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Re: Proper squat form - May 6, 2005 8:09:00 PM
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gomez2
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Having been a PT for 13 yrs, I too have been brainwashed into the parallel only squats ( as well as all the other limiting training methods). I have recently begun studying "functional training" where the focus is getting the client back to moving the way the body was meant to. Why is it that children can function on the playground performing full squats over and over? Children have an inherant balance, agility,ROM and strength-to-weight ratio that is naturally developed by letting kids be kids. Try mimicing what a child does on the playground, few of us can.
We adults begin to lose these natural abilities when we begin to study and work (mostly in a "chair" position) and get away from daily moving. We develope tightnesses and weakness and learn to compensate. Then we demand more from our bodies than is safe and injuries result. Our current rehab systems (most) deal with symptoms rather than the body as a whole. We need to get moving.
The Asian culture and other cultures continue to allow the body to be used as it was meant to. Their bodies are used to the demands required and haven't lost what God gave us. I feel that ATG squating is a functional activity that needs to be addressed in an unweighted manner along with developing functional strength , balance and flexibility of the back,hips and knees in all directions and angles. Finally, muscular endurance is as important as strengthening, it also allows the body to realign itself and redevelope the neuromuscular coordination that we have lost since our younger years.
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Re: Proper squat form - May 11, 2005 7:14:00 AM
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JLS_PT_OCS
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With age and changes in tissue and biomechanics, are some of these activities you propose for adult patients (eg ATG squatting)possible?
While many of those activities may have been functional for a child, are they likewise functional for an adult?
Are these goals, beyond restoring function and reducing pain in an adult patient's life, worth pursuing?
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Proper squat form - May 11, 2005 9:43:00 AM
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anoopbal
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[QUOTE]While many of those activities may have been functional for a child, are they likewise functional for an adult?[/QUOTE]Exactly. Specificty should guide exercise selection than anything else.
Anoop
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Re: Proper squat form - May 12, 2005 7:00:00 PM
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gomez2
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"Specificity" has been the problem with outpatient PT thinking. We zoom in on the "problem" and think that is it. The way the body moves as a whole needs to be addressed. Is what a child does good for an adult? No, not always. However, what is lost due to inactivity or a decrease in activity creates vulnerability. Then add in compensations and then injuries and it becomes a viscious cycle. What I am saying is that the body was designed to be used and to be moved. To focus on one joint or injury or aspect (i.e. flexibility, or hypertrophy of muscle) without addressing the whole body only adds to the cycle. Developing a movement based exercise program addressing all aspects of the body can only add to the well being of a client.
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