Back Health

To Squat or Not to Squat

When looking for an exercise that increases strength, incorporates a long list of muscles, and causes a large metabolic response, look no further than the squat.  Now when I mention “squat” most of you are thinking:

  • My doctor told me not to.
  • I don't want to use that part of the gym.
  • I'm intimidated by free weights.
  • What happens if I can't get back up?

Squats have gotten a bad rep over the years.  I’ve now heard from a wide variety of people including practitioners (Orthos, PTs, Chiros, etc.) that “squats are bad for the knees and / or back”.  My response is, “They can be, but they don’t have to be.” 

We all squat… all day long.  Do you get in and out of a chair?  Do you pick things up from the floor?  Do you get on and off of the commode?  If so, you are squatting.  Squats are an essential part of human movement.  Having the ability to squat effectively and efficiently MAKES LIFE EASIER.  Why wouldn’t you want to make life easier?

I’d say 1-5% of the general public have contraindications that should keep them from squatting consistently.  For the other 95-99% of us, we shouldn’t be asking whether I should or shouldn’t but “HOW SHOULD I?” What determines whether your squat is helping or hurting you is not how many reps, or in what setting (barbell, goblet, front/back, single leg, DB, etc.), or how frequent, it is the technique used when squatting.  

Poor squats can cause: 

  • Bulging disks in lumbar spine
  • Patella-Femoral Syndrome
  • Hip labrum fraying/tears
  • Patellar tendonitis

Squats completed with proper technique can improve:

  • Bone mineral density in pelvis, spine, and lower extremities
  • Core stabilization
  • Efficiency of ADL’s (activities of daily living)
  • Vertical jump
  • Sprint speed
  • Running efficiency
  • Deceleration
  • Change of direction
  • Rotational sport efficiency and power (throwing a baseball, golf swing, lacrosse shot, etc.)

It should be pretty clear by now that squats are one of if not THE most important exercise in your regimen.  Now, let’s focus on the “how”.  For today’s post, I’ll be explaining how to get your lower extremities set up properly for a bilateral (double leg) squat.  I will focus on the back and upper extremity positioning for other variations in a future post.

Alignment

Proper lower extremity alignment for most of the population can be achieve by keeping your patella (kneecap) and 3rd toe on the same line or plane of motion.  As you bend your ankle, knee, and hip joints during a squat, the three points mentioned should all stay in plane.  To determine this, find your pelvic crest on both sides of your hips.  Trace it forward until you feel a bony point in the front of your hips, slightly below your pant line.  This landmark, which we’ll abbreviate as ASIS makes up the beginning of the hip-knee-toe line.  Look in a mirror with your feet hip width and pointed straight forward to determine your standing position.  If you see your knees sitting inside the line between hip and toe, lift the arches of your feet up to bring knees outward (away from midline).  In the picture, you see hip-knee-second toe alignment with a hip width stance and toes straight forward.  This is optimal alignment but not necessarily the optimal squat stance.

 

Stance and Hip Angle

For optimal squat depth, we need to open our stance up from hip width to shoulder width.  This gives our hip sockets “room” to work until end range impingement occurs.  The optimal stance width is roughly shoulder width.  If you take your feet to shoulder width and keep them pointed forward, as you see in this pic, your hips wind up in internal rotation.  This position can damage the hip labrum and causes early impingement in your squat range. 

Based on the hip socket (acetabulum), “ball” of joint (femoral head) and femoral neck, the optimal squat depth can be achieved with your hip-knee-toe line externally rotated.  If you were standing on a clock with 12 o’clock in front of you, your feet should be pointed at 11 & 1 to 10 & 2.  Make sure that the knees stay out with the toe angle or you will fall into a position that causes joint problems and pain.  From top to bottom, the pictures to the right show:

  • Proper width but improper angle of foot placement
DSC01350.JPG
  • Proper width and angle of feet but knees adducting or turning inside optimal alignment
  • Proper width, angle of feet, and alignment

 

Try out your new squat stance next time you are in the gym or using the motion to sit down and get up from a chair.  You should feel your range of motion increase and pain decrease.

 

Happy Squatting!

 

Ryan Morrissey

Don't Be Fooled By The Media

Since I’m kicking off our blog with this post, I feel like it is appropriate to begin with an overview of and industry wide problem.  If you have been following fitness in the media over the past decade, then you are familiar with the fact that most articles, exercise pics, and videos published cater to either cosmetic goals or high level performance achievements.  For example, articles are titled something like “Top 10 Ab Exercises for the Summer” or “Tone Your Inner Thighs”, with the exercises being demonstrated by a minimally dressed model.  I take offense to these articles but not for the reasons you are thinking.  I’m not bothered by minimally dressed models, six pack abs or a lean adductor complex.  What I am bothered by is the lack of education or downright incorrect information that the general public is subjected to.  I spend half of my initial 5-10 training sessions with new clients debunking fitness myths that are spread by garbage magazines and social media. 

Here is some information that should have been provided by the aforementioned articles:

Understand that there is a difference between developing a core that can function well and one that looks cosmetically pleasing.  Also know that you don’t have to sacrifice cosmetics to achieve other goals like decreasing low back pain, improving stabilization (think efficiency for running), and force translation from lower -> upper body (think shooting a lacrosse ball).  We know a pretty good amount about how back pain and injuries occur from researchers like Stuart McGill, who determined how much force and how many repetitions of poor movement patterns it takes to herniate a disc.  The readers of these types of articles have no idea that some of the exercises prescribed are degrading back stability and health taking them one step closer to chronic pain, stiffness, or failure of a tissue.  As professionals in the industry, it is our job to help you reach your goal (cosmetic or performance based) while assessing and decreasing risk whenever possible.  If you have the choice of two exercises that equally activate your “abs” but one increases stress on the spine 4x more than the other, which one would you pick?

Adductors, aka Inner Thighs…  How many thousands of dollars have been spent and hours lost on machines to isolate this area?  For what?  We know that training a single joint movement for an isolated muscle does not do anything for removing fat tissue that sits on top of it.  If we continue to do so without taking into account proper joint function and hip joint health, we are doing way more harm than good.  Learning proper hip range of motion and positioning while applying it to a bilateral squat (barbell, dumbbell, kettlebell, etc.) or lateral lunge is a much more effective approach than the wasted inner thigh machine or ball squeezes!  The more complex (determined by the number of joints involved) the exercise, the more musculature required to perform it… leading to a more productive metabolic response and possibility of actually improving your body’s function!!  Not a bad by product.

At PEAK Custom Fitness Solutions, we provide hands-on, individual specific training based on science and real world experience.  If you can’t see us in person, check us out on social media and follow this blog for exercise recommendations, controversial industry topics, nutrition thoughts, and much more.  Please share with your friends so they can escape the media’s stronghold giving readers what they want to hear vs. what they need to hear! 

Ryan Morrissey