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Human Movement Series (Part 2) The Squat by Michael Hansen, PT, DPT

by jessicag, March 18, 2019

 

In part 2 of our human movement blog series we are going to cover the squat. Maybe one of the most highly discussed, debated and confusing movements. There are endless coaches, trainers, Instagram fitness “pros” and medical profession that differ on how they instruct and explain the proper squat. If you want to see what a good squat looks like then the bet place to look is children. Children have phenomenal mobility and have not developed tightness and mobility restrictions that most adults have from prolonged sitting and inactivity.

          To be completely honest, there is no one perfect squat form. Everyone has different abilities, joint/muscle restrictions, strength imbalances and most importantly everyones anatomy is slightly different. That being said there are a few principles that can be applied to most people when it comes to general technique.

When most people think of the squat, they think of mostly a knee and hip movement. But there is much more to the squat than those two joints. In order to prevent excessive loads and stress on our knees and hip we also need to have good ankle and thoracic spine (upper back) mobility. If we lack any one of these 4 areas our body will try to make up that lack of mobility somewhere else – THIS IS WHERE INJURIES HAPPEN!!

I try to follow 4 basic rules when I am assessing and teaching the squat:

  1. It’s all in the Hips: The motion should always begin at the hips. This is why we covered the hip hinge in Part 1 of our blog series. A slight hip hinge followed by bending of the knees helps to prevent our knees from coming past our toes which can put excessive stress on the knee.
  2. Knee Position: When looking down at your feet during the squatting motion your knees should not go forward past your toes and laterally they should stay in line with your 2nd toe. Keeping this in mind will help to prevent anterior knee pain from serval pathologies (patellar tendonitis, patellar femoral pain syndrome, shin splints, jumpers knee). Keeping the knee in line with your second toe prevent excessive stress on the medial and lateral aspects of the knee. Most specifically we are trying to prevent the knee from collapsing inwards which can stress the meniscus and knee ligaments.
  3. Ankle Mobility: I believe that the ankles are the forgotten joint when it comes to squats. Specifically I am referring to ankle dorsiflexion. Without it, we will compensate by raising our heels off the floor, collapsing our knees inwards or putting more stress on our hips and knees.
  4. Thoracic Spine Mobility: Thoracic spine mobility is required or else we will compensate by rounding our low back, collapsing forward or shifting our hips forwards. All of these place stress on the joints of our spine and hips in unnatural ways.

 

For you athletes out there I like to use several screens from the TItleist Performance Institute (TPI) to assess these 4 regions.

 

-To assess hip stability and mobility I like to use the pelvic tilt and rotation tests. This assesses the body ability to disassociate the lower body and pelvis from the upper body (crucial for a good squat).

-For thoracic spine mobility I use to overhead deep squat assessment to determine how thoracic spine and latissimus doors tightness limit full squat.

-And finally to assess ankle dorsiflexion you can test yourself using the 1/2 kneel ankle mobility subtest. While kneeling, begin with your toes 4 inches away from a wall. Keeping your heel down try to push your kneel towards the wall (don’t let your knee dive inwards or outwards). If you can touch it from 4 inches away you have enough mobility. If not, you need to work on it!

 

Here are some of my favorite exercise to improve mobility in order to help you squat pain-free.

 

https://www.youtube.com/watch?v=YF7qaAbd0q8&feature=youtu.be

 

Here’s an excellent whole body warmup from one of my favorite PT’s online, The Prehab Guys:

https://www.youtube.com/watch?v=j3cI3HK9nns

 

And finally here are 5 great ways to improve that all so important thoracic spine mobility, courtesy of The Barbell Physio:

https://thebarbellphysio.com/top-five-thoracic-mobility-drills-to-improve-your-overhead-pressing/

 

 

Happy Squatting!!