Monday, August 5, 2013

The Why and How Behind Your Squat

The Why and How Behind Your Squat

The Beauty of the Squat
The squat exercise gets a bad rap in the medical community and blamed as a source of back and knee pain. When incorrect technique is used this may be the case. Youth athletes are engaging in squat regimens with little preparation, technique instruction, or with excessive weight. In this case, injury can be the cause of musculoskeletal injury. This may include vertebral body injury(spondylolisthesis or spondylolytic lesion) or soft tissue injury(muscular strain, disc tear, ligament sprain).

The purpose of the Why and How Behind Your Squat is to provide understanding of safe squat principles that will:
  • reduce the risk of injury
  • improve your performance in sports and general daily function 
  • provide an overview of a squat preparation routine
By understanding the Squat you will gain a greater appreciation of the Beauty of the Squat.

Lift with Your Legs and Not Your Back

From the time I was a kid I was instructed to "lift with my legs". It was my Dad that provided this biomechanical advice when performing some lifting chore around the house, or lifting weights in the garage. This advice I pass on to my clients in my physical therapy clinic (Bauer Physical Therapy, Laguna Hills), as poor lifting mechanics are not only important for the athletic, but is important for efficient lifting at work and home. The Squat Mechanic is essential for proper lifting whether this is a heavy object, sustaining a squat position, or just bending to pick a piece of paper from the floor. Squatting is an innate function of humans. Somewhere along our evolutionary path we have neglected our ability to squat correctly.

A Few Reasons that May Explain the Lack of Squat

  • There is a decrease in the physical demands of our work.There is less required lifting and sustained bending in our work.
  • Our work and home postures demand more sitting. These postures are often associated with flexed back positioning.
  • Squatting is just not part of the social norm in western civilization. We do not spend time in sustained squat postures unless we are working in the yard, catching behind the plate, or possibly relieving yourself in the wild.

Do You Know Squat?

The performance of a squat is essential to normal daily function. We must squat to lift objects from the floor, squat to and from a low seated position, and well, if you are an infant you squat to play.
The ability to squat, and do so with proper technique, must be taken seriously. Youngsters must be instructed in physical education classes on the proper technique of the squat. What good is it to test the ability to reach your toes. I can tell you that I am unable to reach my toes, but I do have decent squat technique. 

The Capacity to Squat

The inability to squat as we age is the sign of functional loss and dependency. As the body ages joint mobility and muscular strength decrease at a faster rate in those that that do not engage in moderate physical activity. The result is stasis of the large muscles that stimulate the cardiovascular system(elevate heart rate and provide oxygenated blood to the large muscles). This promotes deconditioning,  progressive loss of function,  and dependency at home and in the community. This is a cause of the cascading events that lead to the decline of health and disease(diabetes, chronic pain, cardiovascular disease). Without argument, the capacity to squat can help combat an your functional and health decline.

Squats and Athletic Performance

Squat Test for Mobility
The squat is a primary element of all athletic strength development and performance programs. Engaging muscles responsible for strength and power is an element of most sports for success in performance outcome and injury prevention. Excessive knee valgus has been shown to be related to diminished hip muscle strength and implicated as a contributor to knee injuries, including ACL injury and patellofemoral joint dysfunction.

Developing strength of the hips in knees with the back squat exercise promotes power for speed, jumping, change of direction, deceleration, and promotes the readiness posture of the "athletic position". The popularity of plyometric training requires development of the squat muscles used in the jumping and landing phase of vertical and horizontal body displacement, as well as bounding type drills. Research has demonstrated that an individual should be able to squat 1.5 times body weight prior to engaging in a plyometric-based program to reduce the risk of injury.

There are many young athletes that are ill prepared for plyometric drills, and this leads to knee, hip and back injuries as a result. Randy Bauer, Physical Therapist

The squat is a closed kinetic chain exercise that involves multiple joints moving together to achieve proper form. Proper form requires varied joints moving together to achieve maximum benefit of the exercise. When performing the back squat exercise the posterior muscles of the hips(gluteus maximus) and quadraceps muscles are the primary movers. There are stabilizers acting to provide coordinated movement. These are stabilizers act at the trunk, back muscles and abdominal muscles, and at the hip, adductors and abductors(gluteus medius).

Poor Squat Mechanics Increases Risk of Injury

Poor squat mechanics can be the result of weakness and/or restricted joint mobility and tight muscles that influence back, hip, knee and ankle action. Weakness of the posterolateral hip muscles(glut medius and maximus) can result in unwanted hip adduction that creates excessive valgus stress at the knee. This can result in increased loads over the patellofemoral joint. 

Another cause of excessive loading of the anterior knee is seen when the knees passing over the toes during the lowering, or eccentric component of the squat movement. In this case the ground reaction forces would pass more posterior to the knee joint. This results in increased demands of the knee extensors and decreased demands of hip extensors(less glut maximus activity). This imbalance of can place excessive loading over the anterior knee (patello-femoral joint).

Excess Knee Valgus

Excessive forward lean of the trunk can have a negative effect on the hip joints. Poor hip flexibility when sitting back into the lowering phase of the squat can create hip impingement, labral tears and can lend to loss of lumbar neutral spine positioning. Incorrect lifting mechanics and poor preparation are a leading cause of low back injury 

Squat Preparation Routine

Performing a Squat Preparation Routine can be useful as a warm-up, instruction of proper mechanics and reduction of risk for sustaining injury. All too frequently the athlete or individual engaging in squats jumps right into the activity without proper preparation. It is recommended that engaging in a pre-workout stretching and prep phase to your leg strengthening routine be included prior to variations of squats, dead lifts, lunges, and power cleans, and plyometric training.

Stationary Bike or light jog 10-15 minutes

Isolated Stretching
Performed to increase the general mobility of the muscles that cross the back, hips, knees and ankles.

Wall Squat Test: The goal of this exercise is to maintain balance with the forehead, and in some cases the nose, knees and toes in contact with the wall. The feet are positioned shoulder width apart, and the knees are directed toward the 2nd and 3rd toe as you squat. The hands are allowed to lightly touch the wall. Notice the spine and shin angle remain parallel. It is the goal to descend to knee level, butt to the horizontal line, without loosing balance. Measuring the thigh to horizontal line angle is Your Objective Measure.
Wall Squat Test

Assisted Squat Stretch: The assisted squat stretch provides a warm-up, stretch mobility activity using a deep squat position. Grasping a pole, or fixed object while standing at your belly level provides stability while you descend into a squat stretch. This will bring the arms to approximately horizontal. It is important to maintain a lordotic to neutral position. In this deep stretch the hips, knees and ankle are allowed to experience squat mobility prior to engaging in your squat, or leg routine.
Assisted Squat Stretch

Lunge Stretch: The lunge stretch provides good endrange motion of hip flexion and extension. The hands are placed inside the front foot. The front knee should be directed toward the same-side shoulder. The back leg is maintained in extension(straight). Hold the position 20-30 secs for 2 reps each side.

Lunge Stretch

Squat with Butt Lift: The squat with butt lift is a dynamic squat movement followed by a hip, or butt lift, movement. Perform by squatting bringing the finger tips to the floor, or a 8 to 10-inch stool/step. Maintaining the lumbar spine in a neutral to slightly lordotic position. You will then lift the hips while maintaining the back in this position until you feel a light to moderate hamstring stretch(For most people you will not be able to fully extend the knees). You then come to a standing position as if performing a reverse dead lift. Repeat this movement 10 times. 

There is Beauty to the Squat when performed with sound technique. The Why Behind the Squat may vary according to your fitness or athletic pursuits. The ability to squat remains a foundation to functional ability whether you are lifting furniture or moving boxes in your garage. Just remember that not using your legs and paying attention to proper back positioning and knee alignment can lead to injury.

The How Behind the Squat requires practicing solid technique. If you are new to the squat seek the watchful eye a your physical therapist, sports conditioning trainer or coach. Preparing the joints and muscles to perform a training program must include a proper warm-up and squat preparation routine. The squat is one of the most important exercises for performance on the field or for your fitness development.

Squat Methodology and Training References:

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