Before I kick off this AMAZING blog post on squats, I’d like to extend a big thank you to Dr. Pat McNamara, PT, DPT, CSCS for collaborating with me and co-writing this post. Pat is a good friend of mine, a Physical Therapy grad from UNC Chapel Hill, who is passionate about sports performance and resistance training. When I decided to tackle this topic, he’s the first person I thought of and I appreciate all of his enthusiasm, experience, and knowledge.
Outside of walking and running, perhaps no movement is performed more often than the squat. From getting out of bed in the morning, getting out of the car, or coming up from the toilet, the squat is a staple of human movement. Outside of the industrialized world where chairs are the norm, cultural differences show how squatting is often a means of resting alternative to sitting.
Squatting is one of the most impactful areas of weakness as people age. As the industrialized world has moved away from the farm-oriented homestead to the computerized desk job, hip function has taken a toll. Americans spend far more time sitting on their squat muscles than actually using them. Many American adults have difficulty squatting, and even our gastrointestinal problems are said to improve with better squat form.
Americans have moved from the farm and factory floor to the local gym in search of fitness, but many start with exercise machines, rather than basic functional movements like squatting. This article is here to convince you that everyone should be squatting, regardless of fitness level. Squatting is for everyone: not just body builders and CrossFit athletes.
If you look at toddlers, you’ll see that they are excellent at this movement very early on. Squatting is the method that allows them to transition from crawling to walking. Watching toddlers progress in mobility reveals how easily toddlers can squat with amazing prowess. They easily bring their bottoms straight to the floor, maintaining a tall upright trunk.
SIngle Leg Squats Are Functional Too
As toddlers progress from walking to going up steps, it’s clear just how strong these muscles are. Toddlers master this skill, despite the step height being nearly 25-35% of their overall height. That's equivalent to a typical adult climbing stairs that were 14-22 inches in height. That’s an impressive single leg squat!
Although most people consider the single leg squat an 'advanced' level exercise reserved for athletes, it’s actually a movement most adults should be able to do. The single leg squat is the movement required for climbing stairs or ascending a ladder. Getting up from the floor requires at least a modified single leg squat. It’s just a part of daily life.
If you're a fly on the wall in any physical therapy clinic, you'll see PTs performing squats with adults into their 80s and 90s. The aspiration is not to turn these people into CrossFit athletes or Olympic lifters. The aim is help them independently perform simple daily tasks like rising from a toilet seat without using their arms, or standing from a low car seat.
Squatting ability has been consistently predictive of falls risk in the elderly. Squatting ability can predict the level of disability in persons with knee osteoarthritis. It is also linked to the performance of the 40-yard dash in division-1 football players. The squat and its derivatives/variations have also been used in standardized movement assessments and injury risk prediction models in an attempt to identify individuals that may be at higher risk for injury. Check out this geriatric squat assessment and test yourself!
In short, the squat is an excellent exercise to incorporate into your regimen. Below I'll discuss a few ways to personalize this exercise, which is the key to success. It is important to mention, however, that not everyone squats in exactly the same way, and even elite level athletes demonstrate some variability.
Basic Components of the Squat
Before we discuss individual modifications, imagine the human body like an erector set. Movement comes at distinct locations, when a force is produced at a specific place. In the human body, muscles (via tendons) apply forces to bones to cause rotation around one another. Individual variations in bone structure/length, tendon insertion point, and soft tissue flexibility around the joint can all impact how much each individual joint is able to move.
In the case of the squat, there are four primary joints that define the movement: the ankle, the knee, the hip, and the low back (in some cases). If any one of these joints is limited, that mobility will need to be achieved at another joint in the chain. For some, this can hinder performance, abnormally stress a joint, or even result in injury.
A basic squat has a couple of ground rules. A basic squat involves the torso maintaining its normal curvature with the trunk upright. The knees should remain lined up over the second toe. The thigh bone (femur) will end-up parallel to the floor, or close to it anyway. In general, most patients giggle at cues to stick their butt out and move it back, but this should happen moreso than the butt simply moving down.
Hip Position is Personal in Squatting
For typical adults, deep squats are met with limitations in the hip joints. If the hips are unable to flex fully (knees toward chest), the compensation is often met through contorted postural changes to the trunk and low back. For many individuals, this is often resolved simply by widening feet and knees to shoulder width.
If you widen your stance, you MUST also widen your knees and keep them directly over the feet. When knees collapse inwards, this is referred to as dynamic valgus, a deviation that is heavily associated with a multitude of injuries to the knee. While elite weightlifters are sometimes able to compensate for this, dynamic valgus creates abnormal stresses on in the knee, similar to those that occur during ACL rupture, meniscus tears, and more.
Some people are unable to do this, even when coached. This can be the case for many reasons. Paying attention to your body may reveal some clues. Joint restrictions in hip flexion are often related to too narrow stance, weakness in the hip rotators, or tightness in the groin. Bony joint alignment alone may be a strong factor.
When restriction is met from tightness in muscles, it is often springy and stretchy, but not typically perceived as painful. Clinical studies have shown that excessive “pronation” or rolling in of the foot can lead to this movement pattern (dynamic valgus.)
As a running specialist PT, many of my patients will receive a very in-depth assessment of their hip and pelvic morphology, structural alignment, and soft tissue assessment. I can think of no other anatomical joint with such a high degree of variability among different people. As a PT, I would never give clinical suggestions or advice regarding the hips without a full awareness of a person's personal biomechanical limitations.
No depth of squatting should cause pain in an uninjured person, so consider a form adjustment if you perceive pain deep in the hip area. Muscle tightness may be a limiting factor for others, but is not thought to be concerning for injuries to the hips. Regularly impinging a hip joint at the end of its range on the other hand, could eventually result in injury to the joint or labrum.
Squatting Can Be Limited by Ankle Mobility
Once hip positioning is optimized to the individual, ankles often become the next limiter. Ankle dorsiflexion, or the movement of the top of the foot toward the knee, is critical for squat mobility at greater depths. When ankle mobility is limited, persons will often compensate with inward collapse of the knees and collapse of the arches, stealing mobility from the arch and midfoot joints. Sometimes the heels will even pop up at the end, as the person moves exclusively to the balls of the feet.
Mobility work in the ankles and regular stretching of the calves may be of benefit to some persons, although true benefit will require weeks to months. One of the easiest ways to continue training with limited dorsiflexion range of motion at the ankle, is to put a “heel lift” underneath the back of your foot.
Generally, a 5 pound weight under each heel is enough to free up ankle mobility during a deep squat and allow for correction of form. This can allow you to practice good form while you continue to address ankle mobility. One might also consider special shoes (Olympic lifting shoes) that have built-in platforms which change the angle of the ankle joint alleviating this problem.
Regardless, one should be weary of letting a joint mobility limitation drive their form toward a compensation. If not carefully assessed, that compensation may result in an injury at another level. This is a frequent theme in sports like CrossFit that center around movements that require explosive power combined with a high amount of flexibility. If the joint lacks sufficient mobility, injury is likely on the horizon.
Choose a Squat Variety that Makes Sense for You
Described above are two limitations that could limit form during a deep squat. Fortunately, most people do not have daily tasks that require such a large range of motion. Many people simply need to rise more easily from a chair and be able to rise from the floor.
When deciding what type of squatting to work into your routine, carefully consider what makes most sense to you. The benefit of any exercise increases as it becomes more similar to the activities. Be that as it may, cyclists and runners use their quads and glutes in very different ways, and may benefit more from different types of squats.
Recent trends in exercise and fitness have popularized certain types of Olympic lifting. These activities may be a fun way to improve fitness, but the cons may outweigh the pros for the average person. Ballistic, complex movements that are loaded in challenging joint positions may pose more risk of injury than simpler versions.
For individuals with labor intensive jobs that require heavy lifting, a well developed exercise program will look vastly different. Consider the physical demands of a piano mover to those of a piano player. A single, non-specific loading program may mean injury prevention for one, and a career change for another.
How Low Should You GO?
Personal fitness is a trendy industry making wise choices difficult. Exercise instructors and personal trainers are always looking for a new way to make you feel the burn, but rarely are clients’ abilities taken into consideration. Taking a loaded squat to “ass-to-the-grass” depths requires a level of skill that is not appropriate for beginners, and may not be relevant for all people. Essentially the risk of injury outweighs the potential benefit for some.
Be that as it may, full depth squats are not inherently dangerous when performed correctly. Conflicting data exists on the “safety” of squatting deeper than thighs parallel to the ground but in general, the deeper the squat the more extreme all joint angles become. For all the physics nerds out there, this means less mechanical advantage for the muscles which means harder work to return to the start.
Greater joint angles also means greater joint compression and loading, which is often regarded as harmful, but I’m not overtly cautious about this. Professionals withstand high volumes of heavily loaded squats for years but the average adult looking to improve fitness will partake in only a small fraction of this level of activity.
The body is meant for squatting and a progressive loading approach with correct form is considered safe. Using bad form, too much weight, or progressing activity too quickly will result in eventual injury with nearly any activity.
Choose a squat that works for you
Using a chair to squat is a great option for beginners. It provides a depth that is familiar and useful. It helps a person focus on form before moving to more challenging depths and heavier loads. It can help standardize the depth and difficulty of a squat, and provides a safety if someone loses balance suddenly. Best of all, the carryover to daily functional activity is easy to understand.
This traditional form of resistance training, is performed with a barbell over the shoulders. This is by far the most common variation. It is fairly neutral in distribution of loading among the glutes, quads, and low back. Depth is optional as with other squats, but back squats are often taken all the way down to the ground. This variety has a lot of moving parts to be mindful of, so always use a mirror and/or a trained professional to help you perfect your form first before proceeding to heavy loading.
The goblet squat is named as such from the posturing of the hands that creates the shape of a goblet. The front loading of the trunk is an excellent teaching tool in helping newbies shift their hips backward. It can also help train the person to maintain an upright trunk without the resistance at the lower back imposed by a traditional back squat.
Because of arm positioning, goblet squat inherently requires a wider stance and knee position than other squats. Because of the reliance on a dumbbell or kettlebell, heavy loading is more limited than a front loaded barbell squat. Goblet squats can easily be transitioned into squat jumps or wall balls.
Single Leg Squat Varieties
Single leg squats provide an excellent way to improve the stabilization (controlling the body during movement) component required to perform agile single leg sports. Which sports are these you ask? Essentially any sport that involves running and/or jumping/landing on a single leg.
The direction and positioning of the suspended limb will alter muscle activation with each squat. There are three basic varieties to consider for beginners. The first one, the forward step-down, has the limb suspended out forward, which preferentially loads the quads and knee joint. The body remains upright over the stance leg. It is biomechanically similar to walking down stairs.
A second variation, the lateral step up, maintains the floating limb out to the side, which can target lateral hip stabilizers more and better distribute the load between the quads and glutes. I use this variation quite a bit with clients to better target gluteus medius and train hip/knee stabilization and motor control in landing mechanics. This variation allows for a greater variability in squat depth than the first, and can be a great precursor for those working toward a pistol squat.
A third variety of single leg squat has the floating limb supported behind the body. It is often referred to as the Bulgarian split-squat. This squat maintains a consistently neutral upright trunk, which means less loading to the lumbar spine extensors, but because of the depth, good activation of glute max and quads persist. If performed correctly, this can be the most challenging of the three, so be sure to master your form.
So, Go Squat Already!
Hopefully by this point, I’ve convinced you of three key points. Firstly, squats are a movement that everyone does daily, a normal part of life. Secondly, many people will benefit from strengthening and developing these muscles in a way specific to their daily needs. Thirdly, everyone squats differently, for different reasons, and there is a wide variety of squat exercises to consider.
Don’t be intimidated by incorporating these into your routine. Many of the above options are simple enough to perform in your home with typical household items. You’ll start to notice a big difference when getting up from a low couch or rising from the floor.
Performing your squatting exercises will result in some muscle soreness for a couple days after, but should never cause pain. Pain, which is different from soreness, is a phenomenon that is often concerning and likely to make you consider ceasing an activity. If this is your experience, find a qualified human movement specialist: a coach, a trainer, a physical therapist, etc.
Until next time, don’t stop moving!