The squat is not only one of the most common exercises included in an exercise program, it is one of the most commonly mis-done exercises as well. Why is it important to squat correctly for your body make-up? Everyday we use this, seemingly simple, movement to get up and down from our bed, get up and down from the toilet, get up and down from chairs, let alone squat to pick something up/place something down and squat to improve our lower body strength during exercise programs. In this post, I will express the ins and outs of what Shallyn's Physical Therapy and Wellness Services looks at to perfect your squat. Please link over to my facebook page to see video demonstration of progressive squats.
I start at the ground, as this is an exercise done on your feet (called "during weight bearing"). I look to see how your feet and ankles support the rest of your body for a squat. Do your toes turn out? Do your arches fall? Where does the weight get distributed on your feet throughout the squat? FIRST, foot alignment (amount of toeing in or toeing out) is dictated by your natural hip alignment. [Mention this post to get a free consult on your natural hip alignment to protect yourself during squatting activity.] Thus, I will look at your hip alignment to see if your squatting toe position is natural or a compensated habit. To protect your knees and hips, you want to use your natural hip alignment (and thus toe alignment) during squatting activity. Next I check your arches. Arch dropping can be structural in nature (thus may benefit from custom orthotics), or more commonly, due to muscle weakness in the lower extremity (in which I can do specific muscle testing and assign you specific exercises to support your arches and thus the rest of your lower body during squatting). I may choose to tape your arches for temporary support while you are building your strength to support your own arches. [See my December 2017 blog post to get an idea of how I check arch support.] Then, does your weight go to your toes, your heels or stay central over your feet during your squat? This weight distribution coincides with knee to toe alignment. In order to protect your knees, you must always be able to see your toes throughout the squat. This dictates, then, that your weight should be over the central to heel area of your foot.
Moving on to knees. Where does your knee cap track in relation to your toes? Your knee cap should always be tracking toward your second toe (the one right next to your biggest toe). If your knees fall together while squatting up/down, this puts undue stress on your hips and can lead to hip "trochanteric bursitis". If your knees fall too far apart, you may find yourself with "IT Band Syndrome" due to over relying on already weak hips. How much knee bend should you use? To ultimately protect your knee joints, you do not want to repetitively squat past 60' knee flexion while in standing (closed kinetic chain position). You can stand erect to the point of locking your knees straight (0' bend) without unnecessary strain on your knee joint. If your job demands you to squat repetitively past 60', contact me about ways to modify your squatting activity to protect your knees long term. If you perform knee strengthening exercises where your feet are not on the ground (open kinetic chain), the safe range of motion for your knee joints is 30-90' -- never locked straight and a little deeper bend. If you are having difficulty obtaining a functional amount of knee bend, I will ascertain if it is joint mobility restriction, muscle length limitation, or specific weakness.
Finally, I look at your lumbopelvic or core control to optimally bend through your hips and low back to perform a squat without unnecessary stress on your lower quadrant.
There are many ways to progress one's ability to perform an ideal squat for their body make-up. I share a few options on my Facebook page to observe proper squatting using different approaches. At Shallyn's Physical Therapy and Wellness Services you will be given a comprehensive individual plan to get you squatting effectively and comfortably for life's demands. If you need help putting your pieces together to perform an ideal squat, please don't hesitate to contact me for an appointment.
Here's to better functional squatting in 2018!
Tidbits from your physical therapist.