Why Squats Suck: Part 1 of The Perfect Squat Series by Dr. Phil

The squat is a foundational movement and incredibly important when it comes to performing tasks in your daily life or becoming a resilient athlete. Unfortunately a lot of people, including trainers, coaches and other healthcare professionals, do not understand how a proper squat is supposed to look like. I'm dead serious, people really don't know what a correct squat is supposed to look like. Now that's not personal knock against them, they have all learned what someone else has taught them. It's the system that makes people spit out information like robots. What this blog series will focus on is breaking down the squat pattern and analyzing key flaws; how to fix those flaws; and what athletic equipment will help to your performance to the next level once you have addressed any movement inefficiencies.

This being the first blog of the series, we are going to focus strictly on what good form is and what some of the common flaws are and why you should be concerned.

The squat has a TON of great benefits when performed correctly, but unfortunately comes with RISKS when performed incorrectly. Let’s look at a few of these benefits from mainly a musculoskeletal standpoint:

• Joint pain
• Muscle Spasms
• Reduced Coordination at Proper Muscle Lengths
• Limited Muscle Gains
• Inefficient Posture
• Tendinitis

The list goes on for both benefits and risks, but those are just several components of each that can be applied to the general athlete. In order to reap the benefits of the squat, we must maximize the movement potential and fluidity. This starts from the ground up beginning at the ankles, moving to the knees, and up to the hips and lower back. The positions of these joints are INSANELY related and need to be modified as necessary to accommodate other adjacent joints and muscle groups so the body can move well.  

 

To reiterate, the squat is butchered all over the world. You will hear voices in many gyms shouting:

While everything is context specific and these cues may help an elite athlete maintain a proper alignment, the MAJORITY of the time they are applied poorly. Sure the coach/trainer shouting the cue may have the best intentions in the world, but that does not mean the cue or position is appropriate? This has led to a lot of athletes presenting to me for pain and other symptoms associated with their squat. Upon evaluation they are inherently confused when I tell them they can in fact “move their knees over their toes and not develop knee pain.”  That is because they have been told/coached their whole life to move a certain way which was that coach’s understanding of “ideal.” But life is never ideal and neither is applying one specific squat position to an entire population.

As Athletic Weightlifters, you are performing a series of movement patterns. You run, jump, squat, pull, kip, push, press, etc. You feed on the variety and crave competition. You will do whatever it takes to be more efficient in your movements so you use less energy to have more in the tank for the next movement. However, some of you may not understand that a certain movement you are performing is not as efficient as it could be. And let’s be realistic, the squat is in a lot of your movements… squat thrusters, single leg squats (pistols), wall ball, cleans, snatches, front squats, back squats, one arm kettlebell squats overhead… the list goes on.  If there’s one movement that could use some review, it’s the squat. This will help with those FASTER, MORE EFFICIENT transitions between movements.

Let’s look at the squat and what general form will look like in terms of motion at the ankle, the knee, and the hip/pelvis. I used myself as an example, I put everything in black and white so you wouldn’t get blinded by how pale I am (Boston had the longest winter, I can barely recall what sun feels like).

 

In the above image I have demonstrated a proper squat position based on the “raw” movement (bodyweight, barefoot, and no assistive devices such as a heel lift). Note, every squat will differ at baseline based on anthropometrics (limb length), bony congruency (ie how the hip fits in the socket), and muscular/soft tissue coordination (existing tone and its ability to relax and “turn-on”). Hitting "depth" is highly specific to all those factors when you are body weight and without heel lifts. **This will differ from competition.** Treat this as an assessment. I have longer femurs and increased stiffness/tone in the hips, hence the above parallel position during a paused body weight squat. This does not mean it is incorrect, it is solely one piece of the puzzle.

Key points from the correct position:

• Relaxed back position (not lifting the chest and increasing low back muscle activity)
• Knees translate forward upon the available ankle range of motion
• Heels stay on the ground
• Maintaining a neutral spine here allows better hip flexion (hip bend) and more leverage placed on the glutes
• Weight/center of mass goes through the middle of the foot
• Toes are relaxed and staying in contact with the ground

A loaded squat will differ in terms of the relative angles at the knee and the hip, however the key points listed above apply to how EVERY squat should be performed.

Now let's examine several examples of incorrect squat form and how this places excessive stress on the body.

Example 1:

This image demonstrates a position with decreased ankle range of motion. When the ankles are stiff or “tight,” several things happen from a biomechanical component: the knees cannot translate forward, the hips are higher at the bottom position and the torso is more parallel to the ground compare to the correct position.

Key side effects of decreased ankle range of motion:

• Mid-foot collapse or excessively “flat” feet
• Increased low back arch or extension to keep the chest up and hip depth (this can directly lead to low back pain and spasm)
• Hip impingement and pain into the groin/front of the hip because the back will arch more to reach depth
• Increased knee pain and tendinitis due to more force placed on the quad tendon for deceleration and acceleration from hitting the bottom position

You will see this quite commonly in a lot of athletes and it may not necessarily be a huge problem until they are loaded consistently/frequently in this position. That is when one or more of the above issues tend to arise and cause pain and other limitations.

Example 2:

This image demonstrates a bottom position with increased extension or arch at the lower back. This typically coincides to cues such as “stick the butt out” or “ raise the chest.”  Unfortunately, for most athletes this position takes the hips right of the equation emphasizing more stress on the back and the quad tendon than anything else. Just promotes poor movement in general.

Key side effects of increased low back extension:

• Increased stress on the lumbar vertebrae leading to stress reactions and fractures
• Impingement symptoms in the groin and hip leading to pain eventually and inability to even do a quarter squat
• Increased adductor, groin, and/or hamstring strains since the hips are not in an ideal position to be loaded appropriately
• Increased paraspinal (back muscles next to the spine) strain and stress
• Abdominal muscle inhibition will tend to accompany this position as well

As you can see, this position has a lot of risks and little to no benefit besides making me look like a duck. (Not sure if looking like a duck is a benefit, but that’s the only thing I could come up with….)

Example 3:

Above you can see a noticeable “round-back” position with the pelvis tucked under. This tends to occur in athletes that are more stiff in the hips and have poor motor control in single leg activities. Although not very common in a mid-range back squat due to where the bar is placed, you may see this more often in body weight movements than loaded patterns. The pelvis and femurs and unable to separate via the hip rotators and glutes which allow more freedom like the picture on the left. Because the hip tissue has stiffened to promote a sense of stability, the body is unable to achieve pure hip flexion (hip flexion means bringing the knees closer to the chest with a neutral spine). If the body is compensating like this in a body weight position, image what loading the spine with a barbell will look like? The brain has a WTF moment.

Key side effects of the inability to achieve pure hip flexion:

• Increased knee pain and patellar tendinitis due to inability to use hips
• Increased back tightness and pain due to concurrent tightness in the hip muscle/fascia
• Poor single leg stability/motor control will accompany this position and lead to potential adductor/hamstring strains due to poor glute and hip rotator control
• Disc bulges and herniations may also accompany this position as the spine and hips will not coordinate movement, this increases shear forces on the discs when the body is on single leg stance

The above three incorrect squat positions are fairly common in general athletes and CrossFit athletes when assessing body weight movement. Keep in mind, there are many side effects, pain, and symptoms associated with performing these positions frequently and with a loaded bar.  That is why it becomes crucial to diagnose the positional flaws and address them as necessary; starting with just body weight and then progressing to loaded movement. 

Now that you know what can happen, I’m sure you want to know how to fix the form, reduce the pain, and achieve some earth-shattering PRs!!! Right???

Don’t worry! I promise I will explain in the next two blogs how to fix these patterns and what tools/techniques may be useful in assisting mobility, stability, and coordination to dominate the pattern.

In the meantime: sit tight, grab a coffee (or two or three), and get ready for the next blog because I am going to drop some knowledge bombs about fixing the squat and returning to dominance.

Also if you really can’t wait, you can join the Athletic Weightlifter Facebook Group for further squat discussion and everything performance/rehab as it relates to weightlifting/powerlifting/CrossFit.