Common Gym Mistakes: Squats

The back squat is rightly called the “king of exercises”, in fact, it’s said that if you don’t have squats in a training program, then you don’t have a program.

Now, I’d never be so absolute, but the squat is a fundamental movement pattern and forms the foundation for lower body performance training and rehabilitation.

Despite squats being such a fundamental movement, because of the amount of muscles and joints involved, there are a lot of chances for compensation.

Compensation is an interesting topic.

Some claim it leads to injury, yet the research is unclear on this.

Additionally, real world examples abound, one only has to look to the recent Paralympics to see examples of high level compensation, so it’s not necessarily a bad thing to compensate.

What Makes A Good Squat?

With the back squat, we can split lifters into two groups:

  1. Competitive powerlifters, whose goal is to lift the most weight in competition
  2. Everybody else

If you are a competitive powerlifter, you can probably ignore this advice, because your goals are so unique.

If you are like most people and you are squatting to improve your leg and core strength to assist with physique goals, health goals or performance goals, then read on.

Executing a squat optimally requires the following:

  • Adequate ankle dorsiflexion range of motion and motor control
  • Adequate hip and knee flexion range of motion and motor control
  • Adequate isometric strength of the erector spinae muscles to maintain the spinal alignment
  • Adequate abdominal strength to maintain pelvic and rib cage position
  • Adequate thoracic extension and shoulder external rotation range of motion and motor control

Unfortunately, most people are deficient in one or more of these areas, which can negatively affect their ability to squat efficiently with a barbell.

That’s not to say they can’t squat heavy loads.

It’s common to see people who are strong squatters with well developed quads, perhaps adductors and low back muscles, but with relatively underdeveloped glutes and sometimes hamstrings.

Others have extremely well developed calf muscles as well.

What is happening?

Their bodies are using a different recruitment strategy to the “optimal” one, which relies on the glutes as primary hip extensors.

Why does this happen?

Safety. Survival.

Our brains are not concerned with long term well-being when it comes to movement, but rather, completing the task at hand, at that moment in time.

When it comes to standing up with a loaded bar on your back, this can mean using whatever muscle is most readily recruited or in the most mechanically advantaged position.

When people have biomechanical limitations elsewhere in the body, this can affect the movement.

As a result, a hip extension becomes a back extension.

Analysis of My Squat

This was a set of 10 repetitions in the back squat, which I have taken still shots from at various points (they aren’t all the same rep, as you can see by the time).

To the untrained eye, my set looks pretty good, but as you’ll see, upon closer look, there are a lot of compensations occurring that are costing me efficiency.

I’m using myself as an example, as my issues are some of the most common issues I see, just in differing degrees.

Set Up:

back-squat-1

My elbows should be further forward, under the bar or as close to as possible, facilitating thoracic spine extension and activation of the erector spinae muscles to stabilise the spine. Additionally, I have a forward head posture, again related to not getting enough extension through my thoracic spine.

Bottom Position:

back-squat-2

This is where it gets tricky, as this bottom position looks really good at first glance. My torso and shins are greater than parallel (blue lines), my hip is below my knee, what’s not to like?

Well, for a start, my weight is too far forward – thus the centre of the barbell is in front of my toes, instead of through my midfoot (yellow line). This sets me up to use a knee extension dominant strategy to stand up.

The most likely culprit for this is a lack of hip flexion range of motion or control.

My ankles don’t have the best dorsiflexion range of motion either, which wouldn’t help.

What we cannot see in this picture is whether my low back is flexing to compensate or what is happening at my feet – they could be pronating to give me extra range of motion at the ankle.

The problem with this strategy, is that by shifting my weight forward by using spinal or pelvic flexion, I will have to extend again at some point, which takes the spinal erectors from stabilisers in the movement to prime movers.

Ascension:

back-squat-3

Here you can see that my torso and shins are no longer parallel (blue lines).

My knees have extended faster than my hips, which have to remain flexed somewhat to keep the weight balanced – this is most likely due to my limited ankle range of motion, which meant my bottom position wasn’t as good as it should have been.

Another factor is the isometric strength of my spinal erectors and abdominals and their ability to maintain my trunk position.

This sets me up to have to use my lower back spinal erectors to straighten me up quickly, as in the image below.

back-squat-4

Here you can see what has happened – my knees have extended only slightly, whilst my back has extended quite a lot in a short time.

What should have been a powerful drive from the hips ends up as a two part movement – the initial extension of my knees with minimal hip extension, followed by the compensatory back extension to get my torso more upright again.

Lockout:

back-squat-5

Finally, once my knees are at almost full extension, my hips are still flexed – I’ve stood up by extending my spine more than my hips.

A Squat Is Not A Squat

This example demonstrates the effect that mobility and motor control limitations have on the execution of movement – I can get the squat done, but sub-optimally.

Now that you are aware, if you watch the video (it’s easier in slow motion) you can see that I compensate by using my back extensors (erector spinae) as prime movers, something their not optimally designed for (we have massive glutes for a reason).

Luckily, our bodies are adaptable, and even “sub-optimal” biomechanics aren’t a recipe for injury – it all depends on adaptability.

Up to a certain point, my low back muscles, joints and ligaments will get stronger to withstand the loading of squatting.

Once that point is reached, I will no longer be able to progress, or I’ll get injured.*

*I’ll get injured not because I’m moving incorrectly, but rather, our bodies are only capable of adapting so much, and inefficient movement patterns put increased demands on an area that are not as well designed to withstand them. The same is true even if I had “perfect” squat mechanics – after a certain point I will fail to progress or get injured.

Does It Even Matter?

I always ask myself, if a patient is paying me money to obtain the best result possible, does this information add value to their experience and outcomes.

In the case of what I’ve just discussed, does it even matter if you squat with optimal motor patterns or not?

As always, it depends.

If I’m not going to the gym, and I only squat occasionally to pick something up at home, then it probably doesn’t matter. As long as I’ve got the physical capacity to withstand the demands of that task, I’ll be okay.

However, if you are squatting to improve your aesthetics, performance or leg and core strength, then executing the movement optimally matters.

Sure you can get away with “just squatting” and moving weight however you can.

But is it ideal? Not to me.

The reason being, that despite our bodies being adaptable, we only have a finite amount of energy. For every inefficient movement pattern, energy cost of execution and recovery increases, thus gains (performance, health, aesthetic) decrease.

Aim High

How you do anything is how you do everything.

To me, the argument of whether you should aim to improve your movement quality and efficiency is a moot one.

Even if the benefits were neglible, I am a person who takes pride in striving for improvement.

In the case of exercise, improving the movement for the sake of improving the movement is enough of a reason to do so.

Be better. – Greg Dea, Sports Physiotherapist

I understand that this mentality doesn’t apply to everyone, so all I can say is this:

  • If you are training for aesthetic goals, and you are squatting to improve your leg and hip muscle development, an optimal movement pattern will best recruit the muscles of the glutes, quads and hamstrings.
  • If you are training for a performance goal, then an optimal movement pattern will improve sequencing of hip extension, as well as power and strength, in turn improving running speed and jumping height.
  • If you are training for a health related goal, then striving for optimal movement patterns can be an end unto itself.
  • Anecdotally, the people I see who strain their backs squatting typically demonstrate this type of movement pattern.

So How Do You Improve Your Squat?

To improve your squat, you have to identify what is limiting your performance. It could be any of the following:

  • A technical issue
  • A flexibility issue
  • A mobility issue
  • A motor control/stability issue
  • A strength issue
  • A structural/anatomical issue

To identify what your particular issue(s) is/are requires an individual assessment.

Once you know your issues, the interventions are relatively straightforward.

 

 

Nick Efthimiou Osteopath

 

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 

 



 

 

Rethink Pain: Posture

Xray bronze Vitruvian man isolated on white

I’d say that almost every practitioner who deals with people in pain would have heard a variation on the following a million and one times:

I have terrible posture.

The implication is that this “terrible” posture is:

  1. A problem, in and of itself.
  2. The cause of their pain.

Previously in this series I discussed moving towards a model of pain that focuses on the nervous system, rather than muscles and bones (and other tissues) and osteoarthritis.

This post is going to look at posture and it’s link, or lack thereof, to pain as well as strategies to improve your posture, including the role of osteopathy.

What is posture?

The position of the body with respect to the surrounding space. A posture is determined and maintained by coordination of the various muscles that move the limbs, by proprioception, and by the sense of balance. (1)

What influences posture?

A commonly held view is that posture is purely structural.

Unfortunately, while this would be great, as it would make things simple, it’s not accurate.

Posture, like pain, is an output of the nervous system, which is influenced by (in no particular order):

  • Skeletal structure
  • Psychological factors – mood, emotions etc
  • Physical activities
  • Postural reflexes

Does posture cause pain?

No.

There are people with all kinds of posture who have pain, and there are people with all kinds of posture who don’t have pain.

If posture caused pain, then all people with the same posture would experience pain, or all people with the same pain would exhibit the same posture.

When you understand pain is a protective output of the brain, you can extrapolate that when you have pain, and your posture is altered, these postural changes are protective.

By the same token, changes in posture that occur after treatment for pain, be it hands on or movement based (or anything else really), occur because your brain is no longer needing to protect the affected region, because the perception of threat or danger has decreased.

Do You Need To Improve Your Posture?

Whilst there is a very low correlation between posture and pain, there are at least a couple of reasons why you may want to improve your posture:

  • Improved movement efficiency
  • Improved aesthetics
  • To improve some musculoskeletal conditions (this is a separate issue, because it is specific to the individual and condition)

So unless these are a priority, then you have to ask yourself if you really want to (or need to) improve (or change) your posture.

If you do want to improve your posture, then there are things you can address:

  1. Your mood, emotions and mindset.
  2. You habitual activities and positions.
  3. Improving postural reflexes.

Sorry, but you can’t change your skeletal structure.

So now you know what to change, but how exactly do you do it?

Let me show you.

Change Your Mood, Change Your Posture, Change Your Mood

You can pretty much tell how someone is feeling by observing how they are holding themselves.

What is interesting, is that whilst mood affects posture, posture also affects mood. So if you are in a bad mood, simply changing your posture can change your mood.

Your mood is simply an emotion, a feeling, and according to the theories surround Rational Emotive Behaviour Therapy (REBT) “humans do not get emotionally disturbed by unfortunate circumstances, but by how they construct their views of these circumstances through their language, evaluative beliefs, meanings and philosophies about the world, themselves and others”. (2)

So really, to change your mood, you have to change your emotions by changing the language you use (to yourself and others), examine your beliefs and philosophies about the world. This will then have a flow on effect to your posture.

This is way beyond my scope of expertise, but if you find you are constantly experiencing negative mood and emotions, you could benefit from speaking with a psychologist trained in REBT or Cognitive Behavioural Therapy (CBT).

What You Do, You Become

Most of our day is made up of habitual tasks and activities. From the way you brush your teeth, to the way you pour yourself a glass of water, all the way through to your regular sitting positions and favourite activities (or lack thereof).

As our bodies crave efficiency, they will adapt to accommodate our habitual postures and positions. Some of this adaptation is structural (bone, muscle and ligament remodelling) and some is functional (loss of stability, range of motion, neural tension).

The way to change this is to increase your awareness of what you are doing throughout the day, and pay attention to how things feel while you are doing them. Then modify.

For example, if you always lean up against the left arm of the couch when watching TV, you are habitually shortening one side of your body and lengthening the other. If this was causing you problems, you could practice alternating sides of the couch, which might feel weird at first, demonstrating both the mental and physical adaptations that have taken place.

What You Really Came For – Reflexive Exercises

When we are babies, we have primitive reflexes. Part of our development sees these reflexes “going away”, however, in a way, they remain as our postural reflexes.

For an example, sit tall or stand, close your eyes and let your body sway. Once you hit a certain point, your righting reflex will kick in so you don’t fall over.

Sedentary lives devoid of rich tactile and movement based sensory stimuli can lead to diminished postural reflexes.

One way to “get these back” is to perform reflexive exercises.

These exercises aren’t like traditional exercises which focus on strength, power or endurance. These develop the qualities that underpin movement, which allow us to express and developed strength, power and endurance.

These are performed in a sequence, from most stable to least stable, and from least complex to most complex.

The positions we can use are:

    • Lying.
    • Quadruped (hands and knees).

  • Kneeling and 1/2 kneeling
  • Standing – bilateral stance, split stance and single leg stance

In terms of complexity, we can progress by:

    • Single joint movement

    • Multiple joint movement
    • Contra-lateral arm/leg movement
    • Contral-lateral arm/leg movement that crosses the midline of the body

 

Reflexive exercises are usually rhythmic and self-limiting (you can only perform them correctly, or not at all), which make them fantastic for not only improving posture specifically, but fundamental movement ability in general.*

Can Osteopathy Improve Posture?

Yes, but not in the way you probably think.

Most people assume that if they walk into an osteopath’s office, and come out after a series of treatments standing taller and feeling “lighter”, that the osteopath has somehow “straightened them up” as you would a stack of blocks.

In reality, osteopathy will affect the 3 aspects of posture described earlier:

  1. Interacting with a personable and affable practitioner can help improve your mood, emotions and mindset.
  2. An osteopath can help you identify your habitual activities and positions, as well as help ease some of the strains that these induce using manual techniques.
  3. Finally, an osteopath can help “re-ignite” your postural reflexes, both by using manual techniques to help improve body awareness and help address any issues that might be negatively affecting them, as well as through exercises as described above.

Conclusions

Posture is very poorly correlated with pain, which goes against much of the information you may have read online or heard from health practitioners.

Most of the time, things that are helpful for treating pain, like manual therapy, exercise and cognitive/emotional therapies will also have a positive effect on posture.

In most cases though, treating pain does not require a specific focus on posture, at least in the traditional sense.

 

Nick Efthimiou Osteopath

 

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.

 

 



 

 

 

References

*I will post up some examples of reflexive exercises on my Instagram and Facebook pages over the next few weeks, so connect with me on those channels to make sure you don’t miss them.

(1) Harris, P., Nagy, S., Vardaxis, N., Mosby’s Dictionary of Medicine, Nursing and Health Professions

(2) Rational Emotive Behaviour Therapy