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Benefits of squatting:
-Great for improving strength of the entire lower extremity, core, and back extensors, synergistically
-A very functional movement used every single day and since we were toddlers
-Improves ligament and tendon integrity, if done properly
-Improves stability of the knee
-Can help bone or maintain bone density
-Recently been linked to improving pelvic floor function
-Because no one ever wrote a song about a small butt
Possible injuries from squatting improperly:
Back:
Spondylolisthesis (stress fracture in the spine)
Herniated disc
Back strain or sprain
 
Hip
Hip impingementàlabral damage
Hamstring strain
Hip flexor tendinitis
Greater trochanter bursitis
IT Band syndrome
Knee:
Patellar tendinitis
Patellofemoral pain (chondromalaciaàosteoarthritis)
Medial/lateral knee pain
Meniscus damage
Cartilage damage (debateable)
 
Ankle/foot:
Ankle Impingement
Arch pain/plantar fasciitis
Posterior Tibialis tendinitis
 
What makes a squat unsafe?
-Poor Form (from muscular imbalances and/or poor mobility)
-Too Much/Many (speed, load, reps), too fast
Risk needs to be managed!
Steps to performing a correct squat:

  1. Stand with feet shoulder width apart (or a slightly different distance based on your comfort level)
  2. Turn toes slightly outward (or straight forward)
  3. Unlock your knees
  4. Contract your abdominals (Gently draw navel to spine, contracting the transversus)
  5. Put most of your weight in your heels
  6. Stick your butt out like sitting in a chair (hip hinge)
  7. Bend at the hips, not the back, the back should stays completely straight the only bend should be at the hips
  8. Keep bending knees until as far down as possible (or comfortable)
  9. Continue to stick the butt out, making sure the toes do not go over the knees (1-2” is alright)
  10. Push through the heels to get back up, very little weight should be in your toes

See more at: http://www.totalperformancept.com/2012/08/15/proper-squat-form/#sthash.RtN4Mq4k.dpuf
Identify and correct muscle strength and flexibility imbalances and enhance neuromuscular control
Back or anterior hip discomfort?  You may have:
-An anterior pelvic tilt
-tight hip flexors-kneeling hip flexor stretch, yoga squat, World’s greatest stretch
-tight lumbar spinal erectors-child’s pose
-weak glutes-hip bridges, stability ball hip bridge hamstring curl, deadlift, good mornings
-weak abdominals (transversus abdominis)- Sahrmann abdominal progression
-Or, you may just need to learn how to move and set your pelvis
Posterior pelvic tilt
Cat/camel
Knee, lateral hip, or foot/ankle discomfort? You may have:
-Tight quads– kneeling hip flexors/quad stretch, foam rolling
-Tight IT band-sidelying IT band stretch, foam rolling
-Tight calves-dorsiflexion lunge test/stretch, gastroc/soleus stretch, foam rolling
-Weak hip external rotators and/or abductors-banded hip external rotation, hip abduction walks
-Overpronated feet-short foot, arch supports
-Or, you may just need to learn how to shift your weight and align your legs
-Practice squat form in front of a mirror
-Use a target to reach your butt towards
-Stand close to a wall so you are forced to keep your chest up
Squat biomechanics:
-Tibiofemoral and patellofemoral compressive forces increase with increasing knee flexion (0-50 degrees is ideal if cartilage pathology exist, ie, if you have knee pain, you may need to do mini-squats for a while)
– Low to moderate tensile forces on the Posterior cruciate ligament increase with increasing knee flexion (>60 degrees), however, the tensile load is still only half of the amount needed to rupture a PCL tendon (Be careful doing squats after a PCL reconstruction)
-Increased compressive forces are generated with a wider squat than a narrow one
-Low tensile forces are present on the ACL ligament at 0-60 degrees (Squats, done properly are very rehab after ACL reconstruction—if done properly!)
-Quadriceps, hamstrings, and gastrocnemius activity increase with increasing knee angle (the lower you go, the more beneficial for increasing strength it becomes)
-Twice as much hamstring activity occurs with a squat vs. a leg press (if you’re coming off of a hamstring strain, you may need to start with leg press for a while)
– The vasti muscles of the quadriceps are more active with a squat compared to leg press
A good rule of thumb:
-Weight, reps, speed should not be increased more than 10% per week AND only when the previous weight can be performed with good form
-Be very cautious with completing 2-3 more reps after the first one performed with poor form when you are fatigued.  Often this is when the injury occurs!
ABOVE ARE JUST SOME BASICS!
-You may have other issues (joint restriction, cartilage, ligament, or tendon damage) that are contributing to your symptoms.
-If you are having continued or worsening discomfort please talk to your trainers and/or see a physical therapist!  A physical therapist can perform more tests to help identify potential impairments and we can direct you to the right people if medical intervention is warranted!
 
 
Thank you, and happy squatting!
References

  1. Kasayma et al. Ankle joint dorsiflexion measurement using deep squatting posture.J. Phys. Ther. Sci.
  2. Krause DA, Cloud BA, Forster LA, Schrank JA, Hollman JH. Measurement of ankle dorsiflexion: a comparison of active and passive techniques in multiple positions. J Sport Rehabil. 2011 Aug;20(3):333-44.
  3. Escamilla et al. Effects of technique variations on knee biomechanics during the squat and leg press. Med Sci Sports Exerc.2001 Sep;33(9):1552-66.
  4. Escamilla et al. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Med Sci Sports Exerc. 1998 Apr;30(4):556-69.
  5. Escamilla et al. Knee biomechanics of the dynamic squat exercise. Med. Sci. Sports Exerc. 2001 Jan;33(1);127-141.