The Hip Pinch – how to fix
Ever been squatting and felt that annoying pinch at the front of your hip? Don’t worry you are not the only one! This is easily one of the most common complaints from CrossFitters/Weightlifters. The hip pinch that is being felt is known as Femoral Acetabular Impingement (FAI) and can occur due to a variety of restrictions when squatting. [Read more…]
The importance of correct squat biomechanics
Squats, squats and more squats. Squats are great but are you performing the correct squat biomechanics? You might think, “oh a squat is a squat”, however, to perform squats to your fullest potential and avoid injury the correct biomechanics need to be used.
Everyone squats differently and there isn’t a ‘one squat fits all’ otherwise that would be easy peasy. There are narrow squatters and wide squatters, which one are you? If you don’t know this it can easily be assessed and will allow you to perform a squat injury free and to your fullest potential. Once you have established this there is a set of guidelines we should follow to allow us to perform a squat without the risk of injury.
Correct squat biomechanics
Squats like any exercise you participate has its injury risks, therefore, it is important we perform the correct squat biomechanics (Chandler et al). Not only will performing the correct squat biomechanics keep you injury free it will also allow you to perform a GREAT squat, hit the musculature we want and avoid overloading of particular structures susceptible to injury.
Things we need to be aware of when squatting to keep away from common faults…
1) Make sure lumbar extension is not lost when squatting as this can increase the chances of back injury (not rounding at the bottom of the squat also known as butt winking).
2) Make sure your knees DON’T track inside of your feet (valgus knees).
3) Make sure you reach at least parallel in a squat (providing you have the mobility to do so).
4) Make sure full hip extension is performed at the top of the squat. Hip extension is one of the most important movements in a squat, with glute activation being 80-120% of muscle voluntary contraction (MVC) in the concentric phase of the exercise (rising up), compared to 20-30% MVC in the eccentric phase (lowering).
5) Heels need to be kept on the ground at all times.
6) Stability and mobility of the joint is very important when performing a squat. These need to be balanced to allow the joint to move through full available range of motion and for the surrounding muscles to stabilise this movement, to avoid any injury (Contereas 2013, Glassman 2002, Cressay 2014 and DeBell 2014).
Are you performing these movements when squatting?
Or are you turning these into common faults? Every time you perform a squat and perform one of this common faults incorrect squat biomechanics is increasing your risk of injury.
Already previously mentioned, everyone squats differently due to our anatomical make up. Our bony anatomy will dictate whether we are a narrow squatter or a wide squatter, the rest of our squat is determined by our stability and mobility (DeBell 2014). Due to this we need to ensure our stability and mobility when performing the squat is on top form to avoid any chances of injury. Just because you’re squatting with a narrow stance doesn’t mean you’re squatting wrong. You maybe squatting incorrectly if you’re not following some of the guidelines previously mentioned.
A common fault is the butt wink. Ever being told you are butt winking and not known what this is? This is basically when you lose your neutral lumbar spine. This is very common in squatters, increasing your chance of lower back injury due to compressive and shearing forces on the spine (Contreras 2013 and Chandler et al). This is where your pelvis posteriorly tilts causing your spine to be forced into lumbar flexion. This movement occurs when hip range is at the athlete’s limits, putting athletes at risk of disc herniation and damaging of spinal ligaments.
Another common fault is forgetting about your knees. Do you squat and feel your knees tracking inwards? This usually occurs in athletes to stabilise themselves to allow participants with weak gluts to perform a squat. This however, will be increasing the risks of injury such as chronic knee syndromes etc. patellofemoral pain syndrome and knee osteoarthritis (Contreras 2013).
Why might your squat mechanics be dysfunctional?
When we are thinking about squatting you automatically think your hip. There are many considerations we need to think about when it comes to squatting such as the spine, knees and ankles (DeBell 2014).
Hip strength is incredibly important for the squat. Knee pain when squatting? This is likely due to poor hip strength of the gluteal muscles such as gluteus medius which can be overpowered by the hip adductors causing valgus knees to stabilise the femur in squatting (where you knees track inwards) (Contereas 2013).
Weak hips can also lead to poor muscle engagement of the surrounding muscles of the hips such as the hamstrings and gluts, which could lead to squatting with the overuse of the quadriceps (Glassman 2002). It is important to have coordination between the glutes, hamstrings and the quadriceps to allow a squat to be performed pain free (Conteras 2013). Weakness in one can inhibit the powerful hip extension that is needed to allow you to fully perform a squat (Glassman 2002).
Impaired function of the hamstrings and vastus medialis function such as decreased strength will cause valgus knees due to decreased stabilisation of knee increasing overloading of the knee joint. Decreased flexibility of the hamstrings will force you into lumbar flexion to allow you to perform a squat which leads to extra loading on your back putting you at higher risk of lower back injuries (Glassman 2002).
If you’re wanting to squat deeper, athletes need to be aware the deeper the squat the higher lumbopelvic stabilisation requirements of the erector spinae and rectus femoris which is shown in a study by Grosuch et al (2013). Poor strength, poor stabilisation= increased risk of injury. Poor control will cause compensations to other areas and can potentially affect the entire lower limb kinematics (Powers 2014).
Lacking ankle range of motion (ROM)?
A lot of people struggle with ankle dorsiflexion (pointing toes towards the ceiling). This ankle movement is important in the squat. If your ankle range is reduced this will prevent your knees from tracking over your feet, therefore, compensations will occur in other areas. For example your feet will pronate (rotate inwards) to allow knee movement. This will then cause hip internal rotation and hip adduction causing valgus collapse of your knees (Contereas 2013).
This is very common as there are many factors which could be restricting you ankle ROM such as tight lower leg musculature for example your gastrocnemius, soleus, anterior tibialis.
Ankle ROM can cause many dysfunctions in the squat, not just knee valgus movement but your weight will be shifted backwards causing compensations such as leaning forwards so you don’t fall backwards (Cecil 2014).
Ways to assess squat technique
Very few people will be at the end of their full hip ROM, therefore, getting your squat assessed will allow a Sports Therapist to give you an individualised strengthening and mobility programme to enable you to perform a squat to your fullest, and prevent you from injury (DeBell 2014).
You don’t have to be injured to see a Sports Therapist; they are there to also prevent injuries from occurring. We will decrease the chance of this by assessing how you squat either by appointment or at a squat clinic. Injury prevention and corrective exercises are important for everyone.
There are many ways to assess squat technique such as movement patterns, mobility and stability. Conteras (2013) first looks at movements of the hip such as hip flexion (bringing knee to our chest) to first establish whether our hips prefer being in a narrow squat or a wide squat angle. When squat technique is assessed the following is looked at.
- Keeping a straight back (don’t let the lower back curve into lumbar flexion at the bottom of the squat)
- Knees tracking over toes
- Heels remain on the ground
- No loss of balance when performing the squat
- Control throughout the eccentric (lowering) and concentric (rising) phase of the squat
- Keeping neutral head position
We want to stress the importance of correct squat biomechanics. Remember you don’t have to be injured to be assessed.
Thank you for reading, happy squatting and lets stay injury free! Any questions don’t hesitate to get in contact.
BSc Sports Therapy MSST
DeBell, R. (2014). The best kept secret: why people have to squat differently. Available: http://themovementfix.com/the-best-kept-secret-why-people-have-to-squat-differently/. Last accessed 7/4/15.
Chandler, J; McMillan, J; Kibler, B; Richards, D. Safety of the squat exercise. Available: https://www.acsm.org/docs/current-comments/safetysquat.pdf. Last accessed 15/4/15.
Contreras, B. (2013). Squat biomechanics: Butt wink- what is it, what causes it, and how can it be improved. Available: http://bretcontreras.com/squat-biomechanics-butt-wink-what-is-it-what-causes-it-how-can-it-be-improved/. Last accessed 8/4/15.
Contreras, B. (2013). 7 dilemmas solved. Available: https://www.t-nation.com/training/7-squat-dilemmas-solved. Last accessed 8/4/15.
Contreras, B. (2013). Knee Valgus (Valgus collapse), gluteus medius strengthening, band hip abduction exercises and ankle dorsiflexion drills. Available: http://bretcontreras.com/knee-valgus-valgus-collapse-glute-medius-strengthening-band-hip-abduction-exercises-and-ankle-dorsiflexion-drills/. Last accessed 8/4/15.
Cecil, A.M. (2014). Squat fix: falling backwards. The Crossfit Journal.
Cressey, E. (2014). Squats vs. Hip thrusts; which is better? Available: http://www.ericcressey.com/squats-vs-hip-thrusts-which-is-better. Last accessed 8/4/15.
Glassman, G. (2002). Squat Clinic. Crossfit Journal.
Gorsuch, J; Long, J; Miller, K; Primeau, K; Rutledge, S; Sossong, A; Durocher, J. (2013). The Effect of Squat Depth on Multiarticular Muscle Activation in Collegiate Cross-Country Runners. The Journal of Strength and Conditioning Research. 27 (9), pp.2619-2625
Powers, C.M. (2014). The influence of abnormal hip mechanics on knee injury. A Biomechanical Perspective Journal of Orthopedics.
What is massage therapy?
Massage therapy has been around for a long long time. What makes this treatment stick around? Perhaps it is because we know anecdotally the positive effects of this treatment. We use massage therapy for a number of purposes. Recovery, flexibility/mobility and injury treatment/prevention to name a few. What does massage actually do and how?
What are the precise effects of massage therapy?
We are not 100% sure. What we think may happen is listed below. However – does this apply to me?
Ankle mobility is my number one for limiting the position of the squat. In my personal anecdotal experience, I find variances in the squat pattern are due to either having short calf musculature (deep posterior tibial tissue) or stiffness through dorsiflexion (think foot coming towards your face). Whilst other factors such as hip mobility or poor motor control can contribute to this, ankle range of motion is one of the first things I assess in my sports injury clinic.
What are the top 3 things we can do to improve this?