Squatting Pain Free

Cooking the Squat

Do your knees cave in during a squat?  Do your feet turn out? Does your low back round?  Are you shifting your weight to one side?

 

These faults may or may not be the cause of your pain, but it is important to identify them because these are factors that may be linked to mobility issues or dysfunctional patterns.  These faults occur all of the time, but most of the time they are subtle.  You will not squat the exact same way every time due to dynamic movement variability.  There will be instances where you slip and over-exaggerate a hip shift, or a knee valgus.  If you want to squat pain free and perform at your best, you have to identify where these issues lie and implement strategies to fix them.

Getting Technical

 

You can get very technical with squat form.  Everyone squats differently due to anatomical differences, such as torso length, leg length, and hip structure.  Just because one person finds their most comfortable pain free squat doesn’t mean you should perform it the same way.  There are many different types of squats: high bar, low bar, front squat, goblet squat and many more. There are also many differences in form, bar path, and positioning in every variation.  The point of this post is to break down the complexity, to identify what is required from your body to allow you to squat pain free.  It really boils down to this. Do you have the capacity to carry load in a squat? If the load is greater than the capacity of your muscles, joints, and tendons to handle that load, then things will breakdown and pain will ensue. Does your body feel safe and protected when there is a slip up, the one time you over exaggerate a fault?  If your body thinks that moving a certain way will do you more harm than good, then it will not grant you the strength to perform that movement and this puts you as risk for injury. You have to ask yourself, can you place that amount of weight on your back, sit down, and lift it back up, over and over again without things breaking down? If you don’t then maybe you should try implementing some kind of programming into your routine in order to have progressive adaptation and build capacity. I will show you some things to work on such as mobility, and tricks to help correct faults in the squat.

The #1 Problem

We can talk form all day, but form is just a factor.  Even if you have perfect form you can still have pain. The problem is that we like to load dysfunctional patterns and joints that lack pre-requisites for an optimal squat.  Do you expect to sit all day at your desk job or stay in a static position all day, and expect to perform an awesome flawless squat with no pain!?  No way! This is where you can make the biggest impact.  Do you move and explore your ranges of motion throughout the day.  Can you sit in a squat without warming up?  It is a problem if you can’t get into a squat without foam rolling.  One strategy is that you could sit in a squat more often to simply get more used to sitting in a squat position.  Spend at-least 10 minutes in a squat everyday.  Or you can work on moving more. Do not allow mobility restrictions to hold you back.  Create a movement enhanced work environment, get out of static positions, add mobility drills into your routine, etc.

Hip Mobility

It is common for the feet to drift out during a squat.  The reason the feet turn out is due to the a lack of hip rotation. Even the feeling of the feet wanting to turn away is a good indication of lacking hip mobility. The hip needs to internally rotate in order to allow you to flex at the hip comfortably without the angle of the hip closing down.  This will cause pain deep within the hip capsule. Another compensation that can occur is the low back extending (arching). This anterior pelvic tilt will decrease the angle of the hip and give it less room to move within the socket.  By closing down the angle of the hip even further, it can cause you to turn the feet out even further to compensate.  Check to see if you have adequate hip internal rotation. If there is a pinching sensation deep within the hip, it may be due to some sort of Hip Impingement, and should be assessed by a medical professional. Here is a quick assessment and drill to work on to help correct this:

 

Here are a few more tips for hip related issues in the squat:

This is called RNF (reactive neuromuscular facilitation). This is utilized to improve functional stability and motor control by feeding the movement dysfunction of the hip shift. So, in this video I had a right hip shift, and the band is feeding the dysfunction to the right side. Therefore I can react and resist the poor movement pattern.

Hip Hinge: With a conventional deadlift, the majority of the motion occurs at the hips rather than at the knees like in a squat. This just gives you a clear indication of how you are shifting your weight. A similar hip hinge pattern should occur during a low bar back squat for example.

Knee Stability

The knee is a stabile joint between two mobile joints (ankle and hip). Most of what the knee does is dependent on healthy functioning ankles and hip joints. In regards to motion at the knee, it is okay for the knees go past the toes, with forward or anterior translation.  It can be necessary for different types of squats.  When we look at the knee tracking side to side, it is optimal for the knee to track in line with the second toe, although it is perfectly okay to drift more outwards.   If the knee collapses in (vagus) it may place excessive torsion on tibial rotation, ultimately stressing the knee and causing pain.  Referring back to the hips, tracking of the knees are dependent on the strength and control of the hips.  If the glute muscles are not driving the knees out to a point over the toes, the knee will collapse inward.  Try this band drill for Reactive Neuromuscular Facilitation to work on strength and control of the knee:

Foot & Ankle

It is most optimal to maintain a stable tripod with your feet, meaning there are all three points of contact gripping the ground.  Some people tend to excessively arch the foot with the “knees out” cue, causing excessive tibial external rotation and placing stress on the knee. This cue may cause too many people to lean to the outside of their sole, which takes away from the tripod.  Footwear: I do not recommend squatting in heavily cushioned shoes. Would you squat heavy on a balance beam?  Squatting requires foot stability and ankle mobility.  It can be a major detriment to be in a shoe that is throwing off your balance. Any cushion in the shoe will take away from balance and proprioception.  Just imagine trying to squat on a pillow.  I like any flat minimal shoe such as Vivobarefoot or Lems, and any Olympic Weightlifting shoe such as Adidas Adipowers or Nike Romeleo, especially if someone lacks ankle dorsi flexion.  Check your ankle mobility by finding a wall and placing the foot about knuckle width from the wall.  Test to see if you can reach the knee to the wall.  If not, its likely that you are lacking ankle mobility.  If you lack ankle mobility I recommend placing the feet outward, about 30 degrees.  Watch this video for ankle assessment and flossing drill:

Pain

If you are dealing with pain, you may need to modify, change the type of squat, or reduce load and other parameters.  If you are looking for the best place to start squatting pain free, I typically recommend the Goblet Squat, Spanish Squat, or going back to the basics.  These squat alterations can help you get back to squatting pain free because they provide a counter balance.  It especially makes it less stressful on the knees. If you are seeking better control and better performance I recommend sitting in a paused squat or performing isometrics to enhance control at different positions. If you need to dial down the pain or go back to the basics check out my beginner squatting video:

Pre-Requisites

One of the major things that I look at as an FRC Mobility Specialist are Pre-requisites. Meaning, do you have the necessary joint hardware properly functioning for you to perform optimal squats.  Your feet are turning out because you lack hip internal rotation.  Your knees cave in because you lack ankle dorsiflexion.  Your low back rounds because you lack hip extension.  You are shifting your weight to one side because your body is actively compensating for these limitations.  These are common faults and some of the many reasons why this occurs.  Ultimately, it is essential to get an assessment to best determine where these faults stem from and how you can progress back to squatting pain free.

Thanks for reading!

Meet Patrick Klaus, DC

Instagram & Facebook: @chirobro