 Do you have trouble bending down to pick up your kids or grandkids? Maybe sitting down or getting up is a problem? Perhaps you’ve been dying to use your new squatty potty and just can’t make it down there? Or maybe you look jealously at others with their non-squatting-impaired-carefree-lifestyles and wish you could be like them? Well then, this is the post for you! Maybe you don’t care about this at all. Well, you should! Here’s why: Squatting is a basic functional demand on our bodies. When we aren’t meeting the functional demands of our bodies, we end up compensating elsewhere, which usually leads to injury, because some tissues were not meant to take all the demand themselves. The ability to do it well can help avoid common injuries, like patellofemoral (kneecap) overload.
The Causes Weakness Many functional movements require what’s known as a co-contraction. Basically, this means 2 opposing muscles have to work together to create the desired movement. In the case of a squat, muscles work together to lower you slowly toward the floor or a chair. The major players here are the quads slowing your knee flexion so you don’t fall backward, and the glutes and hamstring slowing your hip and trunk flexion so you bend down with control. People with weakness in these muscles tend to sit rather hard, or “plop” down into their chair, because they can’t effectively control this movement. They also might find their knees tracking out over their toes to change their center of gravity a bit so they don’t plop down. This example of poor form can lead to injury and is often the cause of creaky knees. Weakness in these muscles affects more than just squatting to sit. You need quads, glutes and hams to be strong in order to support normal walking and help you maintain balance. Weak muscles also fatigue more quickly, increasing your risk for poor control, falls, and other potentially injurious events. Furthermore, strength deficits translate to power deficits. What’s the difference?
If I lack power, I will take short, stumbling, steps as I try to catch myself. This narrows my base of support, which makes it harder to balance and recover, creating the potential for falls. Another common area of weakness in those struggling with squatting involves the hip external rotators. If these are weak, one of the consequences is the knees may buckle inward into an abnormal “valgus” or knock-kneed position. When this occurs we overload the lateral, or outside, compartment of the knee. Being knock-kneed also stresses the MCL, the big stabilizing ligament on the inside portion of the knee. Flexibility During a squat, there are a couple muscle groups undergoing a stretch—most commonly problematic, the hamstrings and calves. Tightness in these muscle groups can alter your squat form, not allowing your knees, hips, or ankles to bend as they should. Quad tightness can also contribute to this, as counterintuitive as it may seem. The quads are undergoing what’s called an eccentric contraction, meaning they are contracting while also lengthening. Tight muscles can affect your functional squat and result in more bending at the low back in order to reach the floor to pick something up. This can result in low back pain or injury.
Soft Tissue Damage If there has been any damage to soft tissue, scar tissue will often form. If this is in the lower limb/back, this may affect your squat by compromising your form and forcing you to compensate in other areas. This can be especially limiting if the scar tissue has not healed properly. Instead of the normal, linear tissue which responds well to stress in certain directions, scarring often forms irregularly. If the proper stresses aren’t put on scar tissue during the healing process, it can attach to other tissues, compromising function and eliciting a pain response when that tissue is moved.  Luckily, there’s something we can do about that! Some physical therapists perform IASTM (instrument assisted soft tissue mobilization), which utilizes specially formed tools to apply pressure to target the tissue with successively refined strokes. IASTM breaks up some of the connections the scar has formed to the underlying tissue, restarting the healing process, allowing the tissue to heal in the right direction. This procedure is followed up with an exercise prescription which helps put the right stresses on the tissue in order for it to heal properly. There are other ways to help fix your squat as well. The best way to start is with a functional screen, done by your physical therapist. He or she will watch you squat, in order to identify what might be holding you up. Once this is done, he or she may prescribe a variety of treatments to help, including strengthening, stretching, and hands on techniques. The Solutions
For muscle flexibility, active movement is usually best pre-exercise. In order to get your muscles warm and your joints moving, it’s a good idea to start on a stationary bike, a short walk or a light jog. Post exercise a cool down and stretching will be the bulk of the program. Stretching should include both sides of the leg (glutes, hamstrings, quads, and calves). This will likely include static stretching, holding a specific stretch for 30-60 seconds without moving. Foam rolling is another stretching technique where you roll the muscle along a stiff foam cylinder. You stretch as you roll back and forth over the muscle using your body weight to control the amount of pressure. Your physical therapist may prescribe a combination of these things. It is important to remember that consistency is key with any exercise program. Results will not be immediate; however, with diligent work, success can be achieved. Be sure to consult your physical therapist or physician before beginning any exercise program.
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AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
January 2024
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