21 Apr The Deep Squat. Is It Safe? The Surprising Answer to a Controversial Exercise Question.

SquatsAre deep squats safe?

This is an extremely common and controversial question I will share some new perspectives on.

I’ll answer this question, knowing what I do about anatomy and biomechanics with my background as an orthopedic physical therapist and long time weight lifter (~30 years experience).

Let’s get started with this hot topic.

First, there was a brand new article about this subject in the latest issue of The Strength and Conditioning Journal (April 2012, Volume 34, No. 2, p.34-36, edited by L. Brown) which peaked my interest in this topic.

Very interesting article giving a ‘pro’ and ‘con’ viewpoint, possibly further confusing things.

The ‘pro’ viewpoint provided some solid rationale on why doing deep knee squats are safe and effective.  Let me define deep knee squats as squating past parallel and peforming a full range of motion to “rock bottom.”

The question is, is this safe to do?

According to the literature, there was some initial concerns with the potential risk for injury doing full squats.  According to some of the earlier studies, there was a concern that full squats could confribute to the increased knee joint structure laxity.

Specifically, the collateral ligaments and the ACL (anteriror cruciate ligament).

More recent studies have failed to show an association between deep knee squats and increased risk for injury in healthy subjects.  And, other data suggested that there was no compromise in knee joint stabilty in subjects that performed the full squat compared to the half squat.

One study even found that subjects that performed full squats had tighter joint capsules, which means there was no laxity in the knee joint by doing full squats.  Interesting, huh?

The ACL (a major knee joint stabilizing ligament) is actually most stressed at 15 to 30 degrees of knee flexion (meaning the knee is more straight than it is bent).  So, with full knee squats, the stress on this important ligament is actually diminished.

What about the increased stress on the internal knee joint structures (the menisci and articular cartilage within the knee joint)?  This appears to be a legitimate concern with deep squats due to the anatomy and biomechanics of this movement.

Again, the data shows us that peak tibiofemoral and patellofemoral (knee joint articulations) are increased with deep knee squats.  However, the clear relationship of the increased contact force and the incidence of injury has not been established.

The key point here is that in a “healthy knee” there does not appear to be an increased risk of injury, even though the knee joint force is increased in the deep knee squat.

I would agree that there are clear benefits to performing deep squats.

Benefits include:

  • potential greater muscle activation of the quads,
  • improved functional capacity,
  • enhanced performance,
  • preservation of optiamal knee joint mobility and health.

There was a couterpoint on the ‘con’ side of deep squats.  Let me provide some perspective on that.

One study suggested that there was, in fact, an increased incidence of osteoarthritis (chronic degeneration of the joint surface) with performing deep knee squats in healthy subjects.

Whoa!  I thought I just said it was safe and there was not an increased risk for injury? What’s going on here?

Welcome to the world of research studies.  Sometimes one trial might find one thing and another trial might find the complete opposite.  That’s when you have to look at the finer details in the study and really consider the study parameters, trial design, and flaws.  Not every study is perfect and addresses all the things it should.  Keep that in mind.

Do the risks outweigh the benefits?

I believe the risks are minimal and the benefits are significant in subjects with healthy knees.

I provided the list of benefits above.

The real answer to the question is, how does the movement feel to you?

I am a huge advocate of listening to what your body tells you.

If you can perform full knee squats pain free, then this is probably good for you to do.  If you have pain, then it’s not.

Now, if you simply cannot do a full knee squat because of something other than pain, then there is some type of dysfunction going on (joint restriction, muscle imbalance, or potential motor control issue).

This is my point.  Many people cannot perform a full deep squat (and I’m talking about a squat pattern that is un-weighted).

Unfortunately, people lose this movement pattern that we were all born with.  We lose it due to inactivity and immobility.

We should all be able to perform a deep knee squat and I would point out that this is a very functional activity.

Let me give you an example.

I have 2 small children.  I constantly squat down to pick them up, to speak to them, to play with them, etc.  You can’t convince me that this isn’t a functional movement pattern and we don’t need to do full squats.

Ok, maybe you don’t have kids or they are grown up.  Now tell me that there aren’t activities, tasks, or projects that you do sometimes that require you to do a full, rock bottom squat.  I know I do.

Deep squats are a very important functional movement pattern, no question about it.  And, if you don’t do it, it’s probably because you can’t.

Getting back to answering the question, it appears that the majority of data suggests that deep knee squats are safe and do not compromise knee joint integrity.

And, because we lose our joint mobility as we age, this alone is a solid reason to perform some type of deep squat (such as the kettlebell goblet squat), providing we can do this without pain.

In summary, are deep squats safe?

My answer is yes, they are.  But, let pain be an indicator that something is wrong, if there is pain associated with this movement.

Comments, questions, shares, and retweets are always appreciated.

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