Barbell Back Squats Are an Awesome Exercise!

Squats kick some serious tail. They really do! They are one of my go-to exercises for nearly everyone. I even prescribe squats for patients who are dealing solely with upper extremity issues because squatting is such an awesome exercise. Squats are tough but rewarding, a great measure of one’s strength, extremely functional and transferable to daily activities, and there are a million different variations! No matter your injury, there is a squat technique out there that will work for you. Before I go any further, I should preface this post by saying that when I’m talking about squats, I’m talking about legitimate squats where your thigh reaches parallel to the floor or even below parallel, and NOT that half-assed squat that we’ve all seen where someone loads 4 plates on each side of a barbell, squats down 3-inches, and then drives back up while making these insane and completely unnecessary grunting noises.

Sadly, too many Physical Therapists don’t know how to Coach the Squat

Now that we’ve established how awesome squats are, I have to say that I’m still extremely disappointed by our profession of physical therapy as a whole with respect to squats. In particular, the number of physical therapists out there who have no idea how to coach a squat is staggering. Even worse is that there are still physical therapists and healthcare providers out there who are telling their patients that in order to squat safely, “don’t let your knees go past your toes!” Well, I’m here to tell you today that the idea of keeping your knees behind your toes while you squat is complete garbage! In the absence of significant lower extremity pathology, mobility limitations, and flexibility limitations, squatting to parallel depth while allowing the knees to go past the toes is safe and effective. I repeat, in the absence of significant lower extremity pathology, mobility limitations, and flexibility limitations, squatting to parallel depth while allowing the knees to go past the toes IS safe and effective.

Knowing how to Squat Properly will Help Distribute Forces Optimally Across the Hip and Knee Joints

Let’s talk about why the knees SHOULD go past the toes in the squat. This conversation will assume that one has sufficient ankle flexibility to allow for full surface area contact between their feet and the floor while they squat. If they don’t, then ankle flexibility needs to be addressed and that is the subject of a different blog post!

A 2003 study looked at 7 recreationally weight-trained men who performed barbell back squats with a barbell weight that was equivalent to their bodyweight (i.e. a 185 lb. male would perform barbell back squats in this study with a barbell load of 185 lbs.) in 2 scenarios. In the first scenario, these men performed their barbell squats in an “unrestricted” scenario where their knees were allowed to go in-front of and beyond their toes. In the second “restricted” scenario, these men performed their barbell squats in the presence of a wooden barrier extending up from the floor at the edge of their toes (see images above). This wooden barrier prevented the athlete’s knees from moving past the toes. In both scenarios, the athletes squatted to a parallel depth (hip crease at the same level as the top of the knee.)

Allowing the Knees to go Past the Toes while  Squatting Better Distributes Forces Across the Lower Extremities

Here’s what the study found…in the “restricted” scenario, when athletes could not allow the knees to travel past the toes during a barbell squat to parallel, forces at the hip were increased 1073% compared to the “unrestricted” scenario. Put another way, forces at the hip were 10.73x higher in the “restricted” scenario compared to the “unrestricted” scenario. Yes, these numbers were absolutely statistically significant in the study. The reason that hip forces are so much higher in the “restricted” group has to do with excessive forward inclination of the torso in the “restricted” condition. Naturally, in order to squat to a parallel depth, our thigh has to achieve a parallel position somehow, and when our knees aren’t allowed to move forward over the toes, the trunk is going to excessively incline or lean forward and take on that excess force to allow the thigh to attain parallel to achieve sufficient depth.

So now, you may be asking yourself: “But what about the knee? Were forces on the knee 10x higher in the “unrestricted” scenario compared to the “restricted” scenario?” That’s a great question. And the answer, according to this study, is a resounding NO. This study found that forces on the knee in the “unrestricted” scenario were only 28% higher compared to the “restricted” scenario. Although this difference was also statistically significant, an increase in forces of 28% at the knee compared to an increase in forces of 1073% at the hip based on the scenario of the squat is a BIG difference. Looking purely at the numbers, it’s clear that the small increase in forces at the knee (28%) in an “unrestricted” squat scenario is the far superior and preferred choice to the massive increase in forces at the hip (1073%) in a “restricted” squat scenario. Therefore, when presented with the opportunity to squat while either allowing the knees to go past the toes or not, this study would certainly suggest that allowing the knees to go past the toes is the better option in terms of distributing forces more favorably across the lower extremity.

Therefore, it bears repeating once again: in the absence of significant lower extremity pathology, mobility limitations, and flexibility limitations, squatting to parallel depth while allowing the knees to go past the toes IS safe and effective.

If you are looking for someone who can provide quality coaching for you to help improve your squat, reach out to me! Similarly, if you are looking to simply get stronger and improve your fitness to increase your quality of life, or to protect against injury during an upcoming season, let’s connect and get you squatting!!

-The Next Level Physio

Reference: 

Fry, Andrew C et al. “Effect of knee position on hip and knee torques during the barbell squat.” Journal of strength and conditioning research vol. 17,4 (2003): 629-33. doi:10.1519/1533-4287(2003)017<0629:eokpoh>2.0.co;2