3 Ways to Improve Squat Form | Chesterfield Chiropractor

The need to improve squat form is a necessity as a sports chiropractor and strength and conditioning specialist.  It needs to be addressed whether you compete in cross fit or you find yourself squatting down consistently throughout the day for your job.  This article will discuss some common squat mistakes and how to improve them.

Things to Consider When Trying to Improve Squat Form

Do you buy into the myth that there is one, perfect way to squat?  Have you ever wondered why some people can squat easier than others?  One of the biggest mistakes I see in the fitness industry is not understanding that one’s anatomy should dictate their squat form.  And I hate to say it, not everybody is meant to be an effective squatter.  I am one of those unlucky individuals!  I have a short torso with longer femurs which creates a disadvantage in squatting.  It’s physics!  Check out this Article written by Dr. Ryan Debell of the Movement Fix for more information on the effects of anatomy on squatting mechanics.

Tip #1 to Improve Squat Form - Consider Sagittal Alignment

A simple way to consider the sagittal plane is to draw a line straight down the middle of the torso when looking at a squatter from the front.  Ideally, we should be able to squat up and down without deviating away from this line.  This becomes harder to do with the more weight you add.  There are three key areas that I look at when it comes to sagittal plane stability:

The anatomical planes of the body
  • Knee Alignment (bowing in or out)
  • Pelvic/Torso Weight Shifting
  • Foot/Ankle Pronation or Supination

As stated above, these faults may be due to anatomical variances or orthopedic conditions which makes a clinical evaluation even more important!  However, let’s just assume that these things are present due to weakness and/or motor control difficulties (the brain struggles to execute the right movement).  I like to use a technique called Reactive Neuromuscular Training (RNT) to trick the brain into the proper pattern.

Reactive Neuromuscular Training (RNT) to Improve the Squat

RNT is a simple technique.  It involves creating a stimulus that tries to push/pull a body part into the WRONG direction.  This requires a concerted effort to offset the bad position which leads to better firing pattern within the muscles.

Increased knee valgus while squatting
Improving squat form for knee valgus using a band

It is particularly helpful when your knees cave inwards (valgus) during the squat motion.  The goal of the band is to pull the knees inwards which requires more glute activation to maintain a neutral position.  This is a helpful technique any time you struggle to feel glute activity.

Weight shifting during a squat
Improving squat form for weight shifting by using a band

This technique can be applied in the same fashion for a weight shift problem.  Simply wrap a band around the torso and pull into the side of shifting.

Applying RNT to the foot and ankle is a little bit more complicated.  I first teach how to activate the foot.  Check out the video below on how to incorporate tripod stability.

Increased foot supination during a squat.
Improve squat form for increased supination using a band

I will now place a band under the big toe with the other end anchored by a weight.  As soon as my foot supinates (rolls outward), the band will snap away.

It’s all about creativity when using RNT.  There is no right or wrong way, only more effective ways.  Playing around with the approach will uncover better methods as you go along.

Tip #2 to Improve Squat Form – Maintaining a Neutral Spine

Everybody has heard of the “butt wink” when it comes to squatting.  It involves excessive lumbar flexion (rounding of the lower back) during the bottom part of the squat. 

Butt wink during a squat

It is certainly true that we do not want excessive flexion on a weight loaded lumbar spine.  However, I tend to see a problem over-correcting for the butt wink which results in over-extending the spine.

Over extension of the lower back when squatting

Extension/Compression Stabilization Strategy (ECSS)

Rich Ulm, DC, CSCS coins the dysfunction seen above as the Extension/Compression Stabilization Strategy (ECSS).  A perfectly functioning core will involve co-activation of the entire abdominal wall during movement.  We call this Intra-Abdominal Pressure (IAP).  IAP is created by the diaphragm and activates the core in an inside-out fashion.  For the record, the core is more than just the abs!  I had to get that off my chest.

Anti-Extension Exercises

With ECSS, the lower back muscles (erectors) tend to dominate the pattern and can lead to lower back pain, lower back tightness, and sub-optimal lifting patterns.  I like to use an anti-extension approach with exercise to help get the athlete to resist spinal extension during movement.  Below are some examples.  Other common anti-extension exercises are front planks, dead bugs (somewhat in the video above), and bird dogs.  Other ways to prevent lower back injuries can be found HERE.

Tip #3 to Improve Squat Form – Optimizing Torso Angle

I am sure many of you have looked at your peers at the gym and wondered how the hell they can squat “ass to grass” while keeping an upright torso.  There must be a trick!  I hate to break it to you, but these people are usually gifted with great mobility in the hips, knees, and ankles.  And these gifts are often genetic, or at least developed in our baby stages. 

To show different squat forms

The image above shows varying torso angles.  The lady in the front right is able to keep an upright spine at the bottom of the squat while the guy to the left has more of a forward lean.  I want to stress that the one to the left isn't bad. However, it can be optimized, especially if he has issues with pain or tightness.

Ankle Dorsiflexion

In my opinion, the most important factor in a perfect, deep squat is ankle dorsiflexion (bringing ankle/toes upward).  Tight ankles make it difficult to squat down with an upright torso.  Click Here for more about the specifics of dorsiflexion.  Ankle mobility can be improved.  But only to a certain degree.  Below are a few ways to work on ankle mobility.

Squat Modifications

Is there hope for those of us that don’t have freakish mobility or a prior history of injuries to the hips, knees, or ankles which limit our mobility?  My answer is Yes and No.  You can’t always stretch or lacrosse ball yourself to death to improve mobility (I’m looking at you Cross-fitters).  However, you can modify your lifts to make up for certain dysfunctions.  For example, lifting shoes can help neutralize limitations in ankle dorsiflexion.  Don’t have weightlifting shoes?  Just prop up your heels with something like a half-cut foam roller.

squatting with limited ankle dorsiflexion
Improving the squat by elevating the heels

The real reason why there are different squatting exercises (e.g. front squats, back squats, goblet squats) is to target specific muscle groups.  Your torso angle will change based on where you hold the weight.  Front squats will allow for a more upright torso angle and will target the quads more.  Back squats will involve a more forward angle and will bias the posterior chain more.

 I am a firm believer that you should marry the squat exercise for your body type.  Due to the length of my femurs and short torso, back squatting without excessive leaning forward is difficult for me.  I do much better with a goblet variation.  Plus, my knee doesn’t hate me as much.  For those of you that compete in weightlifting competitions, I suggest maximizing your mobility with treatment and optimizing core stability.

Improving Squat Form Conclusions

Evaluating one’s anatomy and mobility is vital to establishing a plan to improve their squat form.  Notice that your knees cave in or your shift to the right when squatting?  Incorporate some RNT to your world to help groove better patterns.  Do you struggle to maintain a neutral spine?  Work on diaphragm breathing and IAP for better core activation.  Is there difficulty with excessive forward leaning during the squat?  Look to optimize mobility in certain areas via treatment and exercises.  Or, better yet, modify your squat routine all together.

How Can Your Chesterfield Chiropractor Help?

Let’s say you don’t know where to start.  Let me help you out.  Your initial evaluation will be heavily detailed in screening out orthopedic pathology while also categorizing you into certain groups from a mobility perspective.  A functional movement assessment will be used to look at your global movement patterns such as the squat.  We look to develop a personalized treatment plan to not only eliminate pain, but also optimize function.  Oh, we also do FREE CONSULTS!  Help us help you by giving us a call today! (636) 728-8607.

Preventing Low Back Pain

How To Prevent Low Back Pain (4 Things To Consider)

Prevent Low Back Pain by Looking/Treating Elsewhere

Low back pain is one of the most costly health care conditions in the world.  It is my opinion that we, providers, have managed it poorly over the years.  We are in the middle of an opioid crisis and low back issues are one of the many reasons people seek relief.  There is no excuse for prescribing addictive medications for pain that can be helped and eliminated with conservative measures.  However, I believe even the conservative methods are less than optimal because not enough of us try to prevent low back pain.  Simply adjusting someones low back is not going to get the job done.  We need to evaluate the system as a whole. Click Here to read about the Functional Triage approach to evaluating pain and dysfunction.  In this blog post, I will outline 4 key things to consider when trying to prevent low back pain.

Joint by Joint Approach

The body alternates from mobile segments and stable segments

Low Back Pain and Core Function

Have you been banging out 500 sit ups a day for the past 25 years?  Can you do leg raises with 30-pound ankle weights plus a medicine ball in between your legs because of your super shredded “lower abs”?

What if I told you that a six pack does not equate to a strong core

It is super common for me to find that my patients with chronic lower back discomfort tend to over work their ANTERIOR core.  Needlessly crunching yourself into oblivion to sculpt that perfect 6 pack is counterproductive.  Here’s the thing, your core is actually a 3-dimensional container instead of a flat sheet of abs so the way we train it must be varied.

He Is The One (that is the most important core muscle)

The most crucial muscle for the core also happens to be the most crucial muscle with respiration, and we never use it!  I am speaking of the diaphragm of course.  Proper core stability should begin with an inhale to create intra-abdominal pressure.  In addition, the act of breathing should continue throughout the whole movement/exercise.  This may be a shocker to some since they can barely think let alone breathe during a rep in the gym.

Using the diaphragm to create intra abdominal pressure
Prague School of Rehabilitation
Stabilizing the core from the inside-out
Core Stability from the Inside-Out

You've Been Doing It All Wrong

An ideal scenario involves eccentrically activating ALL the quadrants of the core simultaneously rather than concentrically bracing the abs.  In other words, when you inhale with a tad bit of abdominal stiffness, the air/pressure in turn forces the abdominal wall to contract.  Think of it as “inside-out” core stability.  Many people find this concept abnormal.  Hell, the act of correctly breathing with their diaphragm feels abnormal.  However, we all learned it this way many, many years ago.  In fact, we can trace most of what we do movement wise back to when we were babies.  Creating proper intra-abdominal pressure is the foundation of Dynamic Neuromuscular Stabilization (DNS) and is absolutely crucial when trying to prevent low back pain.  Once the foundation is set, proper movement can be “re-trained” by revisiting the primitive positions that we spent our time in as cute little babies.  In this fashion, we are training the core to do what it is supposed to do, which is transfer load/power/force through the body.

Effective Core Exercises to Prevent Low Back Pain

Low Back Pain and Thoracic Spine Stiffness

The thoracic spine, I feel, is supremely underrated when it comes to many conditions and ailments and is usually needing some TLC when trying to prevent low back pain.  Even with a bulky rib cage attached to it, the thoracic spine should be fairly mobile especially compared to the lumbar spine.  With saying that, I need to point out that the lumbar spine is capable of plenty of movement.  However, its relationship to the core is that it helps create “Good Stiffness” in the mid-section with most physical activities.  Or in other words, we want the thoracic spine to move more during movement and the lumbar spine to move less.  Take the golf swing for example.  If you tend to wield your driver like Thor’s hammer, and in doing so, tend to “reverse spine angle” then you are at a much higher risk for low back pain.  On the flip side, if you rotate more through your hips/pelvis and T-spine you will allow the lumbar spine to do its job which is help the core transfer energy.

Thoracic Spine and Rib Cage

Thoracic spine and rib cage
Bulky but Pliable

Muscles of Rib Cage and Their Role in Respiration

Muscles of respiration and their role
Different muscles. Different roles.

Simply telling somebody to move more in the T-spine rather than the L-spine is easier said than done.  It just so happens that our society influences poor thoracic mobility due to the positions we are in most of the day.  When working with patients that need more thoracic spine mobility (most of them), we are using a combination of treatment to physically loosen up the joints and muscles and rehab/corrective exercise to teach the patient how to utilize this newfound motion.

T-Spine Mobility Drills

Try these exercises out to help mobilize the T-spine.

Low Back Pain and Hip Function

The hips, in my opinion, must be evaluated when attempting to prevent low back pain, even if there is no hip pain.  Unlike the thoracic spine where the issue is usually hypomobility, the hips can have a multitude of dysfunctions.  To make matters more complex, both hips in one individual may have different issues!  In a perfect world, the hips move freely throughout their range of motion with proper muscle activity.  Sadly, the world is not perfect.

 

Anterior Hip/Thigh Muscles

Muscles of the front of the hip
A lot going on in there

Posterior Hip/Thigh Muscles

Muscles of the back of the hip
More than just the glutes

Many Ways for the Hips to Fail

Let’s outline a few scenarios:

  1. Desk worker has “tight” hip flexors and “weak” glutes due to sitting all day. I put tight and weak in quotes for a reason (more on that in a sec)
  2. Dancer has trouble stabilizing on one leg and when doing so, you witness their knee collapse and their pelvis hike.
  3. Cross fitter gets a pinching type pain at the deep aspect of their squat.
  4. Soccer mom is super strong with glute bridging and other hip corrective exercises but they don’t seem to know how to utilize that strength with actual human movement.

The Big Picture

I just listed 4 scenarios for hip dysfunction and all of them are different but similar in that the hips are dysfunctional.  In addition, all four of them may also have low back pain.  It’s simply not enough to say, “oh your glutes are weak” or “my hip flexors are tight”.  The single most important thing that I can do for a patient is get them to FEEL proper hip function during actual activities.  In order to do that, there needs to be some critical thinking and evaluation involved.  I need to know the reason WHY you have reduced internal rotation (IR).  Reduced hip IR due to posterior hip tightness is in a different universe than reduced motion due to some type of impingement.  One can be taken care of with self-stretching and exercise while the other needs to be managed clinically.

Hip Mobility Routines

So what does this have to do with how to prevent pain in the low back?  Well, like the thoracic spine, if the hips are not doing their job the low back will do its best to pick up the slack.  Below are two hip circuits with different objectives.  One is to activate the hips (glute medius).  The other is to stretch and mobilize the hips.  I recommend those with pain in the low back to try these exercises.  Some people need strength AND mobility.  Others just need to loosen up!

Low Back Pain and Daily Activities

Factoring in one's daily activities is a must no matter what the condition is.  Knowing what you do on a daily basis should be the foundation for any treatment and rehab plan.  This concept ties everything mentioned above together.  Lets list two scenarios for low back pain:

  1. Desk worker that sits all day and has a chronic, achy, tight low back
  2. Carpenter that is up and down all day has frequent episodes of low back pain a year

Different Problems. Different Solutions.

Both individuals have totally different job requirements and different pain mechanisms.  They probably each have different goals for themselves as well.  Both patients get a thorough work up.  I might find that patient #1 has a stiff thoracic spine and shortened hip flexors.  My goal with treatment and rehab would be to "reverse his posture".  I would treat his back and hips but also build a daily regimen for him to work on while at work.  As long as I can get him moving in the right direction, things will go well.

Low back pain with activity

Patient #2 may be a different story.  It's the same song and dance with these guys.  They "throw" their back out 4 times a year leaving them handicapped for several weeks.  However, when I question them about it they call it "normal" and don't see any issues with that mindset.  I will have to dig a little deeper and figure out what is causing their back to flare up.  It may be a lack of hip hinging when bending down.  It may be a loading strategy (don't lift a 200 lb fridge by yourself doofus).  The point is, we have to think several steps ahead in order to prevent low back pain and injury from recurring.  Sure, treatment of the above issues is warranted but if we don't get a wrangle on the actual MECHANISM of pain then all we are doing is applying band aids to the problem.

Hip Hinge to Prevent Low Back Pain (sometimes)

Here is a simple video on how to teach yourself to properly hinge through your hips.  I'm not saying that you have to always bend over like this.  However, if you are going to pick up something up heavy I would recommend getting your hips involved.

 

Take Action

If you are a little confused by all of this then I have done my job.  The human population needs to have a better understanding for how their body works so that they can have a better grasp on how to handle whatever life throws at it.  The point is that those grueling lacrosse ball/foam roll sessions may not be helping you.  In fact, it could be hurting you.  Getting the same ole treatment over and over again is no better.  Alternatively, if you are used to banging out the same corrective exercise routine with no regard to how those clam shells apply to human function, then you are in REHAB PURGATORY.  It’s a pitiful place to be.  My challenge to you is to expect more from your body as well as those treating/coaching you.  Don't settle for chronic low back pain!  Learn how to not only manage discomfort, but how to prevent low back pain in the first place!

Contact Your Chesterfield Chiropractor

If you are in the St. Louis and Chesterfield area, we would love to help!  Call us or schedule online for a free consultation.  Can't make it to the office but like what I'm saying?  Reach out to us and I can help you find a provider in your area.


 

  • Anatomy pictures courtesy of Netter's Anatomy Flash Cards, 3rd Edition
  • Core pictures courtesy of the Prague School of Rehabilitation and Dynamic Neuromuscular Stabilization