The Squat

Hip Rotation will set you free….

“Rotator Cuff” of the Hip

The hips are the foundation for any athlete, and when they are unhappy, their discontent is often expressed in the knees and/or low back. For myself and in my clinic I use the bodyweight squat as both a diagnostic tool, and a movement to create a more robust and resilient trunk and lower body.

If we want our hips to continue to cooperate with athletic endeavors or just every day activities, we should be practicing the squatting motion most days. The squat challenges the hips in a way that most exercises cannot. Depending on who’s talking, our hip flexion availability (bending at the hip) should be 110-120 degrees. The squat affords us the opportunity to express this range of motion, under load. The “under load” part of that last sentence is very important. The “load” is our bodyweight (at a minimum) and our ability to balance. These two components provide stimulation of the hip stabilizers, to ensure that the end of the femur (thigh bone)rotates correctly within the joint. These hip stabilizers are the, “rotator cuff,” of the hip. When the rotator cuff of the hip does not function correctly, bad things happen (See my article on hip tendinopathy).

Too often rehabilitation protocols and fitness routines emphasize, “open-chain,” exercises. These are exercise that move the leg through space while keeping the hips stable. These are perfectly legitimate exercises but alone, they are not enough to maintain a healthy, athletic hip. The squat is a, “closed-chain,” exercise in that the foot is fixed and the knee and hip do the moving. The squat allows the pelvis to rotate on the femur, while the femur is moving. In short, the squat allows the pelvis to express it’s full range of motion. As we descend into the squat the femur maximally flexes and externally rotates while the pelvis does a posterior tilt. Conversely, at the top of the squat our femurs maximally extends and internally rotates while the pelvis does an anterior tilt. This full range of movement compels the, “rotator cuff,” of the hip to contract and relax in different combinations and intensities that strengthen these muscles and nourishes the connective tissue throughout the joint.

Everyone squats a bit differently so I try to impart simple squat instructions so as not to cause a patient to over-think a motion that should be natural and pain-free. For the sake of this article I am referring only to body-weight squats. As an individual begins to add external weight to a squat, the necessary form becomes more specific relative to the amount of weight they are lifting and the position of that weight during the squat. That said, begin with your feet hip width or slightly wider. Your toes should be pointed straightforward or bit out to the sides. Start the motion by bending your knees, then pushing your hips back. Continue bending the knees and dropping your hips straight down towards the ground. Keep your chest up and your arms lifted to shoulder height in front of you. That’s it. Keep it simple. If you can get your hips down near the height of your knees, great! If you can get your hips down to your calves, even better.

This is an example of a great squat - the bottom position

Practice

If the bottom position of a squat is difficult for you, grab something stable and hang on.

If you have stiff ankles(like me), try putting something under your heels.

Troubleshooting

If squats make your knees hurt, it is most likely tightness or weakness in the quads. Get a foam roller or Lacrosse ball and roll out your quads for a few minutes paying attention to those painful spots.

Quadriceps Release

Then follow that up with a few minutes of quad stretching.

If you are having trouble squatting low due to balance, work on ankle mobility. Often tight calves prevent us from shifting our weight forward when squatting, the result is a tendency to lose our balance backwards when we get down to knee height.

Calf Release

Practice squatting daily, just a couple sets of minute will build your strength, balance and endurance. Additionally, devote a couple of minutes hanging out in the lowest squat position you can achieve to improve the range of motion of your low back, hips knee and ankles.