Back Squat

Question 1

fundamental movement patterns include

Answer 1

Some fundamental movement patterns include running, throwing, lunging, and squatting,(25) and these fundamental movements have direct biomechanical and neuromuscular implications to successful performance with dynamic tasks inherent to many popular sports and physical activities enjoyed by youth and young adults.

Question 2

back squat proficiency supports derivative squat movements that translate to many everyday tasks

Answer 2

s lifting and carrying heavy objects, which relates this exercise to improve quality of life.(4

Question 3

why in rehab BS

Answer 3

Specifically, closed kinetic chain exercise is commonly used throughout the rehabilitation process to avoid excessive strain being placed on the anterior cruciate ligament (ACL), making the squat a favorable exercise for rehabilitation.(7, 17, 37, 43

Question 4

posterior muscles and how

Answer 4

The posterior torso muscles, particularly the erector spinae, are recruited via isometric muscle action to support an upright posture throughout the entire squat movement

Question 5

the posterior torso muscles are assisted by the

Answer 5

anterior and lateral abdominal muscles to further stiffen the torso by creating tension for the abdominal wall.

Question 6

Berthing before squat

Answer 6

it is recommended for the athlete to inhale approximately 80 percent of maximal inhalation and hold their breath to increase intra- abdominal pressure to enhance stability of the vertebral column (i.e., Valsalva maneuver) (Note: This amount of air may change with the load magnitude). This technique prepares the spine, which is a flexible rod, to bear compressive load. The Valsalva maneuver also establishes “proximal stiffness” that enables more power development in the shoulders and hips, enhancing limb force output and velocity.

Question 7

Deficits id in squats

Answer 7

Deficits identified during the back squat that can impair performance can be categorized as either
inefficient motor unit coordination or recruitment (neuromuscular),
muscle weakness,
strength asymmetry or
joint instability (strength), and/or joint immobility or
e w muscle tightness (mobility).(43

Question 8

BSA, which are subcategorized into three comprehensive domains:

Answer 8

Upper Body, Lower Body, and Movement Mechanics (Table 1).

Question 9

Upper Body domain

Answer 9

The Upper Body domain emphasizes the stability and posture of the head, neck, and torso.

Question 10

Lower Body domain

Answer 10

assesses the joint positions of the hips, knees, and ankles during the squat.

Question 11

Movement Mechanics domain

Answer 11

Movement Mechanics domain assess the timing, coordination and recruitment patterns of the back squat.

Question 12

set up BSA

Answer 12

Athletes are to be instructed to grip the dowel with a pronated grip slightly greater than shoulder width apart and assume a back squat set-up with the dowel resting comfortably on their contracted upper back musculature. Specifically, the dowel should be positioned across the posterior deltoids just below C7 of the cervical spine. Forearms should be held parallel to the torso and wrists should be kept straight and not flexed throughout the movement (Figure 2). The person should be taught to “bend the bar” (pull the bar into trapezius) as this facilitates the back extensors, shoulder retractors and latissimus – all of which stiffen the torso, adding to injury resilience and performance capabilities

Question 13

Stance

Answer 13

approximately shoulder-width apart and toes pointing forward or slightly outward by no more than 10-degrees

Question 14

wide and narrow stance

Answer 14

A wide stance may increase patellofemoral and tibiofemoral compressive forces in the knee joint by up to 15% during descent.(7, 9, 43) On the other hand, an excessively narrow stance may increase forward knee translation and therefore heighten anterior shear forces.(7, 43) Therefore, a moderate stance width is encouraged for this standardized assessment., it is recommended that athletes do not exceed 30 degrees of internal ankle rotation or 80 degrees of external rotation to maximize stability and promote normal patella tracking.(21, 43) Still, extreme tibial rotation in a closed chain movement may potentially lead to increased stress on the static knee structures and should be avoided for most squat variations.

Question 15

head

Answer 15

Excessive tilting of the head backward into a position of extreme cervical hyperextension can be dangerous during the squat, particularly when heavy resistance is integrated.(2)
Excessive cervical hyperextension may be a compensatory movement for a lack of thoracic extension.

Question 16

Gaze

Answer 16

Gaze can either be directed too high or too low. A downward gaze has been shown to increase hip flexion and potentially trunk flexion in comparison to an upward gaze (Figure 4). This position may place increased torque on the vertebral column.(2, 6, 43) However, it is important to disassociate gaze from head position. Although gaze can be slightly upward

Question 17

Head Position Deficits

Answer 17

Neuromuscular
Head Position Deficits
Unsatisfactory head and neck position awareness for maintaining neutral head position throughout squat. Poor disassociation of gaze from head position, which may encourage deviation from neutral head position.
Strength/Stability
Insufficient isometric strength of neck and upper back musculature to maintain head in neutral alignment throughout the entire squat.
Mobility
Insufficient physiological range of motion for head and neck in all three planes.

Question 18

Thoracic Position

Answer 18

.l cueing to instruct the athlete to position their chest up or retract their shoulders does not gain desired technique, then the athlete may lack adequate torso strength, such as the thoracic paraspinal musculature or parascapular musculature,,A propensity for forward rolled shoulders during the back squat may also be due to lifestyle-induced postural weaknesses (i.e., upper crossed syndrome, which results from consistently internally rotated shoulders leading to excessively shortened or tight pectorals).

Question 19

Thoracic Position Deficits

Answer 19

Neuromuscular
Thoracic Position Deficits
Chest down or lack of scapular retraction during squat. Difficulty dissociating the thoracic position from the lower trunk position.
Strength/Stability
Inability to maintain chest- up position, which may be due to weakness of erector spinae, trapezius and rhomboids.
Mobility
Excessive tightness in chest, potentially from upper crossed syndrome, which hinders ability to open chest and retract scapula.

Question 20

Trunk Position

Answer 20

Failure to stiffen the lower back musculature, combined with poor lifting mechanics, increases the potential to overload spine and back tissues to the point of injury, especially when repeated over time.
-A more upright lumbar posture increases load onto lower extremity levers, which may reduce low back stress.
-the individual must demonstrate the ability to maintain a stiffened torso with a neutral, lordotic lumbar position as a safe and optimal squat strategy.

Question 21

Common culprits for increased trunk flexion

Answer 21

during the squat are weakness of the thoracic and lumbar paraspinals (erector spinae), weakness of the parascapular musculature to maintain retracted and depressed scapulae as well as reduced tension in the thoracolumbar fascia through the integration of the posterior chain and back musculature

Question 22

In addition, restricted translation of the knees during the squat

Answer 22

may also increase anterior forward lean of the trunk.(

Question 23

indicative of general core weaknes

Answer 23

A trunk that is unsteady and moves out of an upright position during the squat may be indicative of general core weakness.

Question 24

e athlete flexes at the spine before 120° of hip flexion when squatting,

Answer 24

If the athlete flexes at the spine before 120° of hip flexion when squatting, they may have restriction in the posterior fibers of the illiotibial band or lack of lumbar control.

Question 25

during heavy resistance squatting with the spine in a flexed position

Answer 25

The risk of disc herniation is increased during heavy resistance squatting with the spine in a flexed position as a result of excessive stress placed on intervertebral discs.(26, 43)

Question 26

Trunk Position Deficits

Answer 26

Neuromuscular
Trunk Position Deficits
Excessive trunk flexion and/or rounding (kyphosis) of the spine during the back squat.
Strength/Stability
Inadequate core strength to maintain torso parallel to tibias and lack of lower back tightness to generate spinal stability. Deficit may be due to trunk extensor weakness and hip extensor weakness.
Mobility
Excessive hip flexors (iliopsoas) and trunk flexors (abdominals) tightness and/or lack of lumbar spinal mobility

Question 27

Hip position

Answer 27

During descent, the hamstrings can assist the gluteal muscles by controlling flexion at the hips.(43) In the ascent phase of the squat, the hamstrings contract to extend the hips. The hip adductors, muscles on the inner thigh, stabilize the femurs during the squat. They prevent the knees and hips from rotating inward during descent.

Question 28

desired Technique—

Answer 28

Athlete maintains square, stable hips with minimal mediolateral movement during the squat (Figure 9).
-A deficit can be identified by observing the athlete leaning, dropping or twisting to one side from the anterior or posterior perspective

Question 29

Hip Position Deficits

Answer 29

Hip Position Deficits
Neuromuscular Hips are asymmetrical in frontal plane during the back squat.
Strength/Stability
Lack of strength or stability of hip musculature or asymmetrical strength of hips.
Mobility
Lack of hip flexor range of motion.

Question 30

Frontal Plane Knee Alignment: Internal knee force response to external loads are primarily generated

Answer 30

by the quadriceps, hamstrings, and gastrocnemius

Question 31

Tibiofemoral compressive forces help resist

Answer 31

anteroposterior shear forces and translation

Question 32

Tibiofemoral and patellofemoal compression has been shown to increase with

Answer 32

increasing knee angle as a protective function at the knee by initiating a co-contraction between the quadriceps and hamstrings

Question 33

Although shear forces tend to increase with increasing knee angles, forces on the cruciate ligaments of the knee

Answer 33

decrease at high flexion angles.

Question 34

is no known evidence to support the contention that squat depth below parallel increases the potential for injury

Answer 34

there is no known evidence to support the contention that squat depth below parallel increases the potential for injury to the cruciate and collateral ligaments and menisci in the knee during deep flexion.

Question 35

Training with the squat exercise may enhance

Answer 35

passive and dynamic knee stability in deep knee flexion positions via active muscular protection of the passive structures during sport movements.(7

Question 36

There should be an absence of knee displacement both

Answer 36

medially and laterally.

Question 37

lateral aspect of the knee should not cross th

Answer 37

e vertical plane of the medial malleolus when assessing for medial displacement (Figure 11).

Question 38

the goal position is to have the tibia in

Answer 38

vertical alignment perpindicular to the floor with error towards lateral knee positions

Question 39

the medial aspect of the knee should also not cross the vertical plane of the

Answer 39

lateral malleolus.

Question 40

Knee valgus (medial or knock-kneed movement) during the squat may be influenced by decreased

Answer 40

hip abductor and hip external rotation strength, increased hip adductor activity and restricted ankle dorsiflexion

Question 41

However, knee varus can occur and is sometimes a compensatory strategy employed by athletes

Answer 41

with flat feet

Question 42

Frontal Knee Position Deficits

Answer 42

Neuromuscular
Frontal Knee Position Deficits
Active valgus during the back squat; increased hip adductor activation without adequate posterior chain control and recruitment may lead to knee valgus.
Strength/Stability
Posterior chain weakness which leads to passive valgus during squat motion.
Mobility
Hip immobility that restrict knees from avoiding valgus position during squat.

Question 43

Moreover, a conscious effort to restrict forward translation

Answer 43

has been shown to increase forward trunk lean, resulting in significantly greater forces at the hip and spine that place these joints at greater risk of injury. (16, 23)

Question 44

As general

Answer 44

a general guideline, the athlete should attempt to match tibia angle in parallel with an upright trunk, while keeping their heels on the ground (Figure 13).

Question 44

As general

Answer 44

a general guideline, the athlete should attempt to match tibia angle in parallel with an upright trunk, while keeping their heels on the ground (Figure 13).

Question 45

Excessive tibial progression angle can also be exacerbated by weakness

Answer 45

weakness in calf and soleus, weak hamstrings, or quadriceps dominancweakness in calf and soleus, weak hamstrings, or quadriceps dominanc

Question 46

may also hinder proper tibial progression angle.

Answer 46

Restricted motion of the gastrocnemius and soleus muscle complex via the Achilles tendon, talocrural joint restrictions at the posterior ankle, restrictions in hip mobility, and deficits in foot mobility may also hinder proper tibial progression angle.

Question 47

Tibial Translation Angle Deficits

Answer 47

Neuromuscular
Tibial Translation Angle Deficits
Knee translates excessively over toes during the back squat, even with heel on the ground.
Strength/Stability-Lack of strength of posterior chain, particularly the gluteals, to keep load on the rear. Excessive tibial progression angle can be a result of weakness in calf and soleus, weak hamstrings, or quadriceps dominance.Mobility
Inadequate mobility of knee in sagittal plane from lack of mobility of the soleus and gastrocnemius.

Question 48

FEET FAULTS DEFICITS

Answer 48

—Observations of pronation or supination of the feet as well as the rolling of the feet inward or outward are suboptimal movement strategies, Lifting heels or toes off of the ground at any time is suboptimal during the back squat (Figure 15). Allowing the heels to rise off the ground has been observed to create compensatory torques about the ankles, knees, hips, and lumbar spine. (3) With heels raised off of the ground, the athlete has a smaller surface area and base of support, which may reduce the athlete’s ability to perform a balanced and controlled squat.

Question 49

Ankle inversion or eversion during the squat is also indicative of a

Answer 49

Stiffness in the ankle joint from poor dorsiflexion may cause the foot and the knee joints to compensate. (3) These compensations may have a negative impact to foot and knee stability that is needed for correct squat mechanics.

Question 50

While increasing ankle mobility, and in many cases hip mobility, is the desired endpoint for this deficit, some athletes may benefit in

Answer 50

itially from the use of a heel block to aid in creating a stable platform and assist in pushing through the heels.

Question 51

Foot Position Deficits

Answer 51

Neuromuscular
Foot Position Deficits
Foot comes off of ground during squat not due to strength or mobility limitations.
Strength/Stability
Lack of or asymmetrical ankle strength and/or poor stabilization of ankle and foot. Foot rolls onto either side during squat.
Mobility
Lack of dorsiflexion mobility if heels come up off ground due to restricted Achilles tendon and/or tight soleus and gastrocnemius.

Question 52

Movement Mechanics

Answer 52

Triple extension (extension of ankle, knee and hip) and flexion movement patterns are inherent to sports associated movements such as jumping and landing mechanics.

Question 53

Descent

Answer 53

The athlete should descend by flexing the hip, knees and ankles in a fluid, coordinated movement as the body is lowered in a controlled manner

-The athlete should descend by flexing the hip, knees and ankles in a fluid, coordinated movement as the body is lowered in a controlled manner

-

Question 54

Depth

Question 55

Ascent

Question 56

The vertical distance between

Answer 56

the athlete’s shoulders and hips should remain constant throughout the entire descent

Question 57

Body weight should be transferred to and supported by t

Answer 57

he athlete’s posterior chain musculature, particularly the hamstrings and gluteals, and not placed anteriorly on their knees (

Question 58

Descent Deficits

Answer 58

C
‘Knee-loading’ strategy instead of ‘hip-hinge’ strategy as seen with excessive trunk flexion, excessive tibial progression angle, and/or heels coming off of the ground.
Strength/Stability
Lack of lower limb eccentric strength control, evidenced by an overall lack of control of the tempo of the descent. The athlete appears to ‘drop’ into the apex of the descent. Descent timing is not 2:1 ratio in relation to ascent.
Mobility
Lack of lower limb mobility, leading to a forward trunk lean.

Question 59

Without squatting to the proper depth, t

Answer 59

he hamstrings and gluteus muscular complex may not be adequately challenged.

Question 60

training at shallower knee flexion can

Answer 60

influence quadriceps dominant sport skill performance that can limit performance and increase injury risk.

Question 61

he squat exercise may enhance

Answer 61

active knee stability if performed correctly and may reduce sport injury risk to the passive structures of the knee. (7, 8, 39)

Question 62

Depth Deficit

Answer 62

Depth Deficits
Athlete does not achieve depth of thighs at least parallel to the ground.
Strength/Stability
Athlete lacks posterior chain isometric strength to maintain deep hold.
Mobility
Difficulty achieving depth due to tightness in posterior chain and hip adductors.

Question 63

The athlete may lack++++++ of the+++++ chain to maintain bodyweight support at the apex of depth. Furthermore, ++++in the posterior chain musculature and++++ may further limit the ability for an athlete to achieve appropriate depth.

Answer 63

The athlete may lack isometric strength of the posterior chain to maintain bodyweight support at the apex of depth. Furthermore, tightness in the posterior chain musculature and hip adductors may further limit the ability for an athlete to achieve appropriate depth.

Question 64

Ascent

Answer 64

The primary diver of ascent should be the hips and weight should be kept of the heels and lateral sides of the feet.

Question 65

The back is to be kept i

Answer 65

n a rigid, tight position with stiffened muscles and with the lumbar spine in a neutral to slightly extended position.

Question 66

Common faults in early stages of learning the back squat (i.e., early training age) are fo

Answer 66

r the hips to rise faster than the shoulders, which would increase trunk flexion (Figure 21). If the hips rise too quickly, the vertical distance between the hips and shoulders will decrease during the early ascent phase (Figure 21). Irrespective of the load, the movement pattern represents an incorrect back squat that can be a dangerous strategy to the lower back during squatting with progressive external resistance. In addition, relative to the downward descent, a large deviation in the movement pattern employed during upward ascent is also considered a deficient technique.

Question 67

Ascent Deficits

Answer 67

Ascent Deficits
Hips rise too quickly in relation to shoulder during ascent. The vertical distance between the hips and shoulder does not remain constant.
Strength/Stability
Posterior chain and hip extension concentric muscle action weakness.
Mobility
Lack of thoracic spine and hip flexor mobility.