The Squat

 By: Emily Sluis, PT, DPT, ATC, CSCS and Brittni Hsu, PT, DPT, CSCS, USAW

SQUAT VARIATIONS   

There are a wide variety of different squatting techniques and varying discussion on the differences of each and when to use them. This month, we are going to discuss common squat variations and benefits of each. The main types of squats are goblet squat, front squats, back squats, and overhead squats.

The Goblet Squat   

Named for the way in which you hold the dumbbell - in front of the chest, with the hands cupped - the goblet squat is great for warm-ups, for squat movements where weight isn't the focus, and for teaching technique to beginners. 

The anterior load of a goblet squat forces the patient or athlete to sit their hips back in order to maintain their balance, teaching and reinforcing a proper squat pattern by engaging the posterior chain. While the goblet squat is great for beginners, due to the fact that the resistance is held much farther in front of the center of mass, the weight pulls the body forward and exploits a weak core. Because of the nature of the exercise, heavy loading is difficult and awkward. For focus on increasing load, the front squat is a better option.

The Front Squat

In the front squat, the barbell is in front of the neck, across the front of the shoulders. Front squats require excellent mobility - thoracic spine mobility to keep your chest up, wrist flexibility and shoulder mobility to rack the bar, hip mobility to squat low, and ankle mobility to effectively complete the movement. Very similar to the goblet squat, the athlete needs a more vertical trunk position and the hips and knees will inevitably be pushed forward to keep the bar positioned over the middle of the foot and allow the body to remain balanced.

Because the knee and hips must travel anteriorly into a positive shin angle, the front squat is naturally a more quad-dominant squat variation due to the large moment arm acting at the knee. The front squat typically allows for the greater squat depth, which is great for quad strength development, however, may be irritating to patients or athletes with chronic knee issues.

In comparison to the goblet squat, because the load of the bar is closer to the center of mass, there are fewer complaints of back pain. However, this is only applicable if the athlete is able to perform the front squat with proper technique.

These first two squat variations place the external load anterior to the center of mass during the exercise. The back squat, in comparison, places the load posteriorly, which changes the biomechanics and muscular involvement.  

The above picture illustrates the differences in the front squat and back squat. Notice the more vertical trunk position and greater depth of squat with the front squat. During the front squat, due to greater anterior knee excursion, a larger external moment arm is created from the knee joint center to the line of gravity acting at the barbell. This puts a greater load put on the quad and knee joint. In contrast, there is a larger external moment arm acting at the hip during the back squat, which loads the hips and glutes more as compared to the front squat.  
 

The Back Squat

Goblet squats, front squats, and back squats all effectively work the core, hip, and lower extremities, but there are slight variations in technique and muscular involvement when the load is posterior versus anterior. In the back squat, the barbell is behind the neck, which allows the athlete or patient to extend their hips back further and creates less stress on the knees. The back squat also requires a greater forward trunk lean than the front squat, and thus, doesn’t irritate the back as much.

However, the change in position of the bar also changes the biomechanics and muscular involvement during the squat. Quite simply, anterior-loaded squats target the quads, while back squats focus more on the hips and glutes. Both lifts recruit all these muscles together, but the emphasis shifts from one lift to the other.

Since front squats place a greater emphasis on the quads—as opposed to back squats which rely on the more powerful glutes and hips of the back squat, the maximum amount of weight an individual can lift varies between the two techniques, with increased capacity possible for the back squat. This means that a back squat is generally superior in handling heavier loads, thus maximizing strength gains. It is suggested that a balanced athlete with good mobility and proficiency should be able to front squat around 70-85% of their back squat weight.

The Overhead Squat  

The overhead squat is one of the most difficult of all squat as it also emphasizes overhead shoulder mobility, core stability, and requires excellent thoracic mobility. In an overhead squat position, the dowel rod or if able to tolerate, a load (barbell, kettlebell, dumbbell), would be held at end range shoulder flexion while the athlete completes a squat, looking for the same mechanics as you would in a front and back squat. Common deficits in mobility cause compensations including difficulty maintaining the load with your elbows fully extended and maintaining a neutral spine throughout the movement avoiding lumbar extension. It is also critical to have full closed chain ankle mobility and hip mobility.

The overhead squat is commonly used in movement screens to reveal various mobility and stability deficits. Due to the difficulty of overhead squats, it is very uncommon to have perfect overhead squat.

To quickly recap, the goblet squat is great for teaching beginners proper squat patterns. The front squat can really develop quad strength and hypertrophy, but may be irritating to patients with previous low back or knee issues. In comparison to the front squat, the back squat allows you to add increasing loads for strength development, but focuses more on the glutes than the quads. And the overhead squat is very difficult to complete due common mobility issues, but adds in an additional stability component by having the load overhead. The squat is an instrumental exercise for patients and athlete alike, but needs to be taught with proper technique and keeping these considerations in mind

IBJI's 2017 Running Clinic - Highland Park

On Saturday, February 11th, IBJI Rehab hosted our first of two 2017 Running Clinics.  IBJI Physical Therapists provided foot type and running mechanic analysis, strength and flexibility testing, and personalized home exercise programs to 35 individuals of all running levels.

This clinic is intended to educate runners on how their specific running form and foot type can reveal their future risk for running related injuries as well as, be leveraged to improve running performance. 

"I learned so much from the IBJI running clinic. The staff was very knowledgable and thorough with their assessment and gave me some great tips to keep me running the rest of my life. I highly recommend this clinic" noted Kim Carden, President of the Lake Forest/Lake Bluff Running Club.

If you missed this event, there is still time to register for our March Running Clinic!  This clinic will be hosted on Saturday, March 18th at our Chicago-Logan Square office (2923 N. California Ave). For more information visit our events page

IBJI Hosts "Healthy Gymnast Seminar"

On December 30th 2016, IBJI Rehab staff in collaboration with Elk Grove Gymnastics hosted the "Healthy Gymnast Seminar". This event brought together female gymnasts from the Elk Grove community, as well as, Maine East High School. Over 20 athletes and coaches participated in the seminar events.

Presentation topics included prevention and care of common wrist and elbow injuries, ACL injury prevention, nutrition and the Female Athlete Triad.  IBJI’s panel of experts included Heather Elliot-Smith PT, Julie Fleming PT, Aleksandra Moe PT, Alyssa Bolhous PT, and Sports Performance Coach David Howington CSCS.

Gymnastics coach Neil Adamson, recognizes the importance of educating his athletes on why prevention and purposeful training is important, “This season I have been incorporating a lot of (what was discussed) into our workouts, so to have you guys come in and go into greater depth and not just touch on things but really further the girls understanding of these topics was a huge help!”.  Betty Axelson-McClelland owner of Elk Grove Gymnastics, followed with ”All the therapists' presentations were so well organized and very pertinent to the gymnasts, so they kept the attention of all the girls the entire time.  We greatly appreciate IBJI making this excellent seminar possible”.

One of IBJI Rehab's key initiatives is to promote meaningful community engagement with a special focus on female athletes. It is opportunities like these that really remind us of the importance of sharing knowledge.  “As rehabilitation professionals we believe that it is important to educate individuals about their bodies so that they may be empowered to be active participants in managing their own health.  We were excited for the opportunity to reach out to these active young women to share knowledge and behaviors that will help them perform their best and prevent injury." stated Heather Elliot-Smith, Physical Therapist and Facility Manager of IBJI Rehab Des Plaines clinic. 

If you are interested in having IBJI Rehab present to your team or club, please reach out to Amy Illarde at aillarde@ibji.com 

IBJI Rehab at the Lincolnwood Turkey Trot

IBJI Rehab and 2,000 runners braved the 20 degree temperatures this past Sunday, November 20th at the 40th annual Lincolnwood Turkey Trot!  

This event offered a 5k and 10k run, 5k walk, and a special "drumstick dash" for kids. This was IBJI's first year sponsoring this event. "While it was an awfully cold morning, it was so much fun to see everyone bundled up and ready to run", said Amy Illarde Brand Development Manager, "We are definitely looking forward to supporting next years event". 

Congratulations to IBJI participants: Meir Hildeshaim, Lauren Verrilli, Lindsey Martin, Jennifer Coldea, and Jeanette Smith. Also, a big thank you to Lincolnwood Facility Manager, Melissa Espinal and Peterson Ave. Facility Manager, Julianne Peacock-Rhodes for coming out to support their teams! 

Fall Donation Drive A Success!

In the month of October, IBJI Rehab hosted a month long giving back campaign as a part of our Physical Therapy Month celebrations. Each week of the month focused on collecting different items including used shoes, books, nonperishable food items, and winter weather clothing.  All of our 18 rehab clinics participated and donations were accepted from both staff and patients.

By the end of October, IBJI Rehab had collected over 300 pairs of shoes, 878 books, over 100 food items, multiple sets of mittens, hats, scarves, and coats. Our shoe and clothing donations were accepted by local charities, the food items were donated to Our Lady of Perpetual Help in Glenview as part of their food drive, and the books to Open Books Chicago which provides books and literacy services to underserved communities in Chicago. 

IBJI Rehab would like to thank all the patients and staff that helped contribute to this successful philanthropic event!

IBJI Named Official Orthopedic Partner of Rugby Weekend Matches

This past weekend, Chicago was overtaken by Rugby enthusiasts to take part in "The Rugby Weekend Presented by AIG" festivities.  This two day event included two matches, USA Eagles vs New Zealand Maori on Friday evening at Toyota Park and Ireland vs New Zealand All Blacks on Saturday at Solider Field.  In partnership with The Legacy Agency LTD,  Illinois Bone and Joint Institute was named the Official Orthopedic Partner of the Matches.  

During the games, IBJI provided physician, physical therapist, and athletic training support as part of the pitch side medical team. IBJI staff who attended include, Dr. Eric Chehab, MD, Dr. Mark Hamming MD, and Dr. Craig Westin, MD, Andre Blom, PT, STC, Matt Repa, ATC, MHA, & Phil Duplessy, ATC. 

 "We are honored to be a part of such a fantastic event that helps promote Rugby within the United States ." stated Andre Blom, PT, STC.  In addition to medical support, IBJI also took part in the pre-game Fan Fest where game attendees could meet with an IBJI representative to learn more about our services and win prizes. 

IBJI Training Series - 90/90 Plyometric Toss

In this video Matt Repa, ATC teaches how to perform the 90/90 Plyometric Test as part of our Upper Extremity Return to Play series.

Instructions: The patient performs 2lb plyometric wall dribbles in a seated or standing position with the arm abducted at 90 degrees and externally rotated to 90 degrees for 30 seconds. Monitor for signs of apprehension. 

Scoring:  Pass: Patient is able to compete the 30 seconds without any pain or discomfort.  
                Fail: Patient reports discomfort or cannot complete the test due to fatigue. 

IBJI Training Series - How to Assess Upper Extremity Stability and Power

In our latest installment of IBJI Training Series IBJI Athletic Trainer Matt Repa explaines how to perform the Davy's Upper Extremity Stability Test. This objective test is used determine upper body power and stability. 

The equation discussed is as follows; 68% bodyweight (lbs) x total number of reps/15
Average reps for Males = 23 - Average reps for females = 21