Choosing your squat: benefits vs risks – Newcastle Physiotherapist Jason Bradley

Squat technique by Newcastle Physio

Choosing your squat: benefits vs risks – Newcastle Physiotherapist Jason Bradley

Squats are one of the corner stone exercises of most fitness routines. They help to train leg strength, core control, balance, tight and shapely bottoms as well as strength for sports performance. However, they can also be the cause of a number of the most common injuries we treat in the physiotherapy clinic including: hip pain, knee pain and back pain (eg sciatica and bulging discs). Our Physiotherapists and Exercises Physiologists are experienced in assisting people to avoid injuries while improving function and boosting performance.

Combining a good amount of resistance exercise to your training program has been show to be highly beneficial for all ages and fitness abilities. The inclusion of heavier resistance provides both cardiovascular and strength benefits through loading of these structures. It also plays an important role in weight loss by improving lean muscle mass (muscle burns more energy than fat tissue).

Variations of the squatting movement come with different benefits and risks. In the video below I discuss 4 main variations of a squat. Below is a summary of the recommendations in the video (plus a bonus – the chair squat).

The Chair Squat

Description: No equipment, keep your hands out in front and squat back on to a chair, lightly touching your bottom to the chair before rising back up. This exercise can often form part of a beginner mobility or balance program under the supervision of an exercise physiologist (eg with balance programs for vertigo or osteoarthritis with a Medicare referral).

Benefits: No equipment other than a chair. Great for beginners and people who have strength or balance issues as the chair is there to guide your depth and catch you if you get tired.

Downside: at some point you will get too strong for this exercise and need to progress. Make sure you use a sturdy chair that isn’t going to roll away.

Back Squat

Description: this is the traditional bar squat most people know. Rest a bar comfortably across your shoulders, keeping the chest proud looking forward. Stick the bottom back and sink down till just before your ‘breaking point’. This is where the curve in your lower back reverses and start to put pressure on your lumbar spine.

Benefits: back squats allow large amounts of weight to be lifted with may serious athletes lifting over 2 times their own body weight on their back. Its easy to maintain a hold on the weight once in place and most gym have squat racks which make it easy to load and unload weights.

Downsides: its very rare to see someone try and lift a fridge on the back of their shoulder – its pretty non-functional. At no point in our lives to we really lift weight in this way. Its also very common for people to use weight beyond their ability, use a ‘weight belt’ (no evidence to show it actually helps – a whole other article) and often people go too low generating injuries in their lower back or hips. This position does require a reasonable amount of shoulder range of motion and can cause issues for people with rotator cuff injury.

Front Squat

Description: in a front squat the bar is taken from the squat rack on to the collar bones/anterior deltoids with the arms crossed underneath or from a floor position in a clean movement and maintain by keeping the wrists turned under and the elbows held high in front.

Benefits: a front squat greatly increases the lift difficulty and is often thought to alter the core control requirements due to the forward position. You must maintain good upright posture with this variation otherwise you will drop the bar. For this reason many people find they are unable to go as low compared with the back squat as they can’t cheat with forward bending in the lumbar spine to get lower.

Downsides: this is a much more challenging squat technique and is best performed first with guidance from your physiotherapist or exercise physiologist. For those of us with lower muscle mass it can also be a bit uncomfortable with the pressure of the bar across the chest.

Sissy Squat

Description: a throw back to the ages of misinformation and macho iron pumping of yester-year. This variation is similar to a back squat but instead ignore the normal adviceĀ  of bottom back and keeping the weight central. The knees travel forward over the toes and weight into the forefeet. As you come down through the squat shift your weight and knees forward over your toes as if you are going to kneel forward on to the floor.

Benefits: supposedly to increase focus on the quadriceps, it may do this to some small extent but…

Downsides: the sissy squat greatly increase the pressure in through the knee and patella (knee cap). This movement is not recommended for the beginner and realistically even competitive athletes should avoid it. It provides little benefit and greatly increases your risk of a knee injury.

Above Head Squat

Description: ideally raise the bar above head from a clean movement (see power lifting for more info on these movements – specialist video coming soon). Hands slightly more than shoulder width apart, with the bar held just in front of the forehead so that it remains just within your vision when glancing upwards. Perform your squat ensuring you keep the hands position above your head.

Benefits: above head squat are far and above the most challenging for your core control, flexibility and balance. The combination of all the muscle groups required makes this exercise my favourite squat variation. Admittedly its maybe not quite as functional as we don’t always lift stuff above our head in this position. But if you can master a good weight above head squat through a full range (down to knees at 90 degrees) you are well on your way to being strong and functional.

Downsides: this is a technical and challenging squat variation. I would very much recommend seeking the guidance of your physiotherapist or exercise physiologist to ensure that you complete it safely.

The Verdict

Beginner: Chair squat then back squat

Moderate: Back, front, above head

Advanced: Back/front heavy, and above head for range of motion/function

So what about the Sissy Squat? I wouldn’t bother. It really has no extra benefits and just loads up your knees.

Still have questions about squats?

Book in online for a free assessment with one of our experience Physio or Exercise Physiologists. These sessions are free for all new patients, there is no cost, no rebate and we provide are totally free 15 minute consult including treatment plan with one of our physiotherapists. Please select the Free Initial Assessment or mention this when ringing to book on (02) 49527033.


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