Deep Squatting: Is it Good or Bad?

ProActive Rehab & Sport Injury Centre, Huntsville, ON

Evidence Behind the Deep Squat.

The concept of “deep squatting” is often debated and generally folks fall onto one of two side of the issue: it is the ideal exercise providing end of range joint movement and large muscle activation OR it is the worst thing you can do for your lower extremity joints. So, what do we really know about this issue?


First of all, to be clear, what we are talking about is an “unloaded deep squat”. This is not the kind that weight lifters often perform with a large amount of weight on their shoulders but rather it is defined as a “resting posture of maximal hip and knee flexion where the posterior thighs are in contact with the calves and the heels remain flat on the floor” (1).
There are at least 5 studies (2-5) that have concluded that deep squatting does not contribute to the risk of developing osteoarthritis (OA) of the knee. There are, however, also studies that have suggested that prolonged (ie 30 minutes/day) deep squatting is a risk factor for knee OA. As with all studies, one must evaluate the relevance to our modern way of life...ie, how many of us would actually spend 30 minutes or more a day in a deep squat? Not very many! So what can we do with this information?


If we consider the natural world we can find many examples of repeated use of deep squatting. Take primates for instance, they have always and still do spend a lot of their lives in a deep squat position as do the Asian and African human populations. Deep squatting is a very functional position for cooking, eating, doing laundry and toileting. It is also a commonly used position by young children in our Western world: they use it freely and comfortably to get to ground level to play, explore and retrieve. So what’s up with us western adults? Somewhere along the way we stop squatting and this may have a dramatic effect on our lower extremity joint health and function!


So, why is this a big deal? Well it comes down to anatomy and physiology! All of our lower extremity joints are synovial joints containing synovial fluid and hyaluronic acid. These fluids are essential for joint and cartilage health: they reduce friction, provide shock absorption and transport nutrients to the layer of cartilage on the joint surfaces. It is also known that synovial fluid becomes more viscous, and thus more effective, when under pressure. Further, we know that all synovial joints require both movement and compression to maintain cartilage health (6,7). The combination of movement and compression facilitates the process of synovial fluid movement and thus maintenance of a thin layer of fluid over the joint surface. Evidence of a loss of this process can be found in immobilized joints (8,5). In fact, studies have shown that joints that do not regularly go through their full range of motion will eventually stop producing adequate synovial fluid to keep the entire joint surface healthy and degeneration, or OA, will set in. Interestingly, the deep squatting action fulfills all of these criteria: full joint range of motion and up to 4 times body weight in compression at end of range (9). So, as the old adage says...”use it or lose it”! By completing daily deep squats you will prevent loss of joint motion, facilitate the production and flow of synovial fluid, maintain your lower extremity joint health and regularly engage your large leg muscles to help keep them strong too. If you are currently unable to complete a full deep squat then rest assured that a half squat or even a sit to stand action from a chair have also been shown to be effective methods to achieve a similar result (10,11).


So, is deep squatting good or bad? Well, decide for yourself but the evidence suggests that it is a necessary motion and posture to ensure good lower extremity joint and muscle health!

Good luck and happy squatting!

 

References

1. Jam, B 2015 Deep Squatting: Good or Bad Advanced Physical Therapy Education Institute www.aptei.com

2. Tangtrakulwanich et al 2006 J Med Assoc Thai.

3. Lin et al 2010 Int J Rheumatol.

4. Schoenfeld 2010 J Strength Cond Res.

5. Hartmann et al 2013 Sports Med.

6. Nyguyen et al 2010 J Biomech.

7. Grodzinskye et all 2000 Annu Rev Biomed Eng.

8. Pitsillides et al 1999 Rheumatology.

9. Thambyah et al 2008 Knee.

10. Flanagan et al 2003 Med Sci Sports Exerc.

11. Takai et al 2013 J Sports Sci Med.

ProActive Rehab & Sport Injury Centre is your centre of choice for effective injury management and prevention in a professional, relaxed, motivating environment .  We will guide you along your way to reaching your full potential! ProActive Rehab is a multidisciplinary rehabilitation facility located in the heart of downtown Huntsville Ontario. We offer a wide range of services including physiotherapy, massage therapy, occupational therapy, aquatherapy and post-rehab aquacise, cardiac rehabilitation, custom foot orthotics, braces, supports and rehab products. We pride ourselves in being the centre of choice in north Muskoka for exemplary customer service, professional and effective rehab programs and experienced staff all in a relaxed and motivating environment!