Clinical Pearls: The Squat with Kendra Toothill CAT(C), CSCS, NKT®, FMS

This week’s tip is written by our regular contributor, Kendra Toothill (@toothillperform). Here she discusses her strategy in assessing a patients’ squat and how to determine/deduce where the dysfunction or limitation is coming from. I know i’ll be using this with my patients from now on. Thanks Kendra! -Thomas

During the functional movement section of my assessment, I almost always include a simple squat. This gives me a lot of global clues to where mobility may be lacking and which muscle dysfunctions may be present. At a glance, the squat is assessing mobility of the spine, particularly the thoracic spine, the pelvis, the hips, the knees and the ankles (in the sagittal plane). Lack of mobility could be the cause of several things, for example it could be:

  • muscles tightness causing too much bony proximity
  • poor arthrokinematics,
  • poor alignment of their center of mass
  • lack of motor control
  • injury compensation patterns
  • insufficient stability elsewhere in the chain
  • disease

The list goes on. I have found one simple method to detect whether the lack of mobility is coming from the hip and whether the cause is poor arthrokinematics or muscle tightness within that hip socket. After they perform a normal squat several times, I ask them to lie on their back and bring their legs up as if they were performing a squat with their legs in the air. I note the differences in ROM and movement in this position vs. standing. Next I take both feet into my hand and push on the feet and act as the “ground” and push them into a deeper squat (if range was insufficient in first attempt). I note if a correct squat depth is achieved by me pushing on their feet and note the movement and ROM here.

If they can not achieve a correct squat in this position then I can conclude that they lack mobility due to either bony congruence from muscle or arthrokinematics. If they can achieve a correct squat in this position then I can potentially rule out any structural options and look towards lack of motor control or injury compensation patterns.

Kendra

Kendra toothill is a certified Athletic Therapist (CAT(C)) and Strength & Conditioning Specialist (CSCS). Since graduating university, Kendra has been on a pursuit to enhance her existing knowledge about functional exercise, compensation patterns and movement dysfunction. She is Functional Movement Systems (FMS) level 1 & 2 certified & NeuroKinetic Therapy (NKT®) level 1 certified. Kendra currently works with athletes aged 12-18 in a school and team setting and also works at an athletic therapy clinic called North Star Athletic Therapy, located in Edmonton, Alberta. Please visit her clinic’s webpage, her linkedin account or like her facebook page “Toothill Performance – Kendra Toothill”

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