Last week we talked about the benefits of squatting properly. We also talked about the importance of squatting well, with an appropriate movement pattern. One of the common compensations which occurs when people have a poor squat pattern is known as the valgus collapse. This can occur because of poor core and hip motor control or strength, or from limited ankle mobility. When the person squats their knees the move inward toward each other, rather than staying straight over the toes.
This position and movement change stresses throughout the entire lower extremity and can lead to issues with repetitive activities we perform in sports or life in general. These problems caused by the altered movement patterns don’t need you to be squatting to happen, but looking at your squat pattern can let you know if yo need to work on your mobility or motor control to stay healthy. Below are 5 common problems we see in physical therapy that may be influenced by a poor squat.
- Knee pain: This is one of the most common areas of pain with a poor squat pattern. It can come in many forms and with different diagnoses: anterior knee pain, patello-femoral pain, patellar tendinitis, jumper’s knee, runner’s knee and degenerative joint disease or arthritis among others. These are all knee problems caused by poor mechanics and increased stress at the knee. The knee is a joint greatly influenced by the joints around it. With a valgus collapse pattern, the altered position of the femur causes altered stresses at the knee cap, which can cause tracking issues and increases stresses on the tendons, bursa, and joint surfaces. Frequently people can rest their way out of pain initially, but have difficulty returning to pain free activity until they alter their movement patterns.
- IT Band Pain: IT band pain is pain on the outside of the knee, which is thought to occur with repeated friction of the tendon in sports like running. Again rest and anti-inflammatory treatments can reduce the symptoms. But, the altered mechanics of your hip and femur will add tension to the IT band which can help create the friction which causes the injury.
- Shin Splints: Shin splints is a name for a number of conditions which cause pain in the shin, generally with running. It is very common in adolescents in sports such as soccer, basketball, and distance running. Pain can be occurring because of tendinits in the tendons which the ankle, or in more severe cases stress reactions or fractures. Persistent pain in this area because of the risk of stress fractures.
With valgus collapse, the forces from above the foot can cause the foot to have to over pronate or flatten too much during walking and running. This can create extra work on the muscles in the lower leg which then can create this pain over time.
- Plantar Fasciitis: Plantar fascia pain occurs in the heel, sometimes up into the arch of the foot. Frequently symptoms are worst first thing in the morning or after sitting, feeling like a sharp pain in the heel which can reduce somewhat with walking. Heel bone spurs and tightness in the fascia are often given as the reasons for the problems. Again rest and treating the inflammation can help with immediate symptoms, but with return to activity the pain can stubbornly return. The same valgus collapse forces that we noted with shin splints can also be an issue for your heel pain. The increased pronation forces on the foot will repeatedly over stretch the fascia. Over time this can lead to tearing in the fascia or it pulling away from the bone. This can lead to spurring as the body tries to hold onto it by throwing down more bone.
- Hip Bursitis: Hip bursitis is the result of inflammation of a bursa on the outside of your hip. It can be tender to touch and in severe cases make walking very difficult because of pain. Poor squat patterns can show that hip control is poor, which can lead to increased pressure and friction on the bursa. Over time this can cause it to inflame and cause pain.
As you can see a number of variable conditions can occur because of your squat movement pattern being faulty. If you have any of these conditions and are having trouble returning to activity because of them, you may want to look at how you squat and see if you can correct it. If you are embarking on a new fitness or exercise routine, it may be beneficial to check out your squat to avoid any future issues.