Why We Can t All Squat The Same and What To Do About It. Dean Somerset, BSc. Kinesiology, CSCS, CEP, MES. Who am I?
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1 Why We Can t All Squat The Same and What To Do About It Dean Somerset, BSc. Kinesiology, CSCS, CEP, MES Who am I? Anatomical Differences 1
2
3 WARNING!! Nerd Alert GYNOID ARTHROPOID ANDROID PLATYPELLOID 3
4 Zalawadia et al (2010) NJIRM; Vol. 1(3), July-Sept. Courtesy paulgrilley.com Retroverted acetabulums concentrate pressure on posterior Acetabulum. Reynolds et al (1999). J. Bone & Joint. 81-B, 2 4
5 Fern & Norton (2015) J. Bone & Joint Surgery (epub) Zalawadia et al (2010) NJIRM; Vol. 1(3), July- Sept. 5
6 What s the Point?! Femoroacetabular anteversion ++ flexion, -- extension! <45 degrees Acetabular abduction (lateral placement) ++ flexion, >45 degrees decreased rotation & adduction degrees gave best overall mobility! Thicker femoral necks decreased ROM! D Lima et alj Bone Joint Surg Am Mar;82(3): MOTION CONE DIAMETER Bone Blocks - FAI 6
7 Prevalence of FAI! Asymptomatic cam deformities: 37% à 54.8 in athletes & 23.1% general population! Asymptomatic pincher deformities: 67% à 76 in athletes & 61 in GP! Frank et al (2015) Arthroscopy Jan 28 (epub ahead of print)! Post-op, retroversion has clinically significant reductions in outcome measures vs. anteversion! Fabricant et al (2015) J Bone Joint Surg Am Apr 1;97(7): The Hip and SI Joint! Radiographs of hips in patients with SI joint pain:! 33% had cam impingements, 47% had deep hip sockets or medial protrusion into pelvis! Morgan et al (2013) Hip Int Mar-Apr;23(2):212-7 What the Hell Was The Point of That??! Everyone is different! Not everyone should or ever will squat ATG! Forcing a range of motion on someone who can t achieve it results in bad things.! Varying foot position, width, depth, front/back alignment is necessary to find individual optimal 7
8 The failure of an individual you re working with to deep squat, in many cases, cannot be corrected. - Dr. Stuart McGill ANTEVERTED RETROVERTED V. LIMITED FLEX, NO ++ w/ ABD, GOOD EXTEN. GLOBALLY LIMITED Stratifying Hips RESTRICTED FLEX, BEST w/ ABD, GOOD EXTEN. GLOBALLY LIMITED NOT FULL FLEX, NO ++ w/ ABD, LIMITED EXTEN. FEW LIMITS BEST FLEX w/ ABD, GOOD EXTEN. FEW RESTRICTIONS THICK NECK, DEEP SOCKET RESTRICTED FLEX, GREAT EXTEN. FEW LIMITS NOT FULL FLEX, BEST w/ ABD, GOOD EXTEN. FEW LIMITS < FULL FLEX, GREAT EXTEN. NO MOB LIMITS FULL FLEX, ER, GOOD EXTEN. HIGH MOBILITY THIN NECK, SHALLOW SOCKET INFERIOR LATERAL INFERIOR LATERAL How to Tell Passive table assessment! Hip Scour McGill, Low Back Disorders 2 nd ed (2007)pg 199! Look for hip movement limits, painful spots, mapping their mobility à DON T DIAGNOSE!!! Supine abduction/er FABER test! Prone extension femoral nerve test! Prone rotations Craigs test 8
9 ! Active Assessment How to Tell! Rockbacks alter knee position to observe hip flexion! Hip bridging, 3-point hip extension! Supported squat depth before butt wink! Unsupported squat depth before butt wink How to Tell! Stuff that gets in the way:! Soft tissue restriction, degenerative changes, injuries, fear/guarding! Test, corrective exercise, re-test to see change! If change occurred, you just found your warm up.! If no change, move on Check for Test What it means Movement Checklist Structure CNS, motor patterns Passive Mobility Stability series, Novel movement Theoretical limitation to active range available If (+) with stabilization then (-) when removed, work more with ++ stability. If movement gets easier with reps, could be novelty Strength & Conditioning Reps and More Reps Train hard, and stop when fatigue disrupts movement quality 9
10 Corrective Options! Mobility vs. Stability?! If basic core exercises ++ ROM in any test, they need stability as their warm up! If stability work doesn t ++ ROM, they d benefit from active mobility & pattern grooving! If ROM doesn t ++ with corrections, red light situation. Work within limits Contreras et al (2013) JSCR, 35(2), April 2013 Reprinted With Permission From Bret Contreras 10
11 Nemeth et al, (1984) Scan J Rehabil Med; 16(3): Escamilla et al, (2001) Med Sci Sport Exerc: Aug; 33(8): Schache et al (2010) Gait Posture, 32(1):
12 To Recap! Assess CLIENTS individual ROM, determine if structural or control limitations! Find positions to best train client within their own limits! Provide & remove stability to test ROM outcomes, use appropriate intervention! Use a variety of exercises to get benefits from torque development through entire range of motion. It s Time to Make Choice! You could keep reading random websites, books, and blogs to try and figure out how the core functions Or You Could Have it All Laid Out for You on a Silver Platter 40% off 12
13 What s in Advanced Core Training What are the components?! 4:10 of condensed training knowledge! All 5 components of core training! Digital video series Instant access + watch from anywhere in the World whenever you have time Highlights! Detailed outline of core / hip function! Simplified approach to core training used for all clients (rehab to elite)! All exercises and coaching cues 40% off! Trainers and group-ex instructors who have clients that desire a stronger and nicer core! Anybody who trains people in pain or post-rehab! Coaches looking to improve athlete performance Who is this for? 40% off What Should This Cost?! If you were to see Dean live it would cost $499, and that doesn t include flights and hotel.! Regular price for this video series is $ % off 13
14 Special Launch Price 40% Off! Get your copy today at and get 40% off! Advanced Core Training is only $59 right now and you get immediate access anywhere in the World. 40% off Questions? 40% off 14
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