Deep Sqauts: Personal Trainer vs Physical Therapist

Options
geogal95
geogal95 Posts: 47 Member
in Fitness and Exercise
I have a dilemma:

Background: I am a 43 yr old female and am about 5'4". For most of my adult life, I have not made the healthies decisions. My top weight in my life was probably around 190. However, about a year or two ago, I started to change that. I started hiking and mountain biking, which I love to do. My knees would certainly ache after a hike (coming down the trail is always harder on them). At that point, I weighed probably 175. In July 2012 I joined a bootcamp and barbell program. In 5 months, I have lost 20 pounds and have gone down 3 pant sizes. I am now about 155. I love doing this!! However, lately my knees have been hurting more than ever. My doctor says that my kneecaps are out of alignment and that I needed physical therapy to strengthen the inner thigh muscles which will put my patella back in place. Currently, I have bone on bone crunching going on in there every time I bend and straigthen my leg. Here's my dilemma:

My bootcamp and barbell personal trainers have me doing deep squats (ATG - *kitten* to Grass), which I have been doing all along. My physical therapist says to NEVER go below parallel on my squats, with or without weights. My trainer says there is nothing wrong with it, that there is no actual medical evidence to support that doing a deep squat injures your knees. As long as they are done properly, it will only help. He has even provided articles to disprove what the therapist says.

My trainer/coach has coached thousands, from young to old, including olympic weightlifters and really knows his stuff! My therapist went to school to learn this trade. I want to believe my coach because real life vs books are completely different. However, I am also going to therapy to make my knees feel better and I kind of have to choose which one to believe.

Since my knees started hurting long before I started bootcamp, I tend to believe that it's not the bootcamp or weightlifting that is causing damage, I just feel it more now.

I know this is a touchy subject as people are usually passionate about their beliefs when it comes to this.

Outside of putting these two in a room to duke it out... you got any feedback that could help?? My main goal is to not have to stop this path I am on.. but do it with as little pain as possible!

Thanks!
«134

Replies

  • Lozze
    Lozze Posts: 1,917 Member
    Options
    This is even a question?

    Listen to the medical doctor.
  • DavPul
    DavPul Posts: 61,406 Member
    Options
    If you knees are hurting (more than ever) then stop squatting and any other strenuous, knee centric movement until you get that situation resolved
  • jayche
    jayche Posts: 1,128 Member
    Options
    What DavPul said.

    I'm surprised your therapist even suggested you do squats in the first place, thought that would be the first thing they'd tell you not to do if you were experiencing knee problems.
  • Linli_Anne
    Linli_Anne Posts: 1,360 Member
    Options
    I had knee problems when I started my learn to run, and pushed myself too hard too fast. (Won't do that again).

    I went to my physiotherapist, and same thing, my knee cap had slipped out of alignment.

    Along with the ultrasound and TENS treatments, he had me doing exercises at home which included squats, leg lifts, and actually sliding my knee cap into place and holding it there for a few seconds. His advice with doing the squats though was this: Chest above bum, bum out not tucked under, and knees NEVER over toes. He said to keep that form properly, and likely I wouldn't get much farther than with my quads in line with the floor.

    For the first 3-5 weeks of my treatments though, I was told no additional exercising/running etc. to let things heal.
  • BeachGingerOnTheRocks
    BeachGingerOnTheRocks Posts: 3,927 Member
    Options
    I am not sure your therapist is a doctor but your trainer certainly isn't. Don't go past parallel.
  • drgndancer
    drgndancer Posts: 426 Member
    Options
    I'm a little shocked that your trainer would advise you to go against your therapists advice. Even if he disagrees with the advice, it's never a good practice to ignore a medical professional as a trainer. If something happens and your knee gets worse (even if it's not his fault) he's opened himself up to possible liability. That's dumb. I'd follow the therapist's advice, at least until your knees are stronger.
  • Jim1960
    Jim1960 Posts: 194
    Options
    My trainer says there is nothing wrong with it, that there is no actual medical evidence to support that doing a deep squat injures your knees.

    "In conclusion, there is scant evidence to show that deep squats are contraindicated in those with healthy knee function. The decision as to how low to squat should therefore be based on an individual's performance-oriented goals and considered in conjunction with any pathological issues that may be apparent. Those with PCL disorders should refrain from squatting below 50 to 60 degrees until the injury is fully healed. Disorders such as chondromalacia, osteoarthritis, and osteochondritis may also contraindicate the performance of deep squats." from http://www.lookgreatnaked.com/articles/archive/are_deep_squats_bad_for_your_knees.htm

    It seemed like a reasonable article. Note that it says that if you have _healthy knee function_ then it's ok. If not - then don't. Listen to your Drs and therapists - they are assessing the health of your knees and advising you to exercise in accordance with your knee health. One other thing. Coaches, particularly ones for highly driven athletes have a tendency to push their trainees to their max - and often times past their max. Not all. But it is a tendency. Coaches are driven to win primarily - look after your health secondarily. Not to diss coaches. They care about your health - they have to. But it's a priority thing.
  • geogal95
    geogal95 Posts: 47 Member
    Options
    My therapist is not telling me to stop squatting, she is just saying do not go past parallel and make sure to stick the butt out and not let my knees go past my toes. Just to clear that up... she does not want me to stop what I'm doing, just change HOW I'm doing it.

    My knees do not hurt every day, but when they do, they make themselves heard.

    Linli_Anne: Yes that is my problem as well and I also have exercises I am doing at home like, leg lifts, calf stretches and IT band foam rolling.
  • mommyami1
    mommyami1 Posts: 154 Member
    Options
    I would say to listen to your therapist. Even though your trainer has worked with competitive athletes and knows his stuff, he is still in the business of making you look good, increasing your performance level, etc. Your therapist is in the business of healing and prevention. Not that your trainer has any ill will. He just doesn't focus on fixing your knee.
  • aproc
    aproc Posts: 1,033 Member
    Options
    While its true that ATG is great to do, when you ALREADY have knee problems then listen to your physical therapist. I don't know why your trainer would have you doing those if he knows about your knee problems.
  • AndyStanford
    AndyStanford Posts: 154 Member
    Options
    I had knee problems for 15 years before going to physiotherapy, which sounds a lot like what you've got. I couldn't crouch at all, because of how much it hurt.

    What did my physio get me doing? Stretching my leg muscles.

    What do squats do? Stretch leg muscles.

    Make sure you're going parallel, but maybe not beyond parallel, and push your knees out both on the down motion, and the up.

    Sounds like your therapist is saying the right stuff.

    Medical doctors have a good general knowledge of the human body, but unless they're specialists in the relevant area, which very few GPs are, listen to the specialist, every time.
  • ninerbuff
    ninerbuff Posts: 48,663 Member
    Options
    I would listen to the therapist.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 28+ years and have studied kinesiology and nutrition
  • SideSteel
    SideSteel Posts: 11,068 Member
    Options
    If you knees are hurting (more than ever) then stop squatting and any other strenuous, knee centric movement until you get that situation resolved


    This, absolutely.

    I'm part of the dead/squat/chin/bench meathead group and I had to totally quit squatting too, just recently due to knee pain. There is no lift that is mandatory, period. You can develop an outstanding physique without squats and if you are in "bad pain" then stop for now.

    You might be able to pick them back up later, after/if the knee improves.
  • Lozze
    Lozze Posts: 1,917 Member
    Options
    Fri 01/11/13 10:09 PM
    My therapist is not telling me to stop squatting, she is just saying do not go past parallel and make sure to stick the butt out and not let my knees go past my toes. Just to clear that up... she does not want me to stop what I'm doing, just change HOW I'm doing it.

    Sound advice.

    I'd be listening to the medical doctor. Who has studied for years and has examined your body.

    As opposed to a trainer we has no medical knowledge and has no idea what your specific medics issues are.

    If y insist on listening to your non-medically trained trainer overpriced Physichal therapist I would start looking,for a lawyer. Because you have an awesome case for negligence against your trainer.
  • sunsnstatheart
    sunsnstatheart Posts: 2,544 Member
    Options


    My bootcamp and barbell personal trainers have me doing deep squats (ATG - *kitten* to Grass), which I have been doing all along. My physical therapist says to NEVER go below parallel on my squats, with or without weights. My trainer says there is nothing wrong with it, that there is no actual medical evidence to support that doing a deep squat injures your knees. As long as they are done properly, it will only help. He has even provided articles to disprove what the therapist says.

    Your trainer/coach is one of those that has his own overly strong beliefs and is not going to listen to your personal limitations. Get away from him now before you get hurt!
  • stljam
    stljam Posts: 512 Member
    Options
    It sounds like you have a subluxation of your knee cap (partial or incomplete dislocation). I have had this for years (it is hereditary for me) and have seen numbers orthopedic surgeons/doctors for it over the years. If I was you, I would want a better sense of if this is a temporary dislocation or do I have a more semi-permanent condition like mine because that can guide you as to how careful you need to be in the future.

    Here is consistent advice that I received:
    1) Never, ever, ever do leg extensions
    2) Don't do squats. If you do disobey our suggestion, never go past 90 degrees.
    3) Ice your knees after any activity that puts stress on them
    4) Try to switch to lower impact cardio (skating/elliptical vs running)
    5) Use isometric exercises to strengthen the inner quad

    Here is what has helped me:
    1) Icing after activities helps a lot
    2) Using trekking poles for hiking - you can really use them to absorb some of the impact on the way down rather than your knees taking it.
    3) Using isometric exercises to strengthen the inner quad (stuff like http://www.livestrong.com/article/109807-easy-inner-thigh-exercises/). I also tolerate wall squat holds fairly well but that doesn't focus on just the inner quad.
    4) 30 days on followed by 30days off regiment of naproxen sodium. I only start this when they are consistently bad for a while. The drug needs to build in your system so taking it for 2 days likely won't help. Also, I have had numerous doctors tell me not to be on it for more than 30 days and to make sure I took 30 days off.

    Also, I had one surgeon try to talk me into a lateral release procedure to correct this. If anyone suggests that to you, I would suggest you do a lot of research before agreeing to do it. From what I have researched, I will not be doing that until the pain is pretty substantial and consistent. Of course, it could be right for you. I just don't think it is right for me.
  • erickirb
    erickirb Posts: 12,293 Member
    Options
    This is even a question?

    Listen to the medical doctor.

    Actually the proper way to squat is lower, it strengthens the knees. watch a baby pay with toys, they squat down, chest up back flat, feet flat butt almost on the floor. ATG squat is a natural position for the body to be in.

    That said, if you have knee or joint issues it may be a problem to do them this way, but baring any issue, ATG is the proper way.
  • IronSmasher
    IronSmasher Posts: 3,908 Member
    Options
    One of these people is qualified to advise exercise to an individual with a medical condition/injury.

    The other is not.
  • stljam
    stljam Posts: 512 Member
    Options
    I'm part of the dead/squat/chin/bench meathead group and I had to totally quit squatting too, just recently due to knee pain. There is no lift that is mandatory, period. You can develop an outstanding physique without squats and if you are in "bad pain" then stop for now.

    ^^^^^^^^^^This

    Along those lines, I can't squat because of the knee condition and can't do overhead or bench press due to a torn labrum. I just do other crazy modified exercises that still give me a good workout. Hasn't kept me from dropping 20% of my body weight and 10% body fat since August.
  • HelloDan
    HelloDan Posts: 712 Member
    Options
    Ask the therapist why they advise this?

    All might become apparent why they think it is a bad idea, as it might be something specific to your condition. Then again you might discover the therapist suggests this to everyone, even those with healthy knees.

    Either way, you have a bit more information, which will help the decision.

Categories