Deep Sqauts: Personal Trainer vs Physical Therapist
geogal95
Posts: 47 Member
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!
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!
0
Replies
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This is even a question?
Listen to the medical doctor.3 -
If you knees are hurting (more than ever) then stop squatting and any other strenuous, knee centric movement until you get that situation resolved2
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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.0 -
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.1 -
I am not sure your therapist is a doctor but your trainer certainly isn't. Don't go past parallel.1
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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.1
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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.0 -
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.0 -
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.1
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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.1
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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.1 -
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 nutrition0 -
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.1 -
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.0 -
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!0 -
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.0 -
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.1 -
One of these people is qualified to advise exercise to an individual with a medical condition/injury.
The other is not.2 -
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.0 -
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.1 -
I am having real issues with my knees, and my physio has tried now since 2009 to find ways to help my hyper-mobile kneecaps from going on their own little voyages of discovery.
I have had a couple of flare-ups which my physio believes are the bones grinding where the cartilage has gone, and she has defined a series of ongoing stretches, and imposed certain limits (latest - no running until Feb and then only a minute A MONTH...!).
I've had weeks off, very limited stuff (cycle, swim).
Now gradually adding walking on a treadmill, elliptical, rower ...
My Physio told me the same - no going past parallel - I've discussed this with my Doc (who sent me for an X-ray at the start of the year) and my Personal Trainer.
Doc has tentatively allowed me to ramp up, and the PT took me back through using TRX Straps to take my bodyweight through my arms so I can isolate and focus on form while doing squats and lunges.
My advice is to take the Physio's advice over the PT for the time being... it's not forever... but if it is hurting that much, you really do run the risk of a lot of pain.
If the pain is quite hard to bear, look at maybe doing so low-impact stuff so you are still burning cals, but not knackering your knees...0 -
Okay let me clarify that I have been a stay at home mom for 7 years so I have been out of the loop. However I worked in athletic training and physical therapy for years. Deep squats were always contraindicated with any patellafemoral issues. We always did a shallow wall squat with a ball between your knees to focus on the VMO (The quad muscle that is very important in tracking the patella). Like another said, leg extensions are nasty for it too. I would listen to your Physical therapist and adjust how you are doing the squat.0
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The medically-qualified person is asking you not to give up squats, but only to change how you're doing them. This person has significant experience and specialist training in how your knees function. Listen to them. Your trainer's knowledge in this area is almost certainly less that that of a medical specialist, and probably focused on those with healthy normal joint function, for whom deep squats may or may not be contraindicated. For someone with impaired joint function, any action that puts extreme pressure or stress on the afflicted joint is going to be problematic - it's common sense. There's really no question here - listen to the medic. Otherwise, I'd suggest you start saving up for knee replacement surgery.1
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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.
Yes in a 'healthy' individual. But the OP is not 'healthy' She is having knee issues and is paying a medical doctor to treat her. So ATF is not the best idea.
Healthy is quotation marks because I'm not meaning to criticism the OP regarding her general health.0 -
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
This is your situation. You do not currently have healthy knee function. So stop the deep squats and listen to the physiotherapist. You need to first correct the knee function. That is what your therapist is working toward. Then you can work on building the strength/endurance that bootcamp gives.0 -
Always good advice. Seriously. Not being silly*. It's important for back AND knees.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.
*maybe a little bit0 -
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 but to answer your other question squatting deep is good for people with healthy knees and in itself does not cause knee problems. Overly shallow squatting does cause knee problems eventually.0 -
Ok another clarification is necessary: MY COACH IS "NOT" TELLING ME TO DEEP SQUAT RIGHT NOW. He knows my situation and if I want to keep it at parallel he is absolutely fine with that. He will make sure my form is exactly what the PT asks me to do.
My point was that he disagrees with her on the matter of "does it cause injury", that's all.
This is not a competition weightlifting... it is just a fitness class to help me get in shape, that's all. He is looking out for my best interests and not for a "win", and I trust him 100%.
I just wonder if the PT says this to everyone, healthy or not. Maybe for me, it is hereditary (my son and sisters all have knee issues - 2 out of 3 have had surgery for them). Maybe for me, squatting didn't CAUSE the problem, it just didn't HELP it.
This is the article he referenced. It's lengthy but interesting reading:
http://www.biomechfit.com/2012/02/09/3-squatting-myths-that-refuse-to-die
But yes - my plan is to do what the PT says which is parallel squats, leg lifts, etc... for the next 6 weeks and then I will be re-evaluated. I am following her plan to a "T".0 -
I damaged the cartilage in my knee a couple of years ago in a skiing accident. My personal trainer would always defer to my physical therapist on what I should/shouldn't could/couldn't do. Ask your PT for exercises to strengthen the muscles around your knees that will provide move stability and potentially you could get back to deep squats again.
My knees still act wonky occasionally, but I chalk that up to an active lifestyle and a bit of aging (I'll be 43 on Monday). I usually do squats now using the TRX, and I have no problems--then again, I don't usually do ATG squats...0 -
Haven't read all the threads so if this has been mentioned already, I apologize.
When you partial squat, your quads are dominant and pull on the patella (knee). Bad for the knees.
When you ATG or squat below parallel (the CORRECT way to squat), your hamstrings are now more involved and they pull on the patella as well, so now you have an even pull on the patella from both the quads and the hams. This is safe for the knees.
I'm not posting this to say your Personal Trainer knows more than your physical therapist. There's just so much misinformation on this forum that I don't want people thinking deep squats are bad for the knees, when in reality it's the partial squats that are.1
This discussion has been closed.
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