Deep Sqauts: Personal Trainer vs Physical Therapist

I agree w/those that said to give your knees a break if you're in pain, and try to resolve any injuries, etc. first.

That said, I have also had knee pain periodically, and learned NOT to do deep knee squats in all my previous training (the whole "Don't go past parallel" thing). I would still have periodic pain, depending on what we were doing, how often, and how much weight we used.

However, I've recently started working with a great CrossFit gym with good trainers who work with us slowly and methodically on form. We do deep squats a lot, BUT, our form is completely different than what I learned in other fitness classes (and even in Group Fitness Instructor training).

When we do deep squats, the toes and knees are pointed slightly OUT to let your hips open up more and your back and chest stay more elevated. You are following your mid-line down to the ground instead of leaning over to accommodate keeping your knees straight on. Because of the levers and angle of your legs, it is actually GENTLER on your knees -- and puts less pressure on them, and relies on your leg muscles -- than the legs parallel squat.

I have not had knee issues doing these deep squats, even with heavy weights. BUT, our trainers also do NOT have us do any squat moves if we are having knee pain. We do other workout movements and lots of therapeutic stuff (rolling things out, working on IT bands, stretching) until the pain resolves.

Hope this helps.

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.

I'm not going to disagree with your general premise. You're correct that most trainers recommend deep squats and for good reasons (assuming healthy knee function, etc). But really? Babies do it so it must be "natural" and "correct"? Babies learn almost everything by watching us. They can't even stand till they learn the trick of it, and most of the motions that they attempt while standing result in them falling down. The reasons babies squat the way they do is that they learn it's the most stable way to squat, and they lack the balance and coordination to do anything but the safest and stablest movements without winding up on their butts. It so happens that stability is also very important to weighted squats, so the same motion is also correct for adults doing the exercise version.

If "the way babies do it is the correct and natural way to do it" was a valid argument, the correct way to run would involve hardly bending your knees at all, and winding up on your butt every ten yards.

Sounds like you have a good course of action - follow the advice your PT (and by extension, your coach) wants you to follow right now, see if your knees can't improve a little, and reassess.

In the future, things like this are always a risk-reward analysis. There's always, always, always another (or a series of other) movement(s) or exercise(s) that will work your body in a similar enough manner to the one in question. That's the beauty of the human body, we're so frigging adaptable and capable. So maybe squats past parallel won't hurt your knees, but maybe there's another movement that your coach can come up with that will do something similar, and your PT can agree on.

My example: I have a crappy SI joint. Lunges will leave me unable to walk the next day if I've been lazy and let things go (sadly, not rare). My coach doesn't like that I won't do lunges, but came up with a couple different moves to do instead - surprise, they're the ones I skip usually because I don't like them, because they're really hard and exhausting. But they won't leave me unable to walk, and when I do them regularly and get stronger, I can lunge again.

Another note - I didn't read your knee issue too carefully, but PT isn't the only option before surgery to fix joint issues. I was all set to have my spine fused before I got prolotherapy (google it) on my back - it worked amazingly well. (then again, my husband had a similar issue to me 5 years later and it didn't do anything for him - accupuncture and massage did work for him but not me). Just saying to keep your mind and options open, there are lots of possibilities and specialists and insurers might confuse "outside their purview" with "outside possibility".

Good luck!

DON'T go past parallel, stick your butt out....pretend you're holding onto a bumper to pee off the back of a car! lol But don't go past parallel!

The doctor is giving you the safest advice. A good trainer will be able to fix your squat issues.

Pretty simple really - listen to your body - right know it tells you - I don't like the way you do squats!!
Your physical therapist is right - don't go below parallel - or as my physical therapist calls them " potty squats"

I have had a knee replacement in August, so really needed o do things different ....... Soooo my advice don't aggravate your knees more than you need to - your body will clearly tell you when you need to adapt things!

On the patella re alignment (patella tracking) - my physical therapist taught me a way to tape my knee that helps with the alignment of my patella when I exercise - ask him / her about it - at least helps while I am working on strengthening my muscles

http://www.physioadvisor.com.au/11343550/patella-taping-mcconnell-taping-physioadvisor.htm

Always ALWAYS listen to your Doctor first!!

On a side note - I'm old school (lol like 1980's jazzercise) we were always told NOT to go deep into the squat, so that's the way I've always done mine. No science or research behind it....it's just what I'm comfortable with.

This is something that varies from individual to individual. My experience is that those with a history of knee problems should never to deeper than ~80 degree bend of the knee. However, if you do not have knee problems, there is nothing wrong with going below parallel, provided that you hold good form (back straight and knees behind toes). It has been shown that force actually is at it's peak at a 90 degree bend of the knee.

Much of the distribution of force has a lot to do with knee position (behind toes and not deviating medially or laterally). Many people have a really tough time keeping their knees behind their toes during below parallel squats, usually because your quadriceps are at such a mechanical disadvantage. Again, the condition of your joints and your form will dictate weather or not you should perform an exercise.

Reference to the study showing where forces peak during squats. You'll notice that it is during the concentric phase at 90 degrees.

http://steinhardt.nyu.edu/scmsAdmin/uploads/006/008/Gullet et al 2009 - J Strength & Conditioning Research.pdf

HelloDan wrote: »

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.

What is your therapist doing to help you develop the strength/balance/coordination to return to ATG squats.

My PT suggested I back off from ATG while I worked on my Glute activation/hip mobility.

IF the PT advice is "never ATG" then there's likely an issue, unless you have an unmentioned physical issue.

If the metric we're using to restore someone to as full physical functioning as possible, my experience with physical therapists is they're at best useless to this endeavor. The whole "squats bad for knees/ don't go below parallel / no knees past toes" is entirely made up out of whole cloth.

DrMAvDPhD wrote: »

This is even a question?

Listen to the medical doctor.

Therapists are not medical doctors. However, consulting one for a third opinion is a good idea. Orthopeadic surgeon would be your best bet.

This is what I was going to say.
Your trainer is not a medical person and it sounds like your knee issues are a medical issue.
On the other hand, what the physical therapist is telling you is the old-school canard about squatting.
Get another medical opinion. See what the new person says.
(I am not sure I would go with an orthopedic surgeon, though. They only see people with serious, serious issues, and they do not see or work with healthy people. So they do not necessarily have perspective. Also, they don't really follow people or work with them. They see someone once. They operate. They say goodbye. It's not the kind of attention that breeds expertise, except for surgery.)

Wait a second.....How did i get suckered into a four-year-old thread?