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Why mini squats are BAD for your knees

May 1, 2012

In this video Dr. Spina discusses why the most popular exercise prescribed for knee rehabilitation, the “mini squat,” is bad for your knees.  As described, the mini squat places an un-checked anterior force on the tibia thus leading to anterior shearing of the tibia-femoral articulation.  This is caused due to the lack of posterior line activation.

Also discussed is how to use Progressive Angular Isometric Loading (P.A.I.L.’s) to correct ‘winking’ (counter-nutation of the sacrum) in the ‘basement’ of the squat.  While most think this problem can be corrected by simply improving hamstring flexibility, it actually requires more….

Take home points:

1.  When prescribing squats for your patients/clients, the maximum possible depth should be encouraged (of course this means the maximum depth that can be achieved with proper form…for example without squinting).  To progress to lower depths, use progressively lower ‘targets’ to sit back onto.

2.  In order to prevent squinting at the bottom of the squat (the basement), it is not only a matter of creating improved flexibility in the hamstrings…but creating eccentric strength in the hamstrings outer range of motion…thus the utilization of Progressive Angular Isometric Loading.

3.  Utilizing P.A.I.L’s training in the ‘sticking-points’ of a squat, or any other exercise will allow the athlete to overcome the troublesome range.  P.A.I.L’s teach the nervous system to maximally recruit motor units in a given range.  Recall Hennman’s size principal – increased numbers and sizes of motor units will be recruited based on demand – by using isometric efforts, you have essentially created maximal demand as the object is by definition never going to move.

WANT FREQUENT CLINICAL & ANATOMY ‘GEMS’ THROUGHOUT THE DAY?  FOLLOW Dr. Spina on Twitter @DrAndreoSpina

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5 Comments leave one →
  1. May 4, 2012 2:08 pm

    Hello,

    I don’t understand the notion about hamstring flexibility completely.
    If the hamstrings were short or contracted or not allowing end range eccentric work, then thy would rotate the innominates posterior, therefore putting the sacrum in nutation, unless the sacroiliac ligaments and their connection to the hamstrings would also play a role in this. Could you elaborate on this?

    Thank you.

  2. May 7, 2012 7:01 pm

    Hi Colo
    If the hamstrings are not mobile enough to allow the range to be achieved there would be a pull through the sacrotuberous ligament, to the long dorsal sacral ligament which would cause the innominates to rotate posteriorly. As the SI joint has a maximum of 3-5mm of movement it means that “where the innominates go…the sacrum goes”…and thus it would not nutate as you mentioned…it would counter-nutate — hence the winking. In order to maintain a nutated sacrum, and thus maintain the lordosis of the lumbar spine, the hamstrings must be simultaneously flexible enough to ‘allow’ the motion, but strong enough to eccentrically control it

    • May 11, 2012 10:37 pm

      ok, but then counternutation might be not the right term here, since you mean more like a posterior pelvic tilt, which I can absolutely agree on.

      • May 15, 2012 3:37 pm

        Hi Colo

        Counternutation is in fact the correct term. As the sacrum counternutates (i.e. the sacral base tilts posteriorly) the innominantes have to follow thus also creating a posterior pelvic tilt. So we are in fact in agreement as we are saying the same thing.

        thanks for commenting

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