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Saturday, 9 September 2017

Are Universal Squatting cues good for everyone?

                   

In Bob Takano’s blog, there was an in-depth series of discussions regarding the use of the extreme “knees out” technique when performing the squat.  For those of you not familiar with Bob Takano, he is a USA Weightlifting Hall of Fame inductee who has coached numerous champions at the national and international level.

The debates were sparked when a chiropractor and former USAW Sports Med Chair, Dr. Brendan Murray, emailed Takano about the reasoning behind why athletes (crossfitters specifically) were shoving their knees out forcefully outside of the foot and ankle during squatting and pulling movements.  Murray was finding an increased number of injuries in his clinic, which he thought was due to this technique.  This practice was quickly attributed to the teachings of Kelly Starrett, who’s side I will refer to as, “The Supple Leopard Camp”.  The fun ensued shortly after, as this became a hot topic in the rehab, crossfit, and olympic weightlifting worlds.  The 6-part series of debates can be found here:

http://www.takanoathletics.com/blog/?p=3269

http://www.takanoathletics.com/blog/?p=3272

http://www.takanoathletics.com/blog/?p=3276

http://www.takanoathletics.com/blog/?p=3280

http://www.takanoathletics.com/blog/?p=3286

http://www.takanoathletics.com/blog/?p=3289

To be honest, I was completely oblivious to the drama until I received a voicemail from one, Russell Berger of Crossfit HQ, asking my opinion on the subject as a PT and competitive weightlifter.  It was going to be the topic on some type of Crossfit TV show or something.  I then read the whole 6 part series in my car on my trusty Iphone.  I encourage you all to take a look at the arguments and formulate your own opinion.

 The dealings with CrossfitHQ have not panned out, as of yet; so I will have to put my TV star aspirations on hold.  Regardless, I want to share my thoughts on the subject, because I am encountering many of the same issues in clinical practice.

My goal for this article is to be as objective as possible, and by no means is this meant to be some personal attack or internet jab at Kelly Starrett or his Supple Leopard camp.  Starrett was a big influence in my decision to go to PT school, and his work has continued to influence my practice up to this point; though, my philosophies have evolved greatly over the past 3 years.  Also, I do not intend this article to be an argument for whether shoving your knees out past your feet is right or wrong.  I simply want to address specific statements that were made, because I believe they may contribute to the issues and misconceptions (key word) I see clinically.   Here go’s…

Opening Statements

“Knees out is not the same as driving hips into ground And we seem to solve knee problems.  And back problems.  In everyone.  And help set American records. And world records.” –Kelly Starrett

This was K star’s entire contribution to the discussion.  Basically, I took this to mean,  ‘I’ve got a plane to catch and don’t have time for this shit’.  I cannot imagine how much of this he deals with on a daily basis.  So I’ll leave this one alone.  But c’mon man… You solveeveryone’s knee and back problems?  That’s a damn good percentage.  I can’t wait for that data to hit the peer reviewed literature.

From this point, the minions from the Supple Leopard Camp take over the debating responsibilities.

“Let’s establish one thing, with any movement the goal is to produce the most amount of torque and not allow any torsion [to] occur on a compression/loaded body.  This directly also creates positions that get rid of every single injury we have ever seen in all our athletes/non-athletes.”

–Supple Leopard Camp

The first sentence will be addressed later.  However, the proclamation that this technique, “gets rid of EVERY single injury we have EVER seen in ALL our athletes”, irritates me to the core.  Again, please publish these incredible outcomes.  There is no faster way to lose credibility than to say your shit works for everyone all the time, without data to back it up (I’m trying to stay objective, I promise).

Regarding The Creation Of Torque In The Hips

“Let’s establish one thing, with any movement the goal is to produce the most amount of torque and not allow any torsion [to] occur on a compression/loaded body.”  -Supple Leopard Camp

and

  “During Oly- or Power-lifting the goal again is to set yourself up to produce the most amount of torque to get the bar from point A to point B.”–Supple Leopard Camp

 This idea of “torque” that the Supple Leopard Camp continued to refer to is in reference to Starrett’s book, where he frequently refers to the ‘Laws of Torque’ at the hip and shoulder.

In human biomechanics, internal torque is (Muscle Force) X (Moment Arm).  The product of these two produces a force that acts on something – in this case the femur when squatting.  I have not seen any evidence that suggests pushing your knees outside your feet alters internal torque in the hip in a favorable way, as it is explained in KStar’s book  (which is not a peer reviewed source, nor does it contain any references).  This is also a very difficult thing to quantify because below 90 degrees of hip flexion, the functions of many of the muscles that cross the hip are altered – some of the external rotators becoming internal rotators for example.1  It is fine to use these terms anecdotally, but to say the goals of weightlifting and powerlifting is to produce the most amount of torque is ambiguous at best.

Regarding Stability Of The Hip And Spine When Squatting

“If we want to speak anatomically/biomechanically/physiologically then we know that the hip is the most congruent at 90 degrees of flexion in moderate amounts of abduction and external rotation.  Since Oly lifting requires more depth (Ass to Ankles) then we have to get more external rotation and abduction to maintain this congruent (minimal passive tension) to maintain the stable spine and vertical torso.”  -Supple Leopard Camp

 and

 “Athletes that are squatting with toes out and knees tracking over the feet will have to find stability elsewhere (since it is not coming from the hip)”–Supple Leopard Camp

 I found no evidence suggestion that “getting more” external rotation and abduction when squatting past 90 degrees maintains congruency and minimizes passive tension.  In fact, by shoving your knees out maximally, you would actually increase ligamentous (passive) tension, and limit your ability to attain more hip flexion.  It is shown that full hip flexion (≥120°) decreases passive tension of the capsular ligaments, and increases tension in the glute max.  Full hip flexion also mechanically prepares the adductors to help with hip extension.2  So, if you are limiting hip flexion in any way, you are limiting the rubber band effect of glute max and adductors.  Where I come from, the goal of a squat is to stand up, so maximally loading the muscles that help you do that is probably a good idea


I found nothing to suggest that letting your knees track over your ankles and squatting straight down creates instability in the hip or spine.  The athlete should be able to continue flexing at the hip, while maintaining a neutral pelvis.  If they cannot, I don’t believe the answer is to tell them to shove their knees out in order to compensate (clinical opinion).

http://www.jtsstrength.com/articles/2013/11/15/supple-leopard-vs-world/



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