Too many patients get told not to squat past 90 degrees knee bend. This is supposedly to save their knees from the horrors of arthritis and strengthen their knees...
We have a problem in our modern, western society. We get up in the morning and we sit on the toilet. If we have breakfast, we sit down for that if we are lucky. We either sit in traffic in a car of bus or we hope to get a train early enough to get a seat..TO SIT ON! We love to sit around for work, we then come home and sit at the dinner table and then transition to the lounge where we sit in front of the TV. When we get older, we ship off to the nursing home where the majority of the day, they have us...SITTING! Have you noticed the trend? WE SIT TOO MUCH!
Have a look at our older folk in the community. Watch how they struggle from a chair. Have you noticed that some people avoid sitting on the lounge? They hate sitting in sports cars because they are too low to the ground. In hospital, we accommodate them with chairs and beds so high that their feet barely touch the ground...just so they can get out of them easily.
Some random facts for you.
1. By the time you hit 90degrees, you have LOADS of pressure on your kneecaps anyway. In fact, one study (click here) found that MAXIMAL contact pressures occur at 90 degrees and is about 6.5 times bodyweight. Take home message? You aren't preventing the knee from loading up to the max stress, you are taking the knee to max stress!
2. Most chairs that we sit on today have your thighs just about parallel. Being the good OH+S physio that I am, I counsel people to keep their knees a fraction below their lateral hip bone (greater trochanter). Guess what? That angle is usually more than 90degrees!
3. Have you ever sat in a comfortable lounge? I will bet that your knees were a bit higher than your hips. I know this because it "tips" you back more and you "lounge" around more. Have you seen the comical person trying to get out of a lounge? I bet they don't squat (or if they do, it was not long after Squat Day!)
4. Everyone will get old at some stage. Arthritis foundations around the world suggest strengthening programs for your knees. Start squatting now!
Obviously, some people have found this advice a bit late. They already have arthritis and struggle to even make it up a little step. Some people are born with problems that no amount of squatting will fix. I understand and I recognize that. It breaks my heart that a close family friend has bad arthritis in her knees and she can't squat...we just have to make do with whatever exercises she can to strengthen what she has left.
I hope that takes care of any trolls wishing to point out what a bad Physiotherapist I am 😉
But I will contend that nearly everyone who complains of knee pain can do some form of squats. If you can walk and you can sit down on something from standing, then you can squat!
- Learn to Squat below parallel - get as low as you can go. If you have pain, STOP! This isn't a competition. If you don't feel confident in your ability, ask someone.
- Begin by controlling your sitting to a chair - I don't care how high or low it is...just control it all the way down...then get up without using your hands if possible
- Progress your squats by going to lower chairs...see! I am not just a shiny head 😉
- Start to practice getting up and down multiple times - consider doing 5 squats every time you want to put food or drink in your mouth
- Consider actually putting a barbell on your back and learning how to squat below parallel with weight on your back. Your first medium term goal is a bodyweight back squat. Your first short term goal is to actually get to a gym and do this!
- Challenge ANYONE who tells you to stop at 90degrees because of safety. Ask them "why?" Ask for proof. Tell them to debate me. Ask them how is it functional to stop at 90degrees.
We need our knees to bend more than 90 degrees, even if it is just to sit on our butts and get out of the chair. The research supports my position. The research supports weights as a beneficial, healthy thing to do. Squatting below parallel (when done properly) is good for you and will carry over into every day life.
Do you want to be that person who struggles to get out of a chair? No? THEN SQUAT PROPERLY!!!
Here endeth the rant 🙂 Thank you.