Last week we spoke about common compensations we see in the squats. Again, some common compensations seen are:
Increased Toe Out
Increased Stance Width
Lumbar Spine Flexion
Increased Forward Trunk Lean
Knee not in line with toe (Increased knee out generally with hip flexion restrictions and knees in generally with inadequate ankle mobility)
Athletes coming up on the toes (Weight shifting toward the front of the foot)
If you’re seeing some of these things in your athletes, you’ll know something is “off”. However, before knowing how to address these limitations we have to understand why compensations occur. In my mind there are several reasons why compensations occur:
True Flexibility Issues
Motor Control / Stability Issues / Cueing Issues
1) True Flexibility Issues
If someone lacks true flexibility (passive range of motion) at one joint they will make up for that lack of motion at another joint. If someone lacks hip flexion range of motion as they descend into the squat then they will compensate at another joint (Potentially lumbar flexion or with toe out). Limited ankle dorsiflexion often results in toe out as well. As you can see, true flexibility issues cause problems at other joints (even when there may appear to be no issue at the joint causing the problem). In the above example, limited ankle dorsiflexion and limited hip flexion range of motion may both cause the same compensation (Toes turned out). This is why it’s vital to assess that athlete thoroughly to make sure we’re addressing the true limitation and not providing a shotgun approach of mobility.
Individuals with true flexibility issues also tend to have compensation regardless of the exercise selected, weights used during the movement (sometimes movement improves with load – imagine a heavy load pushing someone down into a squat) or any cue you use as a coach. These individuals need to be taken aside and assessed.
Nerd Side Note: Restrictions can come from a joint or joint capsule, boney restriction, muscular or neural tension restriction. You’ve really got to be on your “A” game when trying to figure out these restrictions. Things like end feel and where patients feel their symptoms (and description of their symptoms) really comes into play here. I generally use the Selective Functional Movement Assessment to determine where limitations come from and a variety of other tests to determine what I feel is the most limited structure.
The major areas of flexibility limitation in the squat:
Ankle Dorsiflexion and Eversion (I like to see 40 degrees of ankle dorsiflexion in half kneeling with the knee headed toward the second toe)
Tibial Internal Rotation (The SFMA likes to see 20 degrees of motion here but if you’re a lifter that likes a more toes ahead and knees out position during the squat then you’re probably going to need more internal rotation of the tibia and eversion of the ankle).
Hip Flexion (I like to see the thigh able to approximate into the stomach in supine with minimal external rotation of the hip and without compensatory lumbar flexion – No more then what you want to see in the squat). Keep in mind that hip internal rotation exercises will help improve this motion generally.
2) Motor Control / Stability / Cueing Issues
This one comes from the Selective Functional Movement Assessment (SFMA) crowd. Here’s a brief description from Gray Cook about stability and motor control. Keep in mind it’s a tough concept to grasp.
Some individuals actually have adequate flexibility passively when a joint is moved through its full range of motion either by gravity or with another person assisting somehow. However, they aren’t able to utilize that full range of motion on their own. This is known as a stability or motor control issue from the SFMA crowd. See below, just a few simple cues (known as pattern assist in the SFMA world) are able to improve the patient’s motion
In this case cueing was effective. This is similar to telling an athlete to push their knees out in the bottom of the squat to get the knee over the toe. If the cue was effective then you can surmise the issue was a motor control problem (not pure flexibility). Other times people have the inability to move their joints through their full passive range of motion without some sort of physical assistance. We see this often with overhead mobility. In this case using some sort of assistance is useful in improving range of motion.
Now if someone had a motor control / stability issue, then flexibility drills won’t be useful for this person. We aren’t actually creating usable motion in that scenario. We have to choose the correct intervention to improve motion in our athletes.
3) Strength Issues
One of the questions I ask at my power monkey seminars is, “Why does our technique fall apart once the weight gets too heavy during a lift?” The answer I’m looking for is that our body is looking for a biomechanical advantage in order to complete a given lift. For example, if I round my lumbar spine during a deadlift I get some mechanical advantage from stretching some of the passive structures in the spine as well as the compressive forces on the discs that increase with spinal flexion. This will create some stiffness and help me get the lift. The same thing occurs when my knees come in during a maximal lift. I get some compressive stiffness on the lateral aspect of the knee, potentially some stretch from the medial ligaments of the knee and maybe some compressive stress at the hip. These things will allow me to complete a lift but probably won’t keep my tissues healthy in the long term.
Another place I see this is during challenging gymnastics movements like the bottom of a dip. In some athletes you’ll see the shoulder blade dump forward (protraction) potentially stressing the anterior shoulder’s passive structures, creating some stability and allowing an athlete to complete the movement. Again, you completed some dips but the stress on the shoulder is probably not optimal.
Nerd Sidenote: This protraction at the bottom of a dip could also be a flexibility issue too. You need to always be trying to figure out why these things occur so we can give our athletes the best intervention.
Athlete’s that fall into this category generally have very good technique with lighter weights or with less challenging bodyweight movements. As the weights increase or the difficulty of the bodyweight movements increase, the technique gets sloppy. These individuals may just need to continue working on easier movements or utilize lighter weights and progress more slowly into big weights and challenging movements.
Compensations occur for a variety of reasons. If we want to effectively correct these limitations we have to figure out why these compensations are actually occurring in order to give the best intervention. If we aren’t assessing these issues then we can very easily be giving people the wrong intervention to correct the issue. Some examples:
Giving an athlete 5 hip mobility exercises when their primary problem is in their ankle on the right side
Stretching someone’s shoulder when they have an underlying motor control issue
Spending too much time mobilizing joints that don’t need it when the athlete really needs more time lifting and being coached properly
Nerd Side Note: As explained earlier sometimes athletes complain of tightness in 1 joint but the problem is in a completely different area. A good example is the athlete with hip and ankle mobility issues complaining of tightness in their shoulders and cramping in the thoracic spine during overhead squats. Your spine and shoulders are trying to make up for the lack of motion further down the chain. If we start stretching the spine and shoulders further we might actually be making the situation worse by creating hypermobility.
Stick around next week because we’ll start talking corrections for these issues as well as a continuum idea that both Dave Tilley and I talk in depth about at Power Monkey Camp,
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