I recently became a Functional Movement Systems (FMS) certified trainer. I was looking for additional tools to add to the current base of Physiotherapy-specific impairment tests. The FMS assessment tool provides a series of functional movements that highlight painful structures, deficits in mobility and deficits in motor control. As emphasised in the course, the FMS does not diagnose or interpret the cause of any faulty movement pattern, but it identifies functional movements with sub-optimal patterns.
What I'd like to share with you is some advice that Gray Cook (Physiotherapist & founder of FMS) shares about the safety of squatting compared to dead lifts and what reasoning we should apply to determine what movement pattern is best for our clients. Both exercises are fantastic for developing functional strength, but the squat requires far more flexibility than the dead lift and some people just don't have the available movement to safely perform the movement. You can watch the original video here.
PREREQUISITE movement for a squat & dead Lift
Active straight leg raise
To safely perform both movements you need to be able to raise you leg above 70 degrees without pain or discomfort. This measures the strength of hip flexion and hamstring/neural tissue length on the lifting leg, and hip extension mobility on the flat leg. If you can't raise your leg above the vertical height of the stationary knee - neither exercise is going to be safe. You may need to focus on restoring your mobility before moving onto these techniques. Below is a video of the active straight leg raise test for the FMS and a possible mobility exercise you can try to improve your range.
Spine forward flexion in standing
The second prerequisite is standing lumbar flexion. In standing relax your back and bend forward allowing the spine to curl from the tail bone to your head and measure what distance on your shins (or floor) your hands reach. If there is pain and discomfort anywhere through the legs, buttock, back or spine (more than a stretch) then you may not be safe to squat or dead lift.
Time should first be spend making sure that both of these movements are painfree and produce enough mobility to allow for the dead lift and squat to be performed safely.
Ways to promote best technique
To perform a squat you are aiming:
To keep you trunk parallel to the shins.
Your knees need to stay behind your toes.
Keep your weight through your heels.
Flex and fold into the knees and hips.
So putting this all together…. have your feet slightly wider that hip distance and toes facing forward. Keeping your weight in your heels and not letting the knees come together, fold through the hips to sit backwards. The shoulders should stack over the knees and the knees as vertical over the ankles as possible. This gives you a great V shape from the side from trunk to hips.
Problems often occur in squat technique:
Stiffness in the ankles, calves or achilles limit dorsiflexion at the ankle and this results in more knee flexion being required to gain the depth in the squat. A great example of this (mostly for females) is doing a squat in high heel shoes compared to barefoot. I'm sure you'll find it's much easier to get lower into the squat when your heels are raised, demonstrating the impact ankle mobility has on the squat.
Poor pelvic and hip strength hinders the ability to keep knees apart and to sit backwards into the squat. Squatting should really be a gluteal dominant movement like sitting back into a chair. If you don't have the strength to fold through the hips and place your hips backwards, you may wish to consider holding onto a rail in front of you to control your body weight.
Overusing the lower back is another issue that I commonly see, where people flex their lower back to get more depth, or keep their back rigid and vertical with the thought process that it's offloading the spine. This is not true. When you watch the athletes squat you notice one thing, their backs are not vertical. The lumbar spine neither flexors or extends, it remains in a neutral position and the trunk leans forward to follow the movement of the hips. Allowing this to happen keeps the trunk parallel to the shins.
Strategies for improving your squat:
- If your suffer from stiff ankles and calves try placing a wedge under the heels to offload the ankles.
- If you suffer from pain in the front on your knee, keep the squat depth above 60 degrees knee flexion i.e. don't aim for a parallel thigh. This helps to minimise compressive loads in the patella-femoral joint. (It also looks more like a dead lift action …. and this might be one reason to try dead lifts instead).
- If you suffer from low back pain try improve your technique by holding onto a rail in front of you with straight aims, this just stops the sensation of falling backwards and encourages the legs to work more and the back to relax.
- Always remember that the weakest part of the squat is in fact the bottom of the squat and you might have great technique but just not the power to drive back up into standing. If this is the case - practice the up phase and down phase separately by resting on a chair or box. Get your position set and drive up into standing. Then slowly sit back down. If your bottom taps the front of the chair instead of sitting deep into the chair, it's a sign that you are dropping your knees forward rather than sitting the hips back.
To perform a dead lift you are aiming:
- Keep your feet parallel and hip width apart, not too wide.
- Choose to have your hands inside or outside your knees (I prefer inside).
- Move your hips backwards to lower your hands straight towards the floor.
- It's more about hip flexion than knee flexion, the knees bend a little but this is a differentiating feature compared to a squat.
- To stand back up drive up through the heels.
Problems often occur in dead lift technique:
- There definately aren't as many sources for error when the dead lift is compared to the squat. But some errors I've commonly observed are...
- Bending too far forward - taking centre of mass forward from feet. This is where holding a weight between the knees and lowering it straight downwards maintains balance.
- Bending knees too much - moving into a squat. The knees do bent, but the focus is on flexing from the hips and moving the hips backwards.
- Lower from the back rather than folding through the hips. The spine should not be flexing, this would result in weighted spinal loading and is undesirable.
Many of the issues discussed above in relation to the squat don't occur with a dead lift. This may be another reason to try this exercise rather than risk injuring yourself with the squat. Functionally we really need to be able to perform both movements and this may take considerable work on mobility, strength, balance etc. But the message I wanted to share with you is that the dead lift has a lot of benefits and when performed well there are great rewards with this exercise.
Personally I've found that the dead lift can have some negative stigma associated with it, particularly because this exercise often is combined with a kettle bell swing. But this doesn't have to be the case. Practice the techniqiue and hold any weight you prefer, I prefer the handle of the kettle bell but it doesn't have to be too heavy. Dead lifts help strengthen hamstrings and gluteals and not the villian. If you or your clients are getting injured doing these movements, perhaps there is an underlying mobility deficit impacting motor control and performance.