In today's episode we take a look at the literature to try and answer the question, "are deep squats bad for the knees?" We go over:
- Does squatting (strength training) slow the rate of arthritis progression?
- Are 1/4 squats or 1/2 squats safer then deep squats?
- What's the best dosage of squatting?
- Does everyone need to squat deep?
- Who should and shouldn't squat deep?
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Show Notes / Relevant Articles:
- The Ultimate Guide to Getting Out of Knee Pain and Back to Squatting, Olympic Lifts and Other Lower Body Exercises
- The Complete Guide to Patellar Tendinopathy
- The Complete Guide to Patellofemoral Pain Syndrome
- Does Knee Cave-in During the Squat Matter?
References:
Willy RW, Meira EP. CURRENT CONCEPTS IN BIOMECHANICAL INTERVENTIONS FOR PATELLOFEMORAL PAIN. Int J Sports Phys Ther. 2016 Dec;11(6):877-890. PMID: 27904791; PMCID: PMC5095941.
Loudon JK. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT. Int J Sports Phys Ther. 2016;11(6):820-830.
Wallace DA, Salem GJ, Salinas R, Powers CM. Patellofemoral joint kinetics while squatting with and without an external load. J Orthop Sports Phys Ther. 2002 Apr;32(4):141-8. doi: 10.2519/jospt.2002.32.4.141. PMID: 11949662.
Kujala UM, Kaprio J, Sarna S. Osteoarthritis of weight bearing joints of lower limbs in former élite male athletes [published correction appears in BMJ 1994 Mar 26;308(6932):819]. BMJ. 1994;308(6923):231‐234. doi:10.1136/bmj.308.6923.231
Kujala UM, Kettunen J, Paananen H, et al. Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheum. 1995;38(4):539‐546. doi:10.1002/art.1780380413
Amin S, Goggins J, Niu J, et al. Occupation-related squatting, kneeling, and heavy lifting and the knee joint: a magnetic resonance imaging-based study in men. J Rheumatol. 2008;35(8):1645‐1649.
Zhang Y, Hunter DJ, Nevitt MC, et al. Association of squatting with increased prevalence of radiographic tibiofemoral knee osteoarthritis: the Beijing Osteoarthritis Study. Arthritis Rheum. 2004;50(4):1187‐1192. doi:10.1002/art.20127
McAlindon TE, Wilson PW, Aliabadi P, Weissman B, Felson DT. Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framingham study. Am J Med. 1999;106(2):151‐157. doi:10.1016/s0002-9343(98)00413-6
Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011;2(2):205‐212.
Nagura T, Matsumoto H, Kiriyama Y, Chaudhari A, Andriacchi TP. Tibiofemoral joint contact force in deep knee flexion and its consideration in knee osteoarthritis and joint replacement. J Appl Biomech. 2006;22(4):305‐313. doi:10.1123/jab.22.4.305
van Rossom S, Smith CR, Thelen DG, Vanwanseele B, Van Assche D, Jonkers I. Knee Joint Loading in Healthy Adults During Functional Exercises: Implications for Rehabilitation Guidelines. J Orthop Sports Phys Ther. 2018;48(3):162‐173. doi:10.2519/jospt.2018.7459
Mikesky AE, Mazzuca SA, Brandt KD, Perkins SM, Damush T, Lane KA. Effects of strength training on the incidence and progression of knee osteoarthritis. Arthritis Rheum. 2006;55(5):690‐699. doi:10.1002/art.22245
Hartmann H, Wirth K, Klusemann M. Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load. Sports Med. 2013 Oct;43(10):993-1008. doi: 10.1007/s40279-013-0073-6. PMID: 23821469.
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Dan Pope DPT, OCS, CSCS