Guest Post: Screening and Assessing the Squat | Modern Manual Therapy Blog

Guest Post: Screening and Assessing the Squat



KEY POINTS:
Screen the deep squat from developmental progression (most challenging position to least challenging). The best place to start the screen is with narrow and neutral positioned feet and arms overhead. The end point will vary person to person, but will have a theoretical end range at diagnostic joint specific range of motion (ROM) testing.

Systematically reduce complexity of the squat by removing components that are performing at less than optimal in kinetic chain performance. A top down simplification standard operating procedure (SOP) works best to ensure you don't miss any contributing factors to dysfunctional squat performance.
Identify components of the squat that are functional, and those that are dysfunctional. Differentiating between the two can be simple when using the right systematic procedure.

Assess the squat screen progression as a whole, and identify your clients functional level. Prescribe anterior chain dominant squat variation based on screen and assessment, and progress with training.

INTRODUCTION:

The squat is one of the most functional multi-joint movements around. From a human developmental standpoint, the squat's primitive movement patterning allows neuromuscular enhancement in almost every region of the body. The simplicity of this movement can be very easily manipulated to add variation to any active component during the squat. Identifying the functional movement capacity of an individual and progressing them through an increasingly challenging continuum will allow an optimal environment for overall movement development.

STANDARD OPERATING PROCEDURE:

Every client who walks through the door to either train or start a rehabilitation program needs to be screened for functional movement capacity. No exceptions, no excuses. Whether you are performance training an NFL all pro, or assessing a patient presenting 4 months post-op total knee replacement, a functional level must be identified to set a starting point of intervention. This SOP will allow any trainer, therapist or coach the necessary tools to screen, assess and program efficient, effective and safe programming for anterior chain dominant squat variations. This is only a portion to the entire screening and diagnostic assessment, but will play an integral roll in overall treatment and programming.

SCREENING THE SQUAT:

The squat will be screened first using the most challenging setup from a mobility, strength, stability and motor control standpoint. From that point, if the level being screened is less than optimal from any component (head to toe) during the movement, the squat will be simplified from the top down. Each level of screen will be given verbal instructions, setup assistance, and 3 attempts to perfect the movement. If the movement is not pristine and perfect from every aspect after 3 attempts, the squat will then be simplified and repeated. All examples used in this article are body weight specific, and targeted as screens for bi-pedal stanced squat. Using this same progression, you can break down the squat into individual components. As soon as the squat is de-loaded, and components are isolated, the stability, strength and motor control contributing factors are lost.

OVERHEAD SQUAT:

OverHead Squat

Verbal Instructions: With feet placed hip width distance apart, and toes facing forward, place hands in air with elbows straight and hands in alignment with head and spine. Squat as low as possible, pause a second at the bottom of the movement, and move up to the starting position.

HANDS BEHIND NECK SQUAT:

Hands Behind Neck Squat

Verbal Instructions: With feet placed hip width distance apart, and toes facing forward, place hands behind neck with fingers interlocked. No not pull or pressure the neck, just position hands to the base of the neck. Squat as low as possible, pause a second at the bottom of the movement, and move up to the starting position.

HANDS DOWN SQUAT:

Hands Down Squat

Verbal Instructions: With feet placed hip width distance apart, and toes facing forward, hang hands between knees and in front of the body. Squat as low as possible, pause a second at the bottom of the movement, and move up to the starting position.

WIDE BASED SQUAT:

Wide Based Squat (disregard the dumbbell loading)

Verbal Instructions: With feet placed shoulder width distance apart, toes slightly turned out hang hands between knees and in front of the body. Squat as low as possible, pause a second at the bottom of the movement, and move up to the starting position.

HEELS ELEVATED WIDE BASED SQUAT:

Heels Elevated (had to throw Arnold in!) Screen unloaded and hands between knees

Verbal Instructions: Elevate heels approximately 1 inch with board or weight plate. With feet placed shoulder width distance apart, toes slightly turned out hang hands between knees and in front of the body. Squat as low as possible, pause a second at the bottom of the movement, and move up to the starting position.

ASSESSMENT:

It is important to go through the squat progression in a systemized manor. The highest level that the individual performs optimally at will identify the starting point for training. That specific level will be loaded for a training stimulus, while other components of training and treatment will be needed to progress into new, more challenging variations of the squat over time.

PROGRAM:

Based on training or rehabilitation goals, program accordingly using set, rep, rhythm and rest schemes that will allow the squat variation you identified in your assessment to progress. Using assistance work and other exercises to break through dysfunctional patterning will also be necessary. Let your professional knowledge guide your interventions.

CONCLUSION:

The days of loading up a dysfunctional squat pattern are over. Through intelligent screening and assessment strategies, clients and patients can begin training an anterior chain dominant squat pattern right away according to their specific functional levels. Providing foundational movement screening will optimize the efficiency of your professional programming, ensure safety, and increase the overall effectiveness of an exercise and program.

Dr. John - visit his website at

Thanks to Dr. John Rusin for this great guest post and an example of breaking out the squat as an assessment!


If you haven't heard, Mike Reinold, Christopher Johnson and myself have decided to offer a live Q&A on Google Hangouts if we win the award for our categories for Therapydia's 2014 PT Blog Awards. Mike is up for best PT Blog, Chris, Best Video Blog, and myself, best Overall Blog. Please vote for us if you find our work helpful and take time to vote for the others who work hard to bring you knowledge.

PS. Mike Reinold will shave his head like Chris' and mine if we win! Bonus!

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