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ExerciseImportant ConceptsKneeSit Like A Man

Do Not Do Squats!

 

I’m going to go ahead and post this blog. It’s going to make a lot of people mad. I posted it on my group’s blog (www.texasorthopedics.com) and we got more responses to it than any we’ve previously posted. And they were all negative! The exercise industry is highly invested in squatting. You just have to look at a health magazine to see that about every 10 pages has an ad or a column or a device incorporating the use of some variety of squat.

 

My physician assistant and I keep a running tally on the number of patients I see every day in my clinic who have knee disease related to the performance of squats. I put a little Post-It note on our work station and we make hatch marks when we see one. Every day there are at least 4, sometimes 5 and occasionally 6. I see patients 3 days a week. Subtract a few days here and there for vacation. Multiply by 24 years and it comes out to something around 15,000 patients. And that’s 15,000 patients who probably wouldn’t have knee disease or would have less of it if they hadn’t been doing squats. So despite the hate mail I continue to stand by my recommendation that you…

 

DO NOT DO SQUATS!  Let me emphasize the point.  DO NOT DO SQUATS! 

 

And learn to recognize deceptive forms of the squat; the deep knee bend, the lunge and its particularly egregious variations, the weighted lunge and especially the forward-moving-weighted-lunge.  I don’t know what it is called but I want to put a red circle with a cross hatch on those. 

 

A lot of people are going to hate me, including many trainers, coaches and promoters of video training programs. I’ve got to admit that squats are a good way and maybe the best, most efficient and cheapest way to build gluts and quads.  They utilize some of the biggest muscle groups in the body and so you can work up a good sweat and “feel the burn.” So doing them accomplishes a goal and maybe for football players, it’s the best way.  But it’s dangerous for their knees, their cartilages and particularly their knee caps as well.  There are some individuals who are biomechanically sound to do squats but they are rare and there’s really no way to identify those people and predict how long they can tolerate it.  So there are some people who tolerate smoking cigarettes just fine. But enough of us can’t and so in general we say, “Don’t smoke.” And in general I like to say, “Don’t do squats!”

 

More on this to come. I’ll get ready for the onslaught of negative comments. Bring it.

13 comments
  1. Sandra

    Perfect timing, my knee is killling me this week. Let me ask, does doing squats against a wall count? (are you laughing?)
    My trainer is big on squats of all kinds.

    1. Barbara

      Most trainers are “big on squats.” It’s a great way to get the burn. That being said, wall squats are better than traditional squats. It’s best to keep your ankle in front of your knee and a wall squat allows you to do that. But if you have pain or crunching and grinding under your knee cap, you must cease and desist! I said in my previous blog, that trying to teach a “good” way to do squats is kind of like trying to tell you a good way to eat sugar. It’s easiest and best to just say “no.” I hate to hear that your knee is killing you. Stop the squats and go walk instead. You won’t get the burn but you’ll spare your knees.

  2. Dee

    Okay, so I can’t do squats. What suggestions do you have to replace squats? I’m studying to become a personal trainer and I have the crunchiest knee you’ve ever heard. I avoid squats like the plague and would like to be able to give good advice to future clients with the same problem I have.

    1. Barbara

      Ugh! I’m so sorry you’re having this problem with your knee. Do lots of straight leg raises, strengthen the external rotators of your hips, and maybe try quarter wall squats (keeping your feet way out in front of you). That’s a tough problem for you. Use bungee chords attached to ankle straps in order to add resistance to the straight leg exercise. Get creative!

  3. Leticia

    Totally listen I wish I came across this blog five months ago.!! I started getting back into shape after my son and i had a knee injury from childhood. My workout was cardio aerobics with lots of squats and lunges. I loved it….but after my workouts I would have knee pain all night sometimes into the next day. Two months in I was running with my dog (in my house) and my knee dislocated! Excruciating pain ever! I did see Dr. Bergin and what she said made total sense. When I would lunge or squat there was always crunching so I pretty much set my self up for a dislocation. Well I’m 29 with 3 kids so its a bummer cause my weight loss is stalled while I’m still rehabbing a life long set up for dislocation let alone I’m limited at the moment to what I can do with my family. Dr. Bergin has been great she is the best doc I’ve ever been to. Seriously. She opened my eyes to a lot about my health….love her

    1. Barbara

      Thank you Leticia! I appreciate your kind words! I wish you didn’t have the problem you are now experiencing. It’s only through SLOW word of mouth that we get the “DO NOT DO SQUATS” message out there, because the exercise industry is so invested in the squat…especially for women!

  4. Nina

    Hi!
    Thank you for getting this message out. I always knew my knees didn’t like squats but it was never a definite thought in my head that squats are bad for my knees.. Before my knee problems I did some martial arts, which involved a lot of “horse stance” ( a 45 degree stationary squat as if sitting on a horse). The back was required to be straight and the butt “tucked in”, the ankles in line with knees. I was wondering if that form is okay to do. That is the base of Kung fu and I will not be able to go back to studying it if I can’t perform it.
    Thank you!

    1. Barbara

      Nina,
      I’m glad you can appreciate the issue I have with squats, but sorry that you have a conflict. Look, it’s a free country and you can do squats and modified squats. When patients ask me if they can do certain modified squats, I tell them that for me to tell them how they can do certain squats, would be like me telling them under what circumstances is it okay to eat sugar. It’s just easier to say “don’t do squats and don’t eat sugar.”
      That being said, I think it’s important for you simply to have a heightened state of awareness. I want you to recognize a problem with your knee cap on the first day you have the problem. Don’t keep doing squats in the face of pain.
      I ride horses competitively. It could be said that I am often doing a modified squat. But I have a heightened sense of awareness of my knee cap’s position in the world, and if it starts hurting, I’m prepared to make adjustments.
      So that’s all I can ask of you. Just be aware. And chose your poison. Don’t do the “horse stance” in a Kung Fu workout and then go down to your local gym and do a bunch of squats. Don’t work out on the stair stepping machine. Use a bench when you’re gardening. Catch my drift?
      Thanks for checking out my blog. Sorry for the delayed response.

  5. Gail

    Agree! I exactly did squats and hurt my knee. I was naive, but not likely to forget the pain and have become cautious in how I move.

    1. Barbara

      Gail,
      Ha! You’re not so naive. When I first came to Austin and started my practice, I also started running stairs between cases while I was waiting for the operating room to turn over for my next case. I just didn’t want to sit around twiddling my thumbs. Within about a week my knees were crunching, swollen and I was in pain. What a doofus! And here I was already an orthopod, so I should have known better.
      Anyway, I’m glad you listened to your body! We have to do that. Don’t work through pain! I can’t tell you how many women come in who continue to do squats and run stairs despite being in agony and being able to hear their knees as they exercise!

  6. Lorraine

    So what is your take on standing leg raises (knees bent) . A slow standing in place march …..no problem because it’s not weight bearing? 🙂

    1. Barbara

      Lorraine,
      It’s not uncommon for patients to ask me about alternative forms of squats. Just like they ask me what forms of sugar are okay. I can tell you it’s okay to eat a little sugar, or it’s okay to put a teaspoon of sugar in your coffee, or it’s okay to eat chocolate. But it’s just easier for me to tell you not to eat sugar, and I would be right in doing so. Same goes for squats. Is it okay to do little squats, quarter squats or Smith machine squats? I can say “everything in moderation.” But then I have some patients who have pain doing everything in moderation! So you have to make the decision based on what works for you. If you have pain doing something, you just shouldn’t do it. You have to evaluate any modification to see how it affects you and your knees. I would have to write a ten page blog to describe every variation on the squat, and how often and how much to do it. And the majority of you are not my patients, so I can’t evaluate how they affect YOU. So it’s easier to say “no squats.”

      Marching in place is just like any repetitive exercise. There is potential for repetitive strain and stress reactions if you do it too much. everything in moderation. Remember, walking is what humans are put together to do. We do it well. If you can march, surely you can walk. Go walk!

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