The #1 reason why people find deep squatting difficult

What is the Deep Squat?

The deep squat describes a position in which one is resting in full flexion of the hips, knees and ankles with the feet on the ground. The deep squat is a comfortable resting position which is more stable than standing because of the low center of gravity. The deep squat serves as an alternative to sitting and is especially handy to avoid sitting on a sharp or dirty surface. Go ahead and give it a try.

Comfortable right?

Or not? For some people the deep squat is very difficult and can only be accomplished with one or several compensations. Your squatting ability can be placed in one of three categories based on the following test.

Stand with your feet together.  Squat down as low as you can without letting your heels come off the ground and keep your arms and trunk as upright as possible.

  1. Uncompensated deep squat: Able to squat all the way down to a resting position with the heels on the ground and arms behind toes.
  2. Compensated deep squat: Able to squat all the way down to a resting position but heels came off the ground or arms came forward.
  3. Unable to deep squat: Pain during movement or unable to reach resting position.

Me demonstrating an uncompensated deep squat with feet together.  You will recognize this picture from my logo.

Deep Squatting in Japan

Now that you have your results, lets see how you compare to a sample of 71 healthy male Japanese college students studied by Tatsuya Kasayma and colleagues. They published the results of the deep squatting test described above in the Journal of Physical Therapy Science in 2009.

Of the 71 students only 55 had an uncompensated deep squat. That’s a 22.5% failure rate.

Kasayma and colleagues measured the following variables in an attempt to uncover why some of these students could pass the squatting test and others could not.

Anthropometric variables

  • age
  • height
  • weight
  • BMI – body mass index= (mass in kg)/ height in meters squared

Range of motion variables

  • Hip flexion with knee extension- straight leg raise
  • Knee flexion- heel to buttock distance in prone
  • Hip flexion with knee extension and spinal flexion-toe touch distance from floor
  • Hip extension- modified thomas test
  • Ankle dorsiflexion- modified lunge test

Only two variables showed a significant correlation with the ability to deep squat.

1.Ankle dorsiflexion- strongly association, diagnostic accuracy of 85% (p= < .001)

2. Weight- weak association P= .02

How to measure your own ankle dorsiflexion

The ankle range of motion test that Kasayma et al used is called the modified lunge test.

Krause et al compared various ways to measure ankle dorsiflexion and reported that the modified lunge test was the most reliable. This simple test can be done at home. Facing a wall, place your toes at the edge of the wall and bend your ankle to touch your knee to the wall, being very careful to keep the knee and thigh in line with the foot. If you are able to touch the wall with your knee, start over with your toe further from the wall. Repeat this process until you find the furthest distance from your toe to the wall that you are able to touch touch your knee to the wall. Measure this distance in centimeters.

The modified lunge test. Photo source.

How much ankle dorsiflexion was needed to squat?

Using the modified lunge test Kasayma et al found that subjects with  >10.75cm from the wall on the right ankle and 11.25cm  from the wall on the left ankle were able to pass the deep squatting test.

This woman spends all day cleaning the grass from between the cobblestones of the streets in Nuevo Rocafuerte. She has the most ankle dorsiflexion I have ever seen in my life, my guess would be around 60 degrees. Her lunge test would be off the charts.

How To Increase Your Ankle Dorsiflexion

If you were less than 11cm from the wall in your lunge test, I recommend working on that ankle range of motion to improve your squatting. Grey Cook popularized the self mobilization for the ankle to increase dorsiflexion demonstrated in this video. I recommend this drill before squatting for anyone with limitations in ankle dorsiflexion. The drill looks a lot like the lunge test but has a few helpful cues to make sure you don’t do it wrong.
Conclusion

In a young healthy population, dorsiflexion is the mostly likely culprit for an inability to deep squat well.  I add the qualifier “well” here because the test of deep squatting used by Kasayma et al is more difficult than a typical deep squat. Kasayma require the feet to be together which eliminates the possibility of collapsing through the arch to increase to effective dorsiflexion.

Many people can get down into a deep squatting position but they collapse through the arch to achieve it. This is potentially harmful because it stretches out the arch of the foot as well as forcing the knee into a valgus (knock- kneed) position which has been shown to be a risk factor for knee cap pain (patello-femoral pain syndrome) as well as injury to the knee ligaments (MCL and ACL during landing). Some people may be able to get away with this compensated pattern their whole life without pain, but I certainly wouldn’t recommend it. If you have limited dorsiflexion, work on improving it diligently until you have reached the maximum your body will allow to get your squatting mechanics as good as possible.

Finally, ankle dorsiflexion is not the be-all end-all of deep squatting. Other factors can come into play such as femur length, torso length, limited knee or hip flexion and perhaps most importantly: coordination. In the clinic I often see asymmetrical squat patterns in patients recovery from surgery of the hip or knee

Gallery of Deep Squats

Me deep squatting to receive my hood for my doctor of physical therapy degree.

I saw this arch collapsing compensation frequently throughout Ecuador and Peru. One of the hallmarks of this compensation is the out-turned toes with the knees facing forward.

This woman (in red) squats every day to milk her cows and has a squatting toilet but still does not have good squatting mechanics.Notice her left toes turned out. Jessica (in black) is demonstrating an uncompensated squatting pattern with feet apart.

None of these boys from a remote Andean farming village in Peru could squat without their heels coming off the ground, some even fell over.

We met this woman while traveling on a river boat from Iquitos to Pucallpa Peru. She is able to squat without compensation with her feet apart.

References

1.  Kasayma et al. Ankle joint dorsiflexion measurement using deep squatting posture.J. Phys. Ther. Sci.

2. Krause DA, Cloud BA, Forster LA, Schrank JA, Hollman JH. Measurement of ankle dorsiflexion: a comparison of active and passive techniques in multiple positions. J Sport Rehabil. 2011 Aug;20(3):333-44.

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19 thoughts on “The #1 reason why people find deep squatting difficult

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  4. A question of one and a half years has been answered here. I’m beyond grateful.

    I started Convict Conditioning a year and a half ago, and have been struggling with squats for all this time. Gradually discovering that my anatomy simply won’t allow me to squat with my feet close together (not even shoulder-width), I’ve been progressing with my squats using a wider foot distance than normally prescribed. I’m at step 5 now, doing proper full squats relatively easily, but I couldn’t for the life of me figure out how it’ll eventually lead to step 6 which is essentially the deep squat from your article but with the feet strictly parallel on the ground.

    So I went on to perform the modified lunge test, and sure enough, I couldn’t go to a full 5 centimeters with either of my ankles, regardless of living a physically active life in my twenties. Suddenly everything became clear.

    While some professional input on this would be insanely appreciated, I’m almost certain I will never reach 11 centimeters no matter how much work I put into my ankle mobility.

    Thank you for this article.

  5. Just a brief follow-up to correct my statement above: Step 6 of Convict Conditioning squats is, in fact, done with the feet slightly in a V shape. In other words, it’s pretty much the deep squat of the article. My bad.

  6. It appears as though I’ve launched my own blog in the comment section of this post, but I feel that my progress with the problems I’m having may help out other folks dealing with the same or similar problems, so here we go.

    While a great starting point to discovering the issues with your squats (or anything else you might have ankle mobility issues with), the article doesn’t mention one important thing that will help you with your further research: the problematic ankle dorsiflexion is a direct result of a problematic Achilles tendon.

    According to a 2006 study, there’s a 1:1 correlation between Achilles tendon length and the degree of ankle dorsiflexion, and the Achilles tendon still remains the limiting anatomical structure behind dorsiflexion even when the Achilles tendon is lengthened (in other words, the fact that the limiting factor is the tendon length itself is not a pathology but the “intended” behavior).
    [http://www.ncbi.nlm.nih.gov/pubmed/16764797]

    To lengthen the Achilles tendon, you have conservative and surgical options. I’ll be looking into the conservative ones for now (some the article already mentions), and probably report back here eventually.

    • I finally got my hands on the full text of the article you cited. While I do agree that the Achilles can be a significant limiter of dorsiflexion, I don’t think it is safe to assume that this is true of everyone because of the limitations of the study.

      1. They used 5 cadavers. This is too small of a sample size to generalize to the rest of the population.
      2. The cadavers were embalmed. Having worked with embalmed cadavers I can tell you that they are much stiffer than fresh cadavers or anesthetized people. It is possible that the achilles tendon stiffened more than the adjacent muscle.
      3. There is no muscle contraction in a cadaver- As we have seen by the fact that the straight leg raise improves by about 8 degrees under anesthesia, it is quite possible that some people’s dorsiflexion is limited by their own muscle contraction. (http://bit.ly/1Cx7Wiz)
      4. Ankle dorsiflexion was measured in knee extension which would tension the gastrocnemius portion of the achilles tendon, because the knee is bent during a deep squat, this portion of the tendon would not be under tension.

      • Bryan: Thank you so much for your reaction and the invaluable insight. I certainly don’t want to pretend I’m any kind of expert on the subject, quite the opposite actually, merely looking for answers and going through a learning process. Your third point especially struck a chord with me because I’ve been experiencing something along the lines of what you’re saying. I’ve noticed that when I can relax my mind while performing lunges and say to myself, “it’s okay”, my body will let me go a little deeper. It seems like a protection mechanism that you might be able to somewhat override, although I’m not at all convinced that it’s a good idea to do so, it’s probably there for a reason. But at the same time, as with all psychological reflexes, sometimes they can go overboard and result in behavior that’s actually counterproductive, so I’m not sure. In my personal case, it makes sense because I’ve been having anxiety-related problems with tension in my body in different shapes and forms that I’m learning to overcome now, so it may indeed vary from person to person what actually helps them with their progress. Apparently the Achilles is just one variable in the equation, although in my case I can definitely feel it stretching as a very significant limiting force every time I do a lunge.

        What I do know is that since my first post here, I went from around 4.5 centimeters to 7.5-8 with both my feet, and I haven’t done much, simply did some lunges (and by some I mean literally a minute or two every day), started squatting with my feet closer together and my heels elevated (it was amazing, I finally felt how a squat can actually be comfortable!), and did the lunge test once or twice a week. I’ll be trying to get to a point where I can perform proper squats without elevation, although I have to warn everyone going down the same road as I am right now that patience is key because in the process I’ve already managed to make one of my feet a little sore. Hopefully it’ll go away in a week or two, but please, people, be wiser than I am, and don’t push too far beyond your boundaries. That’s the very foundation of Convict Conditioning, and responsible training anyway.

        Thank you again, this post has changed my life for the better.

  7. I feel like I´ve made a breakthrough reading this article. I was able to do the full squat but not without my right (weaker) foot raising and my back collapsing. I measured 17cm dorsiflexion in my left ankle and only 7.5 in my right. Have you seen a discrepancy like this before??

  8. It’s taken me a year of regular stretching to reach 0cm of dorsiflexion (knee touching wall while toes touching). Is it likely I’ll ever be able to squat? I can comfortably squat with raised heels for extended periods – would it help my dorsiflexion to use this position all day while working at a modified desk?

    • I don’t recommend squatting on the balls of your feet all day is it runs the risk of cause problems from the maximal knee flexion (meniscus pressure and joint pressure) and pressure on the balls of the feet (metatarsalgia). I use squatting with heels elevated on a surface a few inches tall such as dictionary and leaning forward as an ankle dorsiflexion mobilization. You can test the effectiveness of this mobilization by measuring how far you can get your foot from the wall and still touch your knee both before and after the intervention.

      Eventually you will reach a limit of dorsiflexion based on the shape of your talo crural joint. Feeling a pinching pain along the front of the ankle is a sign that you have reached a bony block either due to variations in anatomy, osteophyte formation or anterior glide of the talus.

      See a physical therapist to help you find what is limiting your ankle mobility and prescribe the appropriate mobilization.

    • For what it’s worth, I can confirm that the squatting with the heels elevated on flat surfaces works. I now measure my progress by the height of my current lowest possible elevation, and I’ve gained a few centimeters over the last few months. At a point I figured that I can still work most if not all of the muscles involved in squatting equally, or close enough, with the elevation, and just the very fact of being able to do proper squats should already help with, you know, squats. And of course, my legs and therefore my squats are generally stronger now, but beyond that, I’ve noticed that roughly every month, I need to lower my elevation, because the exercise is not challenging anymore. With this approach I’m now doing squats with the feet close together, and transitioning into (half) pistols these weeks.

      One other thing I find might help is that I’ve also started to relearn to walk months ago. It’s a skill we all think we have, and apparently most of us get it wrong, with shoes to blame. Engaging my ankles more, while keeping them relaxed and flexible, and ready to react and adjust to the shape of the surface I’m walking on has at the very least helped me with engaging the right muscles when walking, having a good posture doing so, and being way more confident when I’m out and about. As a plus, I think it has added to my ankle mobility, but I can’t be fully sure about that. Buying a pair of Vibrams also helped, though I think they have their own issues and shouldn’t be considered a perfect substitute for barefoot walking, as done by many.

      • Hi,
        I have no idea if you’re still active, but could you give more details of your program? What elevation did you start with, how long did you squat for and how often? I’m trying desperately to improve my dorsiflexion and I would really appreciate any help

  9. Hey Brian,

    I was on the hunt for Squats today and found this post on your website. It will help me a lot to write an article on my website.

    Thank you!

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