If you program narrow stance squats for clients, you may inadvertently be damaging their hips, writes Scott Rawcliffe. Here’s how to check whether your clients can benefit from this movement.
If you program narrow stance squats for clients (feet placed approximately hip-width apart), you probably do so in order to elicit a greater training effect for the quads. What you probably don’t realise is that you may inadvertently be damaging their hips by doing so. Before prescribing this exercise to another client, let’s take a closer look at the biomechanics and what we are really seeing.
Firstly, consider what your client looks like when they are squatting. Are they achieving good depth? Are they able to keep their lumbar spine from flexing? Do their knees track over their feet? By making these three major observations you will be able to learn a lot about your client – and to decide whether or not narrow stance squats are appropriate for them.
Firstly let’s look at squat depth. My personal opinion is that it is ideal for a client’s hips to drop below their knees, known as ‘breaking parallel’. A great analogy that I picked up from one of my mentors (Mark Buckley) is that if you were to place a marble on your client’s knee at the bottom of their squat, the marble would roll down towards their hips if they have broken parallel. If your client is unable to get below parallel, however, don’t assume that it must be due to tightness in the muscles, however: consider that it could actually be caused by an ankle restriction at the talocrural joint or a structural issue in the hips. But we will come back to this.
Lumbar spine flexion
Now, your client may achieve good depth in their squat, but what if they are flexing through their lumbar spine to get that depth? This requires some problem solving. First things first, if your client is unable to keep a neutral lumbar spine when they squat, do not give them load. If you are familiar with Dr Stuart McGill’s work you will know that loaded flexion of the lumbar spine is a recipe for low back injury. But don’t assume that you have found a restriction: it may just be a form issue they are unaware of. So, start by coaching them how to keep a neutral spine while squatting. If, after coaching them on how to squat properly, they are unable to get past parallel without flexing their lumbar spine, there may be a bigger problem. Again, do not assume that joint restriction is the culprit. Simply observe your client’s movement – or lack of it.
So, what happens if your client breaks parallel and keeps a neutral spine, but their knees cave in like they desperately need to use the bathroom? I have heard trainers diagnose this as being caused by a weak gluteus medius. Before you get your client on the floor busting out some clamshells or pull out the mini band to put around their knees, stop for a second. What if it’s not a weakness but this time actually is caused by a tight muscle?
Back to basics
Confused? A lot of us in the fitness industry think in a very linear way: if I see ‘X’ it must mean ‘Y’ – but this is not always the case. So let’s make things a little clearer and look at how to determine whether the narrow stance squat will help or hurt your client.
Let’s look at the squat in a very simple way. Have your client perform four squats (the first few times you do this you may need them to do a few more, just until you’re comfortable with what to look for). For the first three reps stand to the side of your client. The first time they squat, only observe the ankle joint and note whether or not their knees progress forward to the same level as the toes. Make a mental note of whether or not it did. The second rep, watch to see if they can break parallel. Do their hips get below the level of their knees? Again, make a note. On the third rep, look to see if they are able to keep their lumbar curve, otherwise known as a lumbar lordosis. Mental note. For the fourth and final rep, watch them from front-on to see if their knees track in line with their feet. Take note. Now you have this information, you can see whether or not there is a restriction at the ankle by either:
- Having the client squat again using a 10lb plate under each heel. If their squat improves, the ankle is restricted.
- Busting out your trusty goniometer and doing a ROM test to check whether they can get 20° of dorsi flexion (this is only for fellow nerds like myself).
If the client lacks adequate ankle mobility, they will be limited in how far down they can squat, so the effectiveness of a narrow stance squat will be limited, and the potential for injury increased.
Test for tight adductor magnus
If your client couldn’t keep their knees tracking over their feet, there is a simple way to look at the potential cause: tight adductor magnus. The adductor magnus is a very powerful hip extensor that is often overlooked – and extremely tight – in a lot of people. Discover for yourself exactly how tight it can be by, next time you get a massage, asking your therapist to work on your adductor magnus – and don’t be surprised if you jump off the table!
Instruct your client to grab a seat on a bench, but make sure their hips are higher than their knees. Assist them in putting their feet out in a wide position (think of a sumo deadlift position) and, keeping their back straight (lumbar lordosis), bend forward, keeping their knees apart. If they feel tightness in their inner thigh (adductor magnus) or can’t keep either their back straight or knees out, this – not weak gluteus medius – is most likely the cause of their inability to keep their knees tracking over their feet while squatting. Now, this is not to say that they are not weak in the gluteus medius, but no matter how much strengthening work you do on them, if their adductor magnus is tight they will always be pulled into internal hip rotation (knee’s caving in). So, if this is the only issue, a narrow stance squat will be fine for your client, as they will still achieve the intended training response.
Test for retroversion
The final test is probably the most complex thing to look at, so let’s look at the risk/reward for a client performing a narrow stance squat. If your client cannot break parallel and/or keep a lumbar lordosis, it is possible they could have a structural issue at the hip called ‘retroversion’. The neck of the femur and the transverse axis of the femoral condyles form the angle of declination (or torsion) in the frontal plane. The normal angle is approximately 14 degrees anterior, whereas in instances of retroversion, the angle of torsion is pathologically decreased. A client with retroversion will typically appear to have turned out feet, or walk like a duck.
If a client has retroversion, they have limited internal rotation of the hip. It is a structural issue that you cannot change. You need to respect this, or you will cause damage to their hips and knees. If you want to officially confirm whether your client has retroverted hips, refer them to a physical therapist to get checked, because diagnosis is out of personal trainers’ scope of practice. The following simple range of motion test, however, is within our scope of practice and is a good indicator of possible retroversion. Have your client lie prone and then bend their right leg to 90°. Lock their left hip down and take them through internal and external hip rotation. If they are limited in external rotation, take them through a simple PNF (proprioceptive neuromuscular facilitation) contract-relax sequence to see if they can achieve a greater range of motion. If they are not able to get more than about 10 degrees of external rotation at the hip, then you should not put them into too much internal hip rotation. Do not prescribe narrow stance squats for clients like this.
The following table provides a handy summary of how to determine whether a narrow stance squat is appropriate for clients:
|Physical issue||Narrow stance squat appropriate?|
|Lack of ankle dorsiflexion||No|
|Tight adductor magnus||Yes|
|Lack of internal hip rotation/possible hip retroversion||No|
We must always consider that there is a risk/reward for every exercise that we prescribe to our clients. The better we are at assessing our client’s movement in everything they do, the better we will understand what our clients can safely do, and what may injure them.
Scott Rawcliffe, BA (Kinesiology and PE)
A lecturer for the FMA Strength Training Program, Scott has over 10 years’ experience in the fitness industry. With experience working with leading industry figures in Australia and internationally, he brings a wealth of knowledge to his presentations. Scot is passionate about trainer education and raising industry standards in order to create maximum impact in clients’ lives. For more information visit www.scottrawcliffe.com or Like www.facebook.com/ScottRawcliffe