Dynamic Deep Squat:

Lower-Body Kinematics
and Considerations
Regarding Squat
Technique, Load Position,
and Heel Height
Max Todoroff, PT, DPT, OCS, CSCS
Manual Medicine Physical Therapy, Raleigh, North Carolina

ABSTRACT performance (36,810,12,21,23,24,27 extremity kinematics to explore how

THE DYNAMIC DEEP SQUAT IS AN
IMPORTANT AND WIDELY USED
EXERCISE BY STRENGTH AND
CONDITIONING, REHABILITA-
TION, AND HEALTH CARE PRO-
FESSIONALS. THIS ARTICLE
EXPLORES LUMBAR SPINE AND
LOWER EXTREMITY KINEMATICS
DURING THE DYNAMIC DEEP
SQUAT AND CONSIDERS SQUAT
TECHNIQUE, LOAD POSITION,
AND HEEL HEIGHT INFLUENCES.
BETTER UNDERSTANDING OF
DYNAMIC DEEP SQUAT KINE-
MATICS MAY HELP TO
PREVENT LUMBAR SPINE
INJURIES RELATED TO SQUAT-
TING.
INTRODUCTION
he dynamic deep squat is widely
29,34,36,39,40,42,44,46,49,50,5255).
The dynamic deep squat is defined as
squatting down to a position where the
knees are in 1401458 of flexion (2,15).
Despite the widespread use of the
squat, there is currently a debate
whether deep squats are as safe as
other squat variations such as the
parallel squat or quarter squat in regard
to lumbar spine health (15,44). Parallel
squats are defined as squatting down to
where the inguinal fold is parallel in the
horizontal plane to the top of the knee
musculature, whereas quarter squats
are defined as squatting to 40708 of
knee flexion (15). Despite this contro-
versy, it seems that most health and
fitness professionals seem to believe
that keeping the lumbar spine in
a neutral position in the sagittal plane is
important to protect passive interver-
tebral structures (3,4,6,7,15,16,23,31,32,
squat technique, load position, and heel
elevation height influence this exercise.
The purpose of this critical review is to
explore these factors to identify what
may limit neutral lumbar spine deep
squat depth for potentially reduced
lumbar spine injury risk.
APPROPRIATE NEUROMUSCULAR
CONTROL OF THE SPINE
Essential fundamentals required before
deep squatting is even attempted are
appropriate thoracolumbar spine neu-
romuscular control and positioning
along with appropriate dissociation of
hip and lumbar spine flexion
(32,39,51). The thoracolumbar spine
should be kept in a slightly extended
position with slight anterior pelvic tilt
to increase erector spinae activity and
prevent the loss of lumbar lordosis dur-
ing the squat exercise (15,51). This

T used to improve lumbar spine

extensor strength, hip extensor
strength, and knee extensor strength,
39,40,42,43,44,51,53). In fact, this
neutral spine position is advocated for
by the National Strength and Condi-
tioning Association (NSCA) (3,40).
spine position should be rigid and not
involve any planar motion (42,44). It is

reduce injury, and increase athletic To the authors knowledge, no publi-

KEY WORDS:
deep squat; squat; hip kinematics;
Address correspondence to Max Todoroff, cation has critically examined dynamic injury prevention; weightlifting
max.todoroff@gmail.com. deep squat lumbar spine and lower

Copyright National Strength and Conditioning Association 71

Strength and Conditioning Journal | www.nsca-scj.com

Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
 Dynamic Deep Squat
also important that the individual be
able to bend forward using a hip flexion
motor control strategy as opposed to
a lumbar spine flexion motor control
strategy otherwise known as a hip
hinge as described by McGill and
Marshall (33).
HIP RANGE OF MOTION
(COXOFEMORAL JOINT)
The dynamic deep squat requires sub-
stantial ranges of motion at the hip,
knee, and ankle to avoid lumbar spine
movement. It is important that the indi-
vidual has normal joint mobility of
these joints and normal muscle length
of surrounding muscles to even con-
sider safe deep squats. The hip joint
has a normal flexion range of motion
of approximately 130.48 (95% confi-
dence interval [CI]: 129.08131.88) in
men aged 2044 years (n 5 50) and
133.88 (95% CI: 132.58135.18) in
women aged 2044 years (n 5 50) using
a standard goniometer (47). The Center
for Disease Control and Prevention
currently advocates using the data ob-
tained from the study of Soucie et al.
(47) for normal joint range of motion.
With added combined movements of
hip abduction, hip external rotation, or
hip internal rotation, some individuals
may be able to increase this range of
motion because hip movement is 3
dimensional and will use multiple
planes of movement during the squat.
Soucie et al. (47) looked only at passive
hip flexion range of motion measured
while lying in supine. Individuals may
be able to achieve more motion during
the squat as combined multiplanar
movements were not accounted for
and passive weight-bearing move-
ments (aid from an external force) are
generally larger than passive non
weight-bearing movements because
passive tension from surrounding tis-
sues is stretched further (41). Because
of the nature of squatting with a load,
external forces will aid in stretching
this passive tension from surrounding
tissues to allow for increased hip sag-
ittal plane range of motion.
Table 1 shows studies that have ex-
amined hip flexion range of motion
72 VOLUME 39 | NUMBER 1 | FEBRUARY 2017
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
kinematics in the deep squat with
heels flat on the ground in healthy
individuals. It is interesting to note
that Hemmerich et al. (17) showed
only 95.4 6 26.68 (mean 6 SD) of
hip flexion, 26.1 6 11.68 of hip abduc-
tion, and 16.5 6 10.58 of hip external
rotation range of motion necessary to
bodyweight deep squat with the heels
flat on the ground in Indian individuals
older than 40 years. However, lumbar
spine position was not cued or consid-
ered and the authors hypothesized
this small hip flexion range of motion
requirement being due to increased
lumbar spine flexion.
In contrast, Wretenberg et al. (55)
showed a larger hip flexion range of
motion requirement (125.0 6 4.08)
during the deep squat with heels
flat on the ground in the Olympic-
style weightlifter group performing
a high-bar position back squat. The
powerlifter group was not included
in this analysis because of the lack
of knee flexion which was not consid-
ered a deep squat. It is possible that
the National Class Swedish weight-
lifters kept a neutral spine during
the deep squat which may demand
more hip flexion range of motion
(28,32). The study did not control
for footwear as the weightlifter per-
forming the deep squat in their study
picture is wearing weightlifting shoes
which can influence lower extremity
kinematics (43,46,54). It is also impor-
tant to recognize that these measure-
ments in the study were not as precise
as other studies as they did not pro-
vide measurements to the nearest
tenth. The study also excluded
women which may not make their
data generalizable. However, this
was the only study to use external
load which also may have influenced
lower extremity kinematics. Other
differences in hip flexion range of
motion between these studies may
be explained by different sample sizes,
different cultural samples, and high
SDs in hip flexion range of motion
showing anthropometrical differences.
Similar to the study by Hemmerich
et al. (17), lumbar spine position was
not cued in the study by Bagwell
et al. (1), Han et al. (13), or Wretenberg
et al. (55).
KNEE RANGE OF MOTION
(TIBIOFEMORAL JOINT AND
PATELLOFEMORAL JOINT)
Normal knee flexion range of motion is
137.78 (95% CI: 136.5138.98) in men
aged 2044 years and 141.98 (95% CI:
140.9142.98) in women aged 2044
years using a standard goniometer
(47). Knee flexion passive range of
motion was measured in supine ac-
cording to the study by Soucie et al.
(47), which may underestimate total
range of motion. Leszko et al. (26)
showed knee flexion ranges of motion
of 149.4 6 13.08 in male Caucasians
(mean age 27.5 years, n 5 24), 157.1 6
10.48 in female Caucasians (mean age
25.2 years, n 5 24), 157.2 6 9.18 in male
Japanese (mean age 30.9 years, n 5 13),
and 161.1 6 10.38 in female Japanese
(mean age 37.4 years, n 5 11) using fluo-
roscopic surveillance during a deep knee
bend lunge.
Table 2 shows studies that have exam-
ined knee flexion range of motion
kinematics in the deep squat with
heels flat on the ground in healthy
individuals. Analysis of Table 2 shows
that the studies using weightlifters
(6,55) seem to have less knee flexion
during the deep squat. These studies
(6,55) also used external load which
could have influenced knee kinemat-
ics. This seems less likely as Cotter
et al. (6) showed only 1.89 6 2.18 dif-
ference between bodyweight and
external load conditions. This is the
only study that cued a neutral lumbar
spine lordosis and used a light cur-
tain device to cue subjects of proper
squat depth during the deep squat
which may account for its smaller
knee flexion range of motion and
smaller SD compared with the other
studies. It is important to note that the
femur externally rotates (or tibia inter-
nally rotates) during weight-bearing
knee flexion with the lateral
femoral condyle moving posteriorly
(11,18,26,38). The differences in knee
flexion range of motion between the
above-mentioned studies may be
 Subjects (women/men) Subject mean age (y) Study population Deep squat load Neutral lumbar Measurement
explained by different sample sizes in
studies, different cultural samples, dif-
method

tracking

tracking

tracking

tracking
ferent study protocols, and high SDs

system

system

system

system
Dynamic

Dynamic

Dynamic

Dynamic
in knee flexion range of motion show-
ing anthropometrical differences.
spine position

ANKLE RANGE OF MOTION

(TALOCRURAL JOINT,
cued

TALONAVICULAR JOINT, AND

SUBTALAR JOINT)
Normal ankle dorsiflexion range of
No

No

No

No
motion is 12.78 (95% CI: 11.613.88)
in men aged 2044 years and 13.88
Deep squat hip flexion range of motion with heels flat on the ground in healthy individuals

65% of their 1
(95% CI: 12.914.78) in women aged

maximum
repetition
Bodyweight

Bodyweight

Bodyweight

2044 years using a standard goniom-

eter (47). Ankle dorsiflexion was
measured seated which may underes-
timate the total range of motion (41).
In fact, Rabin and Kozol (41) showed
weightlifters

with 2 different examiners that

National class

weight-bearing ankle dorsiflexion

Swedish
American

(examiner 1: 49.7 6 6.48, examiner

Chinese

Indian

2: 49.3 6 5.98) using a fluid-filled incli-

nometer had approximately more
than twice the range of motion as
weightlifters: 19.0

nonweight-bearing ankle dorsi-

flexion (examiner 1: 24.6 6 5.08,
Powerlifters: 31.0
Table 1

examiner 2: 23.2 6 5.48) with a stan-

Powerlifters: 6 subjects Olympic-style
Women: 21.2

dard goniometer. Rabin and Kozol

Men: 21.9

used a weight-bearing lunge tech-

nique in healthy (mean age 25.5
31.9

48.2

years) Israeli college students (29

women and 14 men) (41). Konor
et al. (22) demonstrated less ankle
dorsiflexion (43.2 6 5.88) using a dig-
weightlifters: 8

ital inclinometer when performing

Olympic-style

a weight-bearing lunge technique in

subjects

healthy (mean age 24.0 years) Amer-

20/20

10/20

ican individuals (13 women and 7

0/14
9/6

men). The differences in ankle dorsi-

flexion range of motion between these
Hip flexion range of motion

Powerlifters (low-bar position

studies may be explained by different

(high-bar position barbell):
Olympic-style weightlifters

sample sizes in studies, different cul-

barbell): 146.0 6 3.08

tural samples, different equipment,

Women: 117.8 6 14.98

and high SDs in ankle dorsiflexion

Men: 121.3 6 13.28

range of motion showing anthropo-

125.0 6 4.08

metrical differences.
113.0 6 6.78

95.4 6 26.68

Table 3 shows studies that have exam-

ined ankle dorsiflexion range of motion
kinematics in the deep squat with heels
flat on the ground in healthy individu-
als. Analyzing Table 3, it seems that
Wretenberg
et al. (17)

et al. (55)
Hemmerich
et al. (1)

Han et al.

deep squatting with heels flat on the

Bagwell

ground may require full ankle dorsiflex-

(13)
Study

ion range of motion as mean values and

SDs seem to overlap with the ankle

73 Strength and Conditioning Journal | www.nsca-scj.com

Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
74 VOLUME 39 | NUMBER 1 | FEBRUARY 2017

Dynamic Deep Squat

Table 2
Deep squat knee flexion range of motion with heels flat on the ground in healthy individuals
Study Knee flexion range of motion Subjects (women/men) Subject mean age (y) Study population Deep squat load Neutral lumbar Measurement
spine position method
cued

Cotter et al. Bodyweight: 139.89 6 2.18 0/16 22.7 American Bodyweight and Yes Dynamic
(6) (recreational 50% 1 tracking
weightlifters) repetition system
maximum
50% 1 repetition maximum:
141.78 6 2.18
Han et al. Men: 147.6 6 11.18 20/20 Men: 21.9 Chinese Bodyweight No Dynamic
(13) tracking
system
Women: 154.1 6 10.38 Women: 21.2
Han et al. Young: 145.3 6 11.58 Young: 8/8 Young: 22.2 Chinese Bodyweight No Dynamic
(14) tracking
system
Elderly: 142.8 6 10.78 Elderly: 3/5 Elderly: 63.6
Hemmerich 153.7 6 10.48 10/20 48.2 Indian Bodyweight No Dynamic
et al. (17) tracking
system
Wretenberg Powerlifters (low-bar position 0/14 Powerlifters: 31.0 National class 65% of their 1 No Dynamic
et al. (55) barbell): 126.0 6 4.08 Swedish repetition tracking
weightlifters maximum system
Olympic-style weightlifters Powerlifters: 6 subjects Olympic-style
(high-bar position barbell): weightlifters: 19.0
138.0 6 3.08
Olympic-style
weightlifters: 8
subjects
 Table 3
Deep squat ankle dorsiflexion range of motion with heels flat on the ground in healthy individuals

Study Ankle dorsiflexion Subjects Subject mean Study Deep squat Neutral lumbar Measurement
range of motion (women/men) age (y) population load spine position method
cued

Han et al. (13) Men: 33.6 6 3.78 20/20 Men: 21.9 Chinese Bodyweight No Dynamic
tracking
system
Women: 36.2 6 Women: 21.2
4.88
Hemmerich 38.5 6 5.98 10/20 48.2 Indian Bodyweight No Dynamic
et al. (17) tracking
system

dorsiflexion study by Konor et al. (22). the individual will travel through all of these factors, downward movement
However, because of high ankle dorsi- of the hip and ankle sagittal plane can only come from the knees or lum-
flexion measurements in the study by range of motion before approaching bar spine. Because the hips and ankles
Rabin and Kozol (41), it is hard to end range of motion at the knee. This are locked in an end of movement posi-
make this statement with confidence. is due to different factors. The knee has tion and the lumbar spine is being iso-
Han et al. (13) and Hemmerich et al. more available sagittal plane range of metrically contracted to maintain
(17) did not cue lumbar spine position motion as described above. Trunk a neutral lumbar lordosis, the knees
during the bodyweight deep squat. It is inclination angle will take a large are the only joint that can move at this
possible that deep squatting with heels amount of the available hip flexion point. However, the knees still have
flat on the ground with the lumbar range of motion. The ankle will be available range of motion because the
spine in a neutral position will require either isometrically contracted to angle of the center of mass would
different ankle dorsiflexion kinematics maintain balance by keeping the cen- translate if the knees were to move in
than deep squatting without a neutral ter of mass over the base of support in isolation. This would cause the individ-
lumbar spine. the powerlifting squat (Figure 1) or it ual to lose their balance as the move-
will be at end range of motion in the ment would be a curvilinear path
THE HIP AND ANKLE LOCK traditional squat (Figure 2). As a result
Hip flexion, abduction, and external/
internal rotation range of motion along
with ankle dorsiflexion and knee flex-
ion range of motion will greatly affect
how low the individual can squat in
the sagittal plane while keeping a neu-
tral lumbar lordosis. Because of the
movement of the squat where the feet
are always planted on the ground,
squat technique and position of load
relative to the base of support will have
a dramatic impact on how joints are
stressed as the body has to position
itself to maintain balance with the cen-
ter of mass being placed over the base
of support (42,55). In this situation, the
center of mass would be close to the
barbell and the base of support would
be the midfoot (42).
Despite the influence that squat tech-
nique and position of the load relative
to the base of support will have on the
movement pattern during the squat, Figure 1. Powerlifting squat technique. Figure 2. Traditional squat technique.

75
Strength and Conditioning Journal | www.nsca-scj.com

Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
 Dynamic Deep Squat
around the knee joint. Therefore, the
lumbar spine ventrally flexing forward
causing a loss of lumbar lordosis while
the knees continue to flex is the only
way the body can maintain balance
after the hips and ankles have locked
to allow for more knee range of
motion. This observation of lumbar
spine flexion or a posterior pelvic tilt
during the deep squat has been sup-
ported with research where lumbar
spine position was not cued (1,25,35).
McGill (32) has also hypothesized that
hip range of motion is a significant lim-
iting factor during deep squatting with
a neutral lumbar spine position. Kritz
et al. (23) acknowledged in a literature
review on the bilateral squat that
a common compensatory movement
when hip range of motion is limited
will be increased trunk flexion.
Macrum et al. (30) showed that when
a wedge causing a 128-forefoot angle
was placed under the foot to prevent
ankle dorsiflexion, subjects could not
bodyweight squat as deep using
a powerlifting squat technique and
compensated by moving the knees
medially. Kim et al. (21) showed that
ankle dorsiflexion range of motion in
both men and women was the primary
variable effecting bodyweight deep
squat depth with the heels flat on the
ground, followed by hip flexion range
of motion in men using a stepwise mul-
tiple regression analysis. Lack of ankle
dorsiflexion has been significantly cor-
related (0.94) with the inability to
bodyweight deep squat with the heels
flat on the ground in 2 separate studies
using a discriminant analysis model
(19,20). A majority of these studies
did not cue lumbar spine position dur-
ing the deep squat with heels flat on the
ground (1,1921,25,30,35).
SQUAT TECHNIQUE AND TRUNK
INCLINATION ANGLE
Because of the importance of hip sag-
ittal plane range of motion as described
above, trunk inclination angle is one of
the limiting factors for the depth of
a squat with a neutral lumbar lordosis.
Trunk inclination angle (37), trunk lean
displacement (43), or trunk lean (54) is
defined as the pelvis and spine moving
76 VOLUME 39 | NUMBER 1 | FEBRUARY 2017
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
as a unit anteriorly on the coxofemoral
joints (hips) and is the same hip hinge
(31) as described above. For instance, if
the hip only has 1308 of flexion range
of motion or potentially 1408 with
other added combined movements
(abduction/external rotation or internal
rotation) and selected squat depth is
where the top of the knee musculature
is parallel to the inguinal fold in the hor-
izontal plane where approximately 1008
of hip flexion is required. A trunk incli-
nation angle larger than 408 in the sag-
ittal plane from vertical will cause lumbar
spine ventral flexion due to hip anatomy.
Proposed key factors in determining this
trunk inclination angle are squat tech-
nique, load position relative to base of
support (midfoot), and heel height.
Studies (10,55) have shown that squats
can be performed in 2 distinct move-
ment patterns. The squat that used
a horizontal posterior displacement of
the pelvis such as sitting onto a chair
generated higher hip extensor kinetics,
whereas the alternative squat using an
immediate vertical downward dis-
placement of the pelvis with less hori-
zontal posterior pelvic displacement
generated higher knee extensor and
ankle plantar flexor kinetics (10). A
squat technique that involves a large
horizontal posterior displacement of
the pelvis will potentially cause a larger
trunk inclination angle and as a result,
because of the early hip and ankle lock,
limit safe lumbar spine neutral deep
squat depth (Figure 1). This large trunk
inclination angle is necessary to offset
the center of mass shifting posteriorly
(16,42) and is a common movement
strategy used with powerlifting squats
(50,55). The NSCA squat position
statement advocates a vertical torso
during squatting (3). However, this rec-
ommendation will not be possible dur-
ing this squat technique because of the
physics required to maintain balance as
the base of support (midfoot) will be
anterior to the center of mass if the
individual does not perform an anterior
trunk lean (28).
In contrast, the squat technique that
involves a more immediate vertical
downward displacement of the pelvis
without as much horizontal posterior
pelvic displacement allowing the
knees to track anteriorly past the toes
theoretically will allow for a smaller
trunk inclination angle (42) and allow
for greater squat depth without losing
the lumbar lordosis because the hip
and ankle lock will occur later (Fig-
ure 2). Frye et al. (12) and List et al.
(27) support this observation in their
research data where allowing the
knees to track anteriorly over the toes
reduced trunk inclination angle,
whereas limiting this anterior knee
translation increased trunk inclina-
tion angle. In comparison, Swinton
et al. (50) showed a larger L5-S1 ver-
tebral peak external moment arm (in
centimeters) in the traditional squats
compared with powerlifting squats;
however, the difference was not sta-
tistically significant. This external
moment arm was determined by
measuring the horizontal distance
from the L5-S1 joint center and bar-
bell center (50). It is important to
note that in this study, all participants
were powerlifters and that load posi-
tion and heel height were not con-
trolled (50).
Allowing the knees to track anteri-
orly past the toes while squatting
has generally not been advocated
because of the fear of high knee joint
stresses (9,16,23,28,44). However,
this concern has been questioned
recently and warrants further
research in this area (15,44,45). Some
authors have even had concerns of
increased lumbar spine stresses if
the knees were restricted from trans-
lating anteriorly past the toes
(12,27,28), although this claim has
been questioned (50). If the athletes
goal is to deep squat or perform
Olympic-style weightlifting (squat
cleans, squat snatches, and clean
and jerk) in a safe manner, this tradi-
tional squat technique (Figure 2) is
an essential squat technique that they
must learn and use (55).
LOAD POSITION
Position of the load on the spine in
relation to the base of support will
influence the individuals center of

Figure 3. Low-bar barbell position.
mass and may influence the type of
squat technique that will be performed
(42,55), which may influence trunk
inclination angle and lumbar spine
kinematics as described above. Low-
bar position back squats (barbell evenly
on top of the posterior deltoids at the
middle of the trapezius (40)) will cause
a posterior shift of the individuals cen-
ter of mass due to this bar position
being posterior to the base of support
(Figure 3). This low-bar position will
then require a compensatory anterior
trunk lean to keep the center of mass
over the base of support. This anterior
trunk lean may facilitate a larger trunk
inclination angle at the start of squat
Figure 4. High-bar barbell position.
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
descent and a larger posterior horizon-
tal displacement technique of the pelvis
(powerlifting movement technique)
during the squat descent for the indi-
vidual to avoid losing their balance
(Figure 1). This observation has been
documented in previous studies
(12,27,44,55). Therefore, in most cases,
lock. Another consideration is heel
these low-bar position back squats
should not be reserved for squatting
deep to avoid low back injury.
High-bar back squats (barbell above
the posterior deltoid at the base of
the neck (40))(Figure 4), front squats,
overhead squats, or any squats with
the center of mass shifting forward
Strength and Conditioning Journal | www.nsca-scj.com
or staying close to neutral are theoret-
ically more appropriate to allow for
lower trunk inclination angles and
potentially safe lumbar spine neutral
deep squatting. However, it should
be noted that only one study supports
the notion that a neutral lumbar spine
can be maintained during a deep squat
with heels flat on the ground (6). This
may suggest that only squats where
the center of mass is shifted anterior
to the base of support (front squats,
goblet squats, etc.) are appropriate
when lumbar spine neutral deep squat-
ting with heels flat on the ground.
These anterior loaded squats require
a compensatory posterior trunk lean
to keep the center of mass over the
base of support allowing for a smaller
trunk inclination angle.
HEEL HEIGHT
Ankle sagittal plane dorsiflexion is
important to allow for as much sagittal
plane downward movement to occur
as possible before the hip and ankle
height in relation to the metatarsopha-
langeal joints (ball of foot) because
a higher heel will shift the individuals
center of mass forward (48) and also
allow for more sagittal plane dorsiflex-
ion which will aid in vertical down-
ward displacement and a smaller
trunk inclination angle (43) (Figure 5).
This forward shift of the center of mass
will cause a compensatory posterior
trunk lean to keep the center of mass
over the base of support facilitating
a smaller trunk inclination angle. These
are the principles that make weightlift-
ing shoes advantageous when trying to
deep squat or perform Olympic-style
weightlifting. Most weightlifting shoes
are designed with a raised heel (43).
Sato et al. (43) failed to show improved
squat depth with weightlifting shoes
compared with running shoes; how-
ever, squat technique was not consid-
ered and the subjects were instructed
to squat to parallel using their normal
technique with a high-bar barbell
position.
Whitting et al. (54) showed reduced
ankle dorsiflexion necessary to squat
to the same depth with weightlifting
77
 Dynamic Deep Squat
Figure 5. Heel-elevated squats.
shoes compared with running shoes;
however, trunk lean was not effected.
The authors hypothesized that this
lack of effect on trunk lean may be
due to the study subjects having suffi-
cient ankle dorsiflexion to achieve the
adequate squat depth with running
shoes. This study did not control for
squat technique or load position and
had individuals squat to their normal
training depth. Similarly, Sinclair et al.
(46) showed that weightlifting shoes
increased mean ankle dorsiflexion and
knee flexion range of motion compared
with running shoes, barefoot inspired
shoes, and barefoot conditions while
performing their normal back squat
technique and training depth with
70% of their 1 repetition maximum.
Squat technique, load position, and
squat depth were not controlled in this
study. On observation, many competi-
tive Olympic-style weightlifters and
powerlifters use weightlifting shoes.
OTHER CONSIDERATIONS
Anthropometrically speaking, the human
body varies widely from individual
to individual (6,13,14,17,22,26,41,47,55).
78 VOLUME 39 | NUMBER 1 | FEBRUARY 2017
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
Because of this anatomical variability, in-
dividuals may need different levels of
heel height elevation to reach certain
depths during the squat while maintain-
ing a neutral position of the lumbar spine
depending also on selected squat tech-
nique and load position. Some individu-
als may even be able to achieve the
appropriate deep squat position with
a neutral lumbar spine position without
any heel elevation.
Keeping the lumbar spine in a neutral
to slightly extended position may not
be as necessary as currently believed
during the squat. McKean et al. (35)
showed that as soon as 50% body-
weight was placed across the shoulders
before the squat descent, the lumbar
spine curve flattens and becomes
slightly kyphotic. They also hypothe-
sized that slight lumbar flexion may be
part of the normal movement pattern
for a deep squat and cueing against this
loss of lumbar lordosis during the
descent may not be necessary. Squat
technique, load position, lumbar spine
position, shoe type, or squat depth was
not controlled in this study, although
the authors do state all participants
squatted to at least a position where
the thigh was parallel to the ground.
The study participants were personal
training students who regularly per-
formed squats twice a week for at least
12 months.
Similar to McKean et al. (35),
Lamontagne et al. (25) showed that
a considerable amount of lumbar spine
flexion movement (24.2 6 6.88) is
necessary to deep squat to a distance
of 1/3 the individuals tibial height with
the heels on the ground; however, once
again lumbar spine position was not
cued and this study did not use trained
individuals or an external load. Bagwell
et al. (1) used a similar protocol and also
observed that a posterior pelvic tilt
(lumbar spine flexion) was a normal
movement performed with deep squat-
ting with heels flat on the ground. It is
important to clarify that Lamontagne
et al. (25) and Bagwell et al. (1) were
not using external load in their deep
squatting studies or hypothesizing to
deep squat with an external load.
Clearly, more research studies are
needed in this area before abandoning
current standards of squat technique
that advocate for a neutral lumbar spine
position during a deep squat.
CONCLUSION
There are many factors to consider
when trying to deep squat in a neutral
lumbar spine position. Strength and
conditioning, rehabilitation, and health
care professionals should consider squat
technique, load position, and heel
height when teaching and monitoring
dynamic deep squats. Taking these fac-
tors into account will allow for an
improved lumbar spine neutral position
and hopefully fewer injuries. Further
research needs to be conducted on
the dynamic deep squat to further
understand factors that influence lum-
bar spine kinematics and lumbar spine
injury risk. Based on the paucity of lit-
erature on hip flexion, knee flexion, and
ankle dorsiflexion kinematics during
the lumbar spine neutral deep squat
with heels flat on the ground, this is
suggested to be a specific avenue for
future squatting research.
Conflicts of Interest and Source of Funding:
The author reports no conflicts of interest
and no source of funding.
Max Todoroff is
the owner of
Manual Medi-
cine Physical
Therapy.
REFERENCES
1. Bagwell JJ, Snibbe J, Gerhardt M, and
Powers CM. Hip kinematics and kinetics in
persons with and without cam
femoroacetabular impingement during
a deep squat task. Clin Biomech (Bristol,
Avon) 31: 8792, 2015.
2. Caterisano A, Moss RF, Pellinger TK,
Woodruff K, Lewis VC, Booth W, and
Khadra T. The effect of back squat depth on
the EMG activity of 4 superficial hip and
 thigh muscles. J Strength Cond Res 16:
428432, 2002.
3. Chandler TJ and Stone MH. The squat
exercise in athletic conditioning: A position
and review of the literature. J Strength
Cond Res 13: 5158, 1991.
4. Comfort P and Kasim P. Optimizing
squat technique. Strength Cond J 29:
10, 2007.
5. Contreras B, Cronin J, Schoenfeld B, Nates
R, and Sonmez GT. Are all hip extension
exercises created equal? Strength Cond J
35: 1722, 2013. A.
6. Cotter J, Chaudhari A, Jamison S, and
Devor S. Knee joint kinetics in relation to
commonly prescribed squat loads and
depths. J Strength Cond Res 27: 1765
1774, 2013.
7. Delavier F. Strength Training Anatomy.
Paris, France: Human Kinetics, 2001. pp.
8082.
8. Dionisio VC, Almeida GL, Duarte M, and
Hirata RP. Kinematic, kinetic and EMG
patterns during downward squatting.
J Electromyogr Kinesiol 18: 134143,
2008.
9. Escamilla RF. Knee biomechanics of the
dynamic squat exercise. Med Sci Sports
Exerc 33: 127141, 2001.
10. Flanagan S, Salem GJ, Wang MY, Sanker
SE, and Greendale GA. Squatting
exercises in older adults: Kinematic and
kinetic comparisons. Med Sci Sports Exerc
35: 635643, 2003.
11. Freeman MAR and Pinskerova V. The
movement of the normal tibio-femoral joint.
J Biomech 38: 197208, 2005.
12. Fry AC, Smith JC, and Schilling BK. Effect
of knee position on hip and knee torques
during the barbell squat. J Strength Cond
Res 17: 629633, 2003.
13. Han S, Cheng G, and Xu P. Three-
dimensional lower extremity kinematics of
Chinese during activities of daily living.
J Back Musculoskelet Rahabil 28: 327
334, 2015.
14. Han S, Ge S, and Liu H. The relation of
three-dimensional knee kinematics
between walking and squatting for healthy
young and elderly adults. J Phys Ther Sci
26: 465467, 2014.
15. Hartmann H, Wirth K, and Klusemann M.
Analysis of the load on the knee joint and
vertebral column with changes in squatting
depth and weight load. Sport Med 43:
9931008, 2013.
16. Heiler J and Sorenson SC. Sitting back in
the squat. Strength Cond J 31: 2527,
2009.
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
17. Hemmerich A, Brown H, Smith S,
Marthandam SSK, and Wyss UP. Hip,
knee, and ankle kinematics of high range of
motion activities of daily living. J Orthop
Res 24: 770781, 2006.
18. Johal P, Williams A, Wragg P, Hunt D, and
Gedroyc W. Tibio-femoral movement in the
living knee. A study of weight bearing and
non-weight bearing knee kinematics using
interventional MRI. J Biomech 38: 269
276, 2005.
19. Kasuyama T, Sakamoto M, and Nakazawa R.
Ankle joint dorsiflexion measurement using
the deep squatting posture. J Phys Ther Sci
21: 195199, 2009.
20. Kathiresan G, Jali N, Afiqah NR, Aznie NA,
Fidieyana N, and Osop N. The relationship
between ankle joint flexibility and squatting
knee flexion posture in young Malaysian
men. World J Sport Sci 3: 226230, 2010.
21. Kim SH, Kwon OY, Park KN, Jeon IC, and
Weon JH. Lower extremity strength and
the range of motion in relation to squat
depth. J Hum Kinet 45: 5969, 2015.
22. Konor MM, Morton S, Eckerson JM, and
Grindstaff TL. Reliability of three measures
of ankle dorsiflexion range of motion. Int J
Sports Phys Ther 7: 279287, 2012.
23. Kritz M, Cronin J, and Hume P. The
bodyweight squat: A movement screen for
the squat pattern. Strength Cond J 31: 76
85, 2009.
24. Kushner AM, Brent JL, Schoenfeld BJ,
Hugentobler J, Lloyd RS, Vermeil A, Chu
DA, Harbin J, McGill SM, and Myer GD. The
back squat part 2: Targeted training
techniques to correct functional deficits and
technical factors that limit performance.
Strength Cond J 37: 1360, 2015.
25. Lamontagne M, Kennedy MJ, and Beaule
PE. The effect of cam FAI on Hip and pelvic
motion during maximum squat. Clin Orthop
Relat Res 467: 645650, 2009.
26. Leszko F, Hovinga KR, Lerner AL, Komistek
RD, and Mahfouz MR. In vivo normal knee
kinematics: Is ethnicity or gender an
influencing factor? Clin Orthop Relat Res
469: 95106, 2011.
27. List R, Gulay T, Stoop M, and Lorenzetti S.
Kinematics of the trunk and the lower
extremities during restricted and
unrestricted squats. J Strength Cond Res
27: 1, 2012.
28. Lorenzetti S, Gulay T, Stoop M, List R,
Gerber H, Schellenberg F, and Stussi E.
Comparison of the angles and
corresponding moments in the knee and
hip during restricted and unrestricted
squats. J Strength Cond Res 26: 2829
2836, 2012.
79
Strength and Conditioning Journal | www.nsca-scj.com
29. Lynn SK and Noffal GJ. Lower extremity
biomechanics during a regular and
counterbalanced squat. J Strength Cond
Res 26: 24172425, 2012.
30. Macrum E, Bell DR, Boling M, Lewek M,
and Padua D. Effect of limiting ankle-
dorsiflexion range of motion on lower
extremity kinematics and muscle-activation
patterns during a squat. J Sport Rehabil
21: 144150, 2012.
31. McGill S. Core training: Evidence
translating to better performance and injury
prevention. Strength Cond J 32: 3346,
2010.
32. McGill S. Ultimate Back Fitness and
Performance (5th ed.). Waterloo,
Ontario: Wabuno Publishers, 2014. pp.
90, 157158, 179, 193, 199204,
251257.
33. McGill S and Marshall LW. Kettlebell
swing, snatch, and bottoms-up carry: Back
and hip muscle activation, motion, and low
back loads. J Strength Cond Res 26: 16
27, 2012.
34. McKean MR, Dunn PK, and Burkett BJ.
Quantifying the movement and the influence
of load in the back squat exercise. J Strength
Cond Res 24: 16711679, 2010.
35. McKean MR, Dunn PK, and Burkett BJ.
The lumbar and sacrum movement
pattern during the back squat exercise.
J Strength Cond Res 24: 27312741,
2010.
36. Miletello WM, Beam JR, and Cooper ZC. A
biomechanical analysis of the squat
between competitive collegiate,
competitive high school, and novice
powerlifters. J Strength Cond Res 23:
16111617, 2009.
37. Mitnitski AB, Yahia LH, Newman NM,
Gracovetsky SA, and Feldman AG.
Coordination between the lumbar spine
lordosis and trunk angle during weight
lifting. Clin Biomech 13: 121127,
1998.
38. Moro-Oka TA, Hamai S, Miura H, Shimoto T,
Higaki H, Fregly BJ, Iwamoto Y, and Banks
SA. Dynamic activity dependence of in vivo
normal knee kinematics. J Orthop Res 26:
428434, 2008.
39. Myer GD, Kushner AM, Brent JL,
Schoenfeld BJ, Hugentobler J, Lloyd RS,
Vermeil A, Chu DA, Harbin J, and McGill
SM. The back squat: A proposed
assessment of functional deficits and
technical factors that limit performance.
Strength Cond J 36: 427, 2014.
40. NSCA. Exercise Technique Manual for
Resistance Training (3rd ed.). Champaign,
IL: Human Kinetics, 2016. pp. 4649.
 Dynamic Deep Squat
41. Rabin A and Kozol Z. Weightbearing and
nonweightbearing ankle dorsiflexion range
of motion: Are we measuring the same
thing? J Am Podiatr Med Assoc 102: 406
411, 2012.
42. Rippetoe M. Starting Strength: Basic
Barbell Training (3rd ed.). Wichita Falls,
TX: The Aasgaard Company, 2011. pp. 15,
3738, 4042.
43. Sato K, Fortenbaugh D, and Hydock DS.
Kinematic changes using
weightlifting shoes on barbell back
squat. J Strength Cond Res 26: 2833,
2012.
44. Schoenfeld BJ. Squatting kinematics and
kinetics and their application to exercise
performance. J Strength Cond Res 24:
34973506, 2010.
45. Schoenfeld BJ and Williams M. Are deep
squats a safe and viable exercise? Strength
Cond J 34: 3436, 2012.
46. Sinclair J, McCarthy D, Bentley I, Hurst HT,
and Atkins S. The influence of different
footwear on 3-D kinematics and muscle
80 VOLUME 39 | NUMBER 1 | FEBRUARY 2017
Copyright National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
activation during the barbell back squat in
males. Eur J Sport Sci 15: 583590,
2014.
47. Soucie JM, Wang C, Forsyth A, Funk S,
Denny M, Roach KE, and Boone D. Range
of motion Measurements: Reference values
and a database for comparison studies.
Haemophilia 17: 500507, 2011.
48. Sriwarno AB, Shimomura Y, Iwanaga K,
and Katsuura T. The relation between the
changes of postural achievement, lower
limb muscle activities, and balance stability
in three different deep-squatting postures.
J Physiol Anthropol 27: 1117, 2008.
49. Stephenson MD. Training the human
weapons platform : The squat. NSCA
TSAC Rep 12: 12.712.8, 2010.
50. Swinton PA, Lloyd R, Keogh JWL, Agouris I,
and Stewart AD. A biomechanical
comparison of the traditional squat,
powerlifting squat, and box squat. J Strength
Cond Res 26: 18051816, 2012.
51. VanGelder LH, Hoogenboom BJ, and
Vaughn DW. A phased rehabilitation
protocol for athletes with lumbar
intervertebral disc herniation. Int J Sports
Phys Ther 8: 482516, 2013.
52. Wallace DA, Salem GJ, Salinas R, and
Powers CM. Patellofemoral joint kinetics
while squatting with and without an
external load. J Orthop Sports Phys Ther
32: 141148, 2002.
53. Walsh JC, Quinlan JF, Stapleton R,
FitzPatrick DP, and McCormack D. Three-
dimensional motion analysis of the lumbar
spine during free squat weight lift
training. Am J Sports Med 35: 927932,
2007.
54. Whitting J, Meir R, Mchattan J, and Holding R.
Influence of footwear type on barbell back
squat using 50, 70, 90% of one repetition
maximum: A biomechanical analysis.
J Strength Cond Res 30: 10851092, 2016.
55. Wretenberg P, Feng Y, and Arborelius
UP. High- and low-bar squatting
techniques during weight-training.
Med Sci Sports Exerc 28: 218224,
1996.