Jessica Bento, Physical Therapist (Co-Creator of DVRT Restoration, Pelvic Control, and Shoulder Course)
To squat with elevated heels or not..are we helping or harming?
Not that this is anything new but it seems to becoming back into style when it comes to training (not sure if it really left) , that is elevating the heels when performing a squat. I have actually seen this so many times now, I wanted to address it on this platform. I don’t think people actually know the why’s behind elevating the heels and it’s impact on the body. I say that because I am seeing people elevate their squats when they don’t need to, absolutely no reason to, and it might just fire me up a little bit, but Josh would say pretty much anything fires me up nowadays.
So why elevate the heels when squatting? Where did this all come from, let’s start there. When someone elevates the heels during a squat you take out some of the need for mobility in the foot/ ankle complex. Meaning it places the client into more plantar flexion which means you require less dorsiflexion where people tend to lack, allowing for an easier squat from the clients perspective. Elevating the heels also forces the squatter to shift the weight backwards or more posteriorly allowing, again, an easier squat especially for those that tend to lean forward. So basically like I said, making the squat easier based upon these changes.
What is wrong with that? After all, if people lack some mobility in the ankle, isn’t it good to get them into a position in which they can squat? Shouldn’t we all want to have people squat with a good amount of range of motion?
Well, let’s take the first example I gave placing the ankle into more plantar flexion to avoid the need for more dorsiflexion. If we are simply elevating the squat for this reason, why are we not looking at the cause of the limited dorsiflexion. With all this talk about mobility why are we not addressing this? Why are we letting this one go and instead changing the mechanics of a primal movement pattern such as a squat? Wouldn’t addressing the issue be the better fix than poor pattering of a squat? It could be as simple as some tight calf muscles, not engaging the foot more during the squat and yes it could really be a lack of mobility at the actual ankle joint, but again, wouldn’t you want to address this? As lack of mobility at the foot and ankle could cause issues not only with squatting but also with something so basic such as walking?
I find it quite a paradox in strength and fitness where we say that women’s heels are a problem (which they are), yet, elevating the heels is not an issue. The average height of a woman’s heel shoe is about 3 inches, while I realize that we aren’t aiming for that type of lift I am seeing more and more get closer to it. However, you don’t have to reach 3 inches to cause issues in the knees, hips, low back, and even shoulders. This little infographic I think says it so well!
If we think that elevating the heel wouldn’t be good in locomotion, why are we squatting with it? Why are we using artificial mobility that doesn’t solve the problem in order to teach the body a faulty pattern? This is especially frustrating when you consider that there are some easy solutions. For example, most people are simply detached from what “using their feet” actually means. While we use cues like “push out the knees”, or “put the butt back” the truth is that our starting point for the squat SHOULD be our feet! Yes, the platform that has influence literally on everything else in our body. As renown physical therapist, Gray Cook says, “The ankle is a key component in rehabilitating knee problems—because it is often one of the causative factors of knee stability problems in the first place. Valgus collapse and pronation can be results of limited ankle dorsiflexion mobility. And yet the individual with the limited ankle persists in participating in activities, like squatting, lunging and running, that do require functional ankle mobility.”
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Turn up the 🔈🔈🔈fix those knees… Getting people to train for strength is something we all want to achieve with people, even in a #physicaltherapy setting. Strength can be the way we live better, become more injury resilient, and be healthier, especially women and bone density. However, it isn’t always as easy as telling people to JUST workout. For example, we know #squats are great for building lower body strength, but people struggle with not having pain in their knees and low backs. _________________ 1️⃣ While there are many methods of trying to correct improper movement, it can be something as simple as giving more feedback to people to learn how to use their body smarter. One of my favorite methods is to use @perform_better bands both around the feet and the thighs. This feedback helps people learn to use their feet and #glutes correctly to avoid most common issues like knees collapsing inwards. _________________ 2️⃣ Many people will coach knees and hips, but they rarely coach the feet. Since EVERYTHING comes from the ground up we have to help people learn how to use their feet and that by itself can correct so many issues in performing a proper #squat . Solutions can be simple if we understand what the body wants to do in movement! ________________ 3️⃣ When we put the band around the knee area we don’t want a band to just hang out there, but we want to BREAK the band apart which really engages our glutes and combined with the feet transforms our squats. Not only do we see the knees not collapsing, but we see the trunk become more upright and better range of motion. That’s why I love simple strategies that think about #functionalfitness and get people successful.
“Using the feet” actually works too on the idea of “proximal stability for distal mobility”. That statement from the physical therapy system of PNF refers often to the nervous system creating “tightness” in the shoulders and hips to protect itself when it perceives the spine to be unstable. When we perform exercises which create that stability, the nervous system takes the brakes off and we get all this new mobility. In other words, the shoulders and hips weren’t really the issue, stability of the core was! This concept doesn’t ONLY apply to the spine. If we think about Gray Cook and Mike Boyle’s “Joint by Joint Approach”, we see that the foot should create stability while the ankle is responsible for more mobility. What will happen if the foot does not create its necessary stability? You guessed it, it will probably find the stability in making the ankle more “tight”. This can be a great way to actually unlock, much of the mobility in the ankle for a good amount of people.
Many times we create fast solutions for people by first getting them to use their feet and then understanding how to stabilize the trunk. Josh has shown this many times, but I think still a lot of people miss what simple drills like the Press Out Squat can accomplish.
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So many people struggle with performing great squats and stable lunges. What most people miss is how core strength plays a role in our movements including squats and other lower body movements. Find out how physical therapy Jessica Bento gives us smarter ways to build core strength that helps us move better!
How fast does this work? How about immediately as DVRT Master Cory Cripe helped a fitness pro who was unable to squat due to bad knee pain to achieve a great foundational squat without pain!
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So happy whenever our #DVRT masters can make a positive impact upon other fitness pros. Only through sharing ideas and our philosophy of #functionalfitness can we truly create better solutions for those that come to us for help! Even for ourselves!!! That’s why it is super exciting for me to hear how even fitness pros that thought their bodies were too beaten up can make positive changes. Like one coach learning she could #squat pain free and another that he could press overhead when he thought it wouldn’t be possible. . Great work @corymcripe for representing our DVRT community so well and big thanks to @detroitthrive for being open enough to having us come and work with your great team!
See the emphasis on the feet and the grip?
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One of the great lessons I have learned to linger I’ve been a coach is that the “little things” about the intent of a movement can drastically change the way we not only see an exercise but how we see the results from such exercise. ————- 💪🏻 A great example is our Ultimate #Sandbag Bear Hug #squat . People think it is just about holding the USB. The power of this movement comes from the tension we create against it! ———— 💪🏻 Turn up the 🔈🔈🔈 as I explain how these types of #squats will change how you not just see THIS exercise but how you see squatting in general!
Josh has absolutely horrendous feet and ankles due to his years playing competitive basketball. I can’t tell you how many times I’ve had to mobilize his ankle/foot, do some soft-tissue treatments in them (the days he is nice to me which are few;), because he literally has no support left in these areas but also has tons of scar tissue. Seeing him squat the way you see above should NOT make sense or even happen. However, this is the power of using the DVRT techniques I have been describing. The cool part is it doesn’t take weeks or months, it happens fast (it may take several workouts to cement the pattern, but this too occurs quickly).
I could go on, believe it or not that is only a few of the MANY squat variation in my tool box. Not just to have different types of squat, but to have a progressions in teaching concepts of better squatting.
So do I recommend squatting with heels elevated? No not really, I have so many tools in my tool box that I don’t need to modify the squat by elevating the heels. I can change how the client is engaging the ground with their feet, I can give more feedback to this area as well. I can also change the squat, so I have a lot of solutions I can try before I change the mechanics of the actual squat by elevating the heels. Also with elevating the heels on a squat I tend to see increased forward knee tracking and that can cause excessive wear on the knee joints especially if there is an excessive forward knee. So this is another reason you won’t see me elevating squats.
Don’t get me wrong, there are people that actually legitimately have issues with their ankles/feet (there should be a picture of “see Josh” for that description!). While these strategies can go a long way in helping, we can address the ankle directly as well. Instead of doing isolated stretching and so forth, I always look to do more integrated work because that is how our body likes to function. These drills are inspired by some work Josh got to do directly with Gray Cook of Functional Movement Screen. I have modified them a bit to use some of our concepts of stability through directed tension. Combining the stability of the trunk along with using selected motion from various aspects of my body, this becomes a whole new way of thinking of creating ankle mobility.
A few notes before you incorporate these. In the first drill, the back foot is pressing in the ball of foot and I’m pulling in the Ultimate Sandbag to my body. I want to keep my elbows close and try to “break apart” the USB with my forearms. In the second drill, again, I want to keep tension in the Ultimate Sandbag by pulling it into my body and creating that stability in the core while trying to mobilize the lower extremities. Finally, this is an advanced version of the drill (you can do this in the front loaded position similar to what you saw in the first drill) and the goal is NOT to see how far I can rotate. Squeezing the handles, trying to “corkscrew” my arms while grabbing for the ground, just try to create SMALL rotations in the t-spine. I say just a slight shoulder turn (if you can see the back side of the shoulder or the bellybutton feels like it is moving you are going way to far!). If you haven’t noticed, not only should you see a change in the ankle mobility, but the hips and shoulders too! That is a great way to get a bigger bang for your buck and that is what we love at DVRT! (If you want to know which foam roller I am using, I am using this one from Perform Better HERE. You can use code “USB10” to get a discount on your purchase, no affiliate program here!)