Squats, Prayer, and Knee Pain. (An excuse to use a Ski Patrol clip)

If you have not noticed yet, we tend to squat- a lot. When I first started CrossFit one of the things that really surprised me was the amount of squatting I did in everyday life. I noticed this mostly because my legs seemed to be incredibly sore for about three months, and squatting to pick up a pen, get in the car, and sit on the toilet was very painful. For the first time in my life I felt like I was taller than normal and everything else was smaller and much farther below me. Kind of like the prank they pull on Murray in the movie Ski Patrol. A quick refresher: Murray is the stick-in-the-mud boss, who is vertically challenged. Some of the ski patrolmen give him a bottle of pills that claim to help with growth, and you can see the result (I apologize for the overdubbing):

But I digress, squatting is something we were made to do. Americans (it seems to me) use chairs so often that this movement has become almost foreign to us. Especially the ability to squat deep, hips below the knees. Somewhere along the line the view of deep squats changed. Now it seems that the common belief is that deep squats are unsafe and should be avoided. In the literature review "Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load" the authors assessed whether shallow squats (parallel and above) are safer on the musculoskeletal system than deep squats. They reviewed studies from 2011 to 2013. An interesting outcome is that the highest compression forces occur when the knee is flexed at 90°. As the knee flexes more, and the squat becomes deeper, everything acts as it was designed to and supports the knee joint and the forces lessen. Furthermore, all the structures that make up the knee will grow and become stronger with regular squatting.

Menisci and cartilage, ligaments and bones are susceptible to anabolic metabolic processes and functional structural adaptations in response to increased activity and mechanical influences (Hartmann, Wirth & Klusemann, 2013, p. 993).
— Hagen Hartmann, Klaus Wirth, Markus Klusemann (2013). Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load. Sports Medicine 43, 993-1008.

The authors also found evidence that continued use of short squats can lead to degenerative changes in the knee joints and spinal joints in the long term. They conclude by saying deep squats will in fact strengthen and protect the knee from injury.

What we just discussed may or may not surprise you, since everyone in the gym "drops it like its hot" on a regular basis. But what about evidence of this in everyday life? A study in 2010, looked at the correlation between religious practices and prevalence of knee osteoarthritis. The study looked at Thai elderly population who were either Buddhists or Muslims. The Muslims had a higher average number of religious practices per day, as well as a lower amount of knee pain and Radiographic osteoarthritis. However, when the amount of knee flexion and severity of knee pain scores were compared between the two groups, there was no significant difference. The authors concluded "...the Muslim way of praying since childhood, forcing the knees into deep flexion, may stretch the soft tissue surrounding the knee and decrease stiffness and contact pressure of the articular cartilage."


Lets keep this party rollin' and talk about what type of squat might be the better choice for people with knee pain, front or back? A study preformed by a group from the University of Florida at Gainesville sought to answer this question. They looked at video and force data, as well as surface electromyographic data of 15 healthy trained individuals. The back squat proved to create greater compressive forces as well as knee extensor moments (a moment is force that tends to cause a rotation about an axis. It can be thought of as "leverage" or bending force.) The authors concluded "...the front squat was as effective as the back squat in terms of overall muscle recruitment, with significantly less compressive forces and extensor moments. The results suggest that front squats may be advantageous compared with back squats for individuals with knee problems such as meniscus tears, and for long-term joint health."


Today's WOD

6X 2+1+1, 2 Clean Hi-Pulls, 1 Full Clean, 1 Jerk. All @80% 1RM Clean and Jerk

5X3 Weighted Pullups

4 Rounds

250m Row

30 sec easy row, after each 250.

after the 4th 250m sprint, row 500m easy.

4 rounds

100m Row sprint

15 sec easy row, after each 100m.