Have you heard the old adage of ‘Practice makes Perfect’? Most people have. When learning a new skill or movement at the gym you need to spend time ‘under the bar’, or breaking a movement down into parts and then piecing them back together. This adage is true - you get better at what you practice, and if you practice perfectly, you get better at performing perfectly. However, if you practice poorly, you only get better at performing poorly.  This highlights a crucial concept that can make or break your rehab, which is quality. 

Sometimes, in our Physiotherapy clinic, we treat people doing all the right exercises and release work, but the quality of their rehab sucks. I constantly remind my clients that I would much rather them to 1 great rep of an exercise, rather than 100 poor ones - because that will get them closer to getting their goals and back to what they love. 

In a rehab setting we hear things like ‘squats are the reason why my knee hurts’ or ‘I hurt my back deadlifting, and so now I avoid it’ all the time.  I would challenge most people, is that it’s not the exercise’s fault rather a technical or a loading fault.  What we see is that people have developed poor movement patterns and have practised these so much that they become ingrained into their system and they become habitual. They don’t feel like they are moving poorly because their training is going well, they are hitting new PR’s. The bodies ability to compensate is pretty incredible, it just gets the job done. Until... it’s had enough or can’t compensate anymore, and then something gives and they end up injured, broken and all jacked up.

Can you spot the difference with these two squats?

At quick glance, they both look like a squat. But the squat on the left my weight is too far in my forefoot, causing my knees to load more than my hips, as a result, this loads the muscles of my anterior chain, or the front of my body, more than my posterior chain, or the back of my body, causing an imbalance of muscle load, which over time, can potentially cause an ‘annoyed’ knee, hip or back etc. In the photo on the left you will also notice the increased load on my anterior chain forces me to round my back, in order to achieve the same depth as the squat on the right. This may potentially put my lower back at risk, and/or contribute to my neck pain that I thought was due to work or those tight sore ankles. In both photos, I can still squat but is the squat on the left destined for longevity? Maybe, but most likely not.

Back to the ‘squats are bad for my knees story’, a reasonable thought process might be that if the knees hurt we need to strengthen them because they are weak, so let’s strengthen your quads till the cows come home.  But... what if we taught you to access the muscles of the posterior chain to create more balance between the muscles of the lower limbs, thereby unloading the knees. Looking at the picture below, the muscles of the posterior chain glutes, hamstrings and lats all look pretty big, and their potential to lift heavy things should be great. However, most people's glutes aren’t that fantastic, and they do more sitting than lifting.

The Physiotherapists View

When looking at someone's movement, it’s always on a continuum from something that looks like a dog’s breakfast to something that actually looks pretty solid but may need a little fine tuning. Most people who squat with poor form generally have no idea they aren’t moving that well until they wind up in some physio’s office saying that something hurts. If we can catch you early, potentially before the injury, this opens up another realm to physio, which is more performance upgrade focused rather than just trying to keep your body from falling apart.  There is no better feeling than getting one of our clients coming in saying that they smash their PB and it actually felt easy or effortless.

Improving someone's quality of movement and helping them learn how to access the power in certain muscle groups may be a crucial part of the puzzle to take their performance to the next level. In my next few blog posts I might step you through some of my thought processes about how we go about improving someone's movement quality and some of my go-to rehab exercises to help strengthen some standard weak links.

Bayden is our Senior Physio and a clinic co-director at our Melbourne Physiotherapy clinic based in Richmond. You can book in with him here