The issue for me with back squats is a bum shoulder from back in my high school tennis days - similar to what I outlined earlier.  Because my shoulder doesn't like the externally rotated, abducted position, the only way I can get under a bar pain-free is to use an ultra-wide grip - which means my scapulae are winged out and my upper back is rounded over.  My shoulder range-of-motion is just fine, but the structural flaws I have (partial thickness tear, bone spurring, and likely labral fraying) means that if I want to back squat pain-free, I have to do so like someone who lacks external rotation. Who lacks external rotation?  Well, just about everyone who sits at a computer all day, and every athlete who has spent too much time bench-pressing.    Combine this with poor scapular stability and a lack of thoracic spine extension, and you realize that a large chunk of the weight-training population simply can't effectively put a bar on the upper back, let alone actually stabilize it. Let's be honest: if you have poor hip and/or ankle mobility, both your front and back squats are going to look pretty ugly.  You'll go into lumbar flexion or come up on your toes to get your range of motion, in most cases.  You'd think that one potentially protective factor would be that in the back squat, the lifter can better utilize the latissimus dorsi  (in a more shortened position) to help stabilize the spine. The main problem with the back squat, in my eyes, is that not everyone has sufficient upper body mobility to position and stabilize the bar properly.  As a result, it can "roll forward" on people - and that's where more of the forward lean problems come about.  More forward lean equates to more shear stress, and an increased risk of going into lumbar flexion under compressive load.  The front squat - even under heavier loads - keeps a lifter more upright, or else he'll simply dump the bar.

So, with all that in mind, while it may be a bit of a bold statement, I'd say that for individuals with excellent whole-body mobility and no upper extremity pain, a back squat is no more dangerous than a front squat. While the extra stabilization contribution from lats may reduce some of this risk, the simple fact that one can move more weight with a back squat probably "cancels out" this advantage in this comparison. All that said, regardless of whether you front or back squat, I'd encourage you to regularly get video of yourself lifting - or find an experienced coach - to give you feedback on your technique.

As you work to regain that mobility, it's valuable to build stability within that newly acquired range-of-motion (ROM) with loads of horizontal pulling (rows) and deadlift variations. With respect to the shoulder itself, it's important to regain lost external rotation ROM and scapular posterior tilt.  As I recently wrote in "The Right Way to Stretch the Pecs," I prefer the 1-arm doorway pec stretch and supine pec minor stretches.  You can find videos of both HERE - and you can expedite the process with regular foam rolling on the pecs. In the interim, substitute front squats, overhead squats, single-leg exercises, and deadlift variations to maintain a training effect.

Hopefully, these recommendations get you headed in the right direction and back to squatting as soon as possible! What the experts are saying about The Truth About Unstable Surface Training... "Unstable surface training is many times misunderstood and misinterpeted in both the physical therapy and athletic performance fields. The Truth About Unstable Surface Training e-book greatly clarifies where unstable surface training strategically fits into an overall program of injury prevention, warm-up/activation, and increasing whole body strength. If you are a physical therapist, athletic trainer, or strength training professional, The Truth About Unstable Surface Training gives you a massive amount of evidence-based ammunition for your treatment stockpile." Shon Grosse PT, ATC, CSCS Comprehensive Physical Therapy Colmar, PA Click here for more information on The Truth About Unstable Surface Training.

And, alongside that, work in a solid rehabilitation program that focuses not only on the glenohumeral joint, but also scapular stability and thoracic spine mobility. Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches used by Cressey Performance Pitchers after they Throw!

To Squat or Not to Squat?

I’m going to let you in on a little secret: not all our athletes squat, and the older and more banged up they get, the less they squat.

We’ve all been told that “squats are king” when it comes to leg development, and the carryover of squat variations to athletic performance cannot be overstated. Squats even have a place in corrective exercise settings; I’ve frequently used box squats to help iron out quad-dominant vs. hip dominant imbalances. And, the eccentric strength attained from squatting is of undeniable importance in active deceleration in sports – thus taking the stress off of the passive restraints like menisci, ligaments, and discs. The list of benefits goes on and on.

As with anything in life, though, there’s a downside: you get some pretty crazy compressive loads on the spine when you get stronger:

Cappozzo et al. found that squatting to parallel with 1.6 times body weight (what I’d call “average” for an ordinary weekend warrior who lifts recreationally) led to compressive loads of ten times body weight at L3-L4 (1). That’s 7000N for a guy who weighs about about 150.

Meanwhile, in a study of 57 Olympic lifters, Cholewicki et al. found that L4-L5 compressive loads were greater than 17,000N (2). It’s no wonder that retired weightlifters have reduced intervertebral disc heights under MRI.

The spine doesn’t buckle until 12,000-15,000N of pressure is applied in compression (or 1,800-2,800N in shear) – so it goes without saying that we’re playing with fire, to a degree.

Fortunately, our body can adapt reasonable well – but not if you train like an idiot and ignore marked inefficiencies. Think of it this way:

Roughly 3/4 of all athletes have disc bulges/herniations that go completely undiagnosed.

It’s estimated that 4.4% of six-year olds have spondylolysis (lumbar fracture[s] (3)).

Presence of spondylolyis is estimated at 15-63% in ordinary athletes (highest is among weightlifters) – yet only 50-60% of those diagnosed under imaging actually report lower back pain (4).

This isn’t the only place in the body where this happens. If you’re a pitcher, you’re going to have a ripped up shoulder labrum – but that doesn’t mean that you’re symptomatic. If you’re a pitcher with a junk labrum AND a lack of internal rotation range-of-motion, though, chances are that you’re hurtin’.

What does this tell us? Inefficiency is as important – and possibly MORE important – than pathology.

So, let’s assume for a second that everyone in the world had spondylolysis, disc bulges, and explosive diarrhea (just for shits and giggles – pun intended, if you’d like). To take it a step further, though, let’s say that everyone insisted that they squat and we didn’t have the option of saying “no.” What would I do, in this instance?

1. Avoid Lumbar Flexion. The aforementioned Cappozzo et al. study demonstrated that as lumbar flexion increased under load, compressive load also increased (1). In other words, if you aren’t mobile enough to squat deep, you need to squat a little higher. I’ll use light “tap and go” (to a box) variations in my strength training programs to teach proper depth to those who lack flexibility.

2. Optimize hip range-of-motion. If your hips are stiffer than your lumbar spine, you’ll move at your spine first. Those who move at the lumbar spine get hurt; spine range of motion and power are highly correlated with injury risk. Some schmucks named Cressey and Robertson made a DVD called Assess and Correct that seems to help on this front… I incorporate these in all of my weight lifting programs.

3. Optimize ankle range-of-motion. Those with poor ankle mobility will turn the toes out considerable when they squat in order to make up for a lack of dorsiflexion ROM. When they can’t externally rotate any more, they’ll start to flex at the lumbar spine (mostly because their hip mobility is also atrocious).

4. Optimize thoracic spine range-of-motion. Look at the guys who are lifting the biggest weights injury-free, and examine the way their erector musculature is “allocated.” You’ll notice that the meat is in the upper lumbar and thoracic regions – not the “true” lower back.  Why?  They subconsciously know to avoid motion in those segments most predisposed to injury, and the extra meat a bit higher up works to buttress the shearing stress that may come from any flexion that might occur higher up.  Novice lifters, on the other hand, tend to get flexion at those segments – L5-S1, L4-L5, L3-L4, L2-L3 – at which you want to avoid flexion at all costs.  Our body is great at adapting to protect itself - especially as we become better athletes and can impose that much more loading on our bodies. Just ask Olexsandr Kutcher, who’s pulling close to 800 and squatting close to 900 at sub-200 body weights.

5. Stabilize the @#*$_@^ out of your lumbar spine. This does not mean sit-ups, crunches, sidebends, hyperextensions, or the majority of what you’ll encounter in yoga (although some variations are sufficient). Lumbar rotation, flexion, and hyperextension serve to make the spine less stiff relative to the hips. Your back may feel tight, but stretching it is quite possibly the silliest thing you can do, as you’d be encouraging more problems long-term in the process. Tony Gentilcore likes to talk about how it’s like picking a scab; it feels good in the meantime, but only hurts you in the long-run. Yeah, I think Tony is odd, too.

If I can get my act together, I’ll have a full detailed progression ready for you in a few weeks.

6. Deload the spine once-a-month if you’ve been at this a while. There’s nothing wrong with dropping squatting for a week each month to focus on extra single-leg work, movement training, pull-throughs…you name it. I know of a lot of powerlifters who do it for 3-4 weeks at a time, so one week won’t kill you. Having a balanced workout routine is key to healthy lifting.

7. Avoid training first thing in the morning. Because we’ve decompressed overnight, our spines are “superhydrated” when we first wake up in the morning; this places more stress on the ligaments and discs and less on the supporting musculature. As a little frame of reference, full flexion reduces buttressing strength against shear by 23-43% depending on the time of day – meaning that your spine might be 20% safer later in the day even if exercise selection is held constant. Give the spine a bit of time to “dehydrate” and you’ll be much better off.

8. Get Lean. Ever wonder why pregnant women are always having lower back pain?  Could it be that they're hyperextending (overusing the lumbar erectors) to offset the new weight they're carrying in the abdomen?  Beer bellies work the same way.

9. Keep moving throughout the day. It takes about 20 minutes for "creep" to kick in with your muscles - and the less you let that happen, the better.  The best posture is the one that is constantly changing.

10. Fix asymmetries. Okay, so we know that compression is probably a necessary evil. And, we know that flexion + compression is even worse. And, wouldn’t you know? We can actually make things worse by adding in an element of lumbar rotation. Who rotates at the lumbar spine? Usually, it’s those with asymmetries in mobility or strength at the ankle, hip, or thoracic spine. Compare ROM side-to-side and check side bridge endurance time; fix what’s out of whack.

Obviously, a lot of this requires some more involved functional tests, a solid background in functional anatomy, and an understanding of how to fix what’s wrong. In my most recent product, The High Performance Handbook, I've outlined a Four Phase System that incorporates a self-assessment, proper strength routine, mobility exercises, and de-loading phases for healthy, rapid results. If you're ready to take a good hard look at your routine, you can find more information here.

References:

1. Cappozzo A, Felici F, Figura F, Gazzani F. Lumbar spine loading during half-squat exercises. Med Sci Sports Exerc.1985; 17:613 -20.

2. Cholewicki J, McGill SM, Norman RW. Lumbar spine loads during the lifting of extremely heavy weights. Med Sci Sports Exerc.1991; 23:1179 -86.

3. Morita T, Ikata T, Katoh S, Miyake R. Lumbar spondylolysis in children and adolescents. J Bone Joint Surg Br. Jul 1995;77(4):620-5.

4. Soler T, Calderon C: The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med 2000 Jan-Feb; 28(1):57-62.

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!