Deep Squat: The Board Improves the View but Not the Score
A 34-year-old female runner and recreational lifter (three gym sessions and two 5 km runs per week) has no pain and no injury history. She has a half-marathon in 10 weeks. You screen her deep squat with the dowel held overhead. Without a board, her heels rise about 2 cm off the floor, her torso leans forward so it is not parallel with the tibia, her femurs remain above horizontal, her knees track over her feet, and the dowel stays in contact with her head, thoracic spine, and sacrum. With a 2 x 6 inch board under both heels, her heels stay down, her torso is vertical, her femurs are below horizontal, her knees track over her feet, and the dowel remains in contact. She reports no pain in either condition. She asks whether the board version 'counts as a 3' because it looks better.
1. Assign the deep squat scores for both conditions and justify them using the four scoring criteria.
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Without the board, the score is 1. With the board, the score is 2. The four criteria for a 3 are: upper torso parallel with the tibia or toward vertical; femur below horizontal; knees aligned over the feet; dowel maintained. Without the board she fails the torso and femur criteria (heels rise, torso leans forward, femurs stay above horizontal), so she cannot score 2 or 3. With the board she meets the torso, femur, knee, and dowel criteria, but the board is an external heel lift. A 3 must be achieved without the board, so the board condition is a 2, not a 3.
2. What does the difference between the two conditions suggest, and why is the board score not a 3?
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The board changes the score from 1 to 2, which suggests that heel elevation alters the squat enough to improve the pattern. That is a compensation, not a 3. The most likely contributor is limited closed-chain ankle dorsiflexion, but the screen cannot isolate that; hip mobility, trunk control, and squat strategy can also contribute. Do not tell her the board 'counts as a 3,' and do not use the board as a permanent fix if the goal is to improve the unassisted pattern. The board is useful as a temporary teaching tool or as a way to keep her training while you assess the limitation.
3. What would you assess and program first, and what would you avoid?
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Assess ankle dorsiflexion non-weight-bearing and in a half-kneeling position, hip flexion and rotation, and trunk control. Program ankle mobility drills, calf and soleus work, and squat patterning with a heel lift only as a temporary teaching tool; progress toward flat-foot squats. Avoid aggressive stretching into pain or adding load to the compensated pattern. Because she is asymptomatic and has a race in 10 weeks, do not create a dramatic overhaul; keep her running and lifting, add targeted ankle and squat work, and re-screen in 4-6 weeks rather than expecting an immediate 3.