3/6/2017 Objectives Squat and Deadlift: Breakout • Review specific pre-requisites and assessment techniques required in order to safely perform the deadlift and squat exercise Hunter Stark, PT, DPT, COMT, CSCS • Discuss integration of squat and deadlift 04 March 2017 corrective techniques into clinical practice Andrews Institute Rehab Symposium: LE • Discuss regressions and/or lateralizations of each movement for various diagnoses and body types Deadlift: Deadlift: Pre-requisites for performance Pattern Correctives • Mobility Pattern Mobility Corrective Stability Corrective Pattern Re-training ASLR or • Breathing Pattern re- • ASLR assisted with • Hip Hinge – Posterior chain extensibility “Toe training core pre-activation patterning with Touch” • Manual Therapy • SL bridge ASLR into dowel resisted • Multi-segmental flexion (“toe touch”) techniques band hinge and • Active Straight Leg Raise • Contract-relax SLR • Unsupported Leg assisted standing • Tactical Frog Rocking Lowering to no assistance • Stability (for hip flexion • Tall and ½ kneeling or resistance dysfunction) chops/lifts • KB deadlift with – 2/3 TSPU • Supported ASLR foam roll • Toe Touch Progression external cue restriction Deadlift: Deadlift: Variations Set-up and Performance • Cable Column (patterning movements) • Don’t show people how to deadlift – Resisted/Assisted Dowel Hinge – Avoid overloading them with “rules” – Towel Pull-through • Have them “feel” the position and tension • Kettlebell • Spend time on the start position!! – Double Leg • Basic principle set-up: – Single Leg – Set Posture • “Packed Neck” – look about 5 feet in front on the ground • Barbell • “Butt back into wall” – Conventional • “Pack shoulder blades into back pocket” • Most hip dominant – It is a static stability exercise for the upper body! Do not forget that this is not JUST a hip and back exercise – Sumo • “Crush the Handle” • Increased adductor involvement; less range required to move weight – Produce isometric tension • • Hex or Trap Bar “Let me see your shirt across the room” – • “Drive hard through heels” Knee or “squat”-dominant – Lift with the hips while maintaining stable shoulder and spinal • KB Swing positions – Explosive hinge 1 3/6/2017 Squat: “Cliff Notes” Version Pre-requisites for Performance • Foot – Stability • Mobility – Train to maintain a short foot position to avoid over-pronation and – Ankle DF collapse • • ½ kneeling or standing DF testing Ankle – Mobility – – Knee flexion and bent knee hip flexion, pelvic range of Mobilize in all planes – especially DF motion • Knee – Stability – • Supine DKTC Keep knees over the toes when squatting – Hands on shins / Hands behind knee • Hips – Mobility and Stability • Quadruped rocking – Active and Passive mobility into hip ER and flexion – Spinal/pelvic mobility • Lumbar Spine – Stability – Assessment to determine appropriate squat stance width and depth – Learn to move from the hips and keep the spine flat during squats • Stability and Motor Control • Thoracic Spine – Mobility – Thoracic spine extension/shoulder mobility and motor – Mobilize it into extension and strengthen it so it doesn’t flex (round) pattern control during squats • 2/3 FMS overhead deep squat • Shoulders – Stability and Mobility – Scapular stability for a solid foundation and GH mobility for flexion/ER Squat: Squat: Pattern Correctives Set-up and Performance • Feet shoulder width apart Pattern Mobility Corrective Stability Corrective Pattern Re-training • Deep Squat • Breathing • Supine end- • Resisted supine Toes should be turned out comfortably – not • Soft tissue and joint range triple triple flexion excessively mobilization for ankle, flexion isometric • Hip hinge knee, hip, spine, • Tall Kneeling patterning • Knees should track over the feet shoulders) Chops/Lifts • Squat pattern • Tactical Frog with RNT cues • Pelvis should fall between heels • Ankle DF self- for UE or LE mobilization • Goblet Squat • 3 rules to look for: – Heels stay on ground – No excessive knee valgus or varus – No excessive lumbar flexion or “butt wink” Squat: Variations • Squat Variations Clinical Implementation – “Natural” Bodyweight PRI Squat • Neutral rib and pelvic positioning – Goblet Squat • Deadlift and Hinge prior to squatting • Balance squat; chest up cueing – Counter-balance Squat • Insure proper mobility then stability prior to • Hip dominant squat – Barbell Back Squat performance • High Bar = more knee dominant squat • Low Bar = more hip dominant squat • Dynamic movement patterning prior to – Barbell Front Squat • Knee-dominant squat pattern (“safer” on the back and hips) performance – Box Squat • Hip dominant (“safer” for the knees); more vertical shin • Insure proper technique prior to loading – Split Squat • Exposes unilateral differences; best IMO for performance gains • How do I periodize pushing and pulling in • UE limitations treatment? – Safety Bar Squat – Belt Squat 2.