This is part 1 of Dr. E's blog post on treatment options to improve the overhead deep squat. Many components are involved in the deep squat which makes understanding the true cause of an inadequate performance difficult. The motion requires adequate hip extensor length, thoracic extension, ankle dorsiflexion, stability of the scapulothoracic musculature, and more. Both mobility and stability must be present in order to successfully complete the movement. With adaptive shortening of the hip extensors (especially the hamstrings), you often see difficulty maintaining proper lumbar position, leading to an excessively forward flexed torso. Thoracic extension and shoulder mobility combined with scapulothoracic stability are crucial for maintaining an upright posture while descending into the deep squat. Again, a deficit in this area often involves a forward flexed torso. Ankle dorsiflexion is necessary to prevent heel rise during the deep squat. We often see an adjustment for this in the FMS using the 2x6 wooden board to bring the ground up to the heels. Core stability is an obvious necessity as it contributes to maintaining proper posture during the movement. The components required for completion of the movement go on, but these are some common impairments.
Dr. E outlines 5 treatment options:
1. Thoracic spine manipulation to help improve thoracic mobility and glenohumeral motion.
2. Subscapularis Release for shoulder mobility.
3. Psoas Release: He demonstrates a great new video on a new psoas technique that is much less invasive and utilizes the principles of the neurophysiological effects of muscle tone.
4. IT Band Release using the edge tool to help increase hip mobility
5. Tibial Internal Rotation Mobilization with Movement for both knee and ankle mobility. He describes how the lower leg often is put into relative external rotation due to hip weakness, medial rotation of the femur, and pronation of the foot.
He demonstrates each of these techniques with good clarity. Although he is using these techniques in relation to the overhead deep squat, you can see how they would apply to any patient with deficits in that region.