Squat Essentials

April 27, 2016 by · Leave a Comment
Filed under: Spinewave Bulletin 

How you squat (or not) can yield valuable clinical information

A properly executed squat uses a combination of several joints and muscles, including ankles, knees, hips, spine, abdominal muscles and tons of core strength! While a normal squat will follow normal functional movement, an abnormal squat may lead to additional stress and cause more strain to an already problematic area. Muscle weakness or tightness, instability and reduced joint motion can all be determined with this valuable diagnostic tool called the squat.

One reason the squat is a good evaluation tool is because it is a normal motion pattern – a part of the activities of daily living. We squat hundreds of times a day: getting in and out of the car, sitting in a chair, accessing items from the floor or shelves, exercising, and using the toilet. The inability to do these basic tasks is what may ultimately lead to infirmity and the need for assisted living.

There are several methods for evaluating the squat. For simplicity, it is good to start with the fundamental “air squat”. Prior to doing this though, ensure you can safely perform the squat by ruling out any joint injury with your chiropractor first.

How to do an air squat


  1. Stand with your heels shoulder-width apart and toes pointed forward or slightly out (not more than 10˚ of external rotation).
  2. Squat down until your thighs are at least parallel with the ground. You may extend your arms forward as a counter lever, but it is not required.
  3. Perform three repetitions while the chiropractor observes from the front; then three repetitions while observed from the side; and finally three more while observed from behind.


Characteristics of a normal, stable, solid squat

  • Symmetry, i.e. you do not sway to one side.
  • Your heels and toes remain on the ground; feet unmoved.
  • Your knees do not travel forward beyond your toes.
  • The lumbar curve is maintained throughout the squat.
  • Your head and eyes remain up, neutral to slightly extended (never hyperextended!).
  • Normal ankle dorsiflexion is maintained.
  • Hip and knee motion should be fluid, pain free, and demonstrate good movement throughout the ranges required to perform the squat.
  • Your knees should descend in alignment with the lower leg bones and not drift inward.

squat 2

What does your squat say about you?

Poor head alignment and gaze: Possibly indicative of a spinal joint problem or loss of flexibility of the spine if you are unable to control your head appropriately during the squat. Spinal adjustments supported by strengthening and/or mobility exercises will assist this.

Thoracic spine and chest: The thorax should remain stiff and neutral throughout the squatting motion and is best evaluated from the side. The chest should be held upward. Forward curling of the thoracic spine may indicate a motor/muscle control issue or spinal joint fixation.

Lumbar spine: The lumbar spine should be held in a natural, curved position throughout the squat. The inability to achieve this may be due to weakness of muscles, or a spinal, hip or sacroiliac problem.

Hip position: Excessive abduction (outward movement) of the hips may indicate a femoral head problem, imbalance of the gluteal muscle complex, or reduced dorsiflexion of the ankles.

Knee motion: If a knee is twisted outward during the squat it is indicative of weakness of the gluteus maximus and/or other rotators of the hip. Knees should not drift inward either.

Foot motion: If the feet turn outward during the squat it is strongly associated with loss of normal ankle dorsiflexion. Both feet must remain planted firmly when squatting. Stretching and/or foot adjustments may be indicated.

Squat assessments are a valuable clinical tool for identifying biomechanical deficits and can help determine which sites would benefit from adjustments, exercise, neuromuscular or mobility training. Squats are particularly beneficial for analysing people who wish to participate in rigorous activities. The squat is a functional movement complex used in many activities of daily living as well as athletics.

Why I still take notes by hand even at PhD level

April 18, 2016 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

note taking

Neil’s book of all things PhD

As laptops become smaller and more ubiquitous, and with the advent of tablets, the idea of taking notes by hand just seems old-fashioned to many students today. Typing your notes is faster — which comes in handy when there’s a lot of information to take down. But it turns out there are still advantages to doing things the old-fashioned way.

For one thing, research shows that laptops and tablets have a tendency to be distracting — it’s so easy to click over to Facebook in that dull lecture. And a study has shown that the fact that you have to be slower when you take notes by hand is what makes it more useful in the long run.

In the study published in Psychological Science, Pam A. Mueller of Princeton University and Daniel M. Oppenheimer of the University of California, Los Angeles sought to test how note taking by hand or by computer affects learning.

Read more


osteoarthritis degeneration back painDegeneration of the spine is a prevalent problem that generally advances with age, though is not always restricted to the elderly1.

The presence of osteoarthritis is not always consistent with pain either. While progressive joint failure may cause pain and disability, approximately 50% of people with osteoarthritic changes don’t have any symptoms2. This is known as the “structure-symptom discord”.

How the spine degenerates and how pain is experienced is multifactorial. Firstly, osteoarthritis begins when there is an imbalance of mechanical load that exceeds the limit of what joint tissues can handle. Bony changes and inflammation cause dysfunction and instability of the joints. Secondly, changes to the nervous system occur around the spine, then spinal cord, and finally brain. How people move starts to change; muscle strength changes; and finally sensory awareness of their body changes. When these systems break down, the person experiences persistent pain (Fig. 1).

biopsychosocial model structure symptom_550

Figure 1. Biospsychosocial model depicting the relation of structural pathology to the experience of pain

How such dramatic alterations in shape of the spine occur over time (Fig. 2) is primarily due to a decrease in nutrition to the discs between the vertebrae3. The primary source of nutrition for the intervertebral discs are the end plates of the vertebrae. As degeneration progresses, fissures, cracks, clefts and fractures occur in the end plates, resulting in them thinning and water volume being lost from within the disc. This reduces disc height, misaligning mechanical forces and changing the shape of the spine (Fig. 3). As a consequence, more stress and strain is placed on the joints of the spine creating back pain. Long term pain can lead to more permanent, dysfunctional changes in the central nervous system ■

spinal degeneration disc compression_550

Figure 2. Spinewave case example of degeneration of the lumbar spine over 23 years resulting in scoliosis to the right and persistent low back pain

disc degeneration

Figure 3. Qualitative stress distribution across vertebral end plate for normal and degenerated intervertebral disc under pure compressive and eccentric compressive loading

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