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Cited by 570Knee injuries and reconstruction techniquesLower Extremity Biomechanics and PathologiesMuscle activation and electromyography studies

Knee biomechanics of the dynamic squat exercise

ESCAMILLA, RAFAEL F.·2001·Medicine & Science in Sports & Exercise
DOI 10.1097/00005768-200101000-00020
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Abstract

PURPOSE: Because a strong and stable knee is paramount to an athlete's or patient's success, an understanding of knee biomechanics while performing the squat is helpful to therapists, trainers, sports medicine physicians, researchers, coaches, and athletes who are interested in closed kinetic chain exercises, knee rehabilitation, and training for sport. The purpose of this review was to examine knee biomechanics during the dynamic squat exercise. METHODS: Tibiofemoral shear and compressive forces, patellofemoral compressive force, knee muscle activity, and knee stability were reviewed and discussed relative to athletic performance, injury potential, and rehabilitation. RESULTS: Low to moderate posterior shear forces, restrained primarily by the posterior cruciate ligament (PCL), were generated throughout the squat for all knee flexion angles. Low anterior shear forces, restrained primarily by the anterior cruciate ligament (ACL), were generated between 0 and 60 degrees knee flexion. Patellofemoral compressive forces and tibiofemoral compressive and shear forces progressively increased as the knees flexed and decreased as the knees extended, reaching peak values near maximum knee flexion. Hence, training the squat in the functional range between 0 and 50 degrees knee flexion may be appropriate for many knee rehabilitation patients, because knee forces were minimum in the functional range. Quadriceps, hamstrings, and gastrocnemius activity generally increased as knee flexion increased, which supports athletes with healthy knees performing the parallel squat (thighs parallel to ground at maximum knee flexion) between 0 and 100 degrees knee flexion. Furthermore, it was demonstrated that the parallel squat was not injurious to the healthy knee. CONCLUSIONS: The squat was shown to be an effective exercise to employ during cruciate ligament or patellofemoral rehabilitation. For athletes with healthy knees, performing the parallel squat is recommended over the deep squat, because injury potential to the menisci and cruciate and collateral ligaments may increase with the deep squat. The squat does not compromise knee stability, and can enhance stability if performed correctly. Finally, the squat can be effective in developing hip, knee, and ankle musculature, because moderate to high quadriceps, hamstrings, and gastrocnemius activity were produced during the squat.

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Crossref · 10.1097/00005768-200101000-00020

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  • Trials at higher load intensities performed at lower cadence can increase tibiofemoral shear forces, which can induce cruciate ligament injuries, while excessive tibiofemoral compressive forces can be deleterious to the menisci and articular cartilage.

    “Therefore, trials at higher intensities load performed at lower cadence can increase tibiofemoral shear forces which can induce cruciate ligaments injuries, while excessive tibiofemoral compressive forces can be deleterious to the menisci and articular cartilage (5).”

    From Kinematic analysis of the back squat at different load intensities in powerlifters and weightlifters (2024) · cites this paper as [5]

  • The increase in the knee flexion moment with greater squat depth is not consistent across studies, and can be affected by the trunk and tibia orientation.

    “However, the increase in the knee flexion moment with greater squat depth is not consistent across studies,33,34 and can be affected by the trunk and tibia orientation.”

    From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [33]

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Authors
ESCAMILLA, R. F.
Affiliations
Duke University (US)
Corresponding author
ESCAMILLA, RAFAEL F.
ORCID
ESCAMILLA, RAFAEL F.
Venue
Medicine & Science in Sports & Exercise
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-01
Volume
33
Issue
1
Pages
127-141
ISSN
0195-9131 (ISSN-L)
DOI
10.1097/00005768-200101000-00020
OpenAlex
W2123989299
Cited by
570
References
70
Citations by year
2026: 36 · 2025: 37 · 2024: 29 · 2023: 30 · 2022: 27 · 2021: 36 · 2020: 32 · 2019: 29 · 2018: 29 · 2017: 30 · 2016: 28 · 2015: 24 · 2014: 27 · 2013: 28 · 2012: 33
FWCI
2.62
Type
journal article
Language
en
Open access
closed
Locations
  • Medicine & Science in Sports & Exercise (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
Keywords
knee biomechanics, closed kinetic chain exercises, anterior cruciate ligament, posterior cruciate ligament, knee stability, quadriceps muscle activity, hamstrings, gastrocnemius, knee rehabilitation, knee flexion angle, parallel squat, deep squat
MeSH terms
Adult, Biomechanical Phenomena, Humans, Knee Joint, United States, Weight Lifting

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