Squat is revered as the king of exercises, but is it for everyone?

Squat is one of the most basic movements the human body can perform. Revered as the king of all exercises, its reign has spanned decades atop the iron game. From bodybuilding to akhada fitness, the squat is a vital component of anyone's training repertoire. It engages the entire lower body and core, and is perhaps the most functional movement around.

However, proficiency in squats takes time. One cannot simply stand free, bob up and down and make substantial progress. The squat requires a slew of technical considerations, form corrections and specific, nuanced individual adjustments. What if you happen to be one of those unlucky souls that just can't get it right? What if you happen to experience discomfort around your kneecap during or after squat routines? The truth is that you may need to reconsider your favoured form or volume of exercise. What if you have never been to the gym or are about to join one for the first time, should one avoid squats altogether?

Squat is a compound, full body exercise. Differences in energy expenditure during squatting can be attributed to the various forms of movements, intensities, weights, repetitions, sets and types of items (Smith machine or barbell). There is data to indicate that deep squats and addition of weights (and/or resistance) increase forces across the patellofemoral joint (behind the kneecap). Literature has several reports suggesting squats are associated with injuries to the lumbar spine and knees. Others have suggested that squatting may be one of the factors associated with an increased risk of osteoarthritis (aging) of the knees. 

Some of us just aren't physically cut out to squat and should avoid the exercise for certain reasons:

• The glutes and hamstrings are muscles located at the back of the thigh. These two muscles are often neglected and over time become weak, especially in people who sit for most of the day, drive to office or lead a sedentary life. When you squat with weak hamstrings and glutes, the body overcompensates by using lower back muscles more. This may potentially lead to "overuse" lower back issues.
• Many people have a habit of slouching forward (develops over time). If such people start weighted squats before postural correction, they are bound to overload the back.
• Teenagers, especially obese females and/or those with flat feet (over-pronators) are more prone to anterior knee pain (around the kneecap) if and when their squat quotient exceeds a certain level. This level of tolerance is subjective and may be minimal for some adolescents.
• Hypertensive individuals and those at risk of stroke should avoid squatting as it can lead to a sudden significant rise in blood pressure according to some reports.

So, should one avoid squats? Majority of research agrees that squats are safe and effective, if performed correctly. But can too much of a good thing be a bad thing? Isn't excess of any anything always a bane? Prudence and moderation is the key here.

The author is an Orthopedic Knee Surgeon at The Knee Clinic.