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Hip Positioning With Squats: Should I Correct My Form?

Last updated on June 19, 2016 By Dan Baumstark, MSPT, CHT Leave a Comment

Air squats, goblet squats, lunges, smith machine squats, thrusters, hack squats, back squats, front squats, overhead squats, and so on and so on…

How many of us have been performing one of the above mentioned squats in a gym setting and have been told by a trainer or other professional to “rotate your hips outward or inward” in order to achieve more ideal form?

femur bone

Image credit: © Eraxion/iStock

Take a look at the illustration of a femur.

Notice the rounded head (top right), which fits into the hip socket. This ball and socket structure allows for a significant amount of freedom of motion, but anomalies do exist in how the femur (or leg bone) is shaped.

In some cases, the femur bone has an abnormal torsion to it. (We are going to practice a bit of spatial orientation now….). Pretend that the femur in the illustration is made out of clay. It is bendable and twistable (the femur is most certainly not very bendable and twistable in real life, particularly as we age, but humor me for a minute.).

Take the femur and hold it at both ends, one end with each hand. Now hold your top hand steady (the hand that is holding the “ball” shaped head of the femur), and twist the bottom hand either to the left or to the right. The result is going to be a bone that has more of “twist” to it down the shaft.

Some people are actually born with more of a twist in their femurs than the rest of the population. When the bone is twisted in one direction or the other, it is clinically known as “version” (anteversion or retroversion).

Why does this matter? The answer lies in how an anteverted or retroverted femur connects with both the hip up top and the knee down below. When a femur is anteverted, for example, the knees tend to turn inwards if the top of the femur is lying in the socket in a neutral position. The knees really have nowhere else to go because the femur bone has an internally rotated twist to it. If one were to correct the knee alignment and turn the knees slightly outwards, the hip would have to externally rotate up the chain for the same reason.

This leads us to performing squats. The big message here is that if you have either anteverted or retroverted hips, the regular rules of squatting do not really apply to you. Anteverted people, in order to be in a comfortable hip position, have to be turned inwards at the knee. This isn’t great for knee mechanics, but the only other choice is to place your hip in an uncomfortable position. The same applies to the retroverted hip. The knee and toes need to be slightly more outwardly turned than normal in order to have a normal hip position.

My advice to people performing squats is this: squat the way that feels most comfortable to your hips. If your knees and toes are excessively turned inwards or outwards, get tested to see if you fall into the anteversion or retroversion categories. From my clinical practice, I would say that anteversion of the hips is the more common of the two, and anteversion tends to affect females more often than males.

Here is a great link that I found that illustrates the “Craig’s Test.” This test is taught in most physical therapy schools and is a quick way that a good PT can assess you. (The video is halfway down the article, and the article is a good read as well.)

Filed Under: Exercise & Fitness, Featured Tagged With: Hip



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About Dan Baumstark, MSPT, CHT

Dan is a licensed Physical Therapist in the District of Columbia, license #PT2916. He has a Masters of Science degree in Physical Therapy from Washington University in St. Louis, MO. Dan specializes in sports medicine & upper extremity rehabilitation. He is a Certified Hand Therapist, certified by the American Society of Hand Therapists (initial certification date 11/6/2004, certification #1041100023). Dan has extensive continuing education in manual therapy from the Michigan State University School of Osteopathic Medicine.
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DISCLAIMER: The information on this site is for Educational Purposes Only and is not designed to diagnose, treat, mitigate, prevent or cure any health conditions. The U.S. Food and Drug Administration has not evaluated statements about these health topics or any suggested product compositions. Answers to questions submitted are merely the opinion of the physical therapist and should not be taken as a prescribed course of action. Any advice given by the therapist must be cleared with the treating physician involved in direct patient care. The person posing the question absolves the responder of any liability in regards to opinions given. PhysioDC insists that all patients receive approval from a prescribing physician prior to starting a structured exercise program involving any of the exercises included on this site. PhysioDC.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com; proceeds from product sales help cover the operational & maintenance costs for the site.