To squat or not to squat ??

In the field of physio, its largely thought that we are there to help people overcome your ‘bad’ back, your ‘sick’ shoulder, and to massage (hell no!- any physio who uses massage as an actual front line of treatment needs to have his principles checked- more on this another time). The world of physio is quite large and diverse; from ICU settings, to specialist neurological rehabilitation (eg. stroke), to rehabilitation specialists who help the world’s best recover from and prevent the worst forms of athletic injuries. One aspect which I seem to constantly find myself in, is gerontology (the study of the elderly).

If its one thing we all know about the elderly folks around us, is that when they fall, they fall hard! According to Berg (1992) in his publication for the US Institute of Medicine Division of Health Promotion and Disease Prevention, there are many risk factors and (luckily) preventions to this problem! One such problem with a modifiable prevention is quadriceps strength.

(… you know… the quadriceps. The ones above you knee… ok look at this guy and you’ll know!)

The quads are an interesting muscle. Unlike most of you and your puny biceps (you know who you are!), we expect to see them able to lift approx. Ploutz-Snyder et al (2002) found that in an elderly cohort of 73 year olds (is that even old???) that those who were unable to lift at least 1ftlb/lb body weight through one quadricep muscle were at a higher risk of falls due to reduced levels of ‘function’. We aren’t talking about Enid not being able to play bridge/have tea/ have gin and tonic with Gertrude, we are talking about not being able to climb stairs, stand up from a chair, or even walk!

Ahmadiahagar et al (2018) categorically showed that in a group of 1028 people, 17% had a history of falls, and the older you were and the weaker your quadriceps strength, the more likely they were to fall! This is shocking news! How many of you, ‘younger’ people, reading this can do a single leg squat? Not very many I’m sure!

In our increasingly sedentary society, exacerbated by the current C19 pandemic, we are really not meeting our weekly exercise requirements. This then adds to the circle of inactivity we all seem to be stuck in which then can lead to more dire health defects! We know that reduced quad strength is a predictor of mortality (aka death) in patients with pulmonary disease (COPD, emphysema, bronchitis) and cardiovascular disease (CCF, HTN, high cholesterol) (Kamiya et al 2015, Swallow et al 2007). Again, we are all guilty of thinking we are being kind to the old grannies out there by molly coddling them and tending to their every need, but sometimes we need to be cruel to be kind! Get her up! Get here moving! Get her exercising!

YES SIR!!!

Simply put, we need to get as many people involved with all the favourite leg exercises we have! Mine are plain old squats, deadlifts, step ups, lunges, knee extensions, straight leg raises etc etc etc. I don’t think there is necessarily a ‘wrong’ exercise. The best exercise is the one being done!

You can’t go wrong getting strong! Keep moving people!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091154/

https://www.ncbi.nlm.nih.gov/pubmed/11909879

https://www.ncbi.nlm.nih.gov/books/NBK235613/

https://thorax.bmj.com/content/62/2/115

https://www.ncbi.nlm.nih.gov/pubmed/26169888

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242952/

https://www.sciencedirect.com/science/article/abs/pii/S1050641107001022