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The “single” most important movement for knee health.

If you aint got squat, you aint got squat. A single leg squat is a very useful assessment for physiotherapists and osteopaths as it is a movement that can be used to assess strength, flexibility, balance and motor control post reconstructive surgery for an ACL rupture. Specifically, collapsing of the knee and trunk instability during movements like jumping or a single leg squat have been identified as risk factors in females for ACL injuries.

How to assess your own squat?

Use a mirror to watch yourself. Squat to 60 of knee flexion in a slow, controlled manner at a rate of approximately 1 squat per 2 seconds. Perform this 3 times!

Grading Criteria

  1. Same side trunk lean
  2. Hip Drop on the opposite side
  3. Hip adduction (leaning in) or internal rotation
  4. Knee collapse (knee diving in)
  5. Loss of balance

A good rating requires the absence of all 5 criteria in 2 of 3 trials.

In a study of ACL reconstructed patients, those that could do at least 22 single leg squats from a chair height had better knee-related quality of life at 1 and 3 years post-op than those that couldn’t do 22 reps (Culvenor et al, 2016).

What’s the research say about the single leg squat in ACL Reconstruction?

One study examined ACL reconstructed patients at 6 months with the above single leg squat criteria and found poor performance in 15 of the 33 individuals they examined. Individuals with poor performance on a single leg squat also had:

  • Decreased hip abduction strength
  • Decreased single leg hop distance
  • Lower International Knee Documentation Committee Scores (Self-Report functional measure)

(Hall, Paik, Ware, Mohr, Limpisvasti, 2015)

Another study examined individuals with an ACL reconstruction during double and single leg squats to help correlate muscle activity on EMG with altered movement patterns.

  • Generally lower EMG activity of muscles on injured leg
  • Knee medial deviation to foot on ground and trunk displacement had an affect on muscles at the hip
  • Shifts in activity patterns for muscles in the thigh and calf were found in injured versus non-injured
  • Biomechanics and muscle weakness may not solely cause altered movement patterns but also balance and movement control.

(Trulsson,, Miller, Hansson, Gummesson, & Garwicz, 2015)

Start improving your single leg squat today!

One of the best ways to improve your single leg squat if you have difficulty performing this movement is to go with the 2 to 1 eccentric single leg squat technique. This technique allows you to still load the muscles effectively during the sitting phase and focuses on the balance and control of the movement without the difficulty of the standing phase. 

Perform this exercise 10 times for 3 sets everyday before progressing to harder variations as prescribed by your therapist.

At the Injury Rehab Centre we thoroughly assess all of our patients and athletes to ensure that patients not only have the capacity to compete, but also have the neuromuscular control. Allow our physiotherapists and osteopaths to conduct a full assessment to help you identify potential risk factors that may put you at risk for injury or re-injury so that you can start addressing them with a tailored program.

What we do at the Injury Rehab Centre

At the Injury Rehab Centre in Cheltenham we go above and beyond traditional Physiotherapy and Osteopathy clinics by using the latest assessment technology to perform tests as previously described to collect data on how you move to assess your risk of ACL injury or how your rehabilitation is progressing.

We utilise:

  • M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.
  • Slow Motion Jumping and Running Video Analysis to IDENTIFY YOUR BAD LANDING AND CHANGING DIRECTION HABITS that maintain a risk of injury.
  • Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.
  • Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries and prevent return to full performance.
  •  Traditional Physiotherapy and Osteopathy examinations to identify dysfunction. 

Individual management plans can then be created using baseline data to track progression of a program to address movement deficiencies and discrepancies (muscle and tendon strength, stamina, specific flexibility) as well as increasing your movement skill to make you more efficient out on the road, track or trail to bullet proof your body from injury and increase performance.

The Injury Rehab Centre is currently seeking participants for research we will be conducting into the effectiveness of treatment and rehabilitation for ACL reconstruction patients.

As part of this research participants at the Injury Rehab Centre will receive a FREE M.A.T assessment in which detailed lower limb testing will be performed to identify deficiencies and discrepancies in lower limb function to calculate risk of injury.

If this sounds like you or someone you know go click here to register your interest in being part of this study and getting a FREE assessment today.

Hall, M.P., Paik, R.S., Ware, A.J., Mohr, K.J., Limpisvasti, O. (2015) Neuromuscular Evaluation With Single-Leg Squat Test at 6 Months After Anterior Cruciate Ligament Reconstruction. The Orthopaedic Journal of Sports Medicine, 3(3): 1-8.
Trulsson, A., Miller, M., Hansson, G., Gummesson, C., & Garwicz, M. (2015). Altered movement patterns and muscular activity during single and double leg squats in individuals with anterior cruciate ligament injury. BMC Musculoskeletal Disorders, 1628. doi:10.1186/s12891-015-0472-y

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