18.Sep.18 | Strength & Conditioning

By John Contreras

Squats can be one of the most frustrating exercises for both clinician and patient to take on. Despite the squat having a strong evidence base supporting its use across a range of musculoskeletal conditions, it is an exercise requiring complex coordination across several joints. As a result, learning efficient form can be a frustrating experience for both patient and clinician

Without going into the debate of whether squats should be coached with a hip or knee bias (they both have a place in rehabilitation and performance training), one body region that we as Physiotherapists spend a lot of time addressing is the lumbar spine posture. This is particularly so when progressing a patient through their back rehabilitation. One way to ease the coaching process is by coaching the squat from a seated position and simply focus on postural control at the bottom of the squat

Two simple drills I coach patients through to facilitate lumbo-pelvic-hip postural awareness are Loaded Seated Hip Hinge and Loaded Seated Pelvic Tilts. I should note, that I start with unloaded versions of the two movements and then progress towards these low load versions.

Ultimately the aim is to progress to free standing squats, however as a coaching tool these drills can be very helpful in building both awareness and confidence in patients.

Key Coaching Points:

Loaded Seated Pelvic Tilts:

  • With bar in position, assume a neutral spinal position. In most cases emphasis is on lumbar spine, however in some cases thoracic and cervical spine posture also needs to be addressed.
  • Coach the patient to smoothly rock their pelvis back and forward as comfortable.
  • The aim being for the patient to increase their postural awareness under load.

Loaded Seated Hip Hinge:

  • With bar in position, assume a neutral spinal position as above.
  • Maintaining spinal position, lean forward to maintaining some weight through the pelvis, then return to starting position.
  • The aim being for the patient to shift their weight forward enough to then stand tall completing the 2nd half of a squat.


John is running a Strength and Conditioning Essentials course this November 2018. For more information, click here or email info@physiosports.com.au.