Fundamental Squat Technique, Cueing, and Modifications

The squat is arguably the most ubiquitous and programmed exercise in the personal trainer’s toolbox. This article will discuss fundamental squat technique, not a specific variation of the squat or corrective exercise strategies. It explores key points widely applicable to various types of squats, highlighting essential elements that remain constant regardless of the variation being performed. The following main points will be covered to help personal trainers work effectively with their clients on squats:

• Optimal squat form
• Cueing the squat
• Common regressions and modifications for the squat

What is the Squat?

The squat is a fundamental movement pattern identified as having movement dominant in the knee joint with an upright torso. Relative to the hip hinge movement (where the hips are dominant and the torso is angled more toward the ground), the squat exhibits higher forces through the knees and lesser forces through the hips (Choe et al., 2021).

Collins et al further describe the squat as “ a closed-chain exercise starting with the lifter standing upright, then flexing at the ankle, knee, and hip joints to a preferred depth before pressing upward, keeping the torso mostly upright and movement pattern stable” (2021). The squat can have many variations in unilateral, bilateral, sagittal, frontal, and transverse plane movements (Collins et al, 2021).

Further variables that play into squat variations (and nearly any exercise) are the range of motion, stance, loading position, etc (Swinton et al, 2012). Lastly, there are many modalities of the squat, such as barbell, other free weights, suspension, body weight, etc. As a fundamental movement, the squat is an important component of many types of training programs (Kipp et al, 2021). 

It is important to note that different squat variations and loading positions will have different muscle activation patterns, kinetics, and kinematics. The primary muscles involved in squat exercises include:

• Erector spinae, rectus abdominis, external obliques (Clark et al, 2020)
• Gluteals (Coratella et al., 2021)
• Hamstrings group, quadriceps group, and adductor group (Kristiansen et al., 2021)
• Calves (Kristiansen et al., 2021)

Proper Squat Technique and Form

Stance

An ideal squat stance allows a pain-free, unrestricted, and stable range of motion to optimally meet specific functional demands (ideally in this order) in a normal, otherwise healthy, training client. According to a 2022 research paper, authors cite limited research on stance width (Sinclair et al., 2022). At this point stance widths “are utilized according to the athlete’s morphology and preferences” with their effects “not well established” (Sinclair et al., 2022).

There is concern in the field that different hip structures may necessitate a different, more optimal squat stance for certain individuals. What we know is that hip morphology and whether the femur might be twisted either medially or laterally is reported fairly evenly in a bell curve distribution.

Numerous studies indicate that about 6-8% of the healthy human population may deviate significantly from “normal” (Ezoe et al., 2006; Koerner et al., 2013). However, such deviations may be more common in those with pathologies such as osteoarthritis, developmental dysplasia, and osteonecrosis, necessitating plausible adjustments for this population.

How do we instruct our healthy, normal fitness clients to squat?

Even though squat stance widths are not fully understood, there are several different stance variations that the strength and conditioning field legitimizes (Swinton et al, 2012). 

Here are the results from three different studies that looked at the effects of a narrow versus wide stance under specific research conditions:

• Narrow stances elicit greater force production in the quadriceps and wide stance squats elicit greater force production in the posterior chain musculature (Sinclair, 2022)
• Knee flexion angle was greater in narrow stances compared to wide stances (Lahti et al, 2019).
• Wider stances are commonly found with low bar back squat, a variation that positions the load more posterior and allows for greater loads to be lifted (Glassbrook, 2017)

While the above research is certainly not complete, it shows that there are biomechanical and muscular differences between stances. It is important to consider each person’s goals and history (Demers et al, 2018). Personal trainers should understand the implications of different squat stances on biomechanics, joint kinematics, and muscular recruitment.

Help your client find the stance that is most comfortable to them, that meets their training goals and history, but also allows room to address and correct notable dysfunction. Starting with a movement assessment will provide information to direct your coaching choices. The overhead squat assessment will expose numerous muscle imbalances and shine a light on what your client will default to when the “going gets tough”. A functional movement screen similarly will evaluate seven different movements that are rated on a scale and provide information on how well your client moves.

Given the uncertainty and disagreement about what constitutes an “ideal squat” position, you may need to experiment with your clients, beginning from what would be considered a normal anatomical position (feet pointed straight ahead, and planted hip-to-shoulder width apart). 

Some rotation outwards of the toes may naturally happen as reps increase (usually due to shortness of the calf muscles, but may possibly be due to hip morphology differences). Observe where your client ends after his/her last rep and have them look down at where their feet are pointing.

Are they rotated outward at different degrees (fairly common)? Where were the knees pointing while they descended? Even if you allow for a minor lateral rotation of the foot (which is really rotating at the knee), it is important to keep the knees pointing in the same direction as the toes during the movement to prevent injury.

Read on for more specifics about joint angles and placement.

Feet and Ankles

How the feet and ankles function during the squat impacts the squat performance more than anything else.

In the squat, the two biggest articulations to observe are dorsiflexion/plantarflexion (sagittal plane) and inversion/eversion (frontal plane). Adequate dorsiflexion is needed in the ankle joint to allow for optimal squat form. This requires maintaining the heel on the ground throughout the entire range of motion. If that means the squat is not as deep, that is ok.

Stability, in order to prevent excessive eversion, is also needed. This requires adequate ankle dorsiflexion along with efficient motor control, or stability of the plantar muscles. This creates tension throughout the foot for a stable surface for the closed kinetic chain.

Here are three studies that show a relationship between ankle mobility and squatting:

• Dorsiflexion ROM is significantly positively correlated with knee flexion and hip flexion, meaning that as dorsiflexion increases, so will knee and hip flexion (Endo et al., 2020)
• “The capacity of achieving a higher depth during the back squat is associated with maximal ankle dorsiflexion ROM” (Gomez et al., 2022)
• Squatting on a surface that induces ankle eversion (pronation) significantly reduced ankle dorsiflexion (Nairn et al., 2017)

Knees

The knee joints can articulate in two ways, one indirectly and the other through direct articulation. The knee can be moved in the transverse plane indirectly as a result of movement through the hip or ankle joints (genu valgus or varus). Note: this transverse movement is not direct articulation through the knee joint, but by the musculature of the hips. The knee can also move directly in the sagittal plane through flexion and extension.

The knee joint’s main purpose in the squat is to provide stability during flexion and extension between the ankles/feet and hips. Stability is achieved through the knees tracking over the feet without any genu valgus, or knees caving inwards. To facilitate this, the lateral hip (gluteus medius) creates tension and drives the knees laterally without the feet turning laterally as a result. 

Slater and Hart state that “a poorly performed squat may result in altered lower extremity alignment such as increased knee valgus which may expose the lower extremity joints to excessive torques” (2017). 

The amount of forward knee translation over the toes depends on the variation of the squat being performed, the depth of the squat, and the clients’ ability level, such as ankle dorsiflexion (Gomez et al, 2022). Therefore, the personal trainer should coach the squat in a manner that is within the client’s ability.

Hips

The main job of the hips is to position themselves to allow the powerful glute muscles to receive the load. The first motion of the descent is to slightly hinge the hips backward, and then drop them down like an elevator. Without the initial small hip hinge, the descent will be dominated by the knees and quads, and the client may report not feeling their hips work. 

The hips should descend and ascend without any lateral movement. Lastly, the hips should not have an excessive anterior or posterior tilt at any phase of the squat. 

Torso

The spine should be neutral without the ribs flaring upwards. This is achieved by creating tension in the abdominals. Depending on the client’s mobility, stability, and the variation of the squat, the torso should be relatively upright, compared to hip-hinging exercises (Glassbrook et al, 2019). Lastly, the neck should remain neutral with the rest of the spine without any excessive movement in the head. 

Cueing the Squat

Effective cueing makes a significant difference in clients’ squat performance. The cues below are cues that I personally select from, but are not all-inclusive but serve as a good start for personal trainers to use. There may be some scenarios where one of them doesn’t fit well, so experiment with your cueing to see what communicates best with your client. The following cues provide both internal and external attentional focus to give your client the most likelihood of connecting with a cue.

Feet and Ankles

Imagine how well a car would perform if its wheels were not aligned. Our body is no different when it comes to the feet. Therefore, always begin with cueing the feet properly when coaching your client through a squat. Issues with the feet and ankles are usually the most subtle due to the variety of footwear people have, and the way they cause issues up the kinetic chain. Often, issues above the feet can be traced down to the foot. 

If any part of your clients’ feet is obscured by their shoes, ask if they can remove them so both of you can see their feet better. Try these external cues to coach your clients’ feet:

• • Cues to help stabilize and engage the ankle/foot complex
    • “Create a tripod in each foot by pushing your heel, big toe, and pinkie toe into the floor”
    • “Put more weight on the outside of your feet” (if the client tends to overpronate)
    • “Grab the floor with your feet”
    • “Pull your toes towards your heels”
  • Cues to help ankle dorsiflexion
    • “Keep your heels on the ground”
    • Consider ankle mobility exercises and soft tissue work

• Insert a band under a part of the foot that the client is struggling with maintaining on the floor and say “Don’t let this band come out as I pull on it”

Knees

The knee joint only does what the hip or ankle allows it. Therefore, most knee issues can be resolved at the hip or ankle. Regardless, here is a cue to keep the knees in a stable position. 

• • Cues to help prevent genu valgus
    • “Drive your knees out laterally. You should feel the sides of your hips/glutes firing off now”
    • “Keep your knees over your shoes”
    • “Don’t let your knees cave in on your way up”
  • A cue to help prevent excessive forward movement of the knees
    • Put an object in front of the knees to the point that you don’t want them to go further and say “Don’t let your knees touch this while keeping your feet flat”
  • A cue to help put the knees into more flexion and ankles into more dorsiflexion
    • Put an object in front of the knees to the point that you want them to go and say “Touch your knees to this while keeping your feet flat”

• Push your hand (with their permission) or a foam roller into their knee and say “Don’t let me push your knee in” Then remove the pressure and say “Pretend like I’m still doing that and don’t let your knee get pushed in”

Hips

Along with the ankles and feet, the hips are another joint that has a lot going on during the squat. The biggest potential issues that require effective cueing are improper hip sequencing, hip shifting, and excessive pelvic tilting in either direction. The following cues can help reduce these issues. 

• • A cue to help get into glute lengthening hip flexion
    • “Push the hips back like you’re shutting a door with your glutes, then drop them like an elevator”\
    • Put an object behind the hips to the point that you want them to go and say “Touch your hips to this”
  • A cue to prevent frontal plane hip instability
    • “Watch your hips in the mirror and don’t let one side move laterally more than the other”
    • You can also place a dowel or other straight object on the floor pointing forwards at the client’s midline to allow them to better visually monitor their weight shifting
  • A cue to reduce excessive pelvic tilting in either direction
    • “Imagine your hips are a bucket of water. Only let a little water spill forward as you squat”

• Tap your client’s low back (with their permission) during their descent right before the hips go into posterior pelvic tilt. This will give them kinesthetic feedback to recognize when their hips are beginning to tilt posteriorly

Spine and Core

Everything in the body is connected, including the spine and the hips. A potential issue in the spine or core area in the squat is not having adequate core stability. Excessive lumbar arching (lordosis)/excessive pelvic tilting are the most common issues. Cueing the abdominals is key to reducing these issues in addition to improving the length-tension relationship among the muscles involved (strengthening abdominals and glutes while lengthening hip flexors and spinal erectors).

• • Cues to help engage the core and remove arched back
    • “Lower your rib cage by contracting your abs”
    • “Make your core a cylinder like this foam roller”
    • “Spine neutral with eyes forward”
  • A cue to help reduce excessive forward lean
    • “Imagine your torso is a bucket filled to the brim with water. Try to not let out too much water”

• Place a semi-circle foam roller or dowel along the spine of the client and cue them to “place as much surface area of their back on it as possible throughout the squat”

Modifications to Coach Squat Technique

Sometimes even with great internal and external cueing clients will need modifications to gain competency with the squat. These modifications will help give external feedback to an area of their body or act as a barrier to remove the option to move in an improper way. 

Suspension-Band Assisted Squat

The suspension-assisted squat can be performed with a TRX, gymnastic rings, or even simply holding onto the frame of a squat rack. Its main benefit in helping clients master the squat is facilitating the loading and flexion of the hips. Clients who struggle with loading the hips and mainly flexing the knees are great candidates for this modification.

• Cue your client to “sit back” and 
• “Keep the suspension straps tight throughout the whole motion”. This will force the client to lean and sit back. 

Box Squat

The box squat can be performed with a plyometric box or bench at a height that the client can sit on. Similar to the suspension-assisted squat, the box squat guides the clients’ hips into flexion by serving as external sensory feedback when they touch the box with their glutes. This modification is ideal for clients who struggle with loading the hips and descending with control.

• Cue your client to “Tap, not sit on the box each rep. Pretend as if the box had a carton of eggs that you don’t want to crack”

Goblet Squat

The goblet squat can be performed with any free weight and enhances the client’s ability to feel their muscles working during the squat. This can be useful because sometimes clients can perform a proper bodyweight squat, but report not feeling their muscles working. Sometimes just adding a little external load to the body helps increase awareness of the muscles working. 

Band PNF Squat

Band proprioceptive neuromuscular facilitation variations of the squat encourage specific muscles to activate when they are otherwise underactive. This results in a more stable squat that the client can be aided into with the bands. For a client struggling to keep the knees stable, put a small loop band below the kneecap. For a client struggling to keep their ankles from pronating, also place a small loop band around the distal foot.

• Cue your client to “Not let the band pull your knees/ankles in” or
• “Stretch the band”

Conclusion

The squat fundamental movement pattern should be a staple in any client’s exercise program (if cleared by a medical professional). As the personal trainer, you are going to come up against many different challenges when it comes to teaching your client the squat.

You will need to understand the proper form, from finding the individual stance all the way up to the position of the head. However, knowing the appropriate form is not enough. Effective cueing of the squat is a must. You may find that not every cue clicks with your client, so keep experimenting to find the right cue that works with what they bring to the session.

Remember that cues can be internal or external, and they can provide tactile feedback or present as a physical barrier. Lastly, know when it is appropriate to make a modification to the variation of squat you are training your client with. Understand what pieces of equipment in your training space can be introduced to modify the exercise to the client’s ability level and overcome a specific issue with their form. 

References

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