Today I wanted to write about a recent conversation I had with my grandparents regarding their back and movement. My grandfather has had a bout of bladder cancer and he has had pretty much some hip pains and hip bursitis on and off since then. Luckily it seems to be a little bit more manageable and he was just asking me what I thought about strength training for him. He’s 91 and honestly, I think that strength training is good at any age. You can see benefits from it, sure, and when you’re 91 you might not see the changes in body composition that you might see when you’re in your 20s. However, you will still benefit from doing strength training particularly if you’re having any kind of pain.
And so my grandmother chimed in that she went and saw her MD a couple of weeks ago and her MD told her that squats would be really great for strengthening. And so the MD was going through the squat form and showing her how to do it and then at the very end throws in, “If you don’t have the perfect form you can severely injure your back.” I paused before saying anything. I’m sure my face looked pretty intense because that’s a pretty bold statement for the MD to make. My grandmother continued saying that her whole life she’s been very clumsy so she decided it was better to forego doing the squats because many people in their retirement community experienced back pain and she had noticed once you get back pain it never goes away and so she really just didn’t want to put herself in that position so she has chosen to not do squats or really any strength training because of that.
This is obviously very frustrating for me because as a physical therapist, again, I think when you’re doing some form of strength training whether it be body weight strength training or using weights, it can be really, really beneficial for you. So I thought I would just break this down a little bit and why this statement from the MD was problematic.
Health Care Providers Should Not Increase Fear, Watch Their Language
As health care providers, we don’t want to increase fear in our patients. When we increase fear, that actually increases the chance for pain. So, I’m personally very mindful about the language I use. Of course, I’m sure I’ve said things that have set people off as I cannot be perfect in my language and nobody can really be perfect in their language, obviously. However, it’s important to be cognizant of it as a health care provider just to not make fear worse for the patient.
People already come to me fearful because they are very disconnected from their body and don’t really understand how it works because it’s not something that’s really taught to us growing up. So, it can feel really scary when we’re experiencing pain or trying to start a new habit around movement if we don’t know anything about it and we’re going online and learning certain things. The language that we learn from people online can be really overwhelming and makes it feel like we shouldn’t be doing that activity.
Spine Perceived As Really Fragile
Another thing I wanted to discuss in this blog is the perception of many people that the spine is really fragile. It is not because it has a ton of ligaments around it to support the structure itself. So ligaments are connective tissues that connect the bones to each other and create an incredible amount of stability for the spine.
Of course it has a lot of motion because our spines are required to move during the day and have a decent amount of motion. But the spine is very sturdy. The bones themselves are incredibly sturdy so it is interesting that we have come to think that the spine is so fragile. I think it’s because we are seeing so many people experience lower back pain than ever before. So I think then that’s where the misconception comes from that the spine is fragile.
Realistically, pain is not directly correlated with an injury to the spine. For example, I’ve talked about this on my other blog before, if you have a herniated disc, there’s not a direct correlation between that disc herniation and pain. Many people walk around with disc herniation and have zero pain. So, not to say that disc herniation might not be part of the equation if you’re experiencing pain, but it is a small part of that equation.
So, the spine is really not that fragile. It can withstand a lot of load and be totally fine. To say that your back will be severely injured from squats is just honestly not true. Especially in my grandmother’s case as she’s not going to be squatting with 400 pounds and putting a ton of load on the spine. She’s basically going to be doing moving from a sitting position to a standing position. So that brings me to my next point. We’re doing squats pretty much every day. If you’re moving from a sitting position to a standing position, you’re already squatting and you’re doing it all the time and your spine in general is completely fine. So, it’s kind of wild that this doctor would say that you will be severely injured if you didn’t do the form correctly as I have seen people move from sitting to standing and I wouldn’t say the sitting to standing movement is ever the same between person to person.
The Idea Of Having A Perfect Squat Form
Such idea is also kind of wild. First off, this MD my grandmother saw is her primary care physician and most primary care physicians don’t have a background in strength training and movement. So for them to say that there’s a perfect form is a little bit broken. Obviously I don’t know this primary care physician’s background and that’s just my general understanding that primary care physicians don’t have a lot of education around movement and strength training.
So back to this perfect squat form, the squat form is going to change person to person and there’s many ways to do a squat. What I mean by squat form is going to change person to person is that our anatomy is different person to person. For example, my thigh bones and femurs are very, very long in comparison to my torso. So what that means when I squat, my chest is actually going to lean closer towards my thighs and I’m not going to be as in an upright position and that’s okay because that is my anatomy. For someone who has thigh bones that are shorter or more proportional to their torso length or have a longer torso, their chest is going to be way more upright in the squatting position. That’s just saying squatting with your toes pointing forward to 12:00. Again, there are many different ways to squat so to say that there is one perfect way to do it, is doing a disservice to our patients.
Conclusion
To kind of wrap up here, if a health care provider has given you some advice around movement and you are feeling fearful of that movement, ask more questions. Get your questions answered so that you no longer fear that movement. Also, if that health care provider is unable to answer those questions, a different healthcare provider with the experience around movement will be able to help you. So, get your questions answered because it is really important.
When you are feeling fearful, there’s going to be an increase in your experience of pain and also decrease your want or motivation to move because you will just be fearful of movement and afraid of injuring yourself.
So, if you have questions around a certain type of movement, please, please ask so that you can move in a way that you want to move.
I hope this helped you understand that your back is not so fragile and that there’s not one perfect way to squat.