OVERHEAD SQUAT ASSESSMENTS
OVERACTIVE UNDERACTIVE
COMPENSATION (SHORT) WHY
Feet Turn Out Soleus Excessive plantar
flexion limits
dorsiflexion, which
means that in order to
squat and achieve
Lateral Gastrocnemius desired depth, the Medial Gastrocnemius
feet turn out.
Biceps Femoris Attaches from lower
(Short Head) femur to fibula,
externally rotates lower
leg and disrupts normal
ankle mechanics.
Tensor Fascia Latae Attaches from the ilium
(TFL) to the tibia, will cause
internal rotation of femur
and external rotation
of the tibia, which sets
up tibia/feet to turn out
and knees to cave in.
(LENGTHENED) WHY POSSIBLE INJURIES
Anterior Tibialis Promotes dorsi flexion
to allow proper range of
motion and stabilizes the
foot and ankle complex
Promotes tibial Achilles Tendinopathy
internal rotation
Medial Hamstring Helps stabilize lumbo
pelvic hip complex and
promote internal
rotation of the lower leg
Gluteus Medius/ TFL being an overactive
Maximus internal rotator and hip
flexor can inhibit the hip
external rotators and
hip extenders
Popliteus Promotes tibial internal
rotation and knee
stabilization
WHY
Plantar Fasciitis As the arch falls, fascia is
stretched excessively–
pain typically occurs
at insertion (heel)
Due to excessive
plantar flexion (tight
gastrocnemius and
soleus) and rotation
of the Achilles during
movement patterns
Medial Tibial Improper ankle
Stress Syndrome mechanics (lack of
(“shin splints”) dorsiflexion) and
externally rotated lower
leg leads to overuse of
the ant/post tibialis
Ankle sprains Lack of mobility
through the ankle and
underactive glutes and
be associated with
chronic ankle instability
and repetative ankle
sprains.
Because the lower leg
is not aligned properly,
it is more likely to suffer
from excessive strain
on the patellar tendon
 OVERACTIVE UNDERACTIVE
COMPENSATION (SHORT) WHY (LENGTHENED) WHY POSSIBLE INJURIES WHY

Feet Turn Out Gracilis Promotes tibial internal General knee pain Lack of stability to the
rotation and knee knee and poor
stabilization foundation from the foot
and leads to a variety
of knee problems.

Sartorius Promotes knee internal
rotation and knee
stabilization
General knee pain Lack of stability to the
knee and poor
foundation from the foot
and leads to a variety
of knee problems.

Feet Flatten Peroneal Complex Eversion (show bottom Anterior Tibialis Promotes ankle Plantar Fasciitis As arch falls, fascia is
to outside, so inside dorsiflexion and stretched excessively-
“falls”) – overpronation inversion (bottom of pain typically occurs at
foot to inside) insertion (heel)

Lateral Gastrocnemius Causes eversion Posterior Tibialis Promotes inversion Achilles Tendinopathy Due to excessive
(show bottom to (bottom of foot plantar flexion (tight
outside, so inside to inside) gastrocnemius and
“falls”)- overpronation soleus)

Biceps Femoris Causes tibial external Medial Hamstring Promotes tibial internal General knee pain Lack of stability to
rotation, which rotation and knee the knee and poor
promotes arch falling stabilization foundation from the
foot and leads to a
variety of knee
problems.

Knees Move Inward TFL Attaches from the ilium Gluteus Medius Posterior fibers promote IT Band Tendonitis Caused by excessive
(Valgus) to the tibia, will cause external rotation of pronation of the foot,
internal rotation of femur, if not firing altering the position of
femur and external properly knees will the knee, and the
rotation of the tibia, cave in, which would IT Band becomes
which sets up tibia/feet prevent knee vagus and compressed into the
to turn out and knees tibial external rotation surrounding tissues
to cave in and excessive pronation

Adductor Complex Adduct and interally Medial Hamstring Promotes tibial internal Patellar Tendinopathy Because the lower leg
rotate hips, causing rotation, which would (“Jumper’s Knee”) is not aligned properly,
collapse of knees align entire leg to it is more likely to suffer
prevent knees from from excessive strain
caving in on the patellar
 OVERACTIVE UNDERACTIVE
COMPENSATION (SHORT) WHY (LENGTHENED) WHY POSSIBLE INJURIES WHY

Knees Move Biceps Femoris Causes knee flexion and Medial Gastrocnemius Promotes tibial internal Patellofemoral Pain Larger Q angle means
Inward (Valgus) (Short Head) tibial external rotation, rotation, which would Syndrome the patella is not
causing knees to align entire leg to tracking correctly with
collapse because not prevent knees from the femur
properly aligned caving in

TFL Attaches from the ilium Gluteus Medius/ Promotes hip external ACL Injury More prone to injury
to the tibia, will cause Maximus rotation, which would due to repetative strain
internal rotation of prevent knee vagus and on the ligaments of
femur and external tibial external rotation the knee
rotation of the tibia,
which sets up tibia/feet
to turn out and knees
to cave in

Lateral Gastrocnemius Causes tibial external Medial Gastrocnemius Promotes tibial internal IT Band Tendonitis Caused by excessive
rotation, which rotation and knee pronation
causes knees to stabilization
collapse because not
properly aligned

Vastus Lateralis Knee valgus position Vastus Medialis Oblique Promotes knee Patellofemoral Pain Improper tracking,
creates a “bowstring” (VMO) stabilization and Syndrome typically a lateral tilt or
effect on the VL; alignment of the patella shift of the patella,
it adapts to the begins to wear down
shortened position the posterior articular
over time surface of the patella

Knees Move Outward Piriformis Causes hip external Adductor Complex Would promote hip Piriformis Syndrome Overactive piriformis
(Varus) rotation adduction can place pressue on
the sciatic nerve, often
causing radiating pain
to the knee.

Biceps Femoris Due to attachment at Medial Hamstring Would promote hip Patellofemoral Pain Improper alignment of
ischial tuberosity, can adduction Syndrome the knee will place
pull the knees out repeated stress on the
patellar tendon
 OVERACTIVE UNDERACTIVE
COMPENSATION (SHORT) WHY (LENGTHENED) WHY POSSIBLE INJURIES WHY

Knees Move Outward TFL When not acting as
(Varus) stabilizers, can become
synergistically dominant
for glute med and pull
the knee out
Gluteus Medius/ Can be underactive for IT Band Tendonitis Caused by excessive
Maximus a variety of reasons, pronation of the foot,
leading to TFL altering the position of
becoming the knee, and the
synergistically dominate IT Band becomes
for frontal plane control compressed into the
surrounding tissues

Excessive Forward Soleus Limits dorsiflexion,
Lean which means that in
order to squat and
achieve desired depth,
one leans forward to
offset center of gravity
and prevent from falling
backwards
Anterior Tibialis Inhibited by solues, is Posterior Tibialis Improper ankle
needed to pull the Tendonitis (Shin Splints) mechanics (lack of
knee forward into ankle dorsiflexion) leads to
dorsiflexion during the overuse of the ant/post
squat tibialis

Gastrocnemius Excessive plantar flexion

limits dorsiflexion, which
means that in order to
squat and achieve
desired depth, one leans
forward
Hip Flexor Complex Causes excessive Gluteus Maximus Inhibited by hip flexors. Low back pain As torso falls forward,
hip flexion Glutes are needed to torque on the hips
maintain torso increases and effective
alignment during loading shifts superior
a squat to overload low-back
muscles.

Piriformis When glutes become Intrinsic Core Stabilizers Usually inhibited by Hamstring complex Excessive hip flexion can
underactive, piriformis (transverse abdominis, improper alignment of strains lead to increased stress
becomes overacte in multifidus, transverso- LPHC, are needed to to hamstrings which are
attempt to maintain force spinalis, internal oblique, maintain neutral spine trying to compensate for
reduction during hip pelvic floor muscles) inhibited core and glutes.
flexion

Abdominal Complex Becomes synergistically

dominant due to inhibit
intrinsic core, causes
excessive spinal flexion
 OVERACTIVE UNDERACTIVE
COMPENSATION (SHORT) WHY (LENGTHENED) WHY POSSIBLE INJURIES WHY

Low Back Arches Hip Flexor Complex Causes excessive hip Gluteus Maximus/ Are inhibited by hip Hamstring complex, Excessive hip flexion
(Excessive Spinal flexion, shortens Hamstrings flexor complex, cannot quad and adductor can lead to increased
Extension) distance between maintain force strains stress to hamstrings
torso and femur production for hip and adductor magnus
extension and the spinal which are trying to
erectors compensate compensate for an
which alters spinal inhibited gluteus
alignment maximus.

Erector Spinae Causes excessive Abdominals Would promote spinal Lower back pain Excessive extension in
spinal extension flexion to maintain the lumbar spine can
neutral spine compress facet joints
and cause pain

Latissimus Dorsi Become shortened Intrinsic Core Stabilizers Are inhibited by lumbar Shoulder Injuries Due to the lats
during lumbar spine (transverse abdominis, spine extension and attachment, they can
extension and multifidus, transverso- overactive lats. Are internally rotate the
synergistically dominant spinalis, internal oblique, needed to provide humerus and alter the
for spinal stabilization pelvic floor muscles) proper stabilization to position of the scapula
the lumbar spine leading to shoulder
impingement

Low Back Rounds Hamstrings Short hamstrings resist Gluteus Maximus Unable to be activated Hamstring complex, Excessive hip extension
(Excessive Spinal hip flexion, lumbar due to short hamstrings quad and adductor can lead to increased
Flexion) spine compensates strains stress to hamstrings and
adductors which are
trying to compensate
for an inhibited gluteus
maximus

Adductor Magnus Adductor magnus Hip Flexor Complex Inhibited by hip

attaches to ischial extenders (hamstring
tuberosity and if short and adductor magnus)
will resist hip flexion, unable to maintain
lumbar spine neutral LPHC
compenates

Rectus Abdominis/ Causes excessive Intrinsic Core Stabilizers
External Obliques spinal flexion (transverse abdominis,
multifidus, transverso-
spinalis, internal oblique,
pelvic floor muscles)
Unable to stabilize Low-back pain Excessive spinal flexion,
lumbar spine lack of spinal stability
can compress the disc
and lead to pain in
the low back.
 OVERACTIVE UNDERACTIVE
COMPENSATION (SHORT) WHY (LENGTHENED) WHY POSSIBLE INJURIES WHY

Rectus Abdominis/ Causes excessive Latissimus Dorsi Flexed lumbar spine Shoulder Injuries Due to the attachment,
External Obliques spinal flexion alters position of the underactive lats can
lats and causes them decrease stabilization
to be inhibited to the scapula

Arms Fall Forward Latissimus Dorsi Excessive shoulder Mid/Lower Trapezius Unable to retract and Headaches Tight pecs pull the
extension and internal depress the scapula, shoulder forward,
humeral rotation, leading to an altered causing upper crossed
altering the position of position of the entire posture with tight
the scapula shoulder girdle muscles in neck (upper
traps, levator scapulae),
which can cause
tension headaches

Pectoralis Major/Minor Pec major internal
rotates and horizontall
adducts the humerus,
while pec minor
protracts the shoulder
girdle
Rhomboids Unable to retract the Biceps Tendonitis Upper crossed posture
scapula due to pec causes internal rotation
minor, leading to an of arms, which places
altered position of the stress on biceps tendon
shoulder girdle

Coracobrachialis Attaches to humerus Posterior Deltoid Should stabilize Shoulder Injuries Lack of shoulder
and scapula, would shoulder girdle and stabilization
prevent full shoulder prevent
flexion leading to arms excessive internal
falling forward rotation

Teres Major Excessive shoulder Rotator Cuff Should stabilize Shoulder impingement Improper shoulder
extension shoulder girdle alignment can result in
an anterior and
superior migration of
the humeral head and
compress the
supraspinatus

© 2016 NATIONAL ACADEMY OF SPORTS MEDICINE