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The effect of elevating the heels on spinal kinematics and kinetics during the
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The effect of elevating the heels on spinal

kinematics and kinetics during the back squat in
trained and novice weight trainers

Mark G. L. Sayers, Caroline Bachem, Pascal Schütz, William R. Taylor, Renate

List, Silvio Lorenzetti & S. H. Hosseini Nasab

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JOURNAL OF SPORTS SCIENCES
https://doi.org/10.1080/02640414.2020.1738675

SPORTS MEDICINE AND BIOMECHANICS

The effect of elevating the heels on spinal kinematics and kinetics during the back
squat in trained and novice weight trainers
Mark G. L. Sayers a, Caroline Bachemb, Pascal Schütz b
, William R. Taylor b
, Renate List b,c
, Silvio Lorenzetti b,d

and S. H. Hosseini Nasab b

a
School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, Australia; bETH, Institute for Biomechanics, Zürich,
Switzerland; cHuman Performance Lab, Schulthess Clinic, Zürich, Switzerland; dSwiss Federal Institute of Sport, Magglingen, Switzerland

ABSTRACT ARTICLE HISTORY

This research assessed the influence of various heel elevation conditions on spinal kinematic and kinetic Accepted 20 November 2019
data during loaded (25% and 50% of body weight) high-bar back squats. Ten novice (mass 67.6 ± 12.4 kg,
KEYWORDS
height 1.73 ± 0.10 m) and ten regular weight trainers (mass 66.0 ± 10.7 kg, height 1.71 ± 0.09 m) High bar back squat;
completed eight repetitions at each load wearing conventional training shoes standing on the flat level weightlifting shoes; spinal
floor (LF) and on an inclined board (EH). The regular weight training group performed an additional eight curvature; statistical
repetitions wearing weightlifting shoes (WS). Statistical parametric mapping (SPM1D) and repeated parametric mapping
measures analysis of variance were used to assess differences in spinal curvature and kinetics across
the shoe/floor conditions and loads. SPM1D analyses indicated that during the LF condition the novice
weight trainers had greater moments around L4/L5 than the regular weight trainers during the last 20%
of the lift (P < 0.05), with this difference becoming non-significant during the EH condition. This study
indicates that from a perspective of spinal safety, it appears advantageous for novice weight trainers to
perform back squats with their heels slightly elevated, while regular weight trainers appear to realize only
limited benefits performing back squats with either EH or WS.

Introduction
The back squat and variations of the back squat (front squat, split
squat, single leg squat, etc.) are fundamental components in
many athletic (Lorenzetti et al., 2018; Sato et al., 2012) and
clinical training programmes (Severin et al., 2017). Despite this
extensive acceptance, the back squat has been linked indirectly
with numerous injuries to the lower limbs and vertebral column
(Aasa et al., 2017; Fry et al., 2003; Siewe et al., 2014; Swinton et al.,
2012; Whitting et al., 2016; Winwood et al., 2014). This popular
exercise has been subject to extensive biomechanical investiga-
tions that focus typically on the impact of load, squat depth,
stance width and/or shoe design on lower limb mechanics (at
the time of submission searches on Web of Science and PubMed
using terms such as “Squat”, “Kinematics” and “Biomechanics”
revealed over relevant 100 manuscripts). However, of this exten-
sive body of literature proportionally less focuses specifically on
back squat spinal kinematics and/or kinetics (Charlton et al.,
2017; Hartmann et al., 2013; Lee et al., 2019; List et al., 2013;
Lorenzetti et al., 2018; McKean et al., 2010; Walsh et al., 2007;
Whitting et al., 2016).
Of concern is that coaching techniques and the scientific
literature contain inconsistencies regarding the “ideal” back
squat technique. The classic NSCA position paper (1991) on
squat technique highlights that in order to reduce shear forces
on the knees, the shanks should be kept near vertical during
the movement (i.e., to minimize dorsi flexion and/or the ante-
rior translation of the knees during knee flexion). The Position
Paper also states that the lumbar spine should maintain
a “normal” posture, with the torso vertical throughout the
squat. However, herein lies a paradox as scientific reports indi-
cate that restricting anterior knee movement results in
increased lumbar flexion (List et al., 2013). Importantly,
increased lumbar flexion during squatting is also associated
with increased spinal loading (Fry et al., 2003; Hartmann et al.,
2013; Swinton et al., 2012; Whitting et al., 2016). Additionally,
physical limitations in areas such as reduced dorsiflexion and/or
hip flexion range of motion (ROM) may limit an individual’s
ability to achieve the NSCA’s “optimal” knee position and spinal
posture (Myer et al., 2014; Sato et al., 2012; Whitting et al.,
2016).
To address some of the concerns with lower limb mobility
adversely affect back squat technique, several researchers have
investigated the use of various footwear types (e.g., weightlift-
ing footwear containing wedged heels) and/or heel lifts on
squat kinetics and kinematics (Charlton et al., 2017; Lee et al.,
2019; Legg et al., 2017; Sato et al., 2012, 2013; Sinclair et al.,
2015; Southwell et al., 2016; Whitting et al., 2016). Although
most of these studies report measures of spinal kinetics and/or
kinematics, there are several concerns with these data and/or
the analytical procedures used. Some studies define the trunk
as a rigid body between a marker located on the bar and
another on either the posterior superior iliac spine (Legg
et al., 2017) or the hip (Fuglsang et al., 2017; Sato et al., 2012,
2013). The multiple movements possible at the vertebral

CONTACT Mark G. L. Sayers msayers@usc.edu.au School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, Queensland,
Australia
© 2020 Informa UK Limited, trading as Taylor & Francis Group
2 M. G. L. SAYERS ET AL.
segments between these markers means that data collected
using this approach should be viewed with caution. Other
studies incorporate more complex marker sets into their spinal
models, but limit analyses of spinal kinematics to discrete
descriptions of thorax inclination (Charlton et al., 2017;
Sinclair et al., 2015). This limitation is also applicable to research
on lumbar kinematics using an electrogoniometer (placed over
L3) (Lee et al., 2019). The research by Southwell et al. (2016)
incorporated the most advanced spinal model amongst these
studies, but analyses were limited to maxima and minima data
from each wave-form. The restriction of data analysis to dis-
crete time points or joint and/or segmental maxima and
minima, represents a clear limitation and highlights the need
for future analyses to focus on assessing data over the entire
movement.
Spinal modelling procedures that enable the quantification
of spinal curvature during dynamic activities represent
a significant advance from traditional techniques that define
the spine as a single rigid body segment (List et al., 2013;
Schmid et al., 2015; Zemp et al., 2014). The use of these models
during studies on back squat kinematics and kinetics indicate
that increases in load results in reductions in the ROM of both
the lumbar and thoracic curvature (List et al., 2013), while
changes in stance width appears to have little or no influence
on spinal moments (Lorenzetti et al., 2018). In the latter study,
Lorenzetti et al. (2018) report relatively consistent lumbar ROM
data for different loads and foot placements between experi-
enced and novice participants, but once again, the analyses
were limited to discrete data only. The interpretation of spinal
curvature data using time-series based analytical procedures
such as Statistical Parametric Mapping (SPM) (Friston et al.,
1994), would address many of the limitations associated with
previous research in this field. However, the use of these spinal
modelling procedures in combination with SPM analyses to
assess the influence of either weightlifting footwear or floor
inclination on spinal kinetics and kinematics during the back
squat has not been reported in the scientific literature.
Accordingly, the purpose of this research was to assess the
influence of various shoe/floor conditions on spinal time-
series kinematic (curvature) and kinetic (moments) data in
regular and novice weight trainers.
Methods
Subjects
Ten novice (age 26.1 ± 4.9 years, mass 67.6 ± 12.4 kg, height
1.73 ± 0.10 m) and ten regular weight trainers (age
27.6 ± 3.6 years, mass 66.0 ± 10.7 kg, height 1.71 ± 0.09 m)
volunteered to participate in this project. The distribution of
sexes was equal between groups (i.e., 5 males and 5 females
per group). At the time of data acquisition all participants were
over 18 years of age, free from injury and had no previous lower
limb or spinal surgeries or complaints. The inclusion criteria for
the regular weight training group was based on participants
having a high bar back squat one-repetition maximum (1RM) of
at least 1.2x BW and undertaking weight training at least twice
per week for a minimum of 3 years. While this group were all
regular weight trainers and experienced at performing the
high-bar back squat exercise, their typical weight training
involved lifting moderate loads only (i.e., loads representing
less than 3RM), which also explains the group’s relatively low
1RM high-bar back squat data (1.56 ± 0.32x BW). Similarly,
although the participants in the novice group were familiar
with the high-bar squat exercise they were not regular weight
trainers and had no experience at performing the high-bar back
squat with heavy loads. Due to the latter we did not do 1RM
testing on the novice group. In accordance with institutional
human research ethics approval requirements (EK 2017-N-33),
all participants were informed of the benefits and risks asso-
ciated with this study before providing their written informed
consent.
Data acquisition
Prior to testing, participants were fitted with 77 markers on the
lower limbs, pelvis, trunk and arms in accordance with the IfB
marker set (List et al., 2013; Lorenzetti et al., 2018). Two addi-
tional markers were attached to the end of the barbell (Figure 1).
Marker trajectories were tracked in three-dimensions at 100 Hz
using a 22 camera infra-red motion capture system (MX40 and
MX160, Vicon Motion System, Oxford Metrics Ltd., United
Kingdom). To enable kinetic analyses, this system was synchro-
nized with two force platforms that sampled at 2000 Hz (Kistler
Instrument AG, Winterthur, Switzerland).
The novice athletes performed squats in indoor shoes stand-
ing on either the flat level floor (LF), or with the heels elevated
(EH) by standing on two wooden wedges (Figure 1) that were
machined to a 4.5 deg downslope and secured to each force
platform. In addition to these conditions, the regular weight
training group also performed squats wearing specialist weigh-
tlifting shoes WS (adidas adiPower weightlifting shoes, adidas,
Herzogenaurach, Germany). The heel for this particular WS is
raised 20.1 mm relative to the forefoot, resulting in a mean
decline angle of 4.4 deg over the four different shoe sizes used
(Note: within the participant cohort only four different shoe
sizes were required). After a warm up phase of 5 min, partici-
pants performed a set of eight repetitions of high bar squats in
each of the test conditions. The two loading conditions (25%
BW and 50%BW) and various shoe/floor settings were rando-
mized between participants. A standardized set of instructions
were used (Lorenzetti et al., 2018), which included a directive to
squat “as deep as possible, bringing your thigh at least parallel
to the floor”. Squat depth was later quantified using peak hip
and knee flexion angles. A two-minute rest was provided
between sets to minimize possible effects of fatigue (Kraemer
et al., 2002). All testing was performed on a single day.
All kinematic and kinetic data was reconstructed using Vicon
Nexus (version 2.4, Oxford Metrics Group, UK) and subsequent
calculations were performed using MATLAB (versions 2012a
and 2014a, The MathWorks Inc., Natick, MA, USA). Kinematic
data from the standardized motion tasks allowed joint centres
and axes of rotation for the hip, knee and ankle to be deter-
mined functionally (List et al., 2013). The intervertebral joint
centre of L4 and L5 was determined anatomically based on
anthropometric data (Nissan & Gilad, 1986).
Lumbar and thoracic curvature angles were defined as the
segmental angles of the fitted circle between the markers on

Figure 1. Photographs showing the locations of the Institute for Biomechanics (IfB) spinal marker set (left) and the machined wedges attached to the two force
platforms (right).
the spinal processes of L1 to L5 and T1 to T12 respectively (List
et al., 2013; Schellenberg, Schmid et al., 2017; Schellenberg,
Taylor et al., 2017). Using a quasi-static inverse dynamics
approach, the sagittal plane external joint moments about the
lower lumbar spine (L4/L5) were determined and then normal-
ized to the subject’s body mass. This method incorporates
ground reaction force data, joint centres determined using
kinematic data, as well as sex-specific segment masses into
the calculations (Durkin & Dowling, 2003). Inertial forces were
neglected due to slow accelerations of the segments. Analyses
were performed for the sagittal plane only, with positive values
representing flexion angles and moments. For each experimen-
tal condition, the set of eight repetitions was divided into
individual squat cycles with the participant starting and ending
a cycle in an upright position. The left and right acromion
markers were tracked and their vertical velocities were aver-
aged, with a value of >0.04 m/s defining the start and end
points of a single squat cycle (List et al., 2013; Lorenzetti et al.,
2018). For each participant and experimental condition, the
mean of eight repeated cycles were calculated separately, time-
normalized according to the start and end points and then
used in all subsequent calculations and statistical analyses.
Statistical analyses
SPM analyses were completed using the 1D statistical para-
metric mapping (SPM1D) technique (Pataky, 2012; Pataky
et al., 2013), a procedure that has been used successfully to
JOURNAL OF SPORTS SCIENCES 3
analyse time-series biomechanical data (for a review see
Warmenhoven et al., 2018). Statistical analyses of discrete
data were performed using IBM SPSS software (version 24,
SPSS AG, Zürich, Switzerland). Multiple repeated-measures ana-
lysis of variance (ANOVA) tests were used to analyse the influ-
ence of elevating the heels and load on joint ROMs and peak
joint external moments within each group. In case of violation
of the assumption of sphericity determined by Mauchly’s test,
the Greenhouse-Geisser correction was used. Normality was
tested using the Shapiro-Wilk test on the standardized resi-
duals, with the normality assumption fulfilled unless otherwise
stated. Shoe/floor setups LF and EH were compared in the
novice group while in the regular weight training group, LF,
EH and WS were compared. All significant interactions were
followed up with post hoc tests with Bonferroni corrections
for multiple comparisons. Between group testing of discrete
variables was assessed via independent sample t-tests. Hedge’s
g statistics (with correction for small sample sizes) were also
used, with the relative magnitude of any differences expressed
using standard criteria – small = 0.2, medium/moderate = 0.6,
large = 0.8 (Cohen, 2013). Data are presented as mean ± stan-
dard deviation (SD) with the significance level set to P < 0.01
due to the multiple comparisons.
Results
Both groups had small non-significant changes (P > 0.20) in Hip
ROM (novice: < 2 deg; regular weight trainers: < 3 deg) and
4 M. G. L. SAYERS ET AL.

knee ROM (novice: < 6 deg; regular weight trainers: < 1 deg)
from the LF to the EH conditions. These non-significant differ-
ences were similar when comparing LF to WS conditions for the
regular weight trainers. Between group comparisons indicate
that the regular weight trainers had significantly (P < 0.01)
greater knee ROM than the novices during both heel lift con-
ditions, with the relative magnitude of these difference
decreasing from large (12–16 deg) to moderate (10–11 deg)
from the LF to EH conditions. There were small non-significant
differences between groups in hip ROM (< 2 deg) at each heel
lift condition.
The results from the discrete analyses of spinal curvature
indicate moderate significant effects of load on the ROM in spinal
curvature for both the novice and regular weight training parti-
cipants for all heel lift conditions (Table 1). Analyses of the effect
of load on lumbar curvature time-series data shows that it was
significantly reduced by approximately 4 deg in the regular
weight trainers during the first 10–30% of the squat cycle for
the +50% BW, with no significant differences at any other stage
of the squat cycle in that group. There were no significant time-
series effects of load on lumbar curvature for the novices. Similar
analyses show that the heavier load significantly increased thor-
acic curvature during the first 25–40% and last 15% of the squat
cycle in both groups, although these differences were all less
than 2 deg. Discrete kinetic data analyses indicate large signifi-
cant effects of load on the maximum moment on L4/L5 within
each condition for both groups (Table 1). SPM analyses indicate
that these differences (between 0.5 and 1.0 Nm/kg) were sig-
nificant throughout the squat cycle for both groups. There were
limited within and between group differences in discrete vari-
ables for each of the heel height conditions, with none of these
differences achieving any more than small effect sizes.
Within group SPM analyses indicated no significant influ-
ences of increasing heel height on either lumbar or thoracic

Table 1. Mean (1SD) data of the discrete variables for both groups at each load and for each heel lift condition.
Thoracic
Load on the Peak Moment about Lumbar Curvature at ROM in Lumbar Thoracic Curvature at Curvature
Condition barbell L4/L5 (Nm/kg) Start Position (deg) Curvature (deg) Start Position (deg) (deg)
Novice Level floor +25% BW 2.23 (0.36)‡ large 17 (10) 22 (9)‡ mod 8 (4) 9 (3)‡ mod
+50% BW 2.91 (0.46) 16 (9) 19 (8) 9 (3) 10 (3)
Elevated +25% BW 2.31 (0.32)‡ large 16 (10) 21 (8)‡ large 8 (4) 9 (3)‡ mod
heels
+50% BW 3.03 (0.45)* small 15 (9) 19 (7) 9 (3) 10 (3)
Regular Level floor +25% BW 2.26 (0.56)‡ large 12 (8)† small 15 (8)† small,‡ mod 8 (4) 9 (3)‡ mod
weight +50% BW 3.11 (0.55) 10 (8)† small 13 (7) 9 (4) 10 (3)
trainers Elevated +25% BW 2.33 (0.56)‡ large 12 (7)† small 14 (7)* small, 8 (3) 9 (3)‡ mod
heels
+50% BW 3.11 (0.58) 11 (8)† small 13 (7) 9 (4) 11 (3)
Weightlifting +25% BW 2.39 (0.54)‡ mod 12 (7) 14 (7) 8 (4) 9 (3)‡ mod
Shoes +50% BW 3.04 (0.57) 11 (7) 13 (8) 9 (4) 10 (3)
*Significantly different to the level floor condition within this group; ‡ Significantly different to +50% BW load within this group and condition; † Significantly different
to the novice group for this condition; small, mod (moderate) and large represent the relative magnitudes of the relevant effect sizes.

Figure 2. Time-series mean and standard deviation clouds representing the lumbar (left) and thoracic (right) spinal curvature (deg) for the novice (top) and regular
weight trainers (bottom) together with SPM data. Red lines represent data during the level floor (LF) condition while the green lines are for the Elevated Heels (EH)
condition. These analyses represent comparisons between LF and EH conditions within each test population.
 JOURNAL OF SPORTS SCIENCES 5

Figure 3. Time-series mean and standard deviation clouds representing the lumbar (left) and thoracic (right) spinal curvature for the novice (blue) and regular weight
trainers (pink) together with SPM data. Top graphs represent the Level Floor (LF) condition while the bottom graphs are for the Elevated Heels (EH) condition. These
analyses represent comparisons between each test population as a function of the LF and EH conditions.

curvature for either group throughout the squat cycle (Figure
2). Similarly, although the regular weight trainers had on aver-
age 5 deg less lumbar curvature than the novice group
throughout the squat cycle, SPM analyse indicated no signifi-
cant time-series differences in lumbar or thoracic curvature
between groups (Figure 3).
Both groups experienced nearly a threefold increase in
the moments around L4/L5 during the downward phase of
the movement, with these data peaking during the bot-
tom of the squat at 50% of the cycle. As was the case
with the spinal curvature data, within group SPM analyses
indicated no significant influence of an increase in heel
height on the moment around L4/L5 (Figure 4).
Conversely, the between group analyses shows the novice
group experienced significantly greater moments on L4/L5
than the regular weight trainers during the last 20% of the
squat cycle in the LF condition, with this difference no
longer significant when the heels were elevated (Figure 5).
Discussion
This study used a combination of discrete and contemporary time-
series analytical procedures to investigate the influence of increas-
ing heel height on spinal kinematics and kinetics during the high-
bar barbell back squat in novice and regular weight trainers. Our
findings indicate that lifting the heels during back squats (by either
EH or WS) has limited significant influences on spinal kinematics
and kinetics, particularly in regular weight trainers. However, the
spinal kinematics and kinetics of the novice weight trainers
became similar to those of the regular weight training group
during the EH condition, suggesting elevating the heels might be
advantageous for less regular weight trainers when performing
this exercise. The project also emphasizes the value of SPM as an
analytical procedure and highlight the ability of this technique to
identify the areas within a duty cycle where datasets differ
significantly.
Although not the focus of this study, the non-significant
influence of heel lift condition on hip and knee ROM is

Figure 4. Time-series mean and standard deviation clouds representing the moment around L4/L5 for the novice (left) and regular weight trainers (right) together with
SPM data. Red lines represent data during the Level Floor condition while the green lines are for the Elevated Heels condition. These analyses represent comparisons
between LF and EH conditions within each test population.
6 M. G. L. SAYERS ET AL.
Figure 5. Time-series mean and standard deviation clouds representing the moment around L4/L5 for the novice (blue) and regular weight trainers (pink) together with
SPM data. Left graphs represent the Level Floor (LF) condition while the right graphs are for the Elevated Heels (EH) condition. These analyses represent comparisons
between each test population as a function of the LF and EH conditions.
consistent with previous research in this domain (Legg
et al., 2017). The tendency for regular weight trainers to
squat deeper than novices by utilising greater knee flexion
ROM is also consistent with findings from earlier studies
(Legg et al., 2017; Lorenzetti et al., 2018). Similarly, the
significant effect of load on the maximum moment around
L4/L5 was expected (Aspe & Swinton, 2014; Lorenzetti et al.,
2018), as these data are influenced primarily by the combi-
nation of load and the horizontal position of the bar relative
to L4/L5, where the latter was influenced strongly by trunk
inclination (Walsh et al., 2007). Therefore, with minimal
absolute changes in spinal curvature between the two load-
ing conditions (< 5 deg), it would appear these maximum
moments around L4/L5 were influenced primarily by the
load on the bar. The significant difference in the maximum
moment on L4/L5 at +50%BW load between LF and EH
conditions in the novice participants needs to be inter-
preted with caution, as SPM analysis indicates that when
considered as a part of the entire movement these differ-
ences are no longer statistically significant. Limitations asso-
ciated with traditional discrete analyses are also highlighted
in the between group comparisons of the moments on L4/
L5. The maxima in these data occur approximately 50%
through the squat cycle, a point where both our discrete
and SPM analyses indicate no significant between group
differences. However, analyses of the entire time-series
show significant between group differences in these data
for the LF condition during the last 20% of the squat cycle.
The latter finding would be missed using most traditional
discrete analytical techniques. Differences between our dis-
crete and time-series findings highlight a clear limitation
associated with the use of discrete analysis techniques to
assess complex movement patterns (Warmenhoven et al.,
2018).
The presence of an effect for load on lumbar and thor-
acic curvature is consistent with research suggesting that
increases in load during back squatting are associated with
increased lumbar curvature (Walsh et al., 2007). Our time-
series analyses show that these differences are small (typi-
cally <5 deg) and occur only during the first and last 25% of
the lifting cycle where the joint moments about L4/L5 were
reduced. This ability to maintain spinal curvature during all
phases of the squat cycle is a key issue in spinal safety, as
previous researchers suggest that back pain and high inter-
vertebral disc pressures are associated with excessive lum-
bar lordosis and spinal flexion during lifting tasks (Hartmann
et al., 2013; Sadler et al., 2017; Schmidt et al., 2007). Our
spinal curvature data are similar to earlier research (List
et al., 2013), with the small differences between these data
due to the normalization adopted by the earlier group (i.e.,
their data were normalized to static posture). Similarly, our
relatively large SD data may reflect the inclusion of both
male and female participants, with research suggesting
slight differences in squat technique between the sexes
(McKean et al., 2010). Although slightly more exaggerated,
the spinal curvatures of our novice participants did not
differ significantly at any stage of the squat cycle from the
regular weight trainers. The absence of a within group
effect of increases in heel height on spinal curvature is
consistent with earlier research using discrete analytical
techniques that concludes neither EH (Charlton et al.,
2017) nor WS affect spinal posture during squatting (Lee
et al., 2019; Sinclair et al., 2015).
Analyses of our time-series data highlights the substan-
tial increase in the moments around L4/L5 at the bottom
position of the squat. These data are consistent with pre-
vious research reporting significant differences in maximum
trunk inclination at the bottom of the squat (Charlton et al.,
2017; Legg et al., 2017; Southwell et al., 2016). The rapid
increase in these data at approximately 40% of the squat
cycle for the regular weight trainers may be a function of
these participants achieving greater knee flexion at the
bottom of the squat than the novices. This hypothesis
would be consistent with earlier research reporting the
inter-relationships between knee kinematics, squat depth
and lumbar/thoracic inclination during back squats (List
et al., 2013; Lorenzetti et al., 2018). Regardless, within each
group the moments around L4/L5 were largely unaffected
by raising the heels, a finding consistent with previous
research relying on discrete analyses only (Southwell et al.,
2016). Importantly, the significant differences between
groups in the moments on L4/L5 during the last 20% of
the squat cycle in the LF condition appear independent of
spinal curvature, suggesting an increase in trunk inclination
is responsible for this effect. Conversely, during the EH
condition the non-significant differences between groups

throughout the squat cycle suggests that increasing heel
height enabled the novice weight trainers to adopt a trunk
inclination throughout the movement that was closer to
that of the regular participants. Although again relying
primarily on discrete data analysis, this finding is consistent
with earlier research suggesting that WS (hence increasing
heel height) results in reduced trunk inclination at the
deepest point in the squat (Legg et al., 2017). The absence
of this effect amongst our regular weight trainers in both EH
and WS conditions thus supports the notion that increasing
heel height does not directly influence spinal load in this
cohort (Southwell et al., 2016). While we acknowledge that
poor ankle mobility may be influenced directly by elevating
the heels, any potential change in lower limb mechanics
during the EH and WS conditions (Charlton et al., 2017; Legg
et al., 2017; Southwell et al., 2016) has not been reflected in
the spinal kinematics and kinetics of our experienced
participants.
A considerable body of research has investigated the
relationships between spinal, pelvis and lower limb kine-
matics with kinetics during bending and lifting tasks (for
recent reviews see Sadler et al., 2017; Zawadka et al.,
2018). These papers highlight the complex nature of the
interactions between external load, lifting technique, flex-
ibility and lower body and spinal kinematics and kinetics
during tasks like squatting. During high bar squatting the
maintenance of “normal” spinal curvature while also mini-
mizing the moments surrounding the lower back are
important components for maintaining spinal safety
(Myer et al., 2014; Sato et al., 2012; Whitting et al.,
2016). Although both groups decreased lumbar curvature
slightly at the bottom position of the squat, all partici-
pants maintained a lumbar lordosis throughout the squat
cycle. The regular weight training group achieved this
while also performing “deeper” squats than the novice
group. The latter is particularly noteworthy as previous
research links increases in squat depth with increases in
lumbar flexion (i.e., reductions in lumbar curvature) and
trunk inclination (Hartmann et al., 2013; List et al., 2013;
Lorenzetti et al., 2018). The relative absence of normative
lumbar curvature data (using the approach adopted here)
means that some care should be taken to avoid over-
interpreting the slightly greater lumber curve adopted at
the Start position by the novice weight trainers.
Taken collectively, our data suggest that novice weight
trainers are more likely to gain from any potential benefits
concerning spinal safety provided by increasing heel
height than their more experienced counterparts.
Additionally, in terms of spinal safety, there appears to
be limited benefit for regular weight trainers to elevate
their heels during back squats (either through EH or WS),
as spinal curvature and the moments around L4/L5 appear
independent of heel lift condition in this group. These
findings are consistent with other research in this domain
indicating that the benefits of either EH or WS are limited
to lower limb kinematics and/or kinetics, with these heel
lift conditions having limited effects on spinal loads or
movements during squat exercises (Charlton et al., 2017;
Legg et al., 2017; Southwell et al., 2016).
JOURNAL OF SPORTS SCIENCES 7
This project contains several limitations that are impor-
tant to acknowledge. The regular weight trainers achieved
deeper knee flexion than the novices and so between group
comparisons should be interpreted with caution. Differences
in squat depth may also occur as a function of ankle mobi-
lity (Charlton et al., 2017; Legg et al., 2017; Southwell et al.,
2016) and we did not assess the latter in this project.
Although the repeated measures research design means
that inter-individual differences in ankle mobility will have
minimal impact on our findings, some care should be taken
before generalising these results to individuals with limited
ankle mobility. Similarly, although our regular weight trai-
ners had long training histories, none were weightlifters or
powerlifters and had no experience at lifting heavy loads.
Additionally, the loads used in this study were not high,
with the maximum load added to the bar being only 50% of
BW and so our findings may not be representative of squats
involving heavy loads. Finally, as this project has been
limited to assessing spinal kinematics and kinetics only, we
are unable to comment on whether performing high-bar
back squats with EH and/or WS influences lower limb kine-
matics and/or kinetics in our participant cohort.
Conclusions
This project adds to the body of knowledge in this field by
using contemporary analytical procedures to assess the
influence of elevating the heels on spinal kinematics and
kinetics during the high bar squat. The key finding was that
using either EH or WS to increase heel height during light to
moderate load high bar squatting has minimal influences on
spinal kinematics and kinetics within both our novice and
regular weight trainers. Between group analyses indicate
that our novice weight trainers were able to reduce the
external joint moments about L4/L5 to the same levels as
the regular weight trainers during the EH condition.
Accordingly, from a perspective of spinal safety, there
appears to be some minor benefits for novice weight trai-
ners to perform back squats with their heels slightly ele-
vated. However, it would appear that regular weight trainers
can maintain “optimal” spinal curvature throughout the
squat cycle without their heels elevated, either via a ramp
or using WS. This project also emphasizes the importance of
analysing time-series data and not simply limiting analyses
to discrete temporal or spatial elements.
Acknowledgments
The authors declare no conflicts of interest, with this study being funded
using internal resources. The results of the present study do not constitute
endorsement of the products used in this study by the authors or the NSCA.
Disclosure statement
No potential conflict of interest was reported by the authors.
ORCID
Mark G. L. Sayers http://orcid.org/0000-0001-6275-8982
8 M. G. L. SAYERS ET AL.
Pascal Schütz http://orcid.org/0000-0003-1711-7881
William R. Taylor http://orcid.org/0000-0003-4060-4098
Renate List http://orcid.org/0000-0003-3292-1915
Silvio Lorenzetti http://orcid.org/0000-0002-8339-8960
S. H. Hosseini Nasab http://orcid.org/0000-0002-3518-3316
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