Squatting is one of the best exercises for developing lower body strength.
There is often a squat variation for everyone that can get the job done.
That being said, sometimes there are people that cannot squat due to injury.
A lot of times it is the low back/pelvic area that causes this kind of limitation.
One example is femoralacetabular impingement, or FAI. FAI is an injury where the bones of the femur and/ or the hip socket are in direct contact with each other.
This is extremely painful and the incidence of labral tears with FAI is very high.
FAI is a specific condition where you cannot coach better technique, mobilize the joints, or stretch until the cows come home. None of it will work.
The bones are running into each other and the only way to fix it is surgery.
In this case, there are a few ways that we can work around the impingement to continue training the lower body. *Note: always seek advice of medical professional if injuries are suspected.*
There are other injury cases where people are not going to be able to squat, or sometimes hold the belief that squatting is going to kill them. I have had no success ever trying to force exercises on someone that has ever felt strongly about not doing it.
In that case we need alternatives.
- Bulgarian Split Squats
This exercise is a leg killer. It is extremely challenging and difficult to perform.
Also known as Rear Foot Elevated (RFE) split squats, Mike Boyle is famous for replacing bilateral squats with these. His theory is simple: bilateral squats are not limited by the legs, they are limited by the low back.
Bulgarians limit the loading needed on the core while simultaneously putting more demands on the legs.
Someone may be able to back squat 300 pounds but split squat 200 on each leg. Instead of 150 being put on each leg it is now 200. This isn’t exact but you get the idea.
- Hex bar/elevated deadlifts
Someone with FAI, for example, will be able to only hinge their hips to a certain point before getting stuck. They can then pull the weight from this point.
Forcing them to pull from the floor could mean disaster for the low back by compensating into the position.
A hex bar with high handles allows a higher hip position which the athlete may get into easier.
In the absence of a hex bar, we can elevate a deadlift on plates or boxes until the person can get into a good pulling position.
Working on the deadlift pattern will yield tons of benefits but forcing someone into a variation that they cannot do is a terrible idea.
- Hamstring dominant work
3 exercises come to mind under this term: glute ham raises (leg curl), RDL’s, and slideboard hamstring curls.
Most people regardless of age, competitive level, etc. have weak hamstrings. It is usually comically bad.
Training the hamstrings is extremely helpful in improving lower body strength and injury prevention.
RDL’s require hip flexion, but the other two do not. This makes them great choices for those with FAI since we do not have to worry about smashing on the joint.
RDL’s are limited by the person’s range of motion so it is easily self monitored. The depth will be determined by the point before they get stuck or pain sets in.
The only warning here is that the hamstrings will probably be extremely sore for while. These exercises put a lot of force on the muscle and will be sore until the strength comes.
- Other single leg exercises
Single leg exercises allow a little bit of wiggle room with the pelvis and most people can go through them pain free. Exercises like lunges, step ups, and single leg squats may all fit the bill.
If anything hurts then we must stop using it and pick something else.
Squats are a great exercise but they are not one size fits all. They may be important for getting one athlete ready for the season but they could put another on IR for the season.
It is a dangerous approach to expect everyone to be able to drop into a proper squat without issues.
Be prepared to switch things up for the better of the athlete.