Squats: point feet forward and externally rotate hips?

Question

I saw a physio about a year ago due to some knee problems I'd been having, and while I was there he showed me how I could adjust my form in order to squat deeper.

He said for me to point my feet forward and externally rotate my hips, so that my knees didn't go inwards (perhaps due to me having flat feet).

Rotating my hips feels great as it makes my feet arch, and I'm pretty sure that has solved some problems with squat-related knee pain.

However I'm just not sure about my feet pointing forward, it really doesn't feel natural... and I get the impression my toes want to point out slightly.

My knee has also started hurting again recently after squats and I can't help but think it's due to my feet pointing straight in front of me, surely there must be some twisting going on in my knee? as my knees are going outwards, but my feet are pointing forwards.

Answer 1

Everyone's hips are slightly different. Most people turn their toes out to ensure that their knee tracks over their toes. That said, squat stances can vary massively depending on type and sport: Powerlifting vs Olympic and the myriad of squat types: Safety Bar, Back Squat, Front Squat, Overhead Squat, Sissy Squat, Zercher Squat, Box Squat, High Bar, Low bar...

Personally, I do lots of squatting and with nearly all of them I take a slightly different stance. I worked out my stance by following a 3 month linear progression on them to find what was comfortable.

Keeping feet parallel and forwards puts a lot of pressure/torque on ankles and is not really efficient for holding extremely heavy loads as it can often lead to you shifting weight onto the outside edge of your foot, rather than centre/mid-foot.

The opposite, toes out further than knees track causes torque on the knee joint.

My advice is simple: Squat in a position that feels natural and reduces/eliminates knee pain without your knees caving in or your lower spine flexing.

I'd recommend finding a safety squat bar if your gym has one, they can eliminate a lot of common issues with squatting when used correctly.

Answer 2

I’m going to disagree with the statement that “…pretty much everyone turns their feet out slightly”. I tend to vary my foot placement, and, I know of others that do also. This includes ‘neutral’ (toes forward) placement.

There are reasons to squat with different foot placements. A 2013 study, Effects of Foot Position during Squatting on the Quadriceps Femoris: An Electromyographic Study showed that foot placement did affect activation of specific muscle groups. Four foot placements were studied and the effects of each were recorded using Electromyography. The study showed that foot placement activated those muscle groups differently based on foot placement.

In addition, in SQUATTING KINEMATICS AND KINETICS AND THEIR APPLICATION TO EXERCISE PERFORMANCE, looked to:

“…examine kinematics and kinetics of the dynamic squat with respect to the ankle, knee, hip and spinal joints and, second, to provide recommendations based on these biomechanical factors for optimizing exercise performance.”

In particular, in regards to foot placement, the article may provide some insight into the advice you were given:

“This suggests that a narrow stance may be preferable over wide stance if the goal is to minimize compressive forces at the knee. On the other hand, a narrow stance squat resulted in approximately 4 to 6 cm greater forward knee translation and thus greater shear as compared with a moderate or wide stance. Therefore, a wider stance might be preferable for those seeking to minimize shear at the knees (18).”

The article then states:

“Several studies reveal that varying squat stance alters muscular recruitment patterns. Escamilla et al. (18) found activity of the gastrocnemius was 21% greater in a narrow versus a wide stance. McCaw and Melrose (45) reported a wide stance significantly increased activity of the GM and adductor longus, with greatest activity seen at 140% shoulder width. Ninos et al., Paoli et al., and Escamilla et al. (20,50,53) also reported increased muscular torque of the hip extensors and adductors in wider stance squats. Stance width has not been shown to alter muscular activity in the quadriceps and hamstrings, however (20,42).”

Given the above comments, I tend to vary my foot placement on leg movements. This includes squats, leg press, and leg extensions. I find that the variation allows me to optimize my leg training.