Assisted Squat with Counterweight and Heels Elevated

Giving athletes clients an assist with a particular exercise can come in many different forms. The goal is to still complete a task that resembles the foundational movement patterns. However due to individuals pathology, compensations, pain levels, coordination, etc. we need to know how to modify exercises in order to still elicit a training effect. Assist can come in the form of aiding the movement pattern, as well as providing increased support to reduce the stability demands of the task.

The assisted squat with counterweight and heels elevated is an excellent option for many clients.

1. Heels elevated reduces the demands of ankle dorsiflexion, but more importantly provides an assist for translation of the tibia. Often ankle mobility is not limited, the plantar flexors can be too toned from an anterior weight shift proximally at pelvis (think anterior pelvic tilt, excessive lordosis, and rib flares).
2. Heels elevated allows the diaphragm and pelvic diaphragm to remain stacked as tibia translates forward. However with pelvis stacked it allows for better positional use of the hamstrings to provide contraction and allow for the posterior arthrokinematic glide of tibia relative to femur that goes along with knee flexion (in this case a squat). 
3. Reduced demand is placed on T-spine extension because tibia is allowed to translate forward. Thus less t-spine extension needed. Many individuals who struggle with t-spine extension actually is because they are already in extension and have less room to go in that direction (again think rib flares).
4. Counterweight is used to again help keep diaphragm and pelvic diaphragm stacked. Can be in form of light weight or heavy as maybe trying to train pattern as resisted activity.
5. Height of heel raise can be lowered over time as client improves competency over this pattern.

**Better position of pelvis and diaphragm can lead to increased utilization of glutes to drive back up out of bottom of squat as opposed to excessively utilizing lumbar paraspinals or very quad dominate. Thus this exercise can have an immediate impact on decreasing pain levels and making movement more comfortable.

**Some clients may experience increased pain with this movement, which may be because they have not been able to load the knee joint and extensor mechanism from a position of this much flexion. Furthermore, they usually have a difficult time controlling optimal pelvis and torso position which places hamstrings in a disadvantageous position.

**Loading can then be further progressed when appropriate with a heavier weight used or a Double KB or DB Front Squat