Back Squats for Bone Health

Squats are hard.

They make runners tired, sore, and want to lay on the ground in the fetal position. A squat day for a runner might mean hobbling down the steps the next two days because your quads are so sore. It’s easy to see why this exercise is often left out of a runner’s programming. Runners have enough to manage with their training. The last thing they need is more things to do. Especially if it makes them sore and impacts their ability to train. If you add in squatting at the wrong time or in the wrong manner, it can wreck your training week.

Squatting requires us to move through a knee-dominant pattern as we lower our body to the ground. It’s a category of exercise that contains back squats, front squats, pistol squats, and many others. Lots of different options. If I had to pick one “big lift” for all runners to master it would be a squat. When a runner is rehabbing a stress fracture of the spine, pelvis, or hips they are crucial.

Here’s why.

Strength training provides benefits to our bones, tendons, and muscles running doesn’t provide. Squatting helps prep your “running tissues” to better deal with actually running. Stronger bones, bigger muscles and more resilient tendons. All things runners should strive for.

Bone health and bone stress injuries (BSIs) can be a problem for runners. A key tenet of their rehab and prevention is that we HAVE to load common fracture sites to make them stronger. To get bones strong we need dynamics loads we can add in the weight room. We can target common fracture sites by varying our squat variations. Perform these exercises to prep the area before an injury happens or if you have had a history of BSIs in the area.

Here are a few of my favorites.

Femoral Neck BSIs = Rearfoot Elevated Split Squats

Our femoral neck is in a tough spot. It plays a big role in keeping us upright and moving forward when we are running. Add in that it does not have great circulation and these injuries can take awhile to recover from. The need for a progressive strength routine is paramount for these to get back to 100%. By using an offset load, the rearfoot elevated split squat helps stress the outside of our hip.

Femoral Shaft BSIs: Goblet Squat

The femur’s unique anatomy can make shaft stress fractures tough to rehab. Your quadriceps attach to a big chunk of the anterior femur. This makes quad strengthening important when returning to running. I’m not talking about basic exercises on the table you can do while scrolling social media. I’m talking about heavy, deep squatting. This starts with a goblet squat and progresses to heavy front squats. Keep your trunk relatively vertical throughout and stay smooth and steady throughout every repetition.

Sacrum or Pelvis: Back Squats

Sacral stress fractures can be complex due to the sacrum’s spongy nature. Consulting with a dietician is crucial for me in these specific cases. When it comes to lifting, fractures of the spine and pelvis call for back squats. There is an opinion that back squats in general are bad for your back. I’d argue the opposite in the case a BSI. Adding axial load through the barbell can create positive stress through the trunk. That’s what we want. Stress the area where the fracture occurred so it can come back stronger.

If you have had a history of stress fractures, it’s important to continue stressing that bone. Stress the problem area, progress those lifts over a training season, and reap the benefits on race day.

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