LOWER EXTREMITY BIOMECHANICS DURING
A REGULAR AND COUNTERBALANCED SQUAT
SCOTT K. LYNN AND GUILLERMO J. NOFFAL
Department of Kinesiology, California State University, Fullerton, California
ABSTRACT
Lynn, SK and Noffal, GJ. Lower extremity biomechanics
during a regular and counterbalanced squat. J Strength Cond
Res 26(9): 2417–2425, 2012—If the efficiency of human
movement patterns could be improved using exercise, this
could lead to more effective musculoskeletal disease-injury
prevention and rehabilitation programs. It has been sug-
gested that an efficient squat movement pattern emphasizes
the use of the large hip extensors instead of the smaller knee
extensors. The purpose of this study was to determine
whether a counterbalanced squat (CBS) could produce
a more hip-dominant and less knee-dominant squat move-
ment pattern as compared with a regular squat (RS). There
were 31 recreationally trained college-aged participants
(15 male, 16 female) who performed 10 squats (5 CBS
and 5 RS), while segment kinematics, ground reaction forces,
and muscle (gluteus maximus [GM], quadriceps, hamstrings)
electromyographic (EMG) activations were recorded. Peak
sagittal plane net joint moments and joint ranges of motion at
the hip, knee, and ankle joints along with peak and integrated
EMG activation levels for all 3 muscles were compared using
analysis of variance (squat type 3 sex). The results revealed
that the CBS increased the hip joint moment and GM
activation, while it decreased the knee joint moment and
quadriceps activation as compared with the RS. Therefore,
the CBS produces a more hip-dominant and less knee-
dominant squat movement pattern and could be used in
exercise programs aimed at producing more hip-dominant
movement patterns.
KEY WORDS movement pattern correction, hip-dominant
squat, knee-dominant squat, musculoskeletal injury and disease,
rehabilitation
Address correspondence to Scott K. Lynn, slynn@fullerton.edu.
26(9)/2417–2425
Journal of Strength and Conditioning Research
Ó 2012 National Strength and Conditioning Association
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
INTRODUCTION
T
he goal of any exercise training program should
be to improve the overall efficiency of human
movement patterns. Whether the training program
is designed to improve athletic performance, to
rehabilitate an injury, or simply to improve overall physical
fitness; the goal of performing repeated movements (exercises)
should be to make movement patterns more efficient. The
concept of efficiency as it relates to human movement has been
defined several different ways. In terms of human movement
energetics, mechanical efficiency is defined as the amount
of mechanical work done divided by the metabolic cost
needed to perform that work (39). Although this is the classic
definition of mechanical efficiency, others have proposed
more biomechanical definitions of human movement effi-
ciency. These include patterns of movement that fulfill their
tasks with minimal strain on the musculoskeletal system (27)
or as movement that occurs without pain or discomfort and
involves proper joint alignment, muscle coordination, and
posture (18). These biomechanical definitions hypothesize
that if we can develop more efficient movement patterns, this
reduction in strain on the movement components could
help in the rehabilitation process and in preventing the
development of musculoskeletal pain altogether (31). Because
musculoskeletal conditions accounted for $849 billion in
health care costs in the U.S.A. in 2004 (7.7% of the gross
domestic product), and with these costs expected to escalate
as the population ages (16), developing noninvasive strategies
to prevent these conditions is becoming increasingly
important. Therefore, developing exercises aimed at correct-
ing movement inefficiencies could help in delaying and
preventing the onset of some musculoskeletal pathology.
The most common pathologic conditions in the lower
extremity affect the knee joint (36,37), and women experience
knee pathologic conditions much more commonly than men
(2,13). It can be hypothesized that there may be differences in
muscular activation strategies between men and women that
might be one of several factors leading to these increased rates of
knee injury. Studies that have attempted to determine the causes
of knee pathologies have suggested that hip muscle weakness is
associated with the development of knee conditions (5,6,20,26).
Therefore, designing exercises aimed at preferentially strength-
ening the hip musculature is warranted, as is examining
movement pattern differences between men and women.
VOLUME 26 | NUMBER 9 | SEPTEMBER 2012 | 2417
 Biomechanics and a Counterbalanced Squat
One fundamental human movement pattern that is also
commonly used as an exercise in many training programs is
the squat. Variations on this basic human movement pattern
have been used throughout time during various activities
of daily living and have also been widely used as a core
component of athletic, clinical, and fitness-related training
programs (1,23). The squat is a complex multijoint move-
ment requiring contributions from several muscles and joints
to be performed optimally. It has been suggested that to
perform the basic squat movement pattern efficiently, one
requires mobility of the ankle, hip, and thoracic spine, while
requiring stability of the foot, knee, and lumbar spine (18).
This theory suggests that of the 2 largest lower limb joints
producing most of the work for the squat movement (10), the
hip joint should be most responsible for producing the
movement.
During the squat movement, and during the loading
response of many human movements, the ground reaction
force falls anterior to the hip joint and posterior to the knee
joint in the sagittal plane (8,35). This creates external flexion
moments on both the hip and knee that must be balanced
by the internal extension moments provided by the hip
extensors (gluteus maximus [GM] and hamstring muscles)
and knee extensors (quadriceps), respectively. Without
considering the capability of the hamstring muscles to
extend the hip, the GM alone has a larger cross sectional area
(4,842 mm2) than the total combined area of all 4 quadriceps
muscles together (4,317.5 mm2) (15). Because a muscle’s cross
sectional area is highly correlated to the amount of force it
can generate (11), it can be hypothesized that the larger hip
extensor musculature could be better able to handle external
loading as compared with the knee extensor musculature.
There is also evidence that improving the use of the hip
extensors in the sagittal plane can help unload the knees by
decreasing the amount of quadriceps force required (28).
Therefore, it can be hypothesized that emphasizing the
loading of the hip joint over the knee joint during a squat
exercise could help create a more efficient pattern of
movement.
It has been suggested that keeping the ground reaction
force closer to the knee and further from the hip in the sagittal
plane can help in emphasizing the loading of the hip
extensors over the knee extensors during human movement
(29). One potential method of increasing the contribution of
the hip and decreasing the contribution of the knee during
the squat movement would be to place additional mass in
the hands and move this mass anteriorly so that it can
counterbalance the hips moving posteriorly. Therefore, this
study will investigate a counterbalanced squat (CBS)
technique (Figure 1B) to determine whether this technique
is better able to increase the sagittal plane loading of the hip
while decreasing the same loading of the knee as compared
with a regular squat (RS) technique (Figure 1A). It will also
examine the differences in basic squat biomechanics between
male and female subjects.
the TM
2418 Journal of Strength and Conditioning Research
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
METHODS
Subjects
The subjects were 31 (15 men and 16 women) recreationally
trained (involved in at least 2 hwk21 of sporting activities
for a minimum of 2 years but had never regularly trained
using loaded squats) healthy college-aged participants with
no history of major musculoskeletal injury or surgery. They
were 23.1 years of age (SD 2.1 years), had a height of 1.70 m
(SD 11.4 m), and a mass of 71.0 kg (SD 17.3 kg). All the
subjects signed a letter of informed consent approved by the
University’s Research Ethics Board before participation in
the study.
Instrumentation
Kinematic data were collected using a 9-camera Qualysis
(Gothenburg, Sweden) Oqus 300 motion capture system.
Retroreflective markers were fixed to rigid body clusters
and securely attached bilaterally to the subject’s foot, shank,
and thigh using tensor bandages and athletic tape. There was
also a single rigid body cluster attached to the sacrum and
pelvis. The subject then stood with each foot on a separate
AMTI (Newton, MA, USA) force platform to allow for the
simultaneous collection of ground reaction force data along
with the markers kinematics. Marker clusters were attached
on both legs, and ground reaction force data were collected
for both legs; however, for this current analysis, only the data
for the subject’s dominant leg (i.e., the leg they would
preferentially use to kick a ball) was analyzed.
A Run-Technologies (Mission Viejo, CA, USA) Myopac
8 channel electromyographic (EMG) system was used to
collect all EMG data (differentially amplified with a gain of
1,000, bandpass 20–540 Hz, common mode rejection ratio
(CMRR) . 80 dB, input impedance .1015). Following
standard skin preparation, silver-silver chloride electrodes
were applied in a bipolar configuration (3.0 cm center-to-
center) in line with the muscle fibers over the biceps femoris
(BF) representing the hamstring muscle group, rectus femoris
(RF) representing the quadriceps muscle group, and the GM
muscles. It was also ensured that the motor point of each
muscle was avoided. The reference-ground electrode was
then attached to the tibial tuberosity of the participant’s test
(dominant) leg. The EMG electrodes were only attached
unilaterally to the subject’s dominant leg. Kinematic data
(at 100 Hz), along with EMG and ground reaction force data
(at 2,000 Hz) were collected simultaneously using Qualysis
Track Manager software (Gothenburg, Sweden).
Protocol
Before testing, it was ensured that the subjects had not
significantly deviated from their normal daily habits of
nutrition, hydration, and sleep. After the application of the
EMG electrodes, the subjects performed 3 maximum
voluntary isometric contractions (MVICs): knee flexion
(BF), hip extension (GM), knee extension (RF). The knee
flexion and hip extension MVICs were performed with the
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resting signal was subtracted

off all EMG and squat trial
EMG data.
After the MVIC trials and the
application of motion tracking
rigid bodies, the subjects stood
with 1 foot on each force plate
and were given dumbbells to
hold in each hand. They were
then instructed how to perform
the 2 different methods of
squats: the CBS and the RS.
The RS involved the subjects
squatting with the dumbbells
held at shoulder level the whole
time (Figure 1A).The CBS was
performed with the dumbbells
starting on the subject’s thigh,
then flexing 90° at the shoulder
during the eccentric phase of
the squat and extending the
shoulder back to neutral during
the concentric phase of the
squat (Figure 1B). A metro-
nome was also set to the
preferred speed of movement
for each subject (which was
approximately 60 bmin21 for
all the subjects) to ensure that
each subject performed all the
trials at the same cadence and
speed. They were given suffi-
cient practice trials to ensure
they were comfortable with the
speed of movement and each
type of squat movement. The
subjects were asked to begin
each squat on 1 beat, be at the
Figure 1. A) The regular squat (RS) technique: The weights are held at shoulder height throughout the movement. bottom of the squat on the
B) The counterbalanced squat (CBS) technique: The weights start the subject’s thighs and are brought out in front second beat, and have returned
of the body with 90° of shoulder flexion during the eccentric phase of the squat and back to the thighs during the
to a standing position on the
concentric phase of the squat.
third beat. Any trial in which
the subject did not maintain
a consistent pace was disre-
subject in a prone position, whereas the knee extension MVIC garded and the trial was repeated. This ensured that all trials
was performed with the subject in a seated position. The for both squat conditions were performed at the same speed
hip extension MVIC was also done with the knee flexed to of movement. During testing, 5 trials were performed for
90° in an attempt to decrease the involvement of the each squat condition (RS and CBS) while marker motion,
hamstring muscle group. The subjects were asked to produce force plate, and EMG data were simultaneously recorded.
a maximum isometric exertion of each muscle group while There was at least 1 minute of rest given after practice trials
being manually resisted. The peak muscle activity achieved and between test squats to ensure that fatigue was not
for each muscle group during these 3 tasks was then used to a factor. The order of the 10 total trials was randomized for
normalize squat EMG data as has been done previously each subject.
(9,12). There was also a 1-second resting EMG trace After all the squat trials, the subject stood in view of the
recording taken before data collection, and the average cameras while a anatomical landmark trial was completed.

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 Biomechanics and a Counterbalanced Squat
This involved using a specially designed probe to identify
bony landmarks so that subject-specific segments could be
created during processing. The subjects also performed 3
calibrated motions so the joint centers could be calculated.
The hip calibrated motion involved performing 3 complete
Ôhula-hoopÕ hip rotations in each direction. The knee and
ankle calibrated motion involved performing simple knee
flexion and extension and ankle dorsi and plantar flexion
movements, respectively.
Data Processing
Visual 3D (C-Motion Inc., Rockville, MD, USA) software was
used to process all squat trial data. This software was used to
filter raw marker data (fourth-order, low-pass, double-pass
Butterworth filter with a 6-Hz cut-off frequency) (8) and to
calculate joint angles at the hip and knee during the squat
trials. These joint kinematics were calculated using the
Cardan-Euler representation, which finds the orientation
of the distal segment with respect to the reference proximal
segment using x (flexion/extension), y (ab/adduction),
z (axial rotation) sequence of rotations (40). It also combined
motion, force, and anthropometric data using a standard
inverse dynamics link segment model to calculate the net
external moments at the hip and knee. Subject-specific
anthropometric information used in these calculations was
estimated from their height and weight (14). All the joint
moments were normalized by body mass (newton meter per
kilogram) and reported in the coordinate system of the distal
segment of the joint. It should be noted that joint angles and
moments were calculated in all 3 dimensions; however, this
study only examined these angles and moments in the
sagittal plane. Also, the peak knee flexion angle during the
squat was used to define the concentric and eccentric phases
of the squat movement for all analyses; and variables
calculated from each of the 5 trials per condition were
averaged together for each subject.
The EMG data were full-wave rectified and filtered using
a fourth-order, low-pass, double-pass Butterworth filter with
a 6-Hz cut-off frequency (39). Integrated EMG (IEMG) was
then calculated for the concentric and eccentric phases of the
3 muscles during the squat using the following equation (17):
Zt n
n y i  1 þy i
yðt Þdt ¼ +i ¼ 1 Dt ;
2
t1
where n is the number of data points for the concentric and
eccentric phases, yi is the EMG data at time (t), and Dt is the
sampling interval (1/2,000 seconds). The IEMG is reported
in millivolts.
All EMG waveforms were also converted into %MVIC
units by dividing by the peak MVIC activity of each muscle
(BF, RF, GM).
Angular work was also calculated at the hip and knee joints
by multiplying the external joint moment (in newton meter
per kilogram) by the joint angular displacement (in radians).
the
2420 Journal of Strength and Conditioning Research
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
At both the hip and knee joints, negative work corresponded
to the eccentric phase of the squat and positive work
corresponded with the concentric phase.
Statistical Analyses
Key outcome measures were as follows: (a) the joint ranges
of motion (ROMs) for the knee and hip during the entire
squat movement; (b) the peak external net joint moments
achieved at the bottom during the squat for the knee and hip
joints; (c) total negative (eccentric) and positive (concentric)
angular work performed at the knee and the hip; and (d) the
peak EMG activity (in %MVIC) achieved during the entire
squat and IEMG during the concentric and eccentric phases
of the squat movement for the GM, BF, and RF muscles.
There were 11 separate 2 3 2 (squat condition 3 sex) factorial
mixed model analyses of variance run on each one of the
variables, except for the IEMG data. The 6 IEMG variables
were calculated using raw (nonnormalized) EMG data;
therefore, the between subjects comparison were not
examined on these variables and only the within-subjects
comparison (squat type) were performed. For all analyses,
statistical significance was set at p # 0.05.
RESULTS
The results for the joint kinetic data (hip, knee) are reported
in Table 1. It should be noted that there was a main effect
(p , 0.05) for squat type in both the peak knee (F = 7.9,
p = 0.009, effect size ½h2p  ¼ 0:22) and hip (F = 12.5, p = 0.001,
effect size ½h2p  ¼ 0:30) moments. There was a larger
magnitude of hip moment in the CBS, whereasthere was
a larger magnitude of knee moment in the RS. Also, the hip
moment displayed a main effect for sex (F = 7.1, p = 0.013,
effect size ½h2p  ¼ 0:20) as the male subjects had an increased
magnitude of peak hip moment as compared with the female
subjects. There was no main effect for sex (p , 0.05) in
the peak knee moment (F = 0.9, p = 0.348, effect size
½h2p  ¼ 0:03).
Table 1 also displays the joint work done by the hip and the
knee in both the concentric and eccentric phases. There
was a main effect for all of the joint work variables calculated:
eccentric hip work (F = 126.4, p , 0.001, effect size
½h2p  ¼ 0:82), concentric hip work (F = 70.2, p , 0.001, effect
size ½h2p  ¼ 0:72), eccentric knee work (F = 22.2, p , 0.001,
effect size ½h2p  ¼ 0:44), concentric knee work (F = 32.9,
p = 0.001, effect size ½h2p  ¼ 0:54). It should be noted that for
both the concentric and eccentric phases, the knee does
more work during the RS and the hip does more work during
the CBS. There were also main effects for sex in the work
done by the hip in both the eccentric (F = 10.9, p = 0.003,
effect size ½h2p  ¼ 0:28) and concentric (F = 11.1, p = 0.002,
effect size ½h2p  ¼ 0:28) phases; but no main effect for sex
in the knee work done in either phase (eccentric—F = 6.2,
p = 0.145, effect size ½h2p  ¼ 0:07, concentric—F = 4.9,
p = 0.153, effect size ½h2p  ¼ 0:07).
TM
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TABLE 1. Hip and knee joint kinetics during the RS and CBS.†*

RS CBS

Male Female All subjects Male Female All subjects

(n = 15) (n = 16) (n = 31) (n = 15) (n = 16) (n = 31)

Hip moment (Nmkg21)ठ1.27 (0.51) 0.81 (0.38) 1.04 (0.50) 1.30 (0.51) 0.93 (0.35) 1.11 (0.47)
Knee moment (Nmkg21)‡ 1.39 (0.67) 1.10 (0.38) 1.24 (0.55) 1.33 (0.64) 1.07 (0.36) 1.19 (0.52)
Hip eccentric work (Jkg21)ठ21.65 (0.63) 20.98 (0.39) 21.30 (0.61) 22.28 (0.79) 21.53 (0.58) 21.88 (0.77)
21
Hip concentric work (Jkg )ठ1.81 (0.74) 1.06 (0.36) 1.41 (0.68) 2.24 (0.80) 1.53 (0.52) 1.86 (0.74)
Knee eccentric work (Jkg21)‡ 22.73 (1.27) 21.99 (1.14) 22.33 (1.24) 22.35 (1.26) 21.80 (1.05) 22.06 (1.16)
Knee concentric work (Jkg21)‡ 2.58 (1.12) 1.96 (1.04) 2.25 (1.11) 2.30 (1.12) 1.78 (1.01) 2.03 (1.08)
*RS = regular squat; CBS = counterbalanced squat.
†All the numbers are presented as mean (SD). Moments represent peak net external flexion moments on the hip and knee joints
during the entire squat movement. Joint work numbers represent the total work performed in the eccentric or concentric phase of the
squat movement.
‡Main effect for squat type (RS vs. CBS).
§Main effect for sex (male vs. female).

Table 2 displays the results of the peak EMG activation
data for the GM, RF, and BF. It should be noted that there
was a main effect for squat type (p , 0.05) in the peak GM
(F = 8.0, p = 0.008, effect size ½h2p  ¼ 0:22) and RF (F = 13.7,
p = 0.001, effect size ½h2p  ¼ 0:32) EMG activation data but
not in the BF (F = 2.6, p = 0.117, effect size ½h2p  ¼ 0:08). The
CBS squat produced a higher peak activation level of the
GM, whereas the RS produced a higher peak activation level
of the RF. There was also a main effect for sex in the BF peak
EMG activation data (F = 5.1, p = 0.03, effect size
½h2p  ¼ 0:15), as the women had an increased peak activation
of the hamstring muscles as compared with the men across
both types of squat; however, there was no main effect for
sex in the GM (F = 0.49, p = 0.490, effect size ½h2p  ¼ 0:02) or
the RF (F = 1.7, p = 0.202, effect size ½h2p  ¼ 0:06).
Table 2 also displays the IEMG data for the GM, RF, and
BF during the concentric and eccentric phases. The IEMG
data revealed main effects for squat type in RF activation
during both the eccentric (F = 22.6, p , 0.001, effect size
½h2p  ¼ 0:44) and concentric phases (F = 29.5, p , 0.001,
effect size ½h2p  ¼ 0:50). There were also main effect for squat
type in the IEMG data of the concentric phases for the GM
(F = 16.0, p , 0.001, effect size ½h2p  ¼ 0:36) and BF (F = 7.7,
p = 0.010, effect size ½h2p  ¼ 0:21). These data revealed

TABLE 2. Electromyographic data for the GM, RF, and BF muscles during both the RS and CBS.*†

RS CBS

Male Female All subjects Male Female All subjects

(n = 15) (n = 16) (n = 31) (n = 15) (n = 16) (n = 31)

Peak GM activation (%MVC)‡ 18.0 (7.7) 21.9 (18.5) 20.0 (14.2) 21.3 (9.5) 24.8 (20.1) 23.1 (15.8)
Peak RF activation (%MVC)‡ 57.1 (35.7) 71.3 (51.5) 64.4 (44.5) 41.9 (19.0) 64.5 (45.0) 53.6 (36.2)
Peak BF activation (%MVC)§ 11.7 (9.2) 28.9 (27.0) 20.6 (21.9) 13.6 (9.9) 30.5 (28.9) 22.4 (23.2)
IEMG eccentric GM (mVs) 60.2 (40.4) 64.7 (44.5)
IEMG Eccentric RF (mVs)‡ 323.7 (196.8) 233.1 (126.0)
IEMG eccentric BF (mVs) 118.1 (97.1) 123.9 (114.0)
IEMG concentric GM (mVs)‡ 99.3 (59.0) 124.0 (74.7)
IEMG Concentric RF (mVs)‡ 300.0 (177.7) 226.2 (133.1)
IEMG concentric BF (mVs)‡ 122.8 (69.8) 139.4 (80.4)
*EMG = electromyographic; IEMG = integrated EMG; GM = gluteus maximus; RF = rectus femoris; BF = biceps femoris; RS =
regular squat; CBS = counterbalanced squat; MVC = maximum voluntary contraction.
†All numbers are presented as mean (SD).
‡Main effect for squat type (RS vs. CBS).
§Main effect for sex (male vs. female).

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 Biomechanics and a Counterbalanced Squat

TABLE 3. Mean joint ROM for the hip and knee during both the RS and CBS*†.

RS CBS

Male Female All subjects Male Female All subjects

(n = 15) (n = 16) (n = 31) (n = 15) (n = 16) (n = 31)

Hip joint‡ 93.8 (15.8) 90.0 (11.9) 91.9 (13.8) 91.3 (14.9) 85.6 (12.0) 88.4 (13.6)
Knee joint‡ 119.9 (13.9) 110.1 (18.9) 114.8 (17.1) 120.5 (14.1) 112.5 (17.7) 116.4 (16.3)
*ROM = range of motion; RS = regular squat; CBS = counterbalanced squat.
†All numbers are presented as mean (SD) and are in degrees.
‡Main effect for squat type (RS vs. CBS).
§There were no main effects for sex (male vs. female).

increased activation of the hip extensors (GM and BF) during
the CBS in the concentric phase, whereas the knee extensors
(RF) were more active in the RS during both the eccentric
and concentric phases. There was no main effect for the
IEMG data in the eccentric phases of the GM (F = 3.3,
p = 0.082, effect size ½h2p  ¼ 0:10) or the BF (F = 1.3,
p = 0.260, effect size ½h2p  ¼ 0:04).
The hip and knee joint ROM data are reported in Table 3.
There was a main effect for squat type (p , 0.05) in both
the hip (F = 47.9, p , 0.001, effect size ½h2p  ¼ 0:62) and knee
(F = 5.5, p = 0.026, effect size ½h2p  ¼ 0:16) ROM data. The
hip displayed a greater ROM during the RS, whereas
the knee displayed a great ROM during the CBS. However,
there was no main effect for sex in either the hip (F = 0.9,
p = 0.342, effect size ½h2p  ¼ 0:03) or knee (F = 2.3, p = 0.137,
effect size ½h2p  ¼ 0:08) ROM.
DISCUSSION
This study found that the CBS increased the sagittal plane
loading of the hip joint while decreasing the sagittal plane
loading on the knee as compared with the RS. This is most
likely because of the increased mass placed anteriorly during
the CBS when the dumbbells and arms are moved anteriorly
with shoulder flexion. This coincides with the findings of
previous work that has suggested that forward trunk lean
during a drop jump task increases the demand on the hip
while decreasing the demand on the knee as compared with
landing with a more erect trunk (29), as forward leaning of
trunk would also shift more mass anteriorly. This shift in
external loading that increases the loading of the hip and
decreases the loading of the knee during the CBS also led to
a shift in muscular activation levels by increasing the peak
activity of the larger proximal hip extensor (GM) and
decreasing the peak activity of the relatively smaller distal
knee extensors (RF). This coincides with the results of
Blackburn and Padua (4), because they found that increasing
the mass placed anteriorly during jump landing (i.e., forward
trunk lean) caused decreased quadriceps activation; however,
hip extensor muscle activity was not measured in this study.
the TM
Based on these results, it can be suggested that the CBS
produces a more hip-dominant pattern of movement as
compared with the RS, which produces a more knee-
dominant pattern of movement. However, even though there
are large effect sizes for most of the comparisons, the
magnitude of these changes in external loading and muscular
activation levels are small. It is unknown as to how these small
alterations in muscle activation levels could change the
overall patterns of movement if the CBS is performed as part
of a long-term corrective exercise program. Future research
should investigate both the acute and long-term effects of
using a CBS in a training program to see if this can produce
a more hip-dominant and less knee-dominant patterns of
movement.
The use of a CBS as part of a training program could have
a wide range of uses clinically. It has been shown that those
with a torn anterior cruciate ligament (ACL) adopt a gait
pattern where they attempt to reduce the contraction of the
quadriceps (3) during gait. This is believed to be an attempt to
decrease the anterior shear force produced on the proximal
tibia when the quadriceps contracts. Therefore, performing
a CBS exercise to decrease the recruitment of the quadriceps
and increase the recruitment of the hip extensors may be
advisable. This may allow for the subjects to begin re-
habilitation exercise much sooner after ACL replacement
surgery, because the graft could be spared some of the stresses
of the anteriorly directed forces applied on the tibia with
excessive quadriceps contraction. The CBS may also be useful
in prevention of ACL injury as the decreased quadriceps
activation could potentially help in reducing quadriceps to
hamstring ratio and decreasing the ‘‘quad dominance’’ that has
been shown to increase ACL injury risk (24).
Training a movement pattern that can reduce external knee
moments and the resultant quadriceps activation may also
have implications in the treatment and prevention of several
other knee pathologic conditions. For example, it has been
shown that increased quadriceps strength (force) increases
the rate of cartilage wear over an 18-month period in those
with malaligned knees and laxity in the knee joint (32). This

2422 Journal of Strength and Conditioning Research

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may be because of the combination of compressive and shear
forces placed on the knee with quadriceps contraction when
the knee is misaligned (33), as it has been shown that shear
stresses are highly detrimental to cartilage health (19,38).
Also, training a movement pattern that decreases quadriceps
force could also lead to smaller patellofemoral compressive
forces, especially at larger angles of knee flexion, because this
would decrease the forces in the quadriceps and patellar
tendons (7,8). Therefore, using the CBS to train a pattern of
movement that reduces the external knee moment and the
resultant quadriceps activation may also be beneficial in
prevention and treatment of knee osteoarthritis (OA) and
patellofemoral joint pain.
It has been suggested that increased GM activation during
any hip extension movement would lead to more precise
control of the femur and less stress on the hip joint (21,22).
More specifically, a weakness in the GM results in increased
anterior hip joint forces during hip extension (21), which
could lead to clinical conditions such as acetabular labrum
tears and eventually hip OA. Because it has been discovered
that the majority of hip OA cases have the cartilage wear
occurring on the anterior surface of the acetabulum (25), it
can be suggested that the CBS could be useful in increasing
the activation of the GM during concentric hip extension
movements. This could help in decreasing the anteriorly
directed hip joint force and reduce the stress on the diseased
part of the hip joint in those with hip OA on the anterior
surface of the acetabulum. However, finding other ways to
increase the activation of the GM during eccentric
contraction is warranted, because the CBS did not increase
total eccentric GM activity during the squat.
The CBS also altered the joint ROM at the knee and the hip
as compared with the RS. The differences in the joint ROM
between the 2 squat conditions were small as there was
approximately 3.5° less flexion at the hip and 1.6° more
flexion at the knee in the CBS. Although this is a small
absolute change in angles, the effect sizes for these 2 com-
parisons were relatively strong, especially at the hip joint
(effect size of 0.62). This is because all the subjects had same
small changes in joint angles with the 2 different squat
conditions, and this may be related to the fact that the CBS
also had decreased peak (%MVIC) and total (IEMG) RSF
activation. During the squat movement, the RSF eccentrically
lengthens by an extremely small amount (,2%); therefore,
one could characterize its role as being isometric in the
dissipation of knee extensor torque (30). Because neural drive
to the muscle is smaller in the CBS as compared with that in
the RS, the RSF muscle would be less ‘‘stiff’’ in the CBS,
which would produce less hip flexion and allow for more
knee flexion in the CBS as compared with the RS. The origin
of the RSF muscle on the anterior-inferior iliac spine could
also result in an anterior pelvic tilt during the squat
movement if this muscle has an increased neural drive and
was not allowed to eccentrically lengthen (as would be the
case in the RS). This anterior pelvic tilt would appear as an
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increase in hip flexion but would most likely also increase the
lordotic curvature in the lumbar spine. Because increased
lordosis (or spinal extension) has been shown to increase the
contact forces in the facet joints at L4-5 (34), it can be
hypothesized that reinforcing a movement pattern with
increased RSF activation may increase the loading of the
facet joints. In those with greatly reduced neural drive to the
hip extensors, this could lead to facet joint arthritis and
perhaps even spondilolisis and spondylolisthesis. However,
this is strictly speculation because the curvature of the lumbar
spine was not measured in this work. Therefore, future
research should examine the effect of a CBS technique on the
sagittal plane stability of the pelvis and lumbar spine during
the squat.
Although it has been suggested that a more hip-dominant
and less knee-dominant pattern of movement is beneficial, it
should be noted that there are still relatively large quadriceps
contractions even during the CBS (.50% MVIC). Therefore,
the CBS does not completely unload the knee extensors, it
simply shifts some of the loading onto the much larger hip
extensors. The results of this study also suggest that if the goal
of training is to strengthen the knee extensors in a weight-
bearing closed chain exercise, positioning the mass more
posteriorly (as was done in the RS) would be beneficial.
There were also sex differences in squat biomechanics
across both conditions. The female subjects had decreased
external hip loading (peak hip moment and concentric and
eccentric hip joint work) and increased peak hamstring
activity. It appears that the female subjects in this study adopt
a less hip-dominant movement pattern that preferentially
activates the 2 joint hamstrings rather than the 1 joint GM
to overcome the much smaller (as compared with the male
subjects) external hip moment created during the squat. This
result is supported by the increased rate of noncontact ACL
injury in female athletes (2,13). It can be hypothesized that
this squat pattern observed in the female subjects may lack
the frontal and transverse plane control of the femur that
comes with activation of the large, proximally located gluteal
muscles because this muscle is not needed to control the
smaller external hip moment. This also results in a compen-
satory increase in hamstring activity, which could help
decrease the anterior translation of the tibia and help relieve
some of the stress on the ACL. However, if this were true,
one would also expect decreased GM activation in the female
subjects as compared with the male subjects, which we did
not find. These results also contradict those of Youdas et al.
(41), where it was found that female subjects had more
quadriceps activation and less hamstring activation than did
male subjects during single-limb squatting. These conflicting
results indicate that the sex differences in movement pattern
biomechanics are complex and require a much more
thorough investigation.
The drawback of the CBS is that the amount of mass that
can be used to counterbalance is limited by the amount of
weight the shoulders can support through the 90° of flexion.
VOLUME 26 | NUMBER 9 | SEPTEMBER 2012 | 2423
 Biomechanics and a Counterbalanced Squat
This would also limit the ability to overload the squat pattern
using the CBS and future research should examine whether
it is possible to produce a training effect using the CBS. A CBS
may also be contraindicated for those with certain shoulder or
spine pathologic conditions. For example, placing more mass
anteriorly could increase the moment on the lumbar spine
and therefore, examining the ‘‘costs’’ of this exercise on other
joints is warranted.
Perhaps the best use of a CBS technique would be in the
initial stages of a training program to establish a more hip-
dominant and less knee-dominant pattern of movement
before progressing to more complicated movements. It could
also be used as a warm-up or movement preparation routine
to help establish a more hip-dominant pattern before
performing other movements. It should also be pointed out
that this study simply investigated the differences between
2 different squat techniques. Future research is needed to
examine both the long-term and short-term training effects
of using CBS movements to determine whether they have
the ability to alter the mechanics of a subject’s natural
movement patterns.
PRACTICAL APPLICATIONS
If the goal of a squat training program is to increase the
dominance of the hip extensors in producing a squat move-
ment, there should be an attempt to increase the mass placed
anteriorly. However, if the goal of a squat training program is
to strengthen the knee extensors, there should be an attempt
to increase the mass placed posteriorly.
ACKNOWLEDGMENTS
The authors would like to thank their graduate students
(Melinda Pittman, Yasuo Sakurai, and Lisa Wilson) for all of
their help with data collection, processing, and organization.
There was no funding received for this work.
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