Squatting Difficulties: Causes, Symptoms, and Solutions

Questions related to difficulties in squatting?

Hello, Doctor! I would like to ask about my difficulty in squatting.
Currently, I have self-tested by trying to squat with my feet together, but I cannot keep my heels on the ground.
When I press my heels down, I immediately fall backward.
Usually, when I squat, I have to switch my feet every minute, or else they become very sore or even numb.
Additionally, standing up from a squat toilet is extremely painful.
I wonder if these issues are related.
I found some information online, and the correct term seems to be "squat difficulty," but some people refer to it as "frog leg" or "flat feet," while others say it is none of these.
However, I looked up other assessment methods for frog leg, and I can sit on a chair with my feet together at a 90-degree angle, which indicates that I do not have frog leg.
I can do this with effort, but my thighs become very sore after a while.
The only time I was diagnosed with frog leg was during my middle school entrance examination, but during my military service physical exam, the doctors usually do not examine closely due to the large number of people.
Therefore, I would like to ask the following questions:
1.
Could these symptoms qualify me for alternative service or even exemption? (I will be graduating soon.)
2.
What condition does this fall under? (I can squat with my feet together but cannot keep my heels on the ground; if I press my heels down, I fall backward.)
3.
If I want to get tested first and obtain a diagnosis to apply for a re-examination, what kind of examination should I undergo at the orthopedic department? (I have heard that each test requires different methods, and I am concerned about the potential high costs of multiple tests that I may not be able to afford.)
4.
What information should I provide to the doctor during the examination to accurately explain my situation and allow for precise assessment?
Thank you, Doctor, for patiently reading and answering my questions!

Xiu, 20~29 year old female. Ask Date: 2016/04/25

Dr. Shi Guozheng reply Orthopedics

Difficulty squatting is usually due to issues with either the hip joint or the ankle joint.
In the case of the hip joint, it may involve gluteal fibrosis (commonly known as frog leg syndrome), where the thighs cannot bend beyond 90 degrees when brought together, causing the body to lean backward when attempting to squat.
If the problem is with the ankle joint, it is often due to a tight Achilles tendon (contracture of the tendo calcaneus), making it difficult to perform dorsiflexion at the ankle, which also prevents squatting with the soles of the feet flat on the ground.
To determine which condition you have, you can visit an orthopedic specialist, who can differentiate between the two without the need for special tests.

Reply Date: 2016/04/25

More Info

Understanding squatting difficulties can be quite complex, as it involves various anatomical, physiological, and sometimes psychological factors. Based on your description, it seems you are experiencing significant challenges when attempting to squat, particularly with your heels not being able to touch the ground and the discomfort you feel in your legs. Let's break down your concerns and provide some insights.

1. Possible Causes of Squatting Difficulties:
- Anatomical Factors: Your inability to keep your heels on the ground while squatting could be related to several anatomical factors, including the structure of your feet, ankles, and knees. Flat feet (or pes planus) can lead to difficulties in maintaining balance and proper form during a squat. If you have a history of "frog legs" (a term often used to describe a specific leg positioning), it might indicate a hip or knee alignment issue.

- Muscle Tightness: Tightness in the calf muscles (gastrocnemius and soleus) can prevent your heels from staying down. Similarly, tightness in the hip flexors or quadriceps can affect your ability to squat comfortably.

- Balance and Coordination: The sensation of needing to switch legs frequently and the feeling of discomfort or numbness could indicate issues with balance or muscle fatigue. This can be exacerbated by poor squat mechanics or insufficient strength in the stabilizing muscles.

2. Symptoms and Their Implications:
- The pain and discomfort you experience when standing up from a squat, especially in a squat toilet, can be indicative of muscle fatigue or joint strain. If you feel that your legs are "very painful" or "numb," it may suggest that your muscles are not adequately conditioned for the demands of squatting or that there may be underlying issues such as nerve compression or vascular insufficiency.

3. Diagnosis and Evaluation:
- To determine the underlying cause of your squatting difficulties, it would be advisable to consult with an orthopedic specialist. They may recommend a physical examination and possibly imaging studies such as X-rays or MRIs to assess the structure of your joints and soft tissues.

- You might also benefit from a functional movement assessment, which can help identify specific weaknesses or imbalances in your body that contribute to your squatting difficulties.

4. Information to Provide to Your Doctor:
- When you visit the orthopedic specialist, be prepared to discuss your symptoms in detail. This includes:
- The specific difficulties you face when squatting (e.g., inability to keep heels down, pain, or discomfort).

- Any history of injuries or conditions that may affect your legs or feet.

- Your physical activity level and any exercises you regularly perform.

- Any previous assessments or diagnoses related to your leg or foot structure (like flat feet or "frog legs").

- The impact of your symptoms on daily activities, including any limitations you experience.

5. Potential Solutions:
- Depending on the diagnosis, treatment options may include physical therapy to improve flexibility, strength, and balance. A physical therapist can provide tailored exercises to address muscle tightness and improve your squatting mechanics.

- Orthotic devices may be recommended if flat feet are contributing to your difficulties. These can help provide better arch support and improve your overall alignment.

- Gradual conditioning through specific exercises that focus on squatting mechanics can also be beneficial. This might include practicing squats with a wider stance or using props to assist with balance.

In conclusion, your squatting difficulties may stem from a combination of anatomical, muscular, and possibly neurological factors. A thorough evaluation by a healthcare professional, particularly an orthopedic specialist, will be crucial in identifying the exact cause and developing an appropriate treatment plan. Remember, addressing these issues early can help prevent further complications and improve your overall quality of life.

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