HUMAN MOVEMENT (ISSN 1899-1955)

2022; 23(2): 97–103

COMPARING THE KINEMATICS OF BACK SQUATS PERFORMED

WITH DIFFERENT HEEL ELEVATIONS

© Wroclaw University of Health and Sport Sciences

original paper
doi: https://doi.org/10.5114/hm.2021.106164

PEDRO HENRIQUE MARTINS MONTEIRO1, ALEXANDRE JEHAN MARCORI1,

VITOR BERTOLI NASCIMENTO2, Anderson Nascimento Guimarães2,
VICTOR HUGO ALVES OKAZAKI2
1
University of São Paulo, São Paulo, Brazil
2
State University of Londrina, Londrina, Brazil

Abstract
Purpose. Back squat (BS) is a popular exercise owing to its capacity to develop lower limb strength. During BS, trunk incli­
nation and knee range of motion (RoM) are relevant aspects of a proper technique, and these movement kinematics parameters
can be positively altered with official weightlifting shoes lifting the heel 13 mm above the ground. Wedges are a low-cost
alternative to lifting the heel to different heights, but movement kinematics adaptations with higher elevations, above 25 mm,
are not well described in the literature. Thus, we compared the effect of different heights of heel wedges on BS kinematics.
Methods. Fifteen experienced recreational weightlifters (22 ± 5.4 years; 83 ± 11 kg; 179 ± 6 cm; 5 ± 2.1 years of BS
experience) were conveniently selected. Three randomized conditions were applied: barefoot (B), 25-mm (W25), and 50-mm
wedges (W50). BS movement was assessed by kinematic analysis with an optoelectronic camera system.
Results. After ANOVA, the post-hoc indicated significant RoM differences in reducing trunk (F = 27.27; p < 0.01) and
increasing knee (F = 16.87; p < 0.01) flexions between conditions. Post-hoc analysis verified decreasing trunk inclination
(B > W25 > W50; p < 0.05) and increasing knee (B < W25 < W50; p < 0.05) RoM with increasing wedge height.
Conclusions. Higher wedges allowed positive adaptations by promoting a more upright trunk position and greater BS depth.
Using a heel wedge can be a low-cost and viable strategy to optimize BS technique in a variety of training settings and contexts.
Key words: resistance training, range of motion, injury prevention, biomechanics, wedge

Introduction ance training programs mainly owing to increased

time under tension: a significant variable that aids mus­
Back squat is a major exercise used in resistance cle gains [7]. Recent experimental evidence showed
training [1] and several sports modalities. An organ­ that performing a full squat is superior to half squat
ized and systematic practice of back squat may pro­ training regarding gluteus maximus and adductor
mote lower limb strength and power gains [2], hyper­ hypertrophy [3]. Another issue that deserves attention
trophy [3], assistance in rehabilitation processes [4], in back squat kinematics is the lower limb and lumbar
and maintenance of elderly strength and functionality spine joints overload. For instance, these areas are re­
[5]. Given the enhanced applicability of this exercise, lated to increased injury risk during a back squat,
performing it properly is essential for different goals especially when performing with inappropriate form
and sports. Within this context, range of motion (RoM) or heavy loads [8–10]. This increases muscle torque
is an aspect of performance that needs to be cautiously and shear forces on the lumbar spine, which interact
considered during back squats. Besides being propor­ better with compressive forces that shear [1]. There­
tionally related to different gluteus maximus activa­ fore, proper movement technique is crucial.
tion [6] during back squat, higher RoMs on key joints Previous research has shown that adequate tech­
(e.g. knee) also promote better adaptations in resist­ nique is related to the distance between feet, appropri­

Correspondence address: Pedro Henrique Martins Monteiro, University of São Paulo, Av. Professor Mello Moraes, 65 – Vila
Universitaria, São Paulo – SP, 05508-030, Brazil, e-mail: pedrohm96@hotmail.com

Received: September 21, 2020

Accepted for publication: December 4, 2020

Citation: Monteiro PHM, Marcori AJ, Nascimento VB, Guimarães AN, Okazaki VHA. Comparing the kinematics of back
squats performed with different heel elevations. Hum Mov. 2022;23(2):97–103; doi: https://doi.org/10.5114/hm.2021.106164.
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P. Monteiro et al., Effect of different wedges on back squat kinematics

ated shoes wearing, and vertical trunk position (to squatting is an adequate strategy to optimize biome­
mention a few) [1], since these points decrease shear chanical movement parameters. This study aimed to
forces at lower limbs and lumbar spine [1]. To improve describe the modifications that heel wedges can pro­
some of these aspects, it has been documented that mote in back squat kinematics. We analysed the kine­
using proper weightlifting shoes while back squat­ matics of the lower limb joints (ankle, knee, and hip)
ting can increase knee RoM [11]. Weightlifting shoes and trunk motion in 3 back squat conditions: barefoot
are designed with a 13-mm elevation between the fore­ (B), 25-mm wedge (W25), and 50-mm wedge (W50).
foot and the heel; this parameter has been defined by We set 50 mm as this was the height limit to lift the
the International Weightlifting Federation and the heel with comfort. Considering previous evidence of
value is sufficient to promote a more vertical trunk po­ load influence in knee and hip kinematics during back
sition, greater RoM in the knee joint, and better sta­ squat [18], and that load may promote fatigue (which
bility during back squat [12, 13]. While these inves­ is a potentially confounding effect in our results), it was
tigations suggest technical positive adaptations with decided that the back squat would be implemented
weightlifting shoes, more recent research has been un­ without load in this study. Thus, our study aimed to
able to verify benefits of squatting with raised heel, assess maximal RoM without external interferences
since similar kinematics were observed when partici­ and with minimal variation of technique across trials.
pants squatted barefoot [14, 15]. Additionally, general We hypothesized that a higher heel elevation would
practitioners include other training methods on regular (H1) decrease anterior trunk inclination and (H2) in­
routines, like post-activation potential, being more crease knee and ankle RoM. The results can contribute
practical with using running shoes than weightlifting to better understanding the influence of an elevated
shoes. Hence, an alternative approach to lifting the heel heel during back squat kinematics, aiding an adequate
during this exercise can be an adapted wedge with­ prescription that can be considered in different con­
out a standard height, such as iron plates or a squared texts by coaches, athletes, resistance training profes­
wooden block. With this approach, it would be pos­ sionals, and practitioners.
sible to evaluate the effects of squatting with the heel
elevated above the 13-mm height provided by weight­ Material and methods
lifting shoes. For instance, Charlton et al. [16] described
positive outcomes (e.g. less trunk flexion) with a 25-mm Participants
wooden block beneath the heel during back squat in
trained male subjects. In turn, Lee et al. [14] did not The sample size was calculated by G*Power 3.1
verify modifications in the knee, thoracic, or lumbar (Franz Faul, Germany) for a repeated-measures ANOVA
joint kinematics when comparing back squat per­ within factors (1 group × 3 measures), considering
formed barefoot vs. with 33-mm elevated heels. It is a moderate effect size according to Cohen (d = 0.5),
important to highlight that Lee et al. [14] investigated error probability = 0.05, and power (1 – ) = 0.8,
recreational weightlifters, while Charlton et al. [16] following the recommendations by Faul et al. [19]. On
assessed trained participants. Considering that most the basis of these parameters, a minimum of 9 sub­
skilled participants present a gold standard technique jects was estimated.
[17], investigating this population is a way to attribute A total of 15 men, resistance-trained adults (22 ±
kinematic differences by using wedges. 5.4 years of age, 83 ± 11 kg, 179 ± 6 cm), were conveni­
In the previous evidence, the literature remains ently selected for this study. They had been injury-
inconclusive regarding the benefits of squatting with free in the lower limbs and trunk for at least 6 months
the heel elevated above 25 mm, and no investigation up before the research. All subjects had a minimum ex­
to date has analysed the modifications of back squat perience with back squat exercise of 3 years (5 ± 2.1
kinematics using wedges higher than those. Thus, to years on average), performing it at least once a week
understand the greater height that promotes positive in their training routine.
adaptations, without an uncomfortable heel elevation,
can be useful for practitioners to apply wedges in the Procedures
height range in daily practice. Furthermore, frontal
plane analysis of the hip joint (adduction and abduc­ The participants performed the exercise shirtless,
tion movements) is lacking in the previous research. barefoot, and with standardized shorts. We positioned
Given this scenario, this topic still needs further re­ a wooden block below the participants’ heel (on cal­
search to clarify whether lifting the heel while back caneus) to provide the elevations during both experi­

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A B Figure 1. Wooden block

representation (A) and sagittal
plane angle interpretations (B)

mental conditions (W25 and W50), as represented in Motion analysis

Figure 1A. For this study, we made 2 wooden blocks
that presented the same measures to support calca­ Movement kinematics were assessed by 7 optoe­
neus between the different heights. For kinematic anal­ lectronic cameras (MX-T-Series) of the Vicon System
yses, reflective markers were positioned on the sub­ (v. 1.8.5, Vicon Motion System, Oxford, UK) with a sam­
ject’s skin, and the camera manufacturer’s calibration pling frequency of 100 Hz. The cameras were posi­
procedure was followed. Next, a warm-up set (10 tioned in a way that at least 2 of them visualized the
repetitions) in each experimental condition (B, W25, reflective markers throughout the movement, avoiding
and W50) was performed, followed by rate of perceived gaps during data collection and ensuring accuracy.
exertion scale answer to ensure that the participants A total of 35 reflective markers were positioned in the
were not fatigued. This procedure was in line with subject’s body, in accordance with the Vicon Plug-in
the literature recommendations of Borg scale, and all Gait Full Body model. The following variables were
subjects had previous experience with the scale. On analysed: maximum, minimum, and RoM of relative
resting 2 minutes after the warm-up, the participants angles of hip flexion and abduction, knee flexion, and
performed 3 sets of 6 repetitions in each experimental dorsiflexion, as well as maximum, minimum, and RoM
condition (B, W25, and W50), and rate of perceived of absolute angles of trunk inclination. Angles in the
exertion scale was measured after each series. The sagittal plane were interpreted as presented in Fig­
subjects were instructed to perform the back squat ure 1B. The hip abduction angle was interpreted with
with full RoM in all conditions. Another 2-minute sit­ 180° in the anatomic position, with decreasing angles
ting interval between sets was allowed. A light wood­ during abduction and increasing angles during adduc­
en stick (Figure 1B) was used to replace the iron bar tion. The right body side was analysed.
during the back squat to simulate movement kinemat­ All variables (minimum, maximum, and RoM) were
ics without additional overload. The condition orders acquired in each repetition, and then averaged for each
were randomized among the subjects, and a researcher set. Finally, the average of the 3 sets in each condition
was responsible for replacing the wedge when neces­ was used for statistical purposes. Repetition begin­
sary. Movement speed was controlled by a digital met­ ning was determined when the spatial position of the
ronome (2 seconds eccentric, 1 second concentric), and C7 marker reached a reduction greater than 4 mm from
the first warm-up series served as a familiarization one frame to another (eccentric phase), while repeti­
protocol for the metronome tempo. A black dot fixed tion ending was determined when the same marker
at the eye level was positioned on the wall (2 m away) reached the highest spatial value (concentric phase).
to standardize the visual focus. The deepest point of the squat movement was deter­
mined on the basis of the minimum value of the knee
flexion angle.

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Data processing tional policies, has followed the tenets of the Declara­
tion of Helsinki, and has been approved by the State
Data were processed by using Vicon Nexus (v. 1.8.5, University of Londrina Ethics Committee.
Vicon Motion system, Oxford, UK). The time series of
the joint angles were filtered with a low-pass recursive Informed consent
digital Butterworth filter (4th order, a cut-off frequency Informed consent has been obtained from all indi­
of 3 Hz). The filtering parameters were determined viduals included in this study.
after spectral and residual analysis of the signal [20].
Filtering and analysis, as well as the calculation of the Results
variables, were executed by a personalized MATLAB
routine (2017a, MathWorks, USA). The results showed significant differences in the
trunk, knee, and ankle RoM between conditions (Ta­
Statistical analyses ble 1). Post-hoc comparisons verified decreased RoM
in the absolute trunk inclination with increasing wedge
Normality and sphericity were verified by Shapiro- height (B > W25 > W50; p < 0.05). RoM in knee flex­
Wilk’s and Mauchly’s test, respectively. Mean and ion increased as the wedges were higher (B < W25 <
standard deviation were used to describe the angles and W50; p < 0.05), while for dorsiflexion, RoM was only
joint RoMs, while repeated-measures ANOVA com­ significantly increased between the W25 and the W50
pared the RoM between the different heel elevations conditions (p < 0.05). When comparing B against W50,
in each joint. Bonferroni’s post-hoc test was performed effect sizes indicated a strong effect for absolute trunk
when necessary. Effect sizes were calculated for RoM (d = 1.97), knee (d = 1.23), and ankle (d = 4.68) RoM.
in a paired measure design (B vs. W50), considering No significant differences were verified in the results
the correlation between both measures [21], and in­ of hip flexion or adduction.
terpreted in accordance with Cohen [22] in light of
recommendations by Rhea [23] for trained subjects. Discussion
All analyses were conducted with the SPSS software
(v. 21.0, IBM Statistics), and significance was set at The heel elevation height significantly affected back
p < 0.05. squat kinematics, decreasing anterior trunk inclina­
tion and increasing knee and ankle RoM. Hence, both
Ethical approval hypotheses initially raised (H1 and H2) were accepted.
The research related to human use has complied As such, elevating the heel at 25 and 50 mm can pro­
with all the relevant national regulations and institu­ duce positive adaptations in back squat kinematics,

Table 1. Range of motion, minimum and maximum displacement of joints during back squat
with different heel elevations
B W25 W50
Parameter RoM / Min–Max RoM / Min–Max RoM / Min–Max F p
(SD) (SD) (SD)
32.8 / 176.1–143.2 28.6 / 176.8–148.1 25.3 / 177.0–151.8a,b
Trunk (°) 27.27 < 0.001
(7.1 / 5.9–7.8) (7.9 / 6.0–7.8) (7.5 / 5.9–7.4)
98.6 / 170.4–71.8 97.5 / 170.0–72.5 95.9 / 170.1–74.1
Hip flexion (°) 2.67 0.107
(13.6 / 6.5–10.7) (13.1 / 7.0–10.11) (11.9 / 6.8–9.6)
19.2 / 172.9–153.7 19.9 / 173.3–153.4 19.3 / 172.7–153.4
Hip adduction (°) 1.28 0.165
(7.5 / 3.2–7.7) (6.3 / 2.7–6.9) (5.6 / 2.9–6.3)
115.1 / 175.7–60.6 121.7 / 174.3–52.6 126.2 / 173.6–47.4a,b
Knee (°) 16.87 < 0.001
(17.8 / 5.3–15.9) (15.8 / 6.8–12.5) (11.6 / 7.6–8.0)
32.3 / 93.1–60.7 36.7 / 97.9–61.2 38.2 / 103.0–64.8b
Ankle (°) 6.97 0.009
(6.5 / 3.6–4.8) (11.4 / 4.0–9.9) (11.6 / 4.0–10.4)
B – barefoot, W25 – 25-mm wedge, W50 – 50-mm wedge, RoM – range of motion
a
p < 0.05 vs. B, b p < 0.05 vs. W25

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being possibly applied in different training programs only be observable when squatting at a full depth, as
with various exercising goals. Our results corroborate half-squats do not require excessive inclination of the
previous studies in the literature, allowing to further trunk to maintain balance and perform the exercise.
understand the effect of elevating the heel during back Greater knee RoM values during a back squat with
squat execution and providing information on how elevated heels, on the other hand, seem to be a more
professionals and practitioners can use it in exercise consistent finding in the literature [12–14, 16], espe­
programs that involve back squatting. cially when participants are asked to perform maxi­
Lumbar joints are among the most injury-prone mal RoM. This result should be highlighted, as larger
areas during back squatting, excessive anterior trunk RoM increases time under tension, which is a key vari­
inclination seems to be the leading cause [8, 10]. There­ able in muscle hypertrophy protocols [26]. The in­
fore, our results reveal that elevating the heel at either creased RoM leads to superior stretching of the muscle
25 or 50 mm can promote positive adaptations in squat fibres recruited for the movement in question, which
kinematics owing to its capacity to induce a more up­ induces greater muscle activation patterns in resist­
right trunk position. Equivalent results have also been ance training exercise [27]. Thus, larger RoMs enhance
verified in resistance-trained practitioners who per­ 2 important aspects related to strength and hyper­
formed back squat with wooden blocks of 25 mm [16] trophy training: time under tension and muscle activa­
or weightlifting shoes [12, 13]. This adaptation leads tion. These adaptations, therefore, are critical to prac­
to smaller overload in the lumbar region [24] and may titioners seeking strength and muscle mass gains [28].
potentially improve the technique in novices. By squat­ In line with this evidence, it has been verified that
ting with less anterior trunk inclination, novices are squatting at a greater depth induces additional hyper­
closer to a movement pattern that is observed in expe­ trophy in the gluteus maximus and adductor muscles
rienced practitioners [17]. Indeed, the maintenance when compared with half squats (knee joint stopping
of natural lumbar lordosis curvature, achieved by an at 90° of flexion) [3]. Thus, it is safe to suggest that
upright trunk position, is related to lifting higher loads using a wedge, as implied in our research, may be
during the back squat, which suggests another posi­ a promising approach to allow a greater depth while
tive outcome of squatting with elevated heels. Practi­ back squatting.
cal applications of these results may also be found in Regarding the ankle joint, significant differences
rehabilitation programs, whereas professionals can uti­ were determined for dorsiflexion between W25 and
lize this strategy to aid patients with movement re­ W50, with increased RoM in the W50 condition. This
strictions in these joints, reducing load-related stress result can be explained by the induced plantar flexion
in the lumbar region and developing specific protocols caused by the wooden block, which altered the joint
to reach individualized goals [4]. kinematics, increasing its RoM. Furthermore, it is es­
Some previous research did not reveal adaptations sential to mention that the lack of ankle mobility can be
in trunk inclination as described earlier by elevating a factor contributing to an increase in anterior trunk
the heels [14, 15]. We believe, however, that methodo­ inclination [29]. Hence, elevating the heel with a wood­
logical differences between our and their investigations en block or iron plates could be an alternative to mo­
can account for the divergent results. For instance, Lee mentarily compensate impaired ankle mobility, in­
et al. [14] analysed women, implemented a load of 80% ducing a more upright trunk position during back
of one-repetition maximum, and did not instruct par­ squat execution. With reference to the hip joint, our
ticipants to squat as deep as possible; in turn, Whit­ results were similar to the findings by Legg et al. [12],
ting et al. [15] also analysed loaded conditions (50%, in which experienced practitioners did not present
70%, and 90% of one-repetition maximum). Consider­ RoM alterations in this joint with or without the ele­
ing that there are significant differences in kinemat­ vated heel. However, the present experiment is the first
ics between sexes [25] and that loading affects move­ to report results of the hip joint in the frontal plane.
ment kinematics [15] during back squat, we propose Adduction and abduction RoM were not different be­
that these differences might explain the distinct out­ tween the wedges and barefoot conditions, which sug­
comes between our analyses. More pressingly, the in­ gests that modifications in the heel height impact
struction not to squat as deep as possible hinders fur­ primarily on the flexion and extension movements in
ther comparisons between the experiments, especially the sagittal plane.
when considering the notion of achieving maximal To the best of our knowledge, this is the first ex­
RoMs. It could be speculated that reduced anterior periment to analyse a 50-mm heel height while back
trunk inclination promoted by a heel elevation would squatting, showing an additional benefit compared

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with the 25-mm elevation. Even though previous analy­ exercises. J Sports Med Phys Fitness. 2018;58(3):263–
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