The Role of Compound and Power Lifts in Physical Therapy

By Dominic Violi CSCS, SPT
   The major compound weightlifting movements, with emphasis on the squat and deadlift, are a staple in the world of physical therapy due to their mirroring of functional movements performed every day. For example, rising out of a low bed involves similar concentric quadriceps and gluteal activity to that of a front squat while the lifting of a bag from the floor involves similar extension and balance motor patterns to that of a single leg deadlift.
                The squat and deadlift are both considered closed kinetic chain exercises, indicating the patient is weight bearing while moving a load. Closed kinetic chain exercises are found to significantly minimize the risk of Osteoporosis and age-related falls in the older adult,1 while maximal squat strength is specifically correlated with increased sprint speed and vertical jump heights in elite athletes.2 Due to the fact that 65% of females over the age of 75 report not being able to lift 10 pounds off the floor,3 the deadlift addresses a major functional deficit.
                From a rehabilitation standpoint, both the squat and deadlift are strong tools in the return to premorbid level of function. In a Duke University systematic review, the single-limb deadlift and single-limb squat were found to be the most effective exercise in eliciting glute med and glute max contraction as a percent MVIC.4 The deadlift was also found to be associated with a lower VAS score after 11 physical therapy visits in patients with mechanical low back pain,5 while the maximally loaded barbell squat from 0-90° knee flexion was found to produce 0 Newtons of tensile force across the ACL.6
There is a plethora of benefits that can be attained from compound movements such as the squat and deadlift from both a functional and a rehabilitative perspective. These closed kinetic chain lifts are associated with significant improvements in performance in both athletics and ADL’s, while loading of ligamentous tissue and risk of injury is minimal when performed under the supervision of a skilled physical therapist.
 
Sources:
1. Thabet AAE, Alshehri MA, Helal OF, Refaat B. The impact of closed versus open kinetic chain exercises on osteoporotic femur neck and risk of fall in postmenopausal women. J Phys Ther Sci. 2017;29(9):1612-1616.
2. Wisløff U, Castagna C, Helgerud J, et al Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players British Journal of Sports Medicine 2004;38:285-288.
3. Jette AM, Branch LG. The Framingham Disability Study: II. Physical disability among the aging. Am J Public Health. 1981;71(11):1211-6.
4. Reiman, M. P., Bolgla, L. A., & Loudon, J. K. (2012). A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises. Physiotherapy theory and practice, 28(4), 257-268.
5. Aasa, B., Berglund, L., Michaelson, P., & Aasa, U. (2015). Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial. journal of orthopaedic & sports physical therapy, 45(2), 77-85.
6. Escamilla, R. F., MacLeod, T. D., Wilk, K. E., Paulos, L., & Andrews, J. R. (2012). ACL Strain and Tensile Forces for Weight Bearing and Non—Weight-Bearing Exercises After ACL Reconstruction: A Guide to Exercise Selection. journal of orthopaedic & sports physical therapy, 42(3), 208-220
By Dominic Violi CSCS, SPT