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ABSTRACT
ESCAMILLA, R. F., N. ZHENG, R. IMAMURA, T. D. MACLEOD, W. B. EDWARDS, A. HRELJAC, G. S. FLEISIG, K. E. WILK,
C. T. MOORMAN, and J. R. ANDREWS. Cruciate Ligament Force during the Wall Squat and the One-Leg Squat. Med. Sci. Sports
Exerc., Vol. 41, No. 2, pp. 408-417, 2009. Purpose: To compare cruciate ligament forces during wall squat and one-leg squat
exercises. Methods: Eighteen subjects performed the wall squat with feet closer to the wall (wall squat short), the wall squat with feet
farther from the wall (wall squat long), and the one-leg squat. EMG, force, and kinematic variables were input into a biomechanical
model using optimization. A three-factor repeated-measure ANOVA (P < 0.05) with planned comparisons was used. Results: Mean
posterior cruciate ligament (PCL) forces were significantly greater in 1) wall squat long compared with wall squat short (0-800 knee
angles) and one-leg squat (00-900 knee angles); 2) wall squat short compared with one-leg squat between 00-200 and 900 knee angles;
3) wall squat long compared with wall squat short (70-00 knee angles) and one-leg squat (900-600 and 200-00 knee angles); and 4)
wall squat short compared with one-leg squat between 90'-70' and 00 knee angles. Peak PCL force magnitudes occurred between 800
and 900 knee angles and were 723 + 127 N for wall squat long, 786 197 N for wall squat short, and 414 133 N for one-leg squat.
Anterior cruciate ligament (ACL) forces during one-leg squat occurred between 00 and 400 knee angles, with a peak magnitude of 59
52 N at 30' knee angle. Quadriceps force ranged approximately between 30 and 720 N, whereas hamstring force ranged approximately
between 15 and 190 N. Conclusions: Throughout the 00-900 knee angles, the wall squat long generally exhibited significantly greater
PCL forces compared with the wall squat short and one-leg squat. PCL forces were similar between the wall squat short and the one-leg
squat. ACL forces were generated only in the one-leg squat. All exercises appear to load the ACL and the PCL within a safe range in
healthy individuals. Key Words: BIOMECHANICS, KINETICS, CLOSED CHAIN EXERCISES, KNEE
408
was positioned between the wall and the subject to minimize friction as the subject slid down and up the wall. The
stance width (distance between inside heels) was 32 + 6 cm
for males and 28 + 7 cm for females, and the foot angle
was approximately 00 (feet pointing approximately straight
ahead), and both stance and foot angle were according to
subject preference.
The wall squat was performed with two technique variations, wall squat long (Fig. i) and wall squat short (Fig. 2).
The foot position relative to the wall for the wall squat long
was determined using a heel-to-wall distance that resulted
in the legs being approximately vertical and the knees positioned above the ankles when the thighs were parallel with
the ground (Fig. 1), which is commonly recommended by
clinicians and trainers. The average heel-to-wall distance for
the wall squat long was 45 3 cm for males and 41 3 cm
for females. The heel-to-wall distance for the wall squat
short was one half the distance of the heel-to-wall distance
for the wall squat long. The shorter heel-to-wall distance for
the wall squat short resulted in the anterior surface of the
knee moving beyond the distal end of the toes 9 -2 cm at
the lowest position of the wall squat short (Fig. 2).
METHODS
Subjects
Eighteen healthy individuals (nine males and nine
females) without a history of cruciate ligament pathology
participated with an average age, mass, and height of 29 +
7 yr, 77 + 9 kg, and 177 6 cm, respectively, for males,
Exercise Description
Wall squat (Figs. 1 and 2). The wall squat began with
the right foot on a force platform and their left foot on the
ground, both knees fully extended (00 knee angle), the back
flat against the wall, and a dumbbell weight held in both
hands with the arms straight and at the subject's side. From
this position, the subject slowly flexed both knees and
squatted down until the thighs were approximately parallel
to the ground with the knees flexed approximately 90'1100, and in a continuous motion the subject returned back
to the starting position. A metronome was used to help ensure that the knees flexed and extended at approximately
One-leg squat. The one-leg squat started with the subject standing on one leg with the right foot on a force
platform, the right knee fully extended, the left knee bent
FIGURE I
_71
Data Collection
Each subject came in for a pretest I wk before the testing session. The experimental protocol was reviewed, the
subject was given the opportunity to practice the one-leg
squat and wall squat exercises, and each subject's heel-towall distances for the wall squat short and wall squat long
were determined. In addition, to nonnalize intensity between the wall squat and the one-leg squat exercises, each
subject's 12 RM was determined. To determine the weight
used for the wall squat short and long, each subject used
their 12 RM weight while performing the wall squat using a
heel-to-wall distance that was halfway between the heel-towall distances for the wall squat short and wall squat long,
and this weight was used for both the wall squat short and
the wall squat long during the testing session. The mean
total dumbbell mass used was 56 + 9 kg for males and 36 +
8 kg for females for the wall squat short and wall squat long
410
FIGURE 2 Wall squat with feet closer to wall (wall squat short).
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performance motion analysis system (Vicon-Peak Performance Technologies, Inc., Englewood, CO) was used to collect 60-Hz video data. Force data were collected at 960 Hz
using a force platform (Model OR6-6-2000; Advanced Mechanical Technologies, Inc.). EMG data were collected at
960 Hz using a Noraxon Myosystem unit (Noraxon USA,
Inc., Scottsdale, AZ). The EMG amplifier bandwidth frequency was 10-500 Hz. Video, EMG, and force data were
electronically synchronized and simultaneously collected as
each subject performed in a randomized manner one set of
three continuous repetitions (trials) during the wall squat
short, wall squat long, and one-leg squat.
After completing all exercise trials, EMG data were
collected during maximum voluntary isometric contractions
(MVIC) to normalize the EMG data collected during each
exercise (11). The MVIC for the rectus femoris, vastus
lateralis, and vastus medialis were collected in a seated
position at 90' knee and hip flexion with a maximum effort knee extension. The MVIC for the lateral and the
medial hamstrings were collected in a seated position at
90' knee and hip flexion with a maximum effort knee
flexion. MVIC for the gastrocnemius was collected during
a maximum effort standing one-leg toe raise with the
ankle positioned approximately halfway between neutral
and full plantarflexion. Two 5-s trials were randomly collected for each MVIC.
Data Reduction
Video images for each marker were tracked and digitized
in three-dimensional space with peak performance software.
Ankle, knee, and hip joint centers were mathematically
determined using the external markers and appropriate
equations as previously described (11). Testing of the
Biomechanical Model
As previously described (11,41), a biomechanical model
of the knee (Figs. 4 and 5) was used to continuously estimate cruciate ligament forces throughout a 900 knee range
of motion during the knee flexing (squat descent) phase
(00-900) and the knee extending (squat ascent) phase (900.
0') of the lunge. Resultant force and torque equilibrium
equations were calculated using the inverse dynamics and
the biomechanical knee model (11,41). Anteroposterior
shear forces in the knee were calculated and adjusted to
ligament orientations to estimate ACL or PCL forces (16).
Moment arms of muscle forces and angles for the line of
action for the muscles and the cruciate ligaments were expressed as polynomial functions of knee angle using data
from Herzog and Read (16). Knee torques from cruciate
and collateral ligament forces and bony contact were assumed to be negligible as were forces and torques out of
the sagittal plane.
Quadriceps, hamstrings, and gastrocnemius muscle
forces were estimated as previously described (11,41). Because the accuracy of estimating muscle forces depends
on accurate estimations of a muscle's physiological crosssectional area (PCSA), maximum voluntary contraction
force per unit PCSA, and the EMG-force relationship, resultant force and torque equilibrium equations may not be
satisfied. Therefore, each muscle force FJi(,) was modified
by the following equation at each knee angle:
F,,,()
cjk1k,,iAio,,,,(i) 1EMGi/MVICi].
weight factor c was to adjust the final muscle force calculation. The bounds on c were set between 0.5 and 1.5.
The torques predicted by the EMG driven model matched
well (<2%) with the torques generated from the inverse
dynamics.
Data Analysis
RESULTS
Mean cruciate ligament force curves are shown in
Figure 6. Main effect differences were identified among
the three squat types (P < 0.001), between the two squat
phases (P < 0.001), and among the 10 knee angles (P <
0.001). When examined at each knee angle, a significant
squat type by squat phase interaction was identified at 0'
(P = 0.039), 10 (P = 0.002), 20 (P = 0.003), 300 (P
concentric
kv = C - (C - 1)(b + (a/Fo)v)/(b - v)
eccentric,
-)2
i)2
i=1i=
subject to Clow <Ci < Chi,h, where Clow and Cihig.h are the
lower and the upper limits for ci, and k is a constant. The
412
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1000
o
800
6400
"400
0200
0
U<-200
0
20
40
60
80
1O0
---
80
Sqiuat Ascent (Knee Extending)
Squat Short
Wall Squat Long
One Leg Squat
FIGURE 6-Mean (SD) cruciate ligament force during the one-leg squat and wall squat.
for the wall squat long, 786 197 N for the wall squat
short, and 414 133 N for the one-leg squat. ACL forces,
which were generated only during the one-leg squat (31-59
N range), occurred between 00 and 400 knee angles during
the squat descent and at 0' knee angle during the squat
ascent. The mean peak ACL force magnitude during the
one-leg squat was 59 52 N and occurred at 300 knee angle
during the squat descent.
Significant differences (P < 0.05) in cruciate ligament
force at specified knee angles between the descent and the
ascent phases of each squat exercise are shown in Table 1.
Mean PCL force was significantly greater in the ascent
phase compared with the descent phase between 600 and
800 knee angles for the wall squat long, 700-90' knee
TABLE 1. Mean SD cruciate ligament forces (N) among the three squat types (wall squat long, wall squat short, and one-leg squat) and between the two squat phases (squat decent
and squat ascent) as a function of knee angle.
Knee Angles for Descent Phase
0.
100
200
30
40*
50D
600
70*
800
900
Knee angles for ascent phase
90,
800
70
600
500
40o
300
20'
100
00
+ 205
One-Leg Squat
(OLS)
-31 52
135
124
121
122
133*
136*
149'
150
243
143
100
109
157
231
324
439
578
140
131
100
77
70
81
101*
129*
158*
-36
-51
-59
-22
64
160
227
326
386
723 127
757 185*
714 181 *
542 144*
408 137
355 120
363 141
436 180
539 223
529 249
786
702
529
366
267
223
206
222
253
274
197*
200*
+ 177*
146
141
174
158
139
155
178
414 133
391 169
368 157*
374 178*
329 172*
266 - 159*
231 132*
209 142*
88 130
-37 146
54
77*
52*
66*
93*
97*
81*
118
121
WSL > OLS (P< 0.001); WSS > OLS (P< 0.001)
WSL > OLS (P< 0.001); WSS > OLS (P<0.001)
WSL > WSS (P< 0.001); WSL > OLS (P < 0.001); WSS > OLS (P 0.035)
WSL > WSS (P< 0.001); WSL > OLS (P= 0.002)
WSL > WSS (P<0.001)
WSL > WSS (P = 0.020)
WSL > WSS (P = 0.007)
WSL > WSS (P<0.001); WSL > OLS (P= 0.005)
WSL > WSS (P< 0.001); WSL > OLS (P< 0.001)
WSL > WSS (P= 0.003); WSL > OLS (P< 0,001); WSS > OLS (P< 0.001)
ACL forces are listed as negative values, and PCL forces are listed as positive values. An asterisk (0) implies that there is a significant difference (P < 0.05) in cruciate ligament force at
the specified knee angle between the squat descent and the squat ascent phases of a squat exercise.
413
TABLE 2. Mean + SD quadriceps and hamstrings force values during wall squat and one-leg squat exercises.
Ouadriceps Force (N)
Knee Angles for Descent Phase
00
10
200
30o
40
500
60'
70o
800
900
60o
500
40o
300
20o
100
00
63
83
108
150
209
290
384
478
502
419
57
68
88
114
145
174
190
203
171
158
31
53
84
116
164
235
318
408
486
559
29
51
74
83
98
123
145
155
156
159
505
475
684
632
499
358
263
197
139
93
151
145
196
227
217
161
110
86
62
48
595
705
717
643
525
403
304
221
146
86
205
240
286
260
217
175
139
102
73
51
angles for the wall squat short, and 20'-700 knee angles for
the one-leg squat. Descriptive data of mean quadriceps and
hamstrings force values during wall squat and one-leg squat
exercises are shown in Table 2. Quadriceps force ranged
approximately between 30 and 720 N and generally increased with knee flexion, whereas hamstring force ranged
approximately between 15 and 190 N. At each knee angle,
quadriceps and hamstrings forces were generally greater
during the ascent compared with the descent.
DISCUSSION
It is not well understood what PCL or ACL force magnitudes become injurious to the healthy or reconstructed ACL
and PCL. In healthy adults, the ultimate strength of the
ACL and PCL is approximately 2000 N (36) and 4000 N
(27), respectively, although these values depend on age and
anatomical factors. Therefore, the ACL and the PCL loads
generated during the one-leg squat and the wall squat
exercises appear to be well within a safe limit for the
healthy ACL and PCL. The reconstructed ACL and PCL
have similar ultimate strengths compared with the healthy
ACL or PCL, although these values can change considerably depending on graft type and donor characteristics
(e.g., autograft vs allograft; patellar tendon vs hamstrings
graft) (4,28). However, the healing graft site may be injured
with considerably less force compared with the ultimate
strength of the graft, although it is not well understood how
much force to the graft site is too much and how soon force
can be applied after reconstruction. Therefore, the mean
peak PCL forces of approximately 400 N during the one-leg
squat and approximately 750 N during the wall squat exercises may be problematic early after PCL reconstruction
when the graft site is still healing. Moreover, during PCL
reconstruction, at the same relative intensity, it may be appropriate to use the one-leg squat before wall squat exer-
414
Hamstrings (N)
One-Leg Squat
50 50
63 59
90 64
145 84
253
357
542
668
139
160
181
172
645 178
593 168
450
469
570
594
154
144
160
157
548 132
442 121
344 98
253 78
161 75
97 83
11
19
19
22
25
21
21
19
16
13
15
9
10
+ 24
32
17
18
16
12
9
9
21
24
38
28
26
27
31
33
+ 36
+ 48
53
60
55
49
45
42
40
40
39
44
35
36
35
34
31
29
23
18
21
15
24
23
21
22
20
+ 19
+ 13
8
12
32
49
63
54
49
47
50
55
61
66
35
41
40
39
38
39
40
+ 38
37
40
One-Leg Squat
47
40
39
51
59
61
61
50
47
56
97
81
97
132
152
166
182
192
178
149
29
28
29
24
30
33
33
33
25
26
57
51
51
60
65
72
82
100
112
112
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Biofeedback. Baltimore: Williams and Wilkins; 1980. p. 79-86.
3. Beynnon BD, Johnson RJ, Fleming BC, Stankewich CJ, Renstrom
PA, Nichols CE. The strain behavior of the anterior cruciate ligament during squatting and active flexion-extension. A comparison
of an open and a closed kinetic chain exercise. Am J Sports Med.
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COPYRIGHT INFORMATION
TITLE: Cruciate Ligament Force during the Wall Squat and the
One-Leg Squat
SOURCE: Med Sci Sports Exercise 41 no2 F 2009
The magazine publisher is the copyright holder of this article and it
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