Differences In Overhead Squat Performance Among Powerlifters And Endurance Runners With And Without Knee Pain

Powerlifters and endurance runners are both at increased risk for knee pain secondary to sport participation. Functional performance differences may exist in squat motion among power and endurance athletes with and without knee pain, but these have not yet been identified. PURPOSE: To determine: 1) functional performance differences in the overhead squat movement in powerlifters and endurance runners, and 2) whether knee pain differentially impacts overhead squat performance in each athlete group. METHODS: This was a cross-sectional study of powerlifters (N = 24; 30.8% female; age 26.7 ± 7.6 years; height 173 ± 9 cm) and endurance runners (N = 16; 37.5% female; age 37.6 ± 15.6 years; height 170 ± 11 cm). Medical history and knee pain were collected (28% and 31% of powerlifters and runners with knee pain history). An 8-camera markerless motion system (DARI Motion) recorded bodyweight overhead squat motion at full range of motion (ROM). Individual and total trunk and lower limb ROM mobility values from sagittal and frontal planes were quantified. RESULTS: Runners without knee pain history squatted deeper than powerlifters with no knee pain history (55.1 ± 7.7 cm versus 49.7 ± 9.6 cm, p < .05). Conversely, powerlifters with knee pain history outperformed runners with knee pain history with squat depth by 21% (50.0 ± 11.7 cm versus 39.6 ± 7.8 cm, p < .05). Runners with no knee pain history produced greater total mobility (combined hip, knee, ankle ROM) than powerlifters with no knee pain history (left side: 298° ± 29° versus 273° ± 31°, p < .05; right side: 296° ±33° versus 277 ° ±31°, p < .05). Powerlifters with knee pain history had greater total mobility than runners with knee pain history (left side: 287° ±32° versus 261° ± 18 °, p < .05; right side: 287° ± 34° versus 256 ° ± 22°, p < .05). CONCLUSIONS: Knee pain history is related to worse squat performance in both powerlifters and runners, and this motion could be incorporated into clinical assessment for therapy outcome tracking. Importantly, runners with history of knee pain had the lowest squat functional ROM than any other group. Powerlifters routinely train for squat strength even with pain, and resistance squat training may be a therapeutic target to help runners who experience knee pain from losing functional range of motion. Supported by: UF Strategic Funding Initiative, UF Sports and Collaborative