Proper Squat Form for Women: 3 Myths for Physios
By: Sonia Gavrilova, 2nd year UofT MScPT student ∙ Estimated reading time: 10 minutes

Squat Cues You've Definitely Heard (and Probably Used)

“Keep your feet shoulder-width apart.” 

“Don’t bend your knees past 90 degrees.” 

“Keep your chest up and torso straight.” 

“Don’t lean forward too far.” 

Sound familiar? 

We've all heard these common cues and form fixes for squatting. Whether they come from colleagues, other health and fitness professionals, personal trainers, or social media personalities, many have come to treat them as the holy grail of “proper squat technique.”

And maybe we don’t want to admit it, but most of us (that means you, yes, you!) have given these same cues to our clients.

However, there's nothing necessarily wrong with that! As physiotherapists and exercise professionals, we're taught in school and in practice that technique matters, whether it's for strengthening, injury prevention, or reaching functional goals.

Technique and form can be important. What's even more important is taking the time to explore, question, and reflect on what good movement technique actually means. When strong narratives about movement exist, it's our job to challenge traditional cues and beliefs about “perfect form” so we can meet the individual needs of the client in front of us. After all, every body (not quite the same as “everybody”) is different, and every client has unique movement goals!

 

Why One-Size-Fits-All Doesn't Fit the Female Athlete

For too long, the fitness industry has been molded by rigid standards and “one-size-fits-all” approaches that overlook the complex, nuanced needs of different bodies. A black-and-white approach might feel comforting and give us quick “answers,” but the human body rarely fits such rigid ideas of right and wrong.

Now, enter the female athlete: 

She is a powerful, complex figure who embodies both strength and adaptability in ways that go beyond traditional ideas of form and function. She doesn’t just fit the mold; she recreates it and makes it her own. Her anatomy, physiology, and even the ebb and flow of her hormonal cycles influence her training, recovery, and performance. 

In his course, The Female Athlete, Antony Lo offers in-depth guidance on providing individualized, high-quality care to female clients for whom movement is a foundational part of their identity. A key part of Antony’s approach is challenging the beliefs and judgements we hold as health professionals about exercise and women’s health. The biggest shocker in his content? Learning how to be okay with being wrong. Gasp! 

Check Out Antony Lo's
Female Athlete course 

 

For all of us science kids (enjoy the Big Bang Theory reference below), being wrong can be terrifying. Don’t worry, you are definitely not alone. But it does raise the question: how can we learn and grow as practitioners if we’re never wrong? 

 

The Core of it All: Why Pelvic Anatomy Matters for Every Female Athlete

For the female athlete, a strong understanding of pelvic anatomy isn’t just an academic exercise. It’s the gateway to improving performance, reducing injury risk, and unlocking new levels of athletic potential. So, what sets the female anatomy apart, and why does it matter when it comes to improving foundational movements like the squat? 

Now, let’s shine a spotlight on… drumroll, please… THE FEMALE PELVIS!

The Pelvis is an Absolute Powerhouse

1. It provides structural support for the upper body stability during movement. 

2. It protects important organs, including the reproductive, urinary, and lower digestive organs. 

3. It has features that make it particularly suited for reproduction. For example, the female pelvis is typically wider than the male pelvis to allow for childbirth. 

4. It serves as a framework for the pelvic floor muscles (ding, ding, ding, key term!), which support the pelvic organs, help control urination and defecation, and contribute to sexual function. 

5. It's an attachment point for many muscles and ligaments, including the core muscles that stabilize the trunk and the muscles of the lower limbs. 

As we can see, the female anatomy is far from simple, as it has a variety of complex and necessary functions. 

 

So, let’s ask ourselves: why would movement technique for the female athlete be as simple as “keep your feet shoulder-width apart?” 

For a more in-depth exploration of the pelvic floor anatomy, check out this course by Antony Lo!

Check Out The Female Athlete Lite
with Antony Lo 

Why Squats? 

Squats are one of those compound movements you just can’t run away from. They're always there because they're that foundational. 

Squats mimic movements we do every day, like sitting down, standing up, and lifting objects. They're also incredibly comprehensive, since they hit multiple muscle groups, such as the quadriceps, hamstrings, glutes, and core. For the female athlete, squats can also help improve power output, sprint times, explosiveness for plyometrics, and overall lower body strength. 

This means that, whatever your client’s goals are, squats can most likely help them get there.

As they say, definitely don’t skip leg day! 

 

Who You Gonna Call? Myth Busters!

Now that we’re armed with knowledge and an open mind, let’s tackle some common myths about squat technique and the pelvic floor!

Myth #1: Heavy Squats Will Damage the Pelvic Floor

Squatting heavy has long been labelled “unladylike”. One reason is the belief that adding load will necessarily increase intra-abdominal pressure (IAP), which is thought to harm the pelvic floor. The clinical concerns usually raised are urinary or fecal incontinence and pelvic organ prolapse.

So, what exactly is IAP? 

IAP is the pressure inside the abdominal cavity. It pushes outward on the structures that surround the abdomen, including the abdominal wall, the diaphragm, and the pelvic floor muscles, fascia, and connective tissue. It isn't fixed. It rises and falls with breathing, body position, coughing, and physical activity. 

While the common belief is that heavy lifting and high-intensity exercise generate the highest IAP, the evidence doesn't quite support this. In the Female Athlete course, Antony highlights a couple studies that measured IAP during different movements. In one study, lifting 15 lbs while seated from the floor to the counter generated 47.5 to 54.6 cmH2O in IAP, while spontaneous laughing generated up to 85.5 cmH2O (O'Dell et al, 2007)!

Wait, so laughing can generate that much IAP, but a crunch only generates 12.4 - 23.8 cmH2O? 

Yes, indeed!

Even more surprising: other studies show that functional tasks, like standing up from a chair or walking, produce higher IAP than abdominal exercises that are often considered a “strain” on the pelvic floor (Weir et al, 2006; Tian et al, 2017).

A quick research spotlight: 

A 2016 study by Middlekauff and colleagues compared two groups of nulliparous women aged 18 to 35. One group did strenuous exercise like CrossFit at least three times per week. The other group was recreationally active but didn't do strenuous exercise. The researchers measured pelvic floor muscle strength and pelvic organ support before and immediately after a single workout. The non-strenuous group did a self-paced 20-minute walk, and the strenuous group did exercises like deadlifts and push presses at 80% of their 3-rep max.

Can you guess what they found?

Despite very different training histories, there was no significant difference in pelvic floor muscle strength between the two groups. Pelvic organ support did decrease slightly after exercise in both groups, which the researchers suggested may reflect muscle fatigue or connective tissue laxity. 

If regular heavy lifting were reliably damaging the pelvic floor, wouldn’t we expect the CrossFit group to show weaker pelvic floor muscles? They didn't. Keep in mind, though, that this study only included young women who hadn't given birth, so we should be cautious about applying the results to postpartum, older, or symptomatic clients.

So, what can we take from this? 

Everyone is an individual and moves their body differently! Lifting heavy weights as a woman doesn't automatically mean straining the pelvic floor. IAP is much more nuanced than that, and there are multiple factors to consider when working with your female athlete clients. 

If you’re curious to learn more about pelvic health and working with female athletes, check out this course by Antony Lo: The Female Athlete - LITE.

Myth #2: There’s a “Right” and “Wrong” Squat Depth

Remember that narrow squat width we touched on? Or that *optimal* depth? What about making sure your knees never go past your toes, or that squatting too low is dangerous? 

Many of these rules come from overgeneralization, often based on coaching traditions and research built largely around male lifters.

And if we have learned anything so far, it’s that pelvic and hip anatomy varies, between sexes and from one person to the next. So it’s worth exploring how your female clients move, examining their range and anatomy, getting curious about the sensations in their body, and finding the squat that fits them, instead of making them fit a certain squat. 

Let’s explore optimal squat depth and foot angle in relation to the infamous butt wink ;)

The butt wink gets its name because it’s like the glutes are winking at you at the bottom of the squat. It happens when the pelvis tilts posteriorly, either because of lumbar flexion or because the hip can't flex any further at the bottom of the squat. If the stance is too narrow, the pelvis may tilt earlier in the descent.

Anatomy and balance challenges on the way down can also contribute to a butt wink, so it's important to look at several factors! Under heavier loads, a butt wink may increase stress on the lower back, but this isn't always the case. To play around with the butt wink, we simply need to experiment with squat depth and foot angle. 

One way to do this is to squat all the way down, widen the legs so the feet are flat on the floor, and then “duck walk.” Shift your weight from side to side until you can lift the opposite foot, while maintaining hip external rotation. Does it look ridiculous? Yes. Will it possibly show you a more comfortable way to squat? Also yes. 

Once you find that “duck” position, simply stand up and try a few squats with your feet in the same stance. 

Do you still see a butt wink? 

If you want to learn more fun techniques to help your clients find the squat depth that is best suited to their body, check out Antony Lo’s courses here.

 

See Antony Lo's courses on Embodia Academy

 

Myth #3: Quad Dominant or Glute Dominant? But I Can’t Feel It In either! 

We've all heard that leaning forward during a squat biases the glutes, while keeping the torso upright biases the quads. There's some truth to this: changing trunk angle shifts how much of the work happens at the hip versus the knee. But you'll also hear that some people are naturally more "quad dominant" and others naturally "glute dominant". While individual differences in muscle fiber composition, strength, and activation exist, how someone moves will often matter more than any "innate" dominance.

“Feeling it” in a specific muscle isn't necessary, and not feeling it doesn't mean the muscle isn't working. Instead of your clients feeling that they are doing something wrong, try the following squat technique by Antony Lo to determine what the most comfortable trunk angle is for your female clients!

Use the steps in the previous section to help your patients find their optimal depth and foot angle. Then use a dowel, stick, or other tactile cue to help them keep the same trunk angle they had in the duck position as they come upright, like an elevator, until their knees are nearly straight. At this point, they shouldn’t be able to go any higher without feeling like they have to change their trunk’s position. 

From this starting point, experiment with different amounts of trunk flexion or extension, and see how each squat feels for your client!

Remember, small technique tweaks can help your clients hit different goals for their squat!

Now that we've busted this myth, let’s recap the key takeaway, so you can keep those squat sessions flowing!

Key Takeaways for the Perplexed Physiotherapist

If your main takeaway about squat technique is that “it depends” (my personal favourite as a physiotherapy student) and that all of this is “nuanced,” then I did my job! 

Sorry, I’ll just take a moment to pat myself on the back. 

All jokes aside, embracing uncertainty might not feel like a direct answer, but it is an answer in itself. As physiotherapists and exercise professionals, it's our job to embrace complexity and look at each client as an individual, instead of searching for an approach we tell ourselves will work for everyone.

When it comes to finding the right squat for the female athlete, make sure you: 

1. Listen to your client and ask open-ended questions to learn more about their goals, movement patterns, and the exercises that bring them fulfillment.

2. Refer to fellow experts, such as pelvic health physiotherapists or OBGYNs, when there might be a pelvic health concern. 

3. Don’t underestimate the power of technique tweaks to reduce pelvic symptoms or discomfort during exercise. Try the strategies in this blog to help your client find a pain-free squat!

4. Be aware of the stories you tell yourself about your profession, and be even more open to being wrong and growing as a professional. 

Out with the old, and in with the new!

That means out with outdated squat cues, and in with individualized squats that leave your female athlete clients feeling fulfilled. 

More Content from Antony Lo: 

• Intra Abdominal Pressure and Strength Training
• Stop Hurting Women with Exercise - Part 1
• The Female Athlete - LITE
• The Female Athlete Course - Online Edition (V2)

Pelvic Health on Embodia

Interested in expanding your knowledge and resources in the realm of pelvic health? Check out these resources on Embodia: 

• Pelvic Health Practitioner Resources on Embodia
• Resource Blog: Free Templates for Pelvic Health Practitioners
• Read this blog to find out why women in France don't pee their pants when they laugh
• Yoga as a Pelvic Health Solution
  
  

References 

Ashton-Miller JA, DeLancey JO. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci. 2007 Apr;1101(1):266-96. doi:10.1196/annals.1389.034

Lowe K, Johnson G, Sari-Kouzel H, Hodges P. The effect of pregnancy and postpartum on the pelvic floor muscles. Am J Obstet Gynecol. 2016 Nov;215(5):593.e1-593.e8. doi: 10.1016/j.ajog.2016.02.031

Middlekauff ML, Egger MJ, Nygaard IE, Shaw JM. The impact of acute and chronic strenuous exercise on pelvic floor muscle strength and support in nulliparous healthy women. Am J Obstet Gynecol. 2016;215(3):316.e1-316.e3167. doi:10.1016/j.ajog.2016.02.031

Muscolino JE. Pelvic floor muscles (female) [Internet]. Learn Muscles; 2023. Available from: https://learnmuscles.com/glossary/pelvic-floor-muscles-female/

O’Dell KK, Morse AN, Crawford SL, Howard A. Vaginal pressure during lifting, floor exercises, jogging, and use of hydraulic exercise machines. International Urogynecology Journal. 2007 Dec;18:1481-9. doi: 10.1007/s00192-007-0387-8

Schimpf M, Tulikangas P. Evolution of the female pelvis and relationships to pelvic organ prolapse. International Urogynecology Journal. 2005 Aug;16:315-20. doi: 10.1007/s00192-004-1258-1

Tian T, Budgett S, Smalldridge J, Hayward L, Stinear J, Kruger J. Assessing exercises recommended for women at risk of pelvic floor disorders using multivariate statistical techniques. Int Urogynecol J. 2018;29(10):1447-1454. doi:10.1007/s00192-017-3473-6

Weir LF, Nygaard IE, Wilken J, Brandt D, Janz KF. Postoperative activity restrictions: any evidence?. Obstetrics & Gynecology. 2006 Feb 1;107(2 Part 1):305-9. doi: 10.1097/01.AOG.0000197069.57873.d6

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Date published: 16 December 2024
Last update: 4 December 2025