The squat is a common exercise in rehabilitation and sports performance, with variations in parameters like stance width, foot rotation, trunk position, tibia position, and depth affecting joint loading and muscular demands. This clinical commentary reviews biomechanical factors influencing squat execution and provides recommendations for various clinical conditions. Key parameters include trunk inclination, tibia inclination, foot rotation, stance width, and squat depth. Trunk inclination affects hip and knee flexion moments, while tibia inclination has the opposite effect. Foot rotation influences knee moments, and stance width impacts knee valgus and hip external rotation moments. Squat depth affects knee and hip flexion moments, with deeper squats increasing joint stress. The relationship between trunk and tibia inclination determines the biomechanical demand on knee and hip extensors. Hip extensor bias is associated with reduced knee flexion moments, while knee extensor bias increases them. Clinical applications include patellofemoral pain, ACL reconstruction, FAI, low back pain, and tibiofemoral osteoarthritis. For patellofemoral pain, hip bias squats are recommended to reduce quadriceps demand, with shallow depths to minimize joint stress. For ACL reconstruction, hip bias squats are advised to reduce quadriceps load, with medium stance widths to minimize knee valgus moments. For FAI, gluteus maximus and medius activation are emphasized, with limited squat depth to avoid hip flexion beyond the patient's range. For low back pain, wider stance squats with limited trunk inclination are recommended to reduce lumbar loading. For tibiofemoral osteoarthritis, hip bias squats are initially recommended, transitioning to knee bias as tolerated. The review emphasizes the importance of individualized squat parameters to optimize therapeutic outcomes and minimize joint stress.The squat is a common exercise in rehabilitation and sports performance, with variations in parameters like stance width, foot rotation, trunk position, tibia position, and depth affecting joint loading and muscular demands. This clinical commentary reviews biomechanical factors influencing squat execution and provides recommendations for various clinical conditions. Key parameters include trunk inclination, tibia inclination, foot rotation, stance width, and squat depth. Trunk inclination affects hip and knee flexion moments, while tibia inclination has the opposite effect. Foot rotation influences knee moments, and stance width impacts knee valgus and hip external rotation moments. Squat depth affects knee and hip flexion moments, with deeper squats increasing joint stress. The relationship between trunk and tibia inclination determines the biomechanical demand on knee and hip extensors. Hip extensor bias is associated with reduced knee flexion moments, while knee extensor bias increases them. Clinical applications include patellofemoral pain, ACL reconstruction, FAI, low back pain, and tibiofemoral osteoarthritis. For patellofemoral pain, hip bias squats are recommended to reduce quadriceps demand, with shallow depths to minimize joint stress. For ACL reconstruction, hip bias squats are advised to reduce quadriceps load, with medium stance widths to minimize knee valgus moments. For FAI, gluteus maximus and medius activation are emphasized, with limited squat depth to avoid hip flexion beyond the patient's range. For low back pain, wider stance squats with limited trunk inclination are recommended to reduce lumbar loading. For tibiofemoral osteoarthritis, hip bias squats are initially recommended, transitioning to knee bias as tolerated. The review emphasizes the importance of individualized squat parameters to optimize therapeutic outcomes and minimize joint stress.