The considerations of training with knee valgus

Typical resting knee position with knee valgus

You may have clicked on this blog post because you are perhaps someone who has valgus knees, and like many of the clients I have worked with who present with knee valgus, are confused about what they should and shouldn’t do in the gym.

Many people who have valgus knees, or ‘knock knees’, typically present with no real complaints of pain however it is important that if you are new to training, knee valgus or not, we consider the associated compensations or imbalances present in an attempt to correct them and ensure pain isn’t on the horizon.

This will not only minimise the risk of injury but can also help to prevent plateaus in training by keeping the joints and muscles functioning as efficiently as possible.

So what are the main postural imbalances we see with knee Valgus and what does that mean to your training?

· Tight Adductors: The adductors are the muscles that run down the inner thigh and when these are tight, they pull the hip/femur (thigh bone) into a degree of internal rotation, which then translates down to the knee, being pulled medially.

· Weak Abductors: As antagonist muscle groups, with tight adductors comes weak abductors and vice versa. As the adductors pull the hip into internal rotation it puts the abductors on length making them weak.

· Flat Feet: Flat feet/collapsed arches alter the way the tibia and fibula align to form the ankle joint which then has a knock-on effect on knee alignment as we work up the kinetic chain.

· Naturally wide hips: This is less of a cause and also doesn’t necessarily affect muscle function however people with wide hips are more susceptible to developing knee valgus as wider hips are more prone to sitting in internal rotation. This is also the reason why we see more knee valgus in women than men (sorry ladies).

· Anterior Pelvic Tilt: As the pelvis tilts downward, this again puts the hip joint into a degree of internal rotation, bringing the knee into the medial alignment we see in knee valgus.

Training considerations and exercises:

· Stretch/release the adductors by using myofascial release on a foam roller and/or performing an adductor stretch in a deep side lunge.

· Strengthen the abductors using an abduction machine or side lying leg lifts if you can’t access a gym all the time.

· Perform squats and lunges in socks or bare feet to strength the foot arches. Also make a conscious effort to keep the weight centred when doing so by connecting with the big toe and little toe into the floor throughout the squat/lunge. People with flat feet will struggle with big toe connection.

· Be conscious of hip and knee alignment during lower body exercises. Abduct the hip to bring the knee in line with the hip when carrying out spilt squats/lunges/leg presses etc.

· Work on finding pelvic neutral by performing pelvic tilts through full range and then finding the centre point between the two. Ensure setting of this position during all exercises that aren’t supported by a machine/bench.

Keep your eyes peeled on my Instagram page @siobhandocksey for short exercise videos over the next week that address the above points to implement into your own training to help with knee valgus or even general knee pain.

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