Knee valgus and why it's more common than you think

I would argue that the squat is the most fundamental movement pattern that we humans do. However, Westerners and those in developed countries have chairs, computers, cars – all things that encourage us not to squat. And so this is why there are so many blogs and books and bro-science videos on YouTube that can’t seem to talk enough about squatting.

At the risk of jumping on the bandwagon, I was recently reminded of why so many of us really do need those constant reminders to work on this movement pattern.

My own squat needs work

So here’s my story.

I’ve always felt as though I had a pretty decent squat. I say this because I was (and am) very good about lifting with a neutral spine. In my early days when my lumbar spine was still rounding a bit at depth, I would just squat as far as I could go and stop. That’s how disciplined I was.

Now, fast forward to, oh, say last week – to when a postural specialist told me I had a little knee valgus going on.

What?!

Knee valgus is for people who don’t lift I thought to myself. How could this happen to someone like me?!

Admittedly, mine is apparently very minor. Subtle enough that even I had not detected its nasty little presence in the mirror during my training. But I may be getting ahead of myself. First, some background:

For the uninitiated, knee valgus (or valgus collapse) is when your knee drifts inward (medially). More specifically, it’s defined as an internal rotation at the hip most commonly seen during hip flexion – a squat. As you can imagine, this isn’t a good thing.

Your hip is designed to be mobile. Right? You can move it all over the place. Go two joints down and you see the same thing in your ankle. And in the middle is your knee. It’s more or less a hinge with movement about one axis. This is what we see when we start to break down the kinetic chain of our body: where one joint is highly mobile the next will be more rigid.

A common mechanism for knee valgus is that when your knee drifts inward it means that there isn’t enough strength in your hip to allow for good movement. So now the knee is forced to pick up the extra slack. It can do this to an extent because our bodies are extremely adaptable, but suffice it to say, all the soft tissue in your knee joint isn’t moving the way it wants to.

Another common culprit is poor mobility in your ankle.

So what’s becoming clear is that problems that come up at the knee are not always local to that area. The root cause may be somewhere either up or down the kinetic chain.

But don’t let this get you down. Many, many people have some level of valgus collapse at their knee. Even I do!

Lifting cues versus posture

Here’s something I need to point out: when I was working with this postural specialist, he detected valgus collapse while I was standing! This is an important point to make because a lot of times we only think of knee valgus happening when we move – e.g. squat. But skilled postural therapists can spot something like this as people walk, run and yes, even as they stand.

One common ‘fix’ in the weightlifting community is to wrap an elastic band around your thighs just above the knee and then squat. The elasticity wants to pull your knees inward and thus ‘feed the mistake’ as it’s called. This forces you to push those knees outward. It’s a great lifting cue, but is it really doing anything to help you when you’re not in the squat rack?

Is this just an exercise correction or will it actually carry over into your postural alignment?

That brings me to my next point.

What can you do?

To be honest, I started drafting a short list of fixes for knee valgus. As I did more research on the subject I soon realized that there is a very long list of exercises and treatments that are supposed to reverse knee valgus. And to make matters even more complicated there are at least (3) genres of causes for this condition.

Suffice it to say I’m working through a stack of papers and websites right now to provide you a nice and complete Motus analysis. Expect this in a couple weeks.

In the mean time, I have a homework assignment for you. Next time you’re at the gym, or anywhere you find a full length mirror at your disposal, try to self diagnose whether or not your knees are caving inward when you begin to squat.

If you’re a seasoned lifter you’ve no doubt heard the mantra ‘knees out’ pounded into your head over the years. So you may be thinking, “oh, I’m fine, don’t worry about me, Ryan.” Well, that’s what I thought about myself. It was only when I lifted reasonably heavy that I could detect an ever-so-slight collapse on hip flexion.

So take a close look and let me know in the comments below what you find.

Then we’ll work on fixing it…

By Ryan Wagner

Motus