How to fix Knee Valgus (2020)

knee valgus

  • Got weird looking knees?
  • Do they cave inwards?
  • … Or do you lack a thigh gap?

Yes?… Then you may have KNEE VALGUS!



What is Knee Valgus?

Knee Valgus is where the knees cave inwards towards the mid line of the body.

It is also referred to as being “knock knee” (… or having “no thigh gap”).

Characteristics:

knocked kneed

  • Hip Internal rotation + Adduction:
    • “Hip rolls/moves inwards”
  • Tibia external rotation:
    • “Lower leg bone turns outwards”
  • Ankle pronation:
    • “Foot arch collapses”

Knee Valgus test

knock knee

In the standing position: If your knees touch and there’s a large gap between your ankles, then you likely have knock knees!

Why you should address it:

With Knee Valgus, you lose the optimal alignment of your whole leg.

As a result, there is a higher risk of developing issues such as:

  • Premature arthritis
  • Ligament damage
  • Meniscal tears
  • Knee cap tracking problems
  • (… and a whole lot of other issues involving the lower back, hip and ankle!

Interested in fixing your posture? 

Come join me on Facebook!


What causes Knee Valgus?

a) Functional cause

If any part of your body is not in the “ideal” position, it can eventually lead to Knee Valgus.

… We can fix this!

I have listed all of the areas that you will need to address in the exercise section below.

b) Structural cause

Physical changes to the bone and/or joints can result in Knee Valgus.

This may be related to:

  • Genetic factors
  • Osteoarthritis
  • Rickets
  • Scurvy

Unfortunately – there is no way we can undo these structural changes once they have established.

However… with the appropriate exercises, there are usually other things that can still be improved upon.


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How to fix your Knee Valgus


Note: The following exercises are designed to address Knee Valgus in the standing position. If your knees tend to collapse inwards when your knees are bent (eg. squat, landing from a jump, running etc), you will need do the exercises in the specific position and at the load in which your knee starts to collapse inwards.


1. The Pelvis

anterior pelvic tilt

The Anterior Pelvic Tilt is where the pelvis is in a forward rotated position.

This pelvis position can orientate the knees inwards.

Do you have it?
For more information, check out this blog post:

2. The Hip

The problem: Hip internal rotation + Adduction

(In other words… The hip joint turns and collapses inwards causing the knee to collapse inwards.)


A. Releases

We need to loosen up those tight muscles which are causing your Hip internal rotation and Adduction.

How to do a Release:

  • Place the target area (see below) on top of a foam roller.
  • Apply your weight over the foam roller.
  • Proceed to roll up/down/circle around the area.
  • Continue for 30 seconds.
  • Repeat on other side.

(If you are unsure the location of these exercises, feel free to have a look on Google.)


a) Adductor

Release point:

  • Inner part of your thigh
  • Groin region

b) Tensor Fascia Lata

Release point:

  • Front of the outer hip.

b. Stretches

Now that you’ve released these muscles, it’s important that you follow it up with some stretching!


a) Adductors

adductor stretch

Instructions:

  • Lunge to the side. (see above)
  • Aim to feel a deep stretch along the inside of the leg.
  • Hold for 30 seconds.
  • Repeat on other side.

b) Groin

Instructions:

  • Sit on the floor with your back to the wall.
  • Place your feet together. (see above)
  • Sit as straight as possible.
  • Push your knees down.
  • Aim to feel stretch in the groin.
  • Hold for 30 seconds.

c) Tensor Fascia Lata

Instructions:

  • Assume the forward lunge position. (see above)
  • Keep your feet in line with each other.
  • Proceed to lunge forward.
  • Lean your hips to the side whilst using your arm on a support to keep your balance.
  • Aim to feel a stretch in the front/outer side of your hip.
  • Hold for 30 seconds.
  • Repeat on other side.

C. Strengthening exercises

It is vital that you understand how to activate the muscles that are responsible for hip Abduction and External rotation.

You will need to activate them during the exercises as shown in Step 4: Combining it all together. (down below)


a) Clam shell (External rotation)

hip external rotation exercise

Instructions:

  • Lie on your side with your knees bent at 90 degrees.
  • Whilst keeping your ankles together, lift up your upper leg as high as possible
  • Make sure that you do not move your pelvis.
    • Don’t cheat! Only the leg should be moving.
  • Feel your External rotator muscles (aka your butt) activating.
  • Hold for 3-5 seconds at end range.
  • Repeat 20 times.
  • Repeat on other side.

b) Wall slide (Abduction)

hip abduction exercise

Instructions:

  • Lie on your side with your back to the wall.
  • Bend your bottom leg slightly as to support your body.
  • Plant your foot of the upper leg against the wall.
  • Apply a firm pressure on the wall through your heel.
  • Whilst maintaining this pressure, slide your upper leg up/down the wall.
  • Make sure you feel your Abductor muscles (aka your butt) activating.
  • Hold for 3-5 seconds at end range.
  • Repeat 20 times.
  • Repeat on other side.

2. The Knee

Image courtesy of jk1991 at FreeDigitalPhotos.net

a. Releases of lateral hamstring

When the lateral hamstring (called your Biceps femoris) is tight, it causes external rotation of the lower bone (tibia). This can cause the knee to cave in relative to the tibia.


Instructions:

  • Whilst sitting on the floor, place a massage ball underneath the outside part of the back of your knee. (see above)
  • Proceed to apply pressure through the ball.
  • Straighten and bend your knee.
  • Continue for 1 minute.
  • Repeat on other side.

b. Strengthening of the Quadriceps

Weak thigh muscles do a poor job at stabilizing the knee joint. This leaves the knee susceptible to Knee Valgus!


knee strengthening exercise

Instructions:

  • Lie down on your back.
  • Lock your knee by flattening it onto the floor.
  • Make sure you can feel your quadriceps muscles engaging.
  • Lift your locked leg up/down.
  • Repeat 30 times.

c. Strengthen the Popliteus

This muscle is responsible for correcting the turning out of the lower leg bone. (Tibial external rotation)


exercises knee valgus

Instructions:

  • Sit down with your hip/knees bent at 90 degrees.
  • Hold your knee straight with your hands.
  • Turn your lower leg inwards
    • (Internal rotation of the tibia bone)
  • Make sure your foot does not lift off the ground.
  • Repeat 30 times.
  • Repeat on other side.


3. The Ankle

Image courtesy of Flare at FreeDigitalPhotos.net

The problem: If your ankle collapses inwards (pronation), it can cause your knee to also collapse inwards.

A. Improving Dorsiflexion of the ankle

Having full range of motion in your ankle is essential in any form of leg movement. (running, squatting, walking etc)

Without proper movement, the ankle will likely over pronate (… which is a fancy way of saying that your foot arch collapses), and thus can cause the knees to cave inwards.

How much ankle flexibility should you aim for?ankle dorsiflexion mobility

At bare minimum – Aim to get your toe “a fist width” from the wall with your knee still in contact with the wall.


a) Release the Calf muscle

Instructions:

  • Place your calf muscle on top of a foam roller/ball. (see above)
  • Put your other leg on top and apply pressure down towards the foam roller.
  • Roll your leg from side to side.
  • Make sure you cover the whole muscle
  • Do this for 1-2 minutes each side.

b) Stretch the Calf muscle

calf stretch

Instructions:

  • Place the top of your foot against a wall. (see above)
  • Keep your heel planted on the floor.
  • Learn forward into your ankle.
  • Aim to feel a deep stretch sensation at the back of the calf.
  • Hold for 1-2 minutes.

c) Ankle joint mobilization

ankle dorsiflexion

Instructions:

  • Assume a lunge position with your hands on a wall for support.
  • Using your body weight, proceed to plunge forward as to place pressure on the front ankle.
  • Keep the heels of your front leg in contact with the floor throughout movement.
  • Do not let your foot arch collapse.
  • Repeat 30 times.

B. Improving the arch support:

*** READ THIS ***: It is vital that you understand how to do the Short Foot exercise properly.

It will be required to be activated during the exercises as shown in Step 4: Combining it all together. (down below)


a) Short foot exercise

short foot activation

Instructions:

  • Sit down on a chair with your feet on the ground.
  • Whilst keeping your toes relaxed, proceed to scrunch the under-surface of your foot.
  • If performed correctly, you should be able to feel the muscles under your foot tense up.
  • Hold this for 5 seconds.
  • Repeat 20 times.
  • Progress to a standing position once you understand how to do the exercise properly.


4. Combining it all together

This last part of this post is actually the most important!

Why?… It is where you will learn how to use your Hip, Knee and Ankle with each other to hold the ideal knee alignment.


a) Single leg balance

  • Stand on the leg you wish to target.
  • Perform short foot activation.
  • Push your knee outwards.
  • Maintain your balance for 30 seconds.
  • Do not allow the knee to collapse inwards!
  • If required – you can use your hand to provide some support.

b) Wall push

  • Lift your hip to ~90 degrees and place the side of that leg against a wall. (see position above)
  • Activate short foot exercise on the foot that is planted on the floor.
  • Bend your planted leg to ~15 degrees.
  • Try to put more of your weight on the heel of the foot.
    • This engages your hip muscles more and places less stress on your knee.
  • Push the lifted leg into the wall.
  • Hold this position for 5-10 seconds.
  • Repeat 5 times on alternate sides.

c) Step up

  • For this exercise you will need to use a step.
    • Start with small step height to begin with.
  • Place your leg onto the step.
  • Engage your Short foot and Hip abductors.
  • Step up and slowly lower yourself down.
    • Make sure that your knee and feet are aligned throughout the exercise.
  • Repeat 10-20 times.
  • Repeat on other side.

Avoid these positions!

a) ‘W’ sitting:

This style of sitting is mainly seen in children.

Don’t do it! (… Or don’t let your children do it)

b) Driving

When driving, try to keep your knee and foot in the same alignment.

Many people tend to have their knee facing the brake pedal and their foot on the accelerator.

c) Sitting with knees inwards

Do you sit like this?…

I know it probably looks better than sitting with a massive leg spread, but it’s not doing you any good if you have Knee Valgus.


What to do next…

1. Any questions?… (Leave me a comment down below.)

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the exercises!

413 thoughts on “How to fix Knee Valgus (2020)”

  1. Hi mark I want to know how long will it take for this to have a impact and to able to physically see the changes. Like how long. Also how many times a day am I ment to do this. Also will this work for milder cases and do you have pictures of before and after aswell of patients. Also where can i get one of those muscle relaxer balls

    Reply
    • Hi.
      I’m knock kneed but I think I walk on the outside of my feet. Could I be totally off ony perception. Also, how do I learn where I’m my foot to balance my weight? Im in my 30s and I’ve already had hip surgery. I’m not over weight. I exercise regularly but I’m no athlete. I really want to learn to correct my form to prevent further injuries and to have less hideous legs. Lol

    • HI Kelias,

      Do you have High arches and/or tibial bowing?

      This may explain why you have knock-knees with weightbear on the outside of the foot.

      Mark

  2. I am 15 my weight is 61kg and my height is 164cm as I grow started to notice that I have knock knees (it was on 4th grade) I don’t know the reason but I have big thighs or to say I think most of my weight comes from my thighs
    and does knock knees affect height?

    Reply
  3. Hi Mark,

    THANK YOU for demonstrating these stretches and exercises! I believe I have knee valgus and would like to get started but there’s so much involved and I want to make sure I’m doing all the stretches and exercises properly. That said, I would like to have personal help so are there physiotherapists available at rehab clinics? Where might I find a physiotherapist nearby that I could see? I live in southern Michigan. Thank you.

    Reply
  4. Hey,

    First of all thank you for all those exercises, I’ve find a way to address all of my posture problems.

    The main one appeared due to ankylosing spondylitis. I’ve had inflammation under my heel and to avoid pain my left foot was tilting about 45 degrees on the left. Now it’s hard to make it point in the right direction and I feel like it’s a mix of knee valgus and flat foot.
    When trying to do exercise 2.c strengthening the popliteus I can barely move my foot inward. I also notice that I can easily press the exterior edge of my healthy foot against the floor but it’s much harder with the other one because again I can’t bend it inward.

    I was just wondering if those exercise would help this or if I should try some other one ?

    Thank you for everything.

    Reply
    • Hi Daniel,

      I would first make sure that the heel pain is sorted out. If your body keeps trying to avoid placing weight in that heel, you will continue to compensate.

      If your foot pointing out wards? If so, check out this post for more exercises: Duck feet posture.

      If you can’t turn your foot inwards during the popliteus exercise, your tibia might rest in external rotation. (more exercises on this on the duckfeet posture blog)

      Mark

  5. Hi Mark,

    First, thank you for sharing all the knowledge and exercises.

    In the Ankle joint mobilization exercice, it looks like your foot and your knee are not aligned. There’s also this arrow that you drew around the ankle. I feel like my knee and my ankle should be aligned and apply force with my ankle in the direction of the arrow but without moving it, and stay aligned. But it’s not what it looks like on the picture and there description doesn’t give information about this. Can you please clarify for me ?

    Reply
    • Hey Xavier,

      You want to keep the knee and foot in line as much as possible.

      Then you want to plunge forwards on the leading ankle as to encourage more dorsiflexion without losing this said alignment.

      Mark

  6. Hey Mark, dose this realign the knee or dose it help with the symptoms and help with the issue mildly. Also is surgery required if this didn’t work.

    Reply
    • Hey Tahidur,

      If your symptoms are directly due to the alignment of the knee, then re-alignment of the knee will certainly help.

      Surgery should never be the first option to consider given that exercises will help!

      Mark

  7. Hi mark,
    I’m 18,had straight legs when I was younger,about 13-14 I noticed that when I am standing and not using any of my muscles, my knees go inward. I am able to straighten them out, but then I feel my muscles burn on the side of my legs and hip if I try to keep it in that correct position. What exercises do you suggest please?

    Reply
    • Hey Olakunle,

      If you have the ability to correct the alignment, it is likely you will just need to strengthen your muscles.

      It sounds like you will need to do more exercises for the glute muscles to help push the knees out. (exercises mentioned in blog post)

      Mark

  8. I have knee internal rotation on my right leg. I had ACL recon on this leg 2 years ago. I have tried to gain muscle mass on VMO and focused mainly on quad work but could not manage to do that. Because of this my quads got bigger (apart from VMO) than my left leg. So now I feel mainly my quad even i do posterior chain exercises and I feel tightness on my quads all the time. As you mentioned quad work on the program, i hesitate if this further exaggarete my quad dominance. But how can I manage to externally rotate my femur automatically? Also my tibialis anterior is highly hypertonic besides RF and VL.

    Now I mainly focus on Glute&hamstring work. I really need your suggestions.

    Best.

    Reply

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