Thursday 151112

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Take 20 minutes to establish a 1RM thruster

Then, 3 x10 front rack lunge steps (total) @ 60% of today’s 1RM thruster

Post loads to comments and BTWB

Examples of the valgus knee.
Examples of the valgus knee.

 

What is the valgus knee? By Ryan Pye and Tabata Times

The picture above should explain what “valgus” means. In science-y terms, it is the combination of hip adduction and knee internal rotation. Basically that means your hip turns in and your knee also turns in. This can happen during all sorts of movements but shows up frequently during squats, jumping, and landing (here you see the far right image also shows a valgus position while running). To be clear, we do NOT want to see this position.

What causes valgus collapse?

So now that we know what a valgus collapse looks like, we need to figure out “Why?” it is occurring. This answer can be somewhat more complex and varied, so the options below will only represent the most common reasons it occurs. Additionally, it can be multi-faceted and be a combination of a few of the reasons listed below (or other reasons).

  • Mobility issues, specifically a lack of ankle mobility/ROM
  • Weak glutes (Gluteus Maximus, Gluteus Minimus, Gluteus Medius) & hip external rotators (Piriformis, Gemellus Superior, Obturator Internus, Gemellus Inferior, Obturator Externus, Quadratus Femoris)
  • Poor quad and/or hamstring function
  • Q-Angle (for ladies) – Can’t really fix that one…

Insufficient ankle mobility/range of motion (ROM)

Science-y stuff first. The three main muscles that could lead to “tight ankles” are the soleus, gastrocnemius, and anterior tibialis. The soleus and gastroc comprise your “calf” and connect your knee to your ankle (via the Achilles tendon) and the anterior tibialis (remember, anterior means “in front”) is the muscle in your “shin.”

If any of those muscles lack sufficient ROM, you will compensate for it — usually by pronating your feet — which will compensate for the lack of ROM by internally rotating your hip and forcing you into a valgus knee position. Your knee needs to be able to track past your foot — making an acute angle at the knee. While I have seen different numbers, you definitely need to be able to get your knee past your toes to have appropriate ROM (5 inches is a good number). 

Weak glutes and/or hip external rotators

Your glutes are comprised of your Gluteus Maximus, Gluteus Minimus, and Gluteus Medius. These muscles help you do almost every lower body athletic movement (to varying degrees). Your glutes help with hip extension, hip external rotation, and hip abduction, among other things. If your glutes are not very strong, you tend to compensate. This might mean your adductors kick in to help during a squat and, because of that, your knees shoot in.

Your glutes provide assistance with hip hinge movements and stability with other movements. While deadlifts, squats, and lunges all help with glute strength, lesser-used movements like hip thrusts, glute bridges, clamshells, and bird dogs are all awesome (maybe better?) exercises to strengthen your glutes.

We need your glutes to — at minimum — help keep your hip externally rotated so you don’t go valgus. Additionally, the glutes provide stability.

Your hip also uses a bunch of other muscles to rotate your hip externally (must be important if all these muscles do it!): Piriformis, Gemellus Superior, Obturator Internus, Gemellus Inferior, Obturator Externus, Quadratus Femoris (and for the record, I didn’t know every one of those off the top of my head…thanks, Google!). While these muscles have other functions as well, they work as a unit to externally rotate your hip. So how do we strengthen these puppies? My soccer girls definitely know the answer to this: BANDS! Banded walking (Monster Walks), banded lateral steps/shuffles, squats with band around knees, and clamshells are all great options. Of course bands aren’t the only way to strengthen these muscles, but they are an efficient way to do so (and require no fancy equipment).

We tend to train (in a weight room setting) what we can see. This often leads to an imbalance between our anterior and posterior (front and back) halves, which can further increase injury risk. Don’t be that guy (or gal); train your glutes!

Insufficient hamstring and quad function

There are three muscles that make up your hams: Semitendinosus, Semimembranosus, Biceps Femoris. Without going too deep into the weeds, let’s just say your hammies help stabilize your knee during many athletic movements. On the flip side (literally), your quad is comprised of four muscles: Vastus Lateralis, Vastus Intermedius, Vastus Medialis, Rectus Femoris. Intuitively it probably makes more sense that your quads are used to stabilize your knees, so that’s not a tough sell.

So about now you are expecting a list of things to do to strengthen both of these muscle groups (and that would be helpful), but it is a little more complex than that. Many times field sport athletes (and CrossFitters) have overdeveloped quads relative to their hamstrings. Depending on whom you ask, there is a specific ratio or threshold you want to have between your quad and hammies. While talking about what is the correct ratio is beyond the scope of a blog post like this, I do want to get across the point that many of us need to increase our hamstring strength in relationship to our quads. Yes, we want both stronger, but we tend to neglect the hammies, either due to the demands of the sport or sheer vanity (you can see your quads but not your hamstrings). 

So get to strengthening that posterior chain (back, hammies, glutes). It will help keep your knees out where they should be (not caving in) and will help decrease the risk of an ACL injury. Oh yes, and it will also make you a better athlete.

While the debate will forever rage on about the “knees out” cue many coaches use and the exact optimal position of the knee when squatting, jumping, landing, and running, I hope this post gave you some insight on why you hear coaches arguing about it all the time. Proper knee position is an indicator that your body is operating properly and balanced. So next time you squat (or jump), have someone check out your knees. You might just find something you can improve on!

**This article contains both photos and videos of the tests, stretches, and exercises mentioned. Click here for full article with additional links/ resources. 

 

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