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Breaking Down Knee Valgus

Knee valgus can be defined as the positioning of the knee over the inside part of the foot during a functional movement such as a squat, jump, or land. Knee valgus positioning is not the most ideal when completing static and dynamic exercises due to the increase in pressure it

puts on the inside structures of the knee leading to a greater risk of injury. Knee valgus gets the blame for most ACL injuries as well as other sports related knee injuries especially in female athletes. Yet, the truth is, knee valgus positioning is going to happen while playing competitive sports (see photo on right). A quick cut, change of direction, change of speed, or contact with another player, is a potential situation in which the knee could be in a valgus position. It is inevitable to completely prevent the motion of knee valgus in competitive field/court sports. It is also to not go without saying that there is always a chance that injury can occur and there is no way to prevent it 100%.

Since dynamic knee valgus is inevitable, and there is always a chance of injury, the best thing we can do is provide proper education about strength training and neuromuscular training to our athletes and coaches. Strength training and neuromuscular training to help decrease valgus positioning, would target the muscles that stabilize the knee, as well as specific movements involved in change of direction scenarios. Incorporating 30 minutes of this type of training a few times a week is a beneficial start to help decrease risk of injury in youth athletes by increasing their exposure.

General Exercise Overview

The ACL itself, prevents the tibia from moving forward on the femur during movement. Since the ACL is a ligament, and a passive structure, it is important to build up the muscles around the knee for improved support. In general, the most important areas to strengthen are lateral hips, quads, and hamstrings as well as incorporate single leg balance and stability, and change of direction exercises.

  • Lateral hip musculature helps to control the positioning of the knee through rotation and abduction to better position the knees in line with the toes as seen in the picture to the right.

  • The quad muscle helps with general knee stability, deceleration and acceleration.

  • The hamstrings help to balance out the force of the quad on the knee and helps to decrease excessive forward movement of the tibia on the femur during deceleration, acceleration and change of direction.

  • Single leg stability and balance is very important in sports. If you think about it, you are on one leg more than you are on two. When you run you are constantly in single leg stance. When you kick a ball you typically land on one leg. When you change directions you do so on one leg. It is important that single leg training is incorporated just as much as double leg training.

  • Change of direction and speed, are quick, reactionary, and anticipatory motions. The muscles need to be prepared for any motion at any time when attacking and defending. It is important to train these motions so the body can adapt to the quick changes in direction and speed to be ready for game play scenarios

Overall, if youth athletes can develop good motor patterns and neuromuscular control at an early age it will prepare them to progress strength training later in life and overall improve their game play performance and decrease risk of injury. Check out my instagram @dr.christina.dpt throughout the week for more on knee valgus assessment and exercises. As always reach out with any questions. Together we can change the future of Women's soccer!

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