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Squatting, Valgus Knees, The Knees-Out Cue & Facebook Coaches
Greg Everett  |  Olympic Weightlifting  |  January 28 2014

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Squatting, Valgus Knees, The Knees-Out Cue & Facebook Coaches, Greg Everett, Good knee and leg alignment in the squat
Good knee and leg alignment in the squat
Evidently the most popular term on the internet right now is “valgus”. The legions of keyboard warriors and Facebook coaches have latched on to it and are sanctimoniously eviscerating anyone demonstrating valgus knee movement in the squat, irrespective of the context (e.g. an experienced competitive lifter pushing a maximal effort) and, as is to be expected, irrespective of their own qualifications to opine on the subject. I shouldn’t be surprised, and I suppose I’m not, but my lack of surprise doesn’t mitigate my irritation by the practice.
 
This was brought back to my attention last night when my lovely wife Aimee posted a video of a few of our female lifters squatting. There was a range of degrees of valgus knee movement, from pronounced to minor, and a number of comments were posted in short order about how terribly these girls were squatting (all of whom are competitive in the sport of weightlifting at the national championship level and who are members of a multiple-time national medalist team).
 
 
What We Want
 
In my books, articles and elsewhere, I have explicitly and emphatically stated that what we want to see in the squat is the thigh and foot aligned; that is, we want the knee neither inside nor outside the corresponding foot. Some minor divergence is probable in many individuals based simply on imperfect anatomy, but the goal is to maintain the proper hinging of the knee without introducing odd torque or other forces it’s not well-equipped to handle.
 
We want the feet turned out to some degree to open the hips adequately to allow the lifter to sit into full depth with an upright posture. To what degree the feet must be turned out to achieve this is dependent on the body structure of the lifter (and to some degree that lifter’s mobility, although this is a temporary limiter that should be addressed and corrected). Some will need to turn out very little, maybe 5-10 degrees, and some will need to turn out more, possibly as much as 20-30 degrees. Generally speaking, shorter-legged athletes will feel comfortable and be able to achieve a proper bottom position with the feet turned out less (consider this when looking at “proof” that the feet and knees don’t need to be oriented outward using Chinese lifters as models). When looking at a lifter in the bottom of a squat with such a stance, if the thighs are approximately parallel with the feet, the knees could be fairly described as “out”—that is, they are not oriented straight forward. However, the knees being out and being pushed out are two different things.
 

The ideal alignment of the leg keeps the thigh approximately parallel with the corresponding foot; the knee is neither inside nor outside of the foot.
 
 
 
The “Knees Out” Cue & Ensuing Confusion
 
If you watch the daily training videos we post of Catalyst Athletics lifters, you’ve likely heard me yelling “knees out” at times to certain lifters. Unfortunately, this cue is often misunderstood and taken out of context to be applied improperly. Additionally, some influential people are actually instructing people to actively push the knees out while squatting irrespective of the starting position of the knees or the overall position of the athlete.
 
The previous section should have made it clear the position I want my lifters to be in—the thighs approximately in line with the feet. If a lifter is maintaining this relationship during a squat, I’ll never cue them to push their knees out—that would bring the knees outside the feet, which we don’t want. This particular lifter is doing what is ideal and can be left alone to worry about standing up.
 
In other cases (primarily female lifters), the knees will dive in as the lifter enters the sticking point of the squat. In such a case, I will cue them to push the knees out—they need to work on re-aligning the thigh with the foot to get back to that optimal position.
 
I’m not using the action of pushing the knees out as a contribution to the recovery of the squat directly as some coaches will (whether correct or not). However, there is a direct and immediate benefit to pushing the knees out from a valgus position during the recovery of a squat—as the knees move inward, the hips tend to move backward, which inclines the lifter’s trunk forward. This posture reduces the ability of that lifter to recover successfully. By pushing the knees out, the hips are able to move back in under the shoulders, bringing the lifter back into a more upright posture. This is why you’ll very often hear me say “Hips in” immediately after “Knees out”—the combination of these actions is intended to correct the loss of upright posture and knee alignment and bring the lifter back into a position to finish the recovery of the squat.
 
 
Who is at Risk
 
Generally, the longer-legged and more female an athlete is, the more likely the tendency for valgus knee movement in the squat. I have heard reams of explanations for the prevalence of the issue in female athletes, and none make sense to me. Some have suggested it’s related to the Q-angle, which tends to be greater in women than men, but considering that the two worst examples of valgus knee movement in my gym are in women with particularly narrow hip structure, I have a hard time getting on board with that. The most popular explanation across both geneders seems to be a lack of strength or activation of the lateral hip rotators and abductors. I can buy that, and I supposed I do on some level, because my approach to correcting the problem is strengthening and activating these muscles. What I do know for certain is that it has nothing to do with flexibility, so get off that one (if a lifter’s knees are aligned during the eccentric movement of the squat, it’s obviously not a mobility problem).
 
The wider a lifter’s stance and the more turned out the feet, the more concerned I am about the potential consequences of valgus knee movement in the squat, because the divergence from normal knee alignment is greater. That said, generally Olympic weightlifters don’t squat with particularly wide stances, so my concern is fairly limited. This doesn’t mean it’s not something I want to correct in my own lifters; it does mean that I’m not losing sleep over it, and I’m not going to hold a lifter back from getting stronger to spend a year on the questionably effective remediation of the problem.
 
 
Correcting the Problem… If You Can
 
My experience has been that correcting the valgus knee problem completely is impossible short of avoiding heavy squat efforts. I have been able to get some improvement, but my sense is that if an athlete is possessed of the natural valgus tendency, it will always remain, however attenuated through training and practice, and it will become more and more pronounced as the effort of the squat and fatigue increase.
 
If we accept the idea that the problem is the result of weak or inactive muscles that abduct and externally rotate the femur, the correction would be to strengthen these muscles and teach athletes to better activate them. There are a lot of exercises purported to serve this purpose. Some are downright silly, in league with many of the fancy “core” exercises out there that require more equipment than sense. The ones I will endorse for effectiveness and reasonability (in terms of how likely you are to actually get an athlete to perform them consistently enough for a long enough period of time to actually be effective) are as follows:
 
 
1. Mini-band Squats
 
This is my number-one go-to exercise for this problem because it’s very easy to do, it makes a lot of sense, and it can be done without adding a single second to an athlete’s training session. Wrap a mini-band around the legs just below the knees and squat, resisting the inward pull of the band to keep the knees in line with the feet (not outside the feet, but in line). You can add a pause in the bottom position with an isometric push against the band, or even do reps, allowing the knees to move inward and then pushing them back out into alignment against the band.
 
The time-saving method is to throw the band on during the athlete’s squat warm-up sets; they have to do those squats anyway, so this just adds another element to those warm-ups without adding additional exercises and the time and energy they require.
 
 
2. Pause and 1 ¼ Squats
 
Pause squats are good for a number of problems, but generally, they’re beneficial for anything related to posture, position or tension in the bottom of a squat. The athlete should control the squat down into the bottom position and hold for three seconds, maintaining tension throughout the legs and trunk. When recovering, the athlete will need to consciously and actively prevent the knees from moving in. Without even specific understanding of how to do this, most athletes will naturally do what’s required, and in this way, train the proper muscles (most wouldn’t be able to activate the right thing even if you told them explicitly what it was). Note that when initiating the recovery from a pause squat, there should not be a bounce added to aid it—that’s partially defeating the purpose of the exercise.
 
1 ¼ squats in this case should be done at a fairly slow tempo, maintaining tension on the legs throughout the entire movement. Like the pause squat, this really allows the athlete to feel this tension where it needs to be, and slows the movement down enough to allow them to better control the leg movement, meaning they can more easily train what needs to be trained. The athlete should rise to just through the sticking point of the squat on the ¼ movement.
 
 
3. X-band or Mini-band Side-Steps
 
There are a number of variations to this basic type of exercise, all intended to strengthen and activate the lateral glutes. With a mini-band around both ankles, or a full-size band in the X configuration, step to the side relatively slowly, maintaining tension on the supporting leg (you’ll probably feel the glute more on the support leg than the moving leg). You can do a few steps to one direction and then back, or you can step back and forth alternately. You can also step diagonally (forward and out at at 45-degree angle). Do it with both straight and bent knees.
 
 
4. Lunge or Single-Leg Squat Variations
 
Single leg work can be effective for strengthening the muscles that stabilize the hip IF they’re done properly, which they’re very often not. If you’re performing single-leg exercises and allowing valgus knee movement, don’t expect those exercises to correct your valgus knee movement in your squat—you’re just reinforcing the existing problem. If you have the patience and the ambition, you can set up a band around your lead knee in the lunge position originating from the medial side of that leg—that is, if you’re in a right-leg-forward lunge position, wrap a band around the right knee and affix the other end to a post on your left side so you’re forced to resist the inward band tension against the leg (again, working to maintain the alignment of the knee, not pushing it outside the foot).
 
 
The Final Word (At Least from Me)
 
This is a subject that bores me immeasurably, so I avoid discussions of it as much as possible. Hopefully I’ve clarified my thoughts on the matter well enough here that I won’t have to do anything more in the future beyond linking to this article.
 
I’ll leave you with a few videos for your consideration. One is of Dmitry Klokov, everyone’s current favorite Russian weightlifter. The other is of one of many incredibly strong female Chinese weightlifters. The third is of Ivan Chakarov, one of the strongest squatters in the history of weightlifting (he's doing about triple bodyweight.. for a triple... without even a belt or knee sleeves in this video). All are demonstrating some valgus knee movement in a squat. I provide these videos not to claim that valgus knee movement is desirable, but to suggest that it’s neither entirely avoidable for many athletes, nor is it the terrifyingly dangerous problem that many Facebook coaches would have you believe.
 
 

http://www.youtube.com/watch?v=rl3Vldo7x4c
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Greg Everett is the owner of Catalyst Athletics, head coach of the national-medalist Catalyst Athletics weightlifting team, publisher of The Performance Menu, author of the books Olympic Weightlifting: A Complete Guide for Athletes & Coaches and Olympic Weightlifting for Sports, and director/writer/producer/editor/everything of the documentary American Weightlifting. Follow him on Facebook here and and sign up for his free newsletter here.
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17 Comments
Jordan Caras 1 | 2014-01-28
Greg - I have to wonder if the popularity of "valgus" is due to Kelly Starrett's book (Becoming a supple Leopard). At least in my few years of crossfit, and my new interest in coaching, this is the first place I have seen it extensively used to the point that droves of people would pick up on the lingo. Just a theory ;) Thanks for your wisdom! -jordan
Nick Sanders 2 | 2014-01-28
I agree this has become a hot topic of late due to Starrett's book. Everyone throws inwards knee movement in the same category. I feel there is a huge difference in the super stiff male that can't get into a good bottom position due to mobility and your female who kicks in briefly out of the hole. Assess and correct appropriately for proper movement Great read always enjoy you stuff. Nick Sanders PT
Marcos Ubilla 3 | 2014-01-28
Jordan, he has also increased the word soup rankings for "torque", "smash" and "floss" with respect to mobility and movement.
Sean 4 | 2014-01-28
Greg, thanks for our insight. I'm glad that you took the time to clarify the difference between a 'coaching cue' and a valid movement error. A coaching cue doesn't live in a vacuum, and a single cue will mean something completely different to each athlete. I couldn't agree more that there has been a flood of armchair quarterbacks throwing around the latest buzzword. I'd be will to admit that K. Starr and his nuclear explosion in popularity may have contributed to the word vomiting going on, but hasn't always been about how the knowledge is applied? It's not enough to simple reverberate terms, you have to understand the application of those terms and their intended benefit. I mean, aren't we all here to learn? Thanks again for all that you have done and continue to do. I continue to benefit from all your and your teams efforts.
Ryan Merrill 5 | 2014-01-28
I might be a terribly person but I love reading others bashing others over the internet =)! Not that I ever really get involved 7 years of World of Warcraft taught me better.
daooch 6 | 2014-01-28
Though I can see Starrett's book shining a brighter light on the issue of functional knee valgus, it's actually been quite a concern and point of emphasis w/ most rehab professionals and physical therapists. (Of which Starrett is well-versed). As much as generally love Crossift and know many high-quality coaches, I kinda wish the culture had more of a biomechanical rehab background or perspective. And in re: to PTs and rehabilitative biomechanics - vice versa!
Chad 7 | 2014-01-29
Hey Greg, I'm a fairly new lifter that's basically self coaching myself, through your website and your book (which is a fantastic read by the way). I can only imagine how frustrating it is to be second guessed and bashed by all of the no doubt national level lifters inhabiting facebook and the rest of the internet but I just wanted to say that I'm on your website almost daily and I appreciate all the effort you put into getting as much knowledge, and free knowledge at that, out into the amateur weightlifting community. Big thanks to you and to everyone who contributes to your website. Keep up the great work
PJ 8 | 2014-01-29
Good stuff. Most of the research (concerning medial knee displacement in women specifically) points to all of the the things you have mentioned but also points out that motor control may be the main issue in keeping the knees out. Unfortunately there isn't much research into the motor control idea... I've had success coaching athletes to help correct the valgus knee issue but everything goes out the window when we go from something like the squat to a more "dynamic" movement like a jump (high, long, box, etc) where the problem comes right back. Has anyone seen this?
Greg Everett 9 | 2014-02-05
PJ - The slower, more deliberate movements (e.g. squats and remedial exercises) should set the pattern for the more dynamic ones (e.g. jumping and landing), but the transfer will take longer, I believe. For example, you'd see improvement in a clean before you saw it in a jump. Doesn't mean the corrections are working or won't work, it just means they need to be continued for a longer period.
Zach 10 | 2014-02-24
"Generally, the longer-legged and more female an athlete is, the more likely the tendency for valgus knee movement in the squat." "more female" didn't realize there was an in-between lol
Tj 11 | 2014-03-10
I'm one of those "longer-legged females". I love lifting, but sometimes feel like progress is slow, particularly with this problem. Thanks for writing about it, including some easy to follow homework. I feel reassured that I will make progress on this!
Eric LaRue 12 | 2014-04-30
This is a new pet peeve of mine. I tore my pectineus, obturator externus, and rectus abdominus trying to apply knees-out as a standard. That was my fault for tweaking my LBBS form using an 80+% load. It is not even a general cue, like hips forward or chest up. It should only be used as a corrective cue for a lifter bowing the knees in, above parallel, in my opinion. Movement standards, general lifting cues, and corrective cues are three very different things. The experts need to clearly communicate which they are talking about. Without that kind of differentiation, you will have idiots like me hurting ourselves.
Josh 13 | 2014-06-18
As always Greg, your posts are well thought out, very informative, and well respected! Your talk with me regarding this subject during your cert course has helped me draw a better line when explaining this to clients or "challengers".
Tim 14 | 2014-06-18
Gregg so would a good reference for foot angle be to squat with feet straight; then turn feet so that feet are aligned with femur? I am 6'1 with longer femurs than shins. Unless I rotate my feet pretty far out I have weird torque on my knee. However, I feel it's not a flexibility issue. Should this be corrected or just go with it. Thanks in advance and your site is greatly appreciated!
Greg Everett 15 | 2014-06-19
Tim - Hard to really comment without seeing you. You could be fine, or you could be horribly off. Really doesn't matter where you start to find a good foot position, but I don't see a point in starting straight forward - you know you're not going to be there anyway. Just turn your feet out to whatever degree feels comfortable and use that as your starting point.
Tim 16 | 2014-06-20
Gregg- Thanks for the prompt reply. The more and more I read your articles the more I learn. Foot angle aside; I think my problem has been bending my knees without keeping the weight on my heels. I noticed that when I squat and the knees bend the weight shifts to the toe. So ankle flexibility? I feel as I am compensating for limited flexibility by shifting weight forward. I also am now focusing weight kind of on the outside edge of foot; if not correct please advise. Last thing, with cleans today really focused landing on heels and felt like I was going to fall on my ass, however, I didn't and it felt pretty smooth. Is this the feeling I should look for? Once again, thanks for your advice and professionalism.
Greg Everett 17 | 2014-08-29
Tim - You shouldn't feel like you're falling backward - you should only have slightly more pressure on your heels than on the balls of your feet. The way you describe it, it sounds like your weight is shifting forward well above a low squat, which suggests ankle immobility isn't the culprit (at least at that stage). Also almost falling backward in a clean could suggest limited ankle ROM forcing you to sit back rather than down (i.e. shins are force to remain too close to vertical).
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