Dooley Noted: 6/2/2014
Why You Need to Stop Cueing Everyone to Push The Knees Out
I’ve seen some funky knee pain coming into my office over the past year. The pain has been exacerbated by a specific cue.
Several sources keep telling people to “push out the knees” on squats, lunges, or other strength feats.
I’m assuming this is to prevent valgus collapse at the knee. This is where the knee excessively moves inside the great toe on knee bending.
The general cue of “knees out” May be getting misconstrued by your client – and by you.
Valgosity of the knee in a lunge is – wait for it – normal human biomechanics.
In a pronated foot during gait suspension, the knee tracks over the second toe to stay over it’s center of mass.
By telling clients to “push the knee out,” the client may hear “abduct the femur.” It doesn’t mean they are protecting the knee. It doesn’t mean they are properly pronating, either. And they most likely will shift their weight to the outside of the foot.
That might get you some squat depth. This must not be applauded.
You’ve just lost your perfect triangle of power on the bottom of the foot. And your body will pay the price for bringing supination into a pronation phase of gait. And believe me when I state that the client will try to push their knees out in life.
Supination goes with an abducted, externally rotated, and extended hip. This is gait propulsion, mimicking the “top” of your squat or lunge – not the descent.
So, I implore you to stop cueing everyone to “push the knees out.”
Better cueing involves the following:
1. Make sure the back foot on a lunge or the top of a deadlift is supinating.
2. Make sure the front foot on a lunge or squat descent is pronating. Yes, a valgus knee is acceptable. Valgus “collapse” is not.
3. Check the position of the foot, ankle, knee, pelvis, spine, and ribcage before giving generalized cues like “push the knee out.”
4. Consider that not one client has the same for 1-3.
I know these extra steps take time. But telling someone to “push the knee out” may cause the client to end up seeing me for pain as their workout progress slows.
That cue isn’t for everyone.
As always, it’s your call.
– Dr. Kathy Dooley