What is Knee Valgus?
The Knee Valgus deformity (Genu Valgum) 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
a) Hip Internal Rotation (+Hip Adduction)
This is where the hip collapses towards the mid line.
b) Tibia External Rotation
This is where the lower leg bone (Tibia) twists outwards relative to the upper leg bone (Femur).
c) Ankle Pronation
This is where the arch of the foot collapses towards the floor.
d) Duck Feet Posture
This is where the foot points outwards.
(Although – it is also possible for the feet to point inwards as seen with Pigeon Toe.)
Is Knee Valgus bad?
With Knee Valgus, you lose the optimal alignment of your entire leg.
As a result – this can place excessive amounts of stress on structures of the knee.
This can potentially lead to:
- Premature arthritis
- Ligament damage
- Pain on Inside of Knee
- Meniscal/Cartilage tears
- Knee cap tracking problems (Patellofemoral Pain Syndrome)
- Clicking in the knee
- Anterior Cruciate Ligament (ACL) tears
- Pain when walking down stairs
Knee Valgus test
… How do I know if I have it?
In the standing position: If your knees touch and there’s a large gap between your ankles, then you likely have Knee Valgus (Knock knees)!
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Come join me on Normal vs Knee Valgus
a) In the ideal alignment of the leg:
The hip/knee/foot are in line with one another.
b) With a Knee Valgus deformity:
The upper and lower leg bone are misaligned with one another.
What causes Knee Valgus?
a) Functional cause
A combination of tight and/or weak muscles in the leg can result in the knee collapsing inwards.
This blog post is dedicated to showing you all of the knee valgus exercises that will help address this issue.
b) Structural cause
The physical shape/position/angle of the bone and/or joints in the leg 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 (as listed on this blog post), it is possible to prevent further deformation of the knees.
How to Fix Knee Valgus
Note: You may be required to address multiple areas (such as the Pelvis, Hip, Knee and Ankle) to completely fix your knee position.
1. The Pelvis
In some people – addressing the position of the pelvis may automatically improve the position of the knees.
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.
Feel free to check out my comprehensive guide on fixing an Anterior Pelvic Tilt.
See post: How to Fix Anterior Pelvic Tilt.
2. The Hip
The inward knee position is commonly determined by the inward collapse of the hip.
A. Releases
The tight adductor (groin) muscles which are causing your Hip internal rotation and Adduction need to be released first.
- Place the target area (as shown 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.
(Note: If you are not sure of where these muscles are located, feel free to have a look on Google.)
a) Adductor
Release area:
- Inner part of your thigh
- Groin region
b) Tensor Fasciae Latae
(As the Tensor Fasciae Latae is a weak internal rotator of the hip, it can still contribute to your Knee Valgus.)
Release area:
- Front of the outer hip.
b. Stretches
Now that you’ve released these muscles, it’s important that you follow it up with stretches!
a) Adductors
Instructions:
- Lunge to the side.
- Aim to feel a deep stretch along the inside of the leg.
- Hold for 30 seconds.
b) Groin
Instructions:
- Sit on the floor with your back to the wall.
- Place your feet together.
- Sit as straight as possible.
- Push your knees down.
- Aim to feel stretch in the groin.
- Hold for 30 seconds.
… Is your groin really tight? Check out this blog post: The 14 Best Adductor Stretches.
c) Tensor Fasciae Latae
Instructions:
- Assume the forward lunge position.
- (The leg at the back will be the side being stretched)
- 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.
Check out this post for more stretches: Best TFL stretches.
C. Strengthening exercises
It is vital that you understand how to activate the muscles that are responsible for hip Abduction and External rotation.
(These 2 movements will correct the hip position into a more neutral position which will guide the knees into a better alignment.)
a) Gluteus Maximus Strengthening Exercise
(Movement: Hip External Rotation)
Instructions:
- Lie on your side with your knees bent at 90 degrees.
- Whilst keeping your ankles together, lift the knee of your upper leg as high as possible.
- Make sure that you do not move your pelvis.
- Aim to feel the activation of the Hip External Rotator muscles (Side/Back of hip).
- Hold for 3-5 seconds at end range.
- Repeat 20 times.
b) Gluteus Medius Strengthening Exercise
(Movement: Hip Abduction.)
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 that you can feel the activation of the outer hip muscles (Hip Abductors).
- Hold for 3-5 seconds at end range.
- Repeat 20 times.
For more hip exercises like this: Exercises for Gluteus Medius.
2. The Knee
An imbalance of the muscles in the knee can lead to the outward rotation of the the tibia relative to the femur. (… as a response to the inward collapsed position of the knee.)
a. Release the 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.
Release with Massage Ball
Instructions:
- Sit on the floor.
- Place a massage ball underneath the outside part of the back of your knee.
- Proceed to apply pressure through the ball.
- Straighten and bend your knee.
- Continue for 1 minute.
b. release the outer quadricep
The outer quadriceps (Vastus Lateralis) will generally be in a shortened position when the knee caves inwards.
Release with Foam Roll
Instructions:
- Lie on the floor.
- Place a foam roller under the FRONT/OUTSIDE of your thigh.
- Apply an appropriate amount of your body weight onto the foam roller.
- Keep the leg relaxed.
- Continue for 1 minute.
C. Strengthening of the Quadriceps
If the thigh muscles (Quadriceps) are weak, they will have a difficult time stabilizing the knee in the neutral position.
Straight Leg Raise
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.
d. Stretch outer shin
The muscles located on the outer shin (Peroneal, Extensor Digitorum) tend to be over worked in someone with Knee Valgus.)
Outer Shin Stretch
Instructions:
- Whilst sitting, place your ankle on top of your other knee.
- Place one hand on top of the ankle and the other on the forefoot.
- Whilst anchoring the ankle joint down, pull the fore foot towards you.
- Aim to feel a stretch on the out side of the ankle and shin.
- Hold for 30 seconds.
E. Strengthen the Popliteus
The Popliteus is a muscle that is located behind the knee. It is responsible for correcting the out turning of the lower leg bone (Tibial External Rotation).
Popliteus Exercise
Instructions:
- Sit down on a chair with your hip/knees bent at 90 degrees.
- Keep your knee pointing straight at all times.
- Turn your lower leg inwards.
- (Internal rotation of the tibia bone)
- Make sure that your foot does not lift off the ground.
- Repeat 30 times.
3. The Ankle
The problem: If your ankle collapses inwards (pronation), it can cause your knee to also collapse inwards as well.
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 ankle mobility, the arch of your foot will likely collapse (Foot pronation) which can lead to the knees caving inwards.
Test for ankle mobility:
Instructions:
- Face a wall.
- Whilst keeping your knee in contact with the wall, aim to get the front of your toes as far away from the wall.
- Keep your heel in contact with the floor.
- Maintain your foot arch.
- Measure the distance between the tip of your big toe and the wall.
How much ankle flexibility should you aim for? At bare minimum – Aim to get your toe more than 4 inches from the wall with your knee still in contact with the wall.
If you are lacking Ankle Dorsiflexion, I strongly encourage you to check out my complete guide on how to fix this issue:
See post: Increase your Ankle Dorsiflexion
Here are some simple exercise to get you started:
a) Release the Calf muscle
Instructions:
- Place your calf muscle on top of a foam roller/ball.
- Put your other leg on top and apply a downward pressure towards the foam roller.
- Whilst keeping the leg at the bottom relaxed, roll your leg from side to side.
- Make sure to cover the entire muscle.
- Do this for 2 minutes.
b) Stretch the Calf muscle
Instructions:
- Place the top of your foot against a wall.
- Keep your heel planted on the floor.
- Keep your knee completely straight through this stretch.
- Learn forward into your ankle.
- Aim to feel a deep stretch sensation at the back of the calf.
- Hold for 1-2 minutes.
For more calf stretches: Gastrocnemius Stretches.
c) Ankle joint mobilization
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.
- Make sure that your knees do not collapse inwards.
- Do not let your foot arch collapse.
- Repeat 30 times.
B. Improving the arch support:
Note: It is vital that you understand how to do the Short Foot exercise properly as it will be required to be activated during the exercises as shown in Step 4: Combining it all together.
a) Short foot exercise
Instructions:
- Stand up.
- Keep the base of the big toe in contact with the floor throughout the exercise.
- Without gripping your toes, 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.
- Do not shift all of your weight onto the outer portion of your foot as this will make your ankle roll to the side (Inversion).
- Hold this for 5 seconds.
- Repeat 20 times.
4. Combining it all together
This last part of the blog post is actually the most important as it is where you will learn how to maintain the ideal knee alignment.
a) Single leg balance
(This exercise will help with the neuromuscular control of the lower limb.)
Instructions:
- Stand on the leg you wish to address.
- Perform short foot activation.
- (See section 3B: Improving the Arch)
- Push your knee slightly outwards to maintain the ideal alignment of the leg.
- Make sure that your feet are pointing forwards.
- Maintain your balance for 30 seconds.
- DO NOT allow the knee to collapse inwards!
- (Note: If required – you can use your hand to provide some support.)
b) Wall push
Instructions
- Lift your knee up to hip height and place the side of that leg against a wall.
- Activate short foot exercise on the foot that is planted on the floor.
- Bend your planted leg slightly so that you are not locking your knee completely straight.
- Make sure that you are driving your heel into the ground.
- This engages your hip muscles more and places less stress on your knee.
- Push the lifted leg firmly into the wall.
- Do not lean your body weight onto the wall.
- Aim to feel the outer hip muscles engage on both sides.
- Maintain the straight alignment of your knee.
- Hold this position for 5-10 seconds.
- Repeat 5 times on both sides.
c) Squat
Instructions:
- Sit upright on a chair with your knees bent to 90 degrees.
- Loop a resistance band around both of your knees.
- Keep your feet pointing forwards and shoulder-width apart.
- Push and maintain your knees in an outwards position.
- Aim to feel a muscular contraction on the side of your hip.
- Stand up and sit down.
- Do not allow for the knee to collapse inwards throughout the entire exercise.
- Repeat 10 times.
d) Step up
(For this exercise, you will need to use a small step.)
Instructions:
- Place your foot onto the step. Keep it pointing straight.
- Engage short foot activation.
- Push your knee slightly outwards to maintain neutral knee position.
- 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.
e) Single leg hinge
Instructions:
- Balance on one foot.
- Keep your balancing leg slightly bent.
- Activate the short foot and hip abductors.
- Maintain Hip/Knee/Foot alignment throughout the exercise.
- Proceed to hinge forwards without letting your knee deviate inwards.
- Repeat 10 times.
- Repeat on the other side.
f) Single-leg Squat
Instructions:
- Stand on one leg.
- Maintain your balance.
- Make sure to keep your hip/knee/foot in alignment.
- Proceed to perform a single-leg squat to a depth that you are able to comfortably control.
- Do not allow your knee to collapse inwards throughout the exercise.
- Perform 10 repetitions.
5. Increase Big Toe Extension
In terms of walking, limited big toe extension will generally lead to the out turning of the foot and inward collapse of the knee as the trailing foot pushes off the floor.
(Due to the change in gait pattern, this is why a stiff big toe may also lead the development of a big toe bunion!)
a) Release The Big Toe Flexors
Instructions
- Locate the target muscles: (Use Google to find their location)
- Flexor Hallucis Longus
- Flexor Hallucis Brevis
- Place your foot on top of a massage ball..
- Apply an appropriate amount of your body weight.
- Proceed to roll your foot on top of the ball.
- Make sure to cover the entire big toe flexor.
- Continue for 1-2 minutes.
b) Stretch The Big Toe Flexors
Instructions
- Sit down on a chair.
- Place your ankle onto the other knee.
- Hold the big toe with your fingers.
- Pull it backwards.
- Aim to feel a stretch underneath your foot.
- Hold for 30 seconds.
- Repeat 3 times.
c) Strengthen The Big Toe Extensors
Instructions:
- Keep your foot on the floor.
- Lift up your big toe as high as you can.
- Do not move the other toes as you do this.
- Aim to feel a contraction of the muscles at the top of your big toe.
- Hold for 5 seconds.
- Repeat 20 times.
- Progression: Apply additional resistance with your finger in this end range position.
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.)
It will encourage an excessive amount of internal rotation in the hip.
b) Driving
When driving – keep your knee and foot pointing in the same direction.
(Many people tend to have their knee facing the brake pedal and their foot on the accelerator which can lead to malalignment of the leg.)
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 favors if you are trying to address your Knee Valgus.
d) How to sleep with knock knees
If you feel that your sleeping position may be contributing to your knock knees, consider allowing your knees to drop out wards whilst sleeping on your back.
This places the hip in a position of external rotation.
Knee Valgus Brace
There are braces called Knee Valgus Unloaders that can be worn to help improve the alignment of the knee.
If you have a pronounced presentation – the braces are best used in conjunction with the suggested exercises.
Conclusion
Knee Valgus is where the knee collapses towards the mid line of the body.
It may predispose you to certain issues in the knee such as poor balance, ACL tear, knee cap tracking issues etc.
The suggested exercises on this blog post can help improve the position of your knees.
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!
The content presented on this blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. It exists for informational purposes only. Use of the content on this blog post is at your sole risk. Seek medical guidance before attempting any exercise. For more information: Medical disclaimer.
Hi Mark!
I’ve never heard of or been diagnosed with valgus knees or anything structural but since about the end of middle school, I’ve been aware of the way my knees seem to cave in. I’m quite short so it’s especially eye catching. I play soccer and tend to have a hard time stretching my legs out properly sometimes and I also have weak ankles. I have to wrap them almost every game so they won’t feel “loose.” I understand that since I’ve had these knees most of my life, the change I can produce would be limited but I would love to hear some feedback and where to start with exercises. I’m also curious on whether or not losing weight would aid in the “bump” around my knees? I could upload a photo or two to display what my legs look like but I’m unsure on how to link it.
Hey Jocelyn,
You can try using those image share website and upload your photo. I’ll have a look for you.
Mark
hey Mark. I just read your post about fixing knock knees which u totally have all the symptoms you talked about in my left leg. I need to do all these but I feel so overwhelmed.
but one main question I have right now is. you said to NOT do W sitting. I noticed when I lay on my back and put my left foot outwards to 90 degrees in line with my knee. kinda like making a letter T if I did it with both legs. when I do this it relaxes all my twitching in my leg and reduces my sciatica symptoms. it really helps. it’s not exactly W sitting but it’s close. why does this seem to help me? and should I stop ?
Hey Al,
Interesting how that particular position reduces your sciatic symptoms! I wonder if your piriformis muscle is tight and is being relaxed in this position?
Have you tried performing a piriformis stretch to see if you get similar effects?
In regards to the valgus, this is probably not the best position to be in, but if it reduces your symptoms, it can be fine to do for a short period of time.
Mark
Hey Mark :)
I have a question. I have inner knee pain as well as tightness in the inner quads as well as inner calves. I noticed when I stand straight with feet pointed in front of me my knees go inward and my legs bow outwards, but when I stand at a 45° angle they are pointed straight and my lower legs don’t bow. I was just curious if this is different from knee valgus or if it is it. I weight lift but I am in pain constantly and I’m in nursing school so I need some serious help!
Thank you so much :)
Hi Natalie,
Do you happen to stand with hyper extended knees? This can cause your knees to point inwards and feet to face forwards. This is a different to knee valgus where the knees are closer to each other.
For more info, check out this post: Exercises for Hyper Extended knees
Another thing to look out for is if your hips sit in excessive amount of internal rotation. This can cause your femur (upper leg bone) to rotate inwards which makes the knees face inwards. If this is the case – you may benefit from the hip external rotation exercises mentioned in this blog post.
Also – For more specific information about your knee pain, check out this post: Inner Knee Pain.
Hope this helps.
Mark
Hey Mark,
I hope you and your family are well.
I’ve torn my medial meniscus and due to have surgery in June 😞
I also have severe pain at the lateral side of my tibia for some reason.
I’ve been looking at your blog for knock knees (pretty sure this is me).
Looking at your exercises, it also states anterior pelvic tilt. I think mine is anterior and lateral hike.
Anyway, so not to get overwhelmed I’m unsure of where to start exercise wise? I really don’t want surgery but I’m in so much pain.
I also have swelling too and it radiates down the front of my shin. Literally feels like my bone is about to snap
Your blog is incredible. Im just not sure where to start in my case 🙂
Hello Robyn,
You’ll need to load the knee as much as you can without causing further pain/symptoms. This will give the knee the best chance to get stronger and tolerate more load.
If you get to a stage where there are no symptoms (even if the meniscal tear is still there), you might be able to avoid the surgery altogether.
You might benefit from having a good read of this post. It goes through some exercise that might help.
I would focus more on loading the knee and getting it stronger before addressing your said postural issues.
As you have pain in the knee, it is very likely that you have altered your walking pattern. This can cause other areas of the body to hurt and may explain why you might be having pain on the shin area.
Mark
Mark,
Your website is a lifesaver. I don’t use social media (privacy) but you don’t address flat feet in your article. My feet are so flat that I have an extra bone in each foot (anatomically). I have about 2 degrees of dorsiflexion and about 80 degrees of plantar flexion (it’s been 20 years since I measured it in grad school).
Is there any other way to contact you outside of social media. An email account?
Thank you,
Hi Karyn,
If you would like to see some exercise for flat feet, please have a look at this blog post: How to Fix Flat Feet. Flat feet can occur along side knee valgus.
Is the extra bone the accessory navicular bone? If so – You will still benefit from the exercises mentioned in the blog post.
2 degrees of dorsiflexion is quite limited! Limited ankle dorsiflexion can also lead to pronation of the feet as you walk. Have a look at this post: How to Improve Ankle Dorsiflexion.
In terms of contacting me – best way is through the comments section in the blog post as I make it a priority to reply to every one who leaves a comment.
Hope this helps a bit!
Mark
Hi Mark
It’s pretty amazing how you still keep updating this website/ replying after 4 years!
My case is pretty much complicated. I used to have an anterior pelvic tilt and still struggle with knees pain.
So I have/ had most of this problems from this article. Now my lower back pain is pretty much gone but knees still give me nightmares.
I have been tackling these issues for a long time. First when I started I couldn’t squat without a clicking pain/ sharp pain especially in lunges in the back leg. Nom I’m doing weighted lunges/ squats without a pain. However I think that what flares up my knee is gait. My posture when I stand is pretty good however the right knee while performing one leg stands collapses in. Both knees are in pain btw. When I recorded myself I’ve noticed that I walked like a duck and also feel like my femur is straight but the leg comes into the ground from the side causing a weird leg alignment. Can you please have a look of the video of my gait/ standing on one/ both legs and advise me what to prioritise?
I assume it can be an incorrect tibia rotation.
I went to multiple physio but it seems like they can’t see the complexity of the human body
I would really appreciate it. God bless you
Hey Mateusz!
It does sound like you might have something going on with the relative alignment of the femur and tibia. Is this angulation present on both sides?
Sure – send me a link to your video.
Mark
Hi Mark,
Thanks for getting in touch with me!
Here’s the link on wetransfer. I’ve uploaded 3 pics and 2 videos.
I feel like my left leg is more angulated. Notice how standing on the left leg feels more stable. I’m still on this leg. The right one I recorded myself so you can see how my leg wants to cave in and how I need to actively turn it out, feeling much stable after corrective movement.
Again usually doing weighted exercises brings me actually relief. It’s kind of funny.
Giving you more info my groin, hamstring and lower back are usually pretty tight. The right hip flexor is tighter then the other one. They are pretty good now when doing couch streches.
Recently have introduced Outer Shin Stretch as in your website and first time I’ve tried it my leg would go numb very very tight with a right leg tighter again.
Looking forwared to hear from you :)
Hi Mateusz,
Looks like you have poor control of your hind foot. When you are walking, the hindfoot everts quite excessively which collapses your leg inwards and orients the forefoot out towards the side.
This would make me want to check the amount of ankle dorsiflexion in your ankle. If you are limited in ankle dorsiflexion, this can result in excessive eversion during walking.
I would also check if your mid foot was stiff. As you walk, the mid foot should splay out on the ground. If the mid foot is stiff, this can also lead to eversion of the ankle. You can start to address this my rolling a massage ball underneath your arch.
If your ankles/foot aren’t in the ideal position, this may lead to increased tension in the other leg muscles to compensate for the unstable foot. This can lead to the tightness in the muscles you mentioned.
Mark
hi Mark
I sent you an email…no sure what is wrong or how to fix…I bang my ankles together when backpacking.
Hi Jennifer,
I responded to you on Facebook.
Thanks
Hey mark,
I have a question
When a muscle contract does the other mucles that attches to that muscle getting streched?
Ive seen that the biceps femoris muscle attaches to the fibularis longus and it also attached to the erector spinae thorough ligaments…
So my question is when the biceps femoris contracts does the fibularis longus and erector spinae getting streched?
Hi Aviv,
No – a contraction in one muscle does not automatically mean that the other muscles which are connected via fascia will be stretched.
Mark
Hi there, I was wondering if you offered any online appointments or something related on a one to one online basis which is online
Hi Daniel,
I don’t offer online consultations at the moment. Is there a particular question you wanted to ask me?
Mark
When I try to turn my right inwards (towards my leg foot) it feels extremely stiff, I can barely move it inwards. And my knees seem to cave in when doing exercises. I naturally walk in a duck feet posture so I’m guessing this is why. There are a vast amount of exercises on your blogs and I’m not sure which would be best for me. What would be the best exercise to release the stiffness in my feet for inward motion and what exercise is best to strengthen this inward motion
Hey mark, i have knee collapse inwards in my right leg but not on my left so asymmetric, i did bone scan and pelvic xray for pain purposes nor for knee valgus but they didnt say anything so i dont know, i would say it is moderate valgus, not extreme and not easy, the pain is also moderate but the thing is that i feel like it is affecting also my upper body like i need to compansate or something but i cant seem to fix it or improve, i read the knee valgus,rotated pelvis, anterior pelvic tilt blogs and i tried the exercises but i dont know i tried to do single leg squat to box for example and i can do more than 10 reps but i think my knee collapse during the exercises, i can do like 6 pistol squat all the way down on that leg but i experience my knee in a lot of tension, but i cant seem to fix it , i think i feel mostly my side of my glutes working and less of the glute itself if it makes sense? But how is it possible that i can do 6 pistol squat and i feel strong but doesn’t fix it or improve it because it is a lot of power to to these, i really need your help because im trying to fix this problem for more than 3 months, and i just dont know what to do anymore, i also did infra red walking scan to see how i walk and they said that they also see my right leg like i described where it goes inwards, they said to train quads glute max gastrosoleus, tibialis posterior, external rotators, and do unstable surfaces. But i feels like i dont improve, and i had like 5/6 sessions with a physical therapist for the recommendation the infrared guys said, so please i need your assistance if possible.
The sessions with the physical therapist were once a week so like 5/6 weeks where i did exercises at home and in the pt office or whatever.
Hi Aviv,
Sounds like you have done quite a lot of exercises for the knee and hip already.
Have you tried focusing your exercises on the feet/ankle?
The knee will tend to follow where the foot directs it.
Do you have adequate amount of Ankle Dorsiflexion? Tight ankles may cause the knee to roll inwards as the knee bends forwards (eg. single leg squat).
And do you have flat and/or pronating feet as you perform the single leg squat? If so – you may need to consider exercises for flat feet.
Other thing to consider is to check if your tibial external rotation. This is where your knees point forwards but your tibia (and foot) is rotating out wards.
Mark
Hello. I have femoral retroversion in both legs, tibial torsion in both legs, knock knees, flat feet( no arch) and my feet point out ward and I have a waddling gait. The only way to correct this is surgery. I am unable to do split squats, lunges, balancing on a single leg and any single leg exercise. Is there any exercises I can do that will help the same as the above mentioned exercises do?
Hey Dawn,
For structural knee valgus, there is going to a certain limit as to how much you can really change with exercise alone. You will need to focus on developing strength in as many different positions as possible. For example – if you can’t perform a lunge, you might need to regress to a wall lunge exercise instead. You may also benefit from exercises to the feet as seen in this blog post to help strengthen the foot and to reclaim as much arch as possible.
Mark
How long does it take to see some results?
It would be kind of you to tell as soon as possible : ).
Hey Sam,
It is possible to get results straight away! But this really depends on how committed your body is to having knee valgus.
For example – the tighter or weaker your muscles are, the longer it will take to improve.
Keep in mind – if the knee valgus is structural, there will be a limit as to how much you can change.
Mark
Hi Mark,
I discovered your website after being diagnosed with knee valgus. After a decades of a physically active lifestyle with jogging, yoga etc., all of a sudden I suffer from knee pain, have to cut running, and many easy and familiar yoga poses hurt. What I get from health professionals tends to be “You have knee valgus. Well, too bad.” With limited means to get more professional help, I’ve started to educate myself online. And I’ve learned so much and have started to take steps to work on the problem, which may not be irreversible at all!
I’m just starting to get more familiar with your website, but what strikes me is how thoroughly you go through every aspect of different problems. Your passion and genuine desire to help people shines through! I has already touched my heart, and as the numbers om your followers show, many other people’s, too.
So this is just to thank you. You are a blessing and I pray many blessings to come back on your way!
Thank you,
Mina
Hi Mina,
Thank you so much for this comment.
Comments like this really make my day and I appreciate that time you took to write it.
All the best!
Mark
Hello Mark,
Even after the tests, I am not sure whether I have knee valgus or not. My legs, however, have a strange alignment. I also have knee pains in the inner near joint area. Can you take a look at my legs and help diagnose to see what might be the problem?
Thanks
Hey Justin,
Can you link me a photo of your knees? I can check it out for you if you would like.
Mark
Hi Mark,
Here are the photos: (link removed)
I would also like to note that while sitting down, knees in a 90 degree position, they creak while going back and forth near or on the patella. When flexing the knee, it does not creak.
Any ideas?
Thank you!
Thanks for the photo.
It seems that there might be a degree of bowing in the tibia bone. This is most likely structural and can not be changed. Keep in mind – presence of bowing does not always equate to having any problems in the leg.
I can’t see from the angle you took on the photo, but do you also tend to hyperextend the knees? Are you able to reclaim better alignment if your slightly bend the knees and push the knees outwards? Also – are you or were you involve with any sports which involve a lot of side to side movements such as soccer?
Mark
Sorry for the late reply,
I think I do have hyperextended knees, which I have not noticed.
My tibia seems to be straighter and have better alignment when reclaiming an arch. I do have flat feet and am making good progress on it.
I have played lots of soccer, especially at ages 6-13.
It is possible for the knee joint structure (bump inwards) to change after addressing the problems? Do you have any recommendations?
Justin
Hey mark i have a question, what is the difference between hip external rotation when the leg is free VS hi external rotation when i stand on the leg, meaning i stand on my leg and “creating” knee valgus and then fix it by moving the knee to the side which than the femur, tibia and foot in the same alignment but when i stand on the leg and not like see in pictures that demonstrate hip external rotation, i saw the external rotation muscles but it seem very different when the hip rotate with the foot and without the foot… What is the difference? Is it the same muscles the hip external rotation? I would very like to understand this concept if you can answer thanks.
Hey Daniel,
Hip external rotation of the hip can be produced 2 ways:
1. The leg bone rotating outwards on a stable pelvis.
2. The pelvis bone rotating away on a stable leg bone.
They use the same muscles to produce the movement in the hip.
Mark
Hey mark,
So i have a question, there are a lot of people with knee valgus and there are a lot who doesnt but the thing is if someone fix knee valgus does it have a point where more training would harm it to the other side? Opposite of knee valgus or it doesnt exit, if i fix my knee valgus and i will achieve healthy and proper alignment of the knee,ankle,foot and now i decide to strengthen the same muscles that fixed the problem will it cause the opposite problem? Or does stay the same and just get stronger? Im asking because i saw a lot of people who had anterior pelvic tilt for example and they strengthen the glute max in a crazy amount (guys and girls) and they didnt develop a opposite problem where the glute overpower so much that it causes the opposite problems… So to sum up,
If i train and train the glute max and med and fix my knee valgus and my anterior pelvic tilt and i want to train the glutes way more after, wouldnt it caused me the knee to collapse outwards? Instead of inwards? Because the muscles would flex much?
Hey Daniel,
With the exercises, your goal is to maintain a somewhat neutral position of whatever body area you are trying to address.
For example, if you have an anterior pelvic tilt and using your glutes to bring the pelvis into a more neutral position, if you keep getting stronger glutes, this does not mean you’ll now have a posterior pelvic tilt.
You are essentially aiming to use the glutes in a more neutral position. If you start to use your glutes in a posterior pelvic tilt all of the time, than this may cause an eventual posterior pelvic tilt.
Mark
Is it possible that a knee valgus and flat foot in my right leg cause the leg to be shorter than the other leg which does not have it to the same extent? Its worse in my right leg, can it cause the right leg to be shorter?
Hey Daniel,
It is certainly possible!
Mark
Hey Mark!
I have a question, a friend of mine said that he fixed his knee valgus and gained an inch or an inch and a half in height, I also noticed that my right leg has worse valgus than my left and my right leg is about 2 cm shorter than my left leg.
Do you know if Knee Valgus has an effect on height?
Thanks,
Chris
Hi Chris,
Yes – you can lose a bit of height with knee valgus. This is because the leg bones aren’t in their vertical alignment.
Mark
Hello, Mark! It’s a pity, that I didn’t know all this information at least three years ago. Thank you for this deep and structured material. May be you also can add something about working in front of the PC with the valgus deformation? I also have troubles with my neck and back, and work as web developer. I am thinking of buying a knee chair, but don’t know, if it suitable for knee valgus..
Hey Anastasia,
Kneeling chairs are helpful in keeping your pelvis in a more neutral position whilst sitting.
You can also use them if you have Knee Valgus. You’ll just need to make sure that you don’t allow your knees to point inwards as you are sitting.
Mark
Mark,
Your site is really well put together and informative.
I have wear on my right shoes on the inside heel, and I’ve noticed they are rounded up at the toe in comparison to my left foot.
I have foot pronation on my right ankle, my right femur is rotating internally and my right hip is lower than my left. I’ve had chronic ankle sprains from soccer over my career.
38 years old now and it’s catching up with my. I have back pain, and x rays confirmed the hip drop and my spine is curved medial to lateral…anterior to posterior my spine looks fine per the Ortho surgeon.
When I walk, I do exactly this –
In terms of walking, limited big toe extension will generally lead to the out turning of the foot and inward collapse of the knee as the trailing foot pushes off the floor.
My foot turns out and the medial side of my knee collapses.
With the information given, what can you suggest to deal with the rounding of my foot/knee valgus/internal rotation of the femur?
Hi Aaron,
Thanks for dropping by.
To optimize walking, you will need to make sure that you have adequate big toe extension and ankle dorsiflexion. I would start with these 2 first.
If you don’t address these 2 first, it will be challenging to reclaim a more ideal walking pattern.
Once these factors have been addressed, make sure that you know how to maintain your foot arch. See post: Flat feet. This is so that your foot stays in the correct alignment as you place your weight through it whilst walking.
The next step would be to strengthen the hip muscles that external rotate. This will help prevent the knee from collapsing in.
If your lateral pelvis tilt remains, you might need to address that directly as well. See post: Uneven hips.
Mark
mark,
thanks for sharing this. in my case, at first I think I have a problem with my knee valgus because of the knee plate inward, the thighs look straight, but there is a gap on both my shinbone however my ankle doesn’t apart so it looks like bow legs. kind of confusing, do I have bow-legs or knock-knees? and how to straighten my legs. please help.
Hi Jonathan,
That does sound like a type of bow legs.
Do you also have a degree of knee hyper extension?
Mark
Hi mark, but what does it mean if i only have knee valgus on my right leg and arch collapse but my left leg is fine?
Hi Aviv,
1. Structural issue on the left leg.
2. Weakness in glutes and foot arch muscle in left leg.
3. Pelvis rotated towards one side.
Mark
Hi mark
I’ve always had my right knee look a little like it was on the ‘inside’ rather than central but I walked straight and had a normal life.
Post pregnancy I’ve had a lot of problems – the right knee seems in constant valgus, even in standing, and my right foot points out to the side. I’ve been told my pelvis is also unstable and rotated towards (my) left. I have some sacroiliac joint pain on right.
Scans showed I had quite a lot of external tibial torsion (50 degrees) and femoral anteversion (28) on that side so I’ve been offered surgery to correct it.
I don’t really understand though why the leg is acting so differently – does the pelvis losing stability explain it all? I’ve done seven months of physio but no changes yet. Not sure whether to go for surgery.
Hi Miss Muffet,
If the hip joint and/or the relative position of the neck of femur is causing your leg to be orientated in an internally rotated position, you won’t be able to drastically change this as this is determined by structure/genetics.
That being said, there are still many exercises you can do to strengthen the knee and minimize the amount of valgus.
Generally speaking – I would encourage you to perform exercises that bias the right leg such as single leg balance, step ups/step downs/toe taps/lunges etc to help the leg tolerate being loaded. (Make sure that you are comfortable when performing the exercises)
Due to the internal rotated orientation of the femur, it is common to see the tibia externally rotate as a compensation. Focus on strengthening the inner hamstrings and popliteus muscle to help address this.
I also suspect that your hindfoot may be rolling inwards as you walk. I suggest asking your physio to give your foot stability drills if you are experiencing issues with this.
Do you have tight ankles as well? See post: Ankle Dorsiflexion. Ankle Dorsiflexion is very important to encourage normal walking mechanics. Compensatory patterns during walking could lead to an increased amount of tibial externally rotation.
Poor control of the pelvis may also be associated with lower limb compensatory patterns. The single leg biased exercises mentioned above might help improve this control.
Mark
Should I post a picture of my current status of knock, As it will be helpful to correctly identify the area I need to work on .
Hey Aman,
Feel free to link me to a photo.
Mark
Hi mark, through my research on how to cure my knocked knees, i’ve seen references to “the deep front line” and that it being dysfunctional causes knocked knees too. Do the “putting it all together” exercises hit the deep front line by any chance? I couldnt find any deep front line coordination exercises, so im hoping yours will fit the bill. I hope this question isnt too weird lol… Thank you!!
Hi Jean,
The exercise don’t specifically address the deep front line but I am certain that it will be involved with the “Putting It All Together” exercise.
If you want to include some deep muscular work, you will need to make sure you know how to engage the diaphragm muscle in the appropriate rib cage position in conjunction with your core muscles as you perform these knock knee exercises.
I go through some breath work in the breathing section of this post.
Mark
Hey mark,
I’m a little confused about wether my right hip has an internal or external rotation problem.
So my pelvis is rotated to the left when i’m standing. This would mean that my left hip is rotated internally and my right hip is rotated externally.
Now when i straighten out my pelvis to face forward, my left leg is lined up but my right leg seems to have the knee valgus issue. My right foot pronates and my right knee points inward and my right hip is now internally rotated.
So when my pelvis is rotated to the left i feel like i need to do internal rotation hip exercises on that right hip but when i straight my pelvis out and my right leg has a clear knee valgus issue, i feel like i have to do external rotation exercises on that right hip. which exercises should i focus on more for my right hip? internal or external?
Thanks Mark
Hey Josh,
It does sounds like your right hip is lacking pure internal rotation. (likely due to the fact that this hip is always in hip external rotation)
If this is the case – when you try to rotate the pelvis towards the right hip (internal rotation of the right hip), the right hip will reach a certain limit in its range before it can’t move any more. This will usually cause the right foot to roll in, knee to collapse towards mid line, and perhaps maybe even hyper extension of the right knee.
In this scenario – you will need to work on increase the amount of internal rotation in that right hip before committing to the rotated pelvis exercises.
See post: Internal rotation of hip
Mark
Hello
My daughter is 13. She used to be pretty pigeon toed, however I noticed more recently that her feet are straighter but her knees look knocked. Today she was on stage for a play and I would have sworn she was clenching something between her thighs even while doing a box step dance move. Anyway, she tends to get some lower back pain, do you think that could be related? I would like to try these exercises with her however I’m not sure her attention span would allow for the whole workout. So would it be still beneficial to split it up I to two days? How long do you think it would take to see a difference to know if it was worth contiuing? What type of doctor/physio would I go to to diagnose whether it was structural?
Hi Amy,
Knee position can definitely be related to lower back pain.
It is fine to split the exercises up between 2 days.
In terms of how long it will take, it really depends on how committed the body is to the knee valgus position. Keep in mind, if this is a structural issue, there will likely be a limit as to how much your daughter can change with exercises.
Most Physiotherapists should be able to help you out!
Mark
Hi Mark,
I had developed right knee valgus 4 years ago from being flat footed due to scar tissue in the plantar aspect of foot. With exercises and stretching it jas been under control, but now for the past 4-5 months it’s limiting my functionality due to pain in ankles, and starting to develop some back pain early in the morning to get out of bed. Do you think these exercises will improve the structure and functionality? It’s time consuming.
Hi Esther,
These exercises should help improve the position of the knee.
If you developed knee valgus after a foot injury, you might actually need to spend more time addressing that. (See post: Flat feet)
Mark
Yo ive been doing alot of exercies for flat foot hip and glutes none seem to be helping i want to know whats the main problem for causing my knee to cave inward please help me out i dont want to waste time with workouts that wont help me
Hey there,
If you have persisted with glute and foot exercises for a prolonged amount of time (which I assume you are performing correctly and the right intensity) and still have knees that cave inwards, your knee valgus may be structural.
This means there may be a limit as to how much you can correct this. If you do not feel that it is structural, I would suggest seeing a health professional to double check if you are performing the exercises correctlty.
All the best!
Mark
Hi mark,
My issue is i tore my right acl 5 years ago.. my knee is a bit unstable Still but it doesn’t cause me Much pain And I can still run in straight lines and do things on it like work and gym but my right calf is like over working to like protect my knee I think and it’s restricting my right ankle dorsi flexion And ruining my ability to squat.. and when I stretch my calf and ankle in certain positions it makes my right knee sublux quickly or feel like it wants to sublux or something shifts in my knee and I was wondering is there Exercises I can do to fix this or do I need to get the acl reconstruction to make the calf let go to make everything else work normally ?
Hey Jake,
In 90% of the people that I see with a complete ACL rupture, they have had the ACL reconstruction surgery. Since the ACL provides a significant amount of support to the knee joint, it is generally recommended that you get the surgery. (but please consult your doctor if you have any doubts)
If there is additional laxity in the knee joint, your surrounding knee muscles will need to compensate for this. In your case – It sounds like your calf muscle.
Controlled strengthening of the calf in full range of motion will be important. I would also recommend strengthening the hamstring muscles in full range as well.
If it has been 5 years since the initial injury and you no longer have major dysfunction, I would say keep persisting with strengthening of the hamstring and calf muscles.
Mark
Very good thankyou 👍
Excellent article. Many thanks! I am wondering if a person can have knee vaglus but no duck feet? My knees are valgus, I have internally rotated hips but my feet are also internally rotated. (called pigeon toed as a child). I had to wear a brace as a baby. It was shoes with a hard bar between them that externally rotated my feet but also my hips. Obviously, it wasn’t enough because at 48, I still trip over my inward turned feet on occasion and I’m knock-kneed!
Hey Amber,
Yes – you can certainly have knee valgus without the duck feet presentation.
If you have inward facing feet, this would usually occur along side a prominent amount of hip internal rotation.
Do you have femoral anteversion?
Mark
Yes I believe so. I have not been evaluated since I was a child but my Mom always told me that the doctors said it was my hips that were turned in. I suppose that meant femoral anteversion. Docs insisted that I not sit in the W position even though I found it most comfortable. They were concerned it would make the hips turn in more. Since my feet are the thing I notice most, because they are visibly “off”, I tend to forget that the problem starts at the hip. Will these exercises help with that?
If you have femoral anteversion, your normal “neutral” hip position might actually be in the rolled in position.
The exercises mentioned can help, but I wouldn’t force the position as it could cause irritation in the lower limb.
You can get a scan to the hips to check if they are anteverted. (Alternatively – you can perform the Craig’s test)
Mark
Thank you for sharing your knowledge Mark. I finally have some understanding of what is going on with my legs. Only took me 48 years! I will look into that test for sure. 8 )
Amber
Hi… My 14 year daughter has flat foot… Can it is possible to build arch with exercise at this age…. Her left foot point in while working… How to fix it.
Hi Reeta,
If she has a functional flat foot (not structural), then these exercises should help develop an arch in the foot.
Mark
Hello Mark, I will try these exercises for sure and this is the best website i have found. But i have some questions, please tell me is it due to knock knees or any other problem:
1. I have heel pain when i walk and push off for a run. I can’t walk faster and walk weirdly too.
2. I can’t do squats or lunges means i can’t go down and i don’t think i have meniscus tear.
3. I have knee pain when i climb stairs and sometimes i think i can’t climb.
4. Since my i childhood i used to sit with bent back so is it the main problem of this.
I am just 15 please help me.
Hey Rahul,
Thanks for your questions.
1. Heel pain is common plantarfasciitis, heel spur and/or achilles tendon issue. Can certainly be related the knock knee.
2. This really depends on what is stopping you from bending your knees all the way down. If you suspect a structural problem, I would advise getting a scan.
3. This can be related to Knock Knee. On top of performing the exercises mentioned on the blog post, I would also suggest doing these exercises.
4. If you are referring to a slouched posture, check out these exercises.
Mark
Nice
Mark, glad you!
1. My pelvis is turned to the right, but my left leg is also turned to the right, it seems to me (in internal rotation) – when I stand in place relaxed. but when I start walking my left leg seems to be in external rotation. does it work like that? how to understand what I have, internal rotation of the leg or is it rotation of the pelvis?
2 If the pelvis is turned to the right, the left leg will always be in the outer rotation, and the right in the inner rotation … and standing still and walking?
thanks Mark.
Hi Olga,
Thanks for the questions.
1. Your static posture does not always indicate your dynamic posture. This basically mean, how you stand does not dictate how you walk. I would have to see how you walk to give you better recommendations.
2. I think I may have answered this question in the previous answer. If you are having issues with pelvis rotation, I would recommend these exercises: Rotated Pelvis.
Mark
Mark, can I email you to help me? I am ready to pay for your consultation, in any amount of money, how much you say. I don’t know who to turn to anymore, please help. I am asking not for myself, but for my brother, he has a problem that arose after a sports injury and an imbalance in the muscles started. We are from Russia, and we do not have specialists like you, please help!
Hi Olga,
I currently am not accepting online consultations. (I don’t have time at present).
Feel free to ask me questions through here as I try to answer everyone!
Mark
My son has really bad knee valgus. He has very limited leg strength and balance. Along with these movements what braces would you recommend for the knee or feet?
Hi David,
Unloader knee braces can help, although, I would say that the exercises should always be the main method to address knee valgus.
If your son has flat feet, orthotics in the short term may also help.
Mark
Excellent article! When I was younger I W sat. My knees hyperextend naturally because of this and I want to fix my posture/ hip, knee, ankle alignment so I won’t have issues when I’m older. Thank you for this.
Hi Tierra,
Hope the exercises help!
Make sure to check this post too: Exercises for Knee Hyperextension.
Mark
Hi Mark
My right knee turns in slightly and my right foot points out to the side. My right foot is also pronated. Does this sound like knee valgus to you? And do you think that stretching my internal rotators and strengthening the external rotators should solve this problem?
Thanks for the post!
Hey Rose,
Yes – this sounds like knee valgus.
If your feet are positioned directly underneath your pelvis, then stretching internal rotators and strengthening external rotators should help.
However – if your pelvis tends to be more shifted towards the left side, this can give the appearance of a knee valgus. In this case – you will need to shift your pelvis back over the feet.
Mark
Hi Mark,
Thanks for the guide. Helps a lot.
I have been doing these exercises for the past few months and see some improvement:
* Stretches (3-4 times per week) – Adductors, groin, Dorsiflexion Of The Ankle (release, stretch calf muscle, ankle join mobilization);
* Strength (1-2 times per week) – clamshells, monster walk etc.
* Arch (Daily) – Short foot exercise
* Toe (Daily) – all 3
I also did a quick check from other exercises to find out that I don’t have tight calves, but I have tight hamstrings. Hips feel not too tight as well.
Can you recommend a way to figure out which muscle/area should I focus more on to get better results?
Hi Sahil,
If you do not have tight calves, you may not need to work on your ankle dorsiflexion. This might save you time.
If you have tight hamstrings, I would prioritize releasing lateral hamstring.
I would say you probably could get most of benefit from focusing on the hip exercises.
Mark
Hi Mark! My daughter is 13, I have never paid attention I guess before, but now I really noticed that she has the knee facing inside, she was always active, doing gimnastics for 7 years, but for the past couple of years she only goes for a walk with me, my question is should I take her to a doctor or just do an exercise first?
Thank you so much 😊
Hi Oxana,
I would recommend that you see a health professional (physio, chiro etc) in conjunction with these exercises. (just to be on the safe side)
Mark
On strengthening the big toe… i cannot raise my big toe at all without raising my others! Is it ok to start out by holding the other four down?
I was told by a physiotherapist that i have one hip rotated inward and one rotating outward and I definitely notice knee valgus on the internal rotated hip, this page should help!! Thanks!
Hi Cynthia,
Yes – you can do this to begin with. As you gain control of your toes, try not to use your hand.
Also – check to see if you have any Pelvic Rotation.
Mark
Hi Mark , thank you so much for this informative post. I am suffering from exact non structural valgus which caused due to ACL injury in left leg but my right knee caved in to compensate loading and strength while playing Badminton. I have stopped playing now.
3 Question if you can answer plzz .
a) Can i do cycling and running alternative say 3 to 4 times a week around 5 miles a day?
b) Does all these exercises have to be done in single session or everyday different?
c) If i follow your recommended exercises when can i expect to get rid of valgus deformity?
Many thanks again for guidance. Regards Jatinder
Hi Jatinder,
a) Yes – this is fine as long as your body can tolerate it comfortably.
b) It depends on what your body specifically requires. If your main issue is weakness, focus more on strengthening and less on releases/stretches.
c) You should see some results within 6 weeks. To 100% completely rid of it, that is difficult to answer as everyone will be different.
Mark
Hi Mark!
Great job as always !
But… 1mln dollar question, when can we expect knee varus ?;) i Think they usually came in pairs.
Stay healthy !
Hey Rafal,
Great question.
Knee Varus is a bit harder to address!
This is mainly due to the fact many presentations are due to structural reasons such as the actual bowing of the tibia bone.
Stay healthy!
Mark
I have vagus of the left knee and arthritis in both knees.
Is there a brace that would correct the valgus and what brand is it.
What a service! I’ve been more concerned about my scoliosis, and have made great strides with pilates, yoga, a specialist chiropractor. I’ve been looking at family photos over the last month, and it’s VERY clear I’ve had a L unilateral valgus, lifetime– from toddlerhood. Explains so much — childhood knee pain, axilla furunkles as a young person, preferences now (like, not keeping my knee joint at 90 degrees, sitting with legs fully extended.
Not sure what my first steps should be, besides creating a regimen for myself: I think I’ll have a better time of it doing sets of exercises daily, so I’d best study them and create a strategy. Interested in the use of braces: some seem for walking, others for sleeping. Also, it seems the idea of getting shoe innersoles makes a great deal more sense, though re-building the arch and weaning myself away from them also seems important.
Thanks for this effort: I’ll look forward to working with it, showing clinicians.
How many times a week should I be doing this? My case isn’t bad but it’s made me concerned and I’ve notice the pain starting to build up after having borderline knocked knees for awhile now
Hi Christian,
1-2/week is a good place to start.
Mark
Hey Mark,
This article bring so much awareness to me towards my posture and knock knees. Actually I have weak quadriceps and abductor muscles which I think lead to Anterior pelvic tilt and flat foot ultimately. What do you think its STRUCTURAL or FUNCTIONAL knock knee ? I think its fuctional maybe . What you think ?
And thank you so much Mark for this article this gave me so much hope
Hey Rohan,
If your issues are purely due to weak muscles, then it is not likely going to be a structural issue. This is great news as this means you can change it!
Mark
Hi! Is it possible to have this more on one side? My Q angle on my right is exaggerated and I also have a gait difference when I run- my right leg goes out and then internally rotates excessively and my foot pronates big time. Over a few months I end up with si joint needing to be adjusted at chiroptactor due to low back pain on the right. On a daily basis I am fine with the exception of tight right ql every am. Is there something else I should be doing or do you think this program will help? I will add that my legs are strong but adductors seem weak- when I train legs they are always the first part to get sore and may remain sore for days!! Thank you in advance for your help and insight!
Jessica
Hi Jessica,
Yes – you can have it more pronounced on one side.
The exercise mentioned should help. However, if your knee valgus is due to structural causes, there may be a limit as to how much it can change.
It also sounds like your pelvis may be compensating for how your legs are moving. The first thing I would check is your single leg balance. This should reveal quite a few things that you might be able to start working on. (eg. foot pronation, knee collapsing inwards, hip hitch, torso lean etc)
Mark
Hi Mark,
Thanks for your info. It’s really helpful. I have flat feet, anterior pelvic tilt and flat feet resulting with knee pain and lower back pain. Where would you start in my case ?
Hi Mateusz,
You can start anywhere really. But out of the ones mentioned, I would address your painful area first (the back). Once the back is symptom free, then you can start to tackle the pelvis.
Mark
Hi
Can my knock leg go back to normal ☹️ at the age of 17?
Hi Debbie,
Yes – as long as it is not structural (bone/joint shape).
Mark
Hi Mark, Are knee braces affective to assist in fixing knew vulgar? Do you have any recommendation?
Hi, i am going to try these exercises out with my youngest, 11 years old. In the whole family it is only she and I that have knock-knees.
I went to a doctor in Korea about 15 years ago and based on the X-rays, my hip to knee faced inwards while knee to ankle faced outwards. Feet are normal with high arch however due to the hip to ankle bone alignment, my step is inwards unless I consciously try to walk on the flat of the feet. And I so wish my legs were straight.
The plan the doctor gave me was:
Do leg exercises to have my legs become “bow-legged” then we will then focus on fixing alignment. I was supposed to do side leg lifts as high I can for 30 minutes per leg.
My concern now is my youngest will grow to have the same issues as me.
Any advise? Much appreciated.
Also in order to make my legs a bit less noticeable I walk on the sides of my feet. In the pst couple years I’ve formed sharp pain across the top of my feet.
Hi Kimberly,
If your knee/hip/pelvis are facing forwards but segment between the knee and foot is pointing outwards, this suggests tibial torsion (External rotation).
You can try some exercises for that in this blog post.
In regards to walking, try not to overly force a change in your gait pattern. Persist with the exercises to help naturally change your walking pattern..
Mark
I remember finding this website before and finding you in Facebook, and it just showed up in my newsfeed for the first time in a LONG time. I have knee valgus but I’m worried it’s structural because my legs have always looked weird compared to everybody else’s and it wasn’t until a few years ago that I realized why. I hate the way It looks in photos, so I always try to pop my knee out to hide it. It also makes it a little harder for me to squat and lunge with proper form when I workout at the gym.
I’m 31 now and starting to have issues with my knees, lower back, and feet. I’m going to try these though and see if it helps! If it’s not structural, I feel like it could be from my hips rotating inward.
Hi Amanda,
Glad to see you back here! (I think facebook hides a lot of my posts for some reason!)
Give the exercises a try! Even if it is structural, strengthening your knee will only do you good in the long term.
Mark
Hey Mark!
Thank you for such a detailed plan. I, luckily, dont have the genu valgus issue but I’m currently studying towards a sports masaage diploma and have found slightly conflicting information online when doing some extra research.
Yours seem to be by far the most superior as it addresses in great detail all the muscles engaged in the postural aspect of the issue (I had known about roughly half of them, but others like the tibial external rotation or banded seated squat were an eye opening surprise to me). Obviously, I’ll have to introduce such plan to my clients bit by bit as it’s very lengthy, but things like this don’t resolve overnight and the more info the better.
Thank you for all that
Lukas
Hi Lukas,
Thanks for the comment.
I hope the exercise help your clients!
Mark
Mark,
I want first to thank you for creating this website and putting so much of your time and effort into helping people on the road to a better posture!
For the last six months, I’ve been trying to find the root cause of my back pain in the thoracic region (between my left shoulder blade and spine). When I take a deep breath and push the air into the area (think vacuum squeeze), I feel discomfort in the front of my ribcage as well as in the rear (left intercostal muscles).
Over the past couple months, I’ve seen my primary doctor for bloodwork and an EKG, referred to a PT for eighteen sessions, had three deep tissue massages, and I’m a little frustrated!
My physical therapist thought my pain was nerve related because when she’d massage my neck I’d get temporary relief. We went through loads of exercises, but the pain lingered. I was referred to a deep tissue massage therapist and she mentioned I have a 1/2 inch discrepancy between legs, then acted out my posture and things started to click. For the first time in my life, I saw someone mimic how I’ve been carrying myself for all these years! I saw her three times and by the third time she told me, “I don’t want to continue taking your money, in good ethics, if I can’t get to the root of this” and referred me to a chiropractor who specializes in adrenal fatigue and applied kinesiology but I had had enough.
That’s when I started my independent research and found this website and I have hope again! Here’s what I’ve noticed:
1. My left leg appears to have a degree of knee valgus.
2. My left arch is lower than my right
3. My left hip is lower than my right.
4. My hips are slightly twisted to the left
5. Spine looks pretty good maybe a little curve left (not sure??)
6. Belly button points toward right foot.
7. Shoulder hike and rounded (left side)
8. Shoulder drop (right side)
9. Hip crease (right side)
10. Knee pain after long walks (right side)
My questions are:
Does my left leg discrepancy sound structural to you?
Do you think my rib/intercostal discomfort is related?
Thanks again for your time,
Andrew
Hi Andrew,
Pain only experienced on the left interscapular region makes me think that there is probably some degree of rotation in your body.
Pain in that said area may be the body trying to counter rotate to compensate for the rotation occurring further down.
It sounds like you have a Right hip hike (lateral pelvic tilt) which may be related to the left knee valgus (especially if you tend to stand on the right side more, Right rotated pelvis, Side bending of the torso to the right (scoliosis) which then would give you a high left shoulder (uneven shoulders).
If the left interscapular region is hurting, I would think your torso is following the rotation to the right from the pelvis and the muscles between the spine and shoulder blade on that left side are trying to counter rotate.
Do you sit down a lot for work? If so, check your sitting posture. This might be the key.
Mark
Hi mark, great information. If I do these exercises will it improve the look?
Have you worked with anyone with knee valgus and have you seen people with valgus improve?
Also how often should I do these exercises?
Hi Johnathan,
Yes – as long as your knee valgus is not structural.
Yes – I have seen people improve their knee valgus.
At least 2-3/week, but I would do as often as you practically can.
Mark
Is there any way to determine if it is structural in nature?
I don’t know what mine is but I just know I have a walking abnormality same with my dad. please can it be corrected?
Don’t know if it’s structural
Would it be possible please for an option of PDF to print on your blog/exercise protocols? Much appreciated, thanks Anto
Hey Anto,
Sounds like a good idea. I’ll have to figure it out.
Mark
Hi Anto! I made a visual scheme to more easily follow the valgus knees routine according to the Mark’s post. I hope it helps you!
In English: https://drive.google.com/file/d/1RNP9zK4jKK30CRdQkCqkZ7BDd8-cOHcY/view?usp=sharing
In Spanish: https://drive.google.com/file/d/1VVmcGoxlg2uYPVBnTznbwSQyC3zva19t/view?usp=sharing
:)
Will this routine really work for me because it in the gene?
Hey Tito,
Only one way to find out! Give the exercises a try.
Mark
How long does it take to correct knock knees with exercise?
Hey Vincent,
It is possible to correct it straight away, but maintaining it is definitely the challenge.
As long as it is not structural in origin, you should be able to improve upon it.
If there is absolutely no improvement within 6-12 weeks and you’re doing all the correct exercises at the right intensity, there may be a structural component to your knock knee.
Mark
6-12 weeks
Thank you for the concise and instructive information here. Trying to help a friend resolve foot issues, but realize the problem doesn’t start with her shoes! Severely knock kneed with ankles more than 12″ apart, flat feet that turn way outward. Strangely she wears her shoes out on the outside of heel and ball of her foot & has thick callises on the outside ball of her right foot. She doesn’t have medical insurance but assume she needs a complete medical evaluation. She is only 32 yrs old. She works 40 hrs/week on her feet at Sonic. She complains always about her feet hurting and sometimes about back pain. This is a hard case–don’t know where to start!
Hey Marg,
Sounds like she is walking with Duck feet posture. I am not sure what her gait pattern looks like but sounds like she is weight bearing on the outside of her foot.
I would usually start from the feet as this is the our contact with the ground (and it is a painful area of concern for your friend). Check for big toe extension, ankle dorsiflexion, strength of toes and the medial arch.
If that is all good, I’d go straight to the hips. Make sure to check that she has adequate amount of hip internal rotation as limitations here can cause compensations during walking. Other things to check is single leg stance, single leg squat, balance, hip abduction/external rotation strength. Address any deficits.
Pelvis could also be a factor as you have mentioned back pain. Anterior pelvic tilt could internal rotation the hips.
Hope this helps.
Mark
I’m shocked a health care professional would glorify a thigh gap. Baiting readers to aspire to a thigh gap sends a VERY unhealthy message.
It’s a feature natural only for women with a certain type of body shape and bone structure (wide hips, thin legs) that most women do not have. Attempts to achieve this unattainable ideal result in problems of self-esteem that can lead to eating disorders.
Hi Cynthia,
The goal of this blog post is to help those who are having functional issues with their knee due to the inwards collapsing of the knees. By no means do I intend for this blog post to judge the appearance of one’s knee. If a knee valgus can be corrected and reduces knee pain, I feel like this would be beneficial to people?
As mentioned in the article, I agree with you that the knee valgus can not be significantly altered if it is due to structural means (and honestly it’s really not an issue if there is nil effect on function and/or the musculoskeletal system). However, there are also many people that may have developed hip, knee and foot issues due to the poor control of the knee.
Mark
Hi there,
Thank you for this informative article – I look forward to implementing this into my life! I have terrible knee valgus which was inherited but made worse by long standing laziness.
I was wondering – I’ve looked online at hip abduction pillows and braces and think they could help the internal rotation of my hips and generally help improve hip strength/alignment – do you think this would help?
Also, my 55 year old mum and 80 year old grandma have knee valgus (gma now how bad arthiritis in her knees which I assume was encouraged by the valgus) – would it be worth trying these excercises with them?
Thanks In advance,
Jasmine
Hey Jasmine,
The pillows and braces can help. But only if followed up with an exercise program.
Mum and Grandma could benefit from these exercises too! (but probably best to get clearance from the doctor to be on the safe side)
Mark
Hi Mark,
If you have like 7 of these issues you have exercises for, how often do you recommend doing the exercises? I have mild knock knees, anterior pelvic tilt, kyhposis, forward neck, rounded shoulders, flared rib, and winged scapula. You had said to another person to do the knock knee exercises 3 times a week. How often should I do each of these groupings? Or should I pick 3 and do like twice a week each? And if so which do I pick? They are all equally bad?.
Hi Jackie,
I generally recommend to start with just one area, 3-4 /week.
You might spread yourself too thinly if you tackle everything at once.
Mark
I cannot thank you enough for all this information. I am a 28 year old female that has had knee valgus for years. I have been to my doctor many times concerned about it, as I am a nurse and it has really affected me being on my feet for long periods of time. I wear orthotics and go to a yoga class 3 times a week. It is at the point where I have bad knee pain intermittently that keeps me awake. Although yoga incorporate many of these stretches/ exercises, I am going to start this routine religiously. Through my own assessment; I have bilateral collapsed foot arch (to the point where my pinky toes do not touch the floor at all), tibial external rotation, hip internal rotation /knee adduction, and anterior pelvic tilt. I am so desperate to find a solution. Do you have any other suggestions for sleep positions?
Hi Meghan,
Hope the exercises help !
In terms of sleeping with knee valgus, just try to avoid adducting the legs. If you sleep on the side, best way to address this is by placing a pillow in between the legs.
Mark
Hi Mark,
You mention that you should not let your arch collapse when doing the dorsiflexion exercise. Is there a correlation between the two?
Hey Ryan,
If your arch completely collapses as your ankle goes through dorsiflexion, then you will not be getting a pure movement in the ankle joint.
As a result of the collapse, the knee will tend to follow and collapse towards the mid line.
Mark
Hi mark I was wondering how do you make sure you have good stability and strength in your knee and what are some good knee strengthening exercises and tests to test knee strength and mobility
And also can unstable knee lead to further problems up the body ie back pain?
Hi, Mark. First off, thanks for all the helpful information you provide, it’s very much appreciated. I have knock knees and I’m trying to see if it’s structural or not without having to go to a doctor. This may be silly or futile relative to finding out but I noticed when I stand upright, my knees touch before my ankles do but when I start to bend at the waist my knees start to separate and my ankles still touch and it displays a more traditional leg stance. It stays this way if I walk in that waist bent position as well. Is this telling at all?
Also, if you have the time, do you find that one of those knee unloader braces could work?
Thanks again for all your help to the community.
Hey James,
It sounds like when you are bending forwards, the hip is going into hip external rotation which would then push the knees out.
If you can correct the knee alignment (that is, it is not fixed), then it is likely not structural.
Unloader braces can help in conjunction with a strengthening program.
Mark
Can kt help with knock knees?? With doing the exercises too.
Also how do I know if it is structural in origin. How do I know if it can be fixed?? Or if I am stuck like this for life?
Hi Smith,
I suppose it can. The spiral chain taping with the k tape would probably be the best.
Mark
Since external tibia rotation is one of the symptoms of knock knees, how does letting your feet fall outward when you sleep help? Why wouldn’t you want to at least keep them straight?
Hey Trish,
The knee out sleeping position is more so to help place the hip into External rotation.
Mark
Hi Mark
Firstly, thank you for such a thorough and informative page – this is the first set of exercises that has helped with my inward knees. I have not yet built up to doing the whole program at the recommended reps, but the glute strengthening has been great in particular.
My question relates to the cause of the knee valgus – it is slightly worse on my right side and I can’t get to the bottom of why this is. I’m already wearing foot supports so they are in neutral, so must be knees or hips? Something structural is the cause I think because after stretching and strengthening the muscle groups you mention, after a few days the knee valgus returns again and glutes deactivate. Any suggestions for how I can get to the root of the structural imbalance?
I would also second the previous commenter – it would be incredible if you could offer online consultations. I would certainly sign up!
Kind regards
James in London, UK
Hey James from London,
If your feet are perfectly fine and in the absence of any structural bone/joint issue, I would feel it is either coming from the hips and/or pelvis.
Make sure to check that you do not have a Rotated pelvis.
Mark
Ps. Thanks for letting me know regarding online consultations!
Hi mark
Wanting to know is knee valgus something you normally get on one side or both sides because I think I have it on just my right side and also can knee valgus cause your shoulder to drop on the same side and cause back pain? I just feel as though my whole right side is tight but the tension in my right knee is crazy also I have a an acl reconstruction and they took a hamstring graft this was 6 years ago though any idea or what could be happening
Hey Sean,
It can occur on one or both sides.
Knee valgus on one side can be associated with a dropped shoulder and one sided back pain.
Surgeries such as your ACL recon tend to cause distortions throughout the body. This is mainly due to a change in the way you walk.
If there were no issues prior to the knee issue, I feel you would probably get best results by making sure the knee has full mobility and strength.
Mark
So does that mean I need to change the way I walk because the acl recon would have changed it and that’s what causing my knee an d back problems?
And What would be some good knee strengthening exercises ?
So would I need to change the way I walk ? And is there a blog on knee strengthening and mobility ?
I have the exact same things happening on the same side. I feel tightness and stiffness sometimes on the knee and lateral portion of my body.
Your site is awesome, thank you!
I get knee valgus when I bend my legs, so I think it’s the cause of my duck feet. From reading your article, I understand that I need to do the exercises at ‘a particular load’. Would you be open to offering a virtual session to help me figure out how to do the exercises correctly?
I read a reply of yours to someone else and you said that you didn’t offer virtual sessions but might do so if there was enough demand. The demand is here! ??♀️
Hi Sydnie,
Unfortunately – I am still not offering online consultations. (But thanks for expressing your interest!)
If you have knee valgus as you bend your knee, it is likely you will need to perform strengthening exercises at the same knee angle as to when your knee collapses inwards.
Mark
hey mark!
Will my knock knees get fixed if they’re from genetics? like if i do those exercises, can they get fixed? i’ve been really insecure about my legs! i don’t like the way they look haha
arika
Hey Arika,
The exercises will help as long as the knock knee is not structural in origin.
Best of luck.
Mark
Hi Mark! I would absolutely LOVE a video of you doing these exercises. Pictures are one thing, but video helps visualize the exercise so much better. Even converting the images to GIFs would be super helpful.
Anyway, much appreciated!
Hey Steve,
This is a great idea and something that I have been meaning to do in a long time!
Mark
This is really helpful. I’m a Nigerian and this type of leg is not common here. At first, I always feel embarrassed while walking but now I walk freely with confidence because I realized having a K-leg (as I’d call it) is not a disease. “”People see what you want them to see you as”. Most times I don’t really care about people, I only care about myself.
I started some exercises last year and it has been turning out well. Hopefully, trying these exercises would turn out better.
Sincerely, I love this and I appreciate it.
Thanks for the comment Iyanuoluwa!
Hope the exercises continue to serve you well.
Mark
Hey, I have all the problems (knocked knees, no thigh gap, ankles going flat), but my knees point outwards. Which exercises should I do to help me fix myself, should I use these ones or can I just make it worse with them?
Hey Tomk,
These exercises should be a good place to start.
Mark
This is the most helpful article I’ve read on knee valgus so far. One thing that is different about me is that I always supinate with my feet in my attempt to correct the lower leg splay. I’m wondering if there is anything you’d recommend I do differently.
I think this might be why my peroneus muscles are always hurting so much.
Hi Katrina,
Glad you found the blog post helpful.
You can definitely have supinated feet AND knees that go inwards.
Do you have a fair bit of tibial external rotation? If so – you would benefit focusing on this area more so. (see knee section)
Mark
Hi mark, last 5years i have noticed a decline in my knees on and off, but recently noticed it mire, im mid 20s, noticed my knees are inwards and my right leg is the worst, the bottom part of my right leg seem to point outwards and making it feel uncomfortable, can i some how send you images of my knees if possible via some email thanks.
How to know whether my knee valgus structural or not without seeing doctor
can u tell me any advise
I had a torn meniscus in my right knee so I had surgery to repair it back in Dec. 2019 and I’m still having issues and pain. My doctor examined my knees n my legs and from what I told him, he said I have knocked knees and the only real way to fix this issue now is to go in and have part of my inner leg bones shaved down. I’ve already done physical therapy and that didn’t help. My question is, will it be fixed after the surgery now?
Hi Melissa,
If you have STRUCTURAL knock knee, the only way to straighten them is via surgery.
HOWEVER – this does not mean you can not regain a fully functional and pain-free knee!
Progressive loading of the knee from various angles over a long period of time is the way to go.
Mark
I have the same issue, but have been offered a brace to improve alignment before going back down the surgery route. I’ve done loads of physio following meniscus surgery, but nothing that has specifically targeted the knee alignment, esp during movement, so going to concentrate on that next. Agree that there is plenty more I can do to get my knee out of pain and functioning without further surgery. Good luck!
Mark is it possible ,These exercise will correct my knock, because I am 21, at this time, the knock can be cured, although my knock is very minimum degree I want to get rid from it because I have medical test… Please tell my knock knees can be cured
Hey Ashima,
It is possible to improve knock knee as long as it is not caused by structural factors (shape/angle of the bone, joint)
Mark
When I was 13 years old I had suddenly developed knee pain while running , step down stairs then after 6 months my knee pain had disappeared but I got knock knee and still I have knock knee now I am 21 years old can my knock knee will cure
Hey Ashima,
Give the exercises a try!
Mark
Hey mark
I am 23 years old and when I was 20 I found that I developed knock knee. My question is that can I correct it I mean it develops at 20 so it can be cure by doing exercise and wearing brace? And one more question can I do weightlifting exercise for legs in gym?
Hey Kavish,
If there is no structural reason why your knees have developed a knock knee, then I would say it more likely that it can be improved.
Exercises at the gym should be fine, but just make sure your technique is good and that you are able to tolerate the weight you decide to use.
Mark
Mark should I consult to doctor to find out the reason behind knock knee or should I start the exercises given by you?
Hey Kavish,
It should be fine to start, but if you want to make sure, definitely consult your doctor first.
Mark
Hi Mark,
I have this problem that when am standing without using any muscles my knee tends to bend inward but I was able to push my knees to the correct position ,but when I do that I feel some burn in my muscles at my legs and my hip, pls can u give me a solution to this, and how long does it takes to fix my knees to the correct position . thanks.
Hey Mark,
Are the directions for fixing valgus knee geared at a specific leg/knee? EX: The earlier pics show you releasing your right adductors with a foam roller but then later on you’re stretching your left adductors….
If I have a left valgus knee, would I want to do everything just on the left side(hip/leg/etc)
Hi Taylor,
The exercises are meant to be for the one side only. (I have re-used images from other blog posts that probably was targeting the other side)
Mark
Hey marc will do you believe in custom orthotics for helping some of the discomfort in the short term while working on the exercises
Hey Chad,
Yes – short term use of orthotics is fine whilst you work on the exercises.
Mark
Hi Mark,
I have knocked knees and I earlier tried some exercises but it kept getting worse. Was I doing it wrong or there are some exercises I shouldn’t do?
Hi Anitah,
Hard to say without an assessment. (too many factors that needs to be considered)
If any doubts – best to see someone in person.
Mark
Hi Mark
If my knock knees are hereditary, does that mean that it is structural and nothing can be done to improve the appearance?
Please advise what exercises if any are appropriate…
Hey Chez,
If your knock knees is structural, then there will be a limit as to how much you can change with exercises.
I would still encourage to do these mentioned exercises to see if it helps to a degree.
Mark
Hi Mark
Do you do consultations for assessment and what is the cost please? Do the above mentioned exercises really work and fix/ correct knee valgus even in adults ( 47years old)?
Hi Sharon,
I don’t do online consultations at present.
The exercises will help improve knee valgus for adults as well provided that the cause is not structural.
Mark
Hi Mark, thanks so much for this guide! I will definitely be starting it as I have all of the problems associated with knock knees. I’m also going be trying barefoot running with a forefoot strike, and walking on minimalist shoes as it is supposed to help strengthen the muscles of your feet and build an arch. I was wondering if you recommend that we start using sleeves for the knees as we are exercising/running? Will the sleeves for knees serve as a brace that will help on our journey to correctly align our legs, or should we stay away from the knee sleeves? I found one on amazon that is budget-friendly at $14. Thanks in advance!
Hey Sam,
Knee sleeves keep the structures warm and help support the knee.
They are fine to use!
Mark
Thank you so much for this. Its the most detailed yet simple/easy to follow blog and guide I have found thus far. I’ve kept returning to this over the last two years to help me with anterior pelvic tilt, flat arches, scoliosis and knee valgus. It always helps!
Hey Rose,
Thanks for keep coming back!
Mark
Hi Mark,
Your work is really impressive. You don’t leave any stone unturned. Really appreciate!
Not sure of my condition-
Just that I knew I had little carrying angle in my right elbow: Cubitus Valgus. I recently started some Calisthenics exercises which included a lot of pull ups and tricep extension which may have caused my right shoulder to internally rotate- now my right shoulder width is smaller than left.
Later I decided to give up Calisthenics for sometime, and chose to run- which created so much compression down my right foot, and then I realised I may have developed a Knee Valgus.
Now I see my Pelvis is tilted/rotated as well, but not able to understand if its Anteriorly, Posteriorly or Forward or Backwards.
I don’t even know which came first-the Cubitus Valgus or Knee Valgus Or the Pelvis Tilt(or rotation)- and how do I go on from here.
Even walking creates pain in the foot. Maintaining a balance while sitting is difficult- always dropping towards my right side.
Left side feels Okay.
Could you please help me here?
Not sure if the carrying angle of right side is Genetic or I developed it a while ago while doing heavy biceps curls?
Hi Rohit,
Cubitus Valgus is quite common in people who throw. Are you involved with any sport that requires any repetitive throwing?
Knee Valgus can be influenced by the pelvis position. But for most people, you likely need to address both the knee and pelvis.
If you are not sure what position your pelvis is in, I’d encourage you to have a look at the following:
– Lateral Pelvic tilt
– Rotated Pelvis
You possibly might even need to have a look at the torso (esp. if you keep falling towards the right side)
– Scoliosis exercises
If you have acute pain in the foot, you might need to consider addressing that area first.
Mark
Thanks Mark
Yes I was involved in Cricket as a Bowler, where I had to throw the ball with right arm with a lot of jerk. Also a little bit of basketball.
But that was almost a decade ago..
Hi, just like to know how often you should do these exercises and how long it should take to see results? Thanks
Hey Tom,
I’d recommend 3/week and then monitor how you are responding. Adjust as appropriate.
In terms of how long to see results, that depends what has caused your knee valgus.
If it just due to lack of awareness, you could fix it within a day.
However – if there is major tightness pulling you into this position, you are looking at months
Mark
Can I fix my knees in a month with these exercises as I am going to a medical test. Please help me..???????????
Is it possible to have this just on one side?
Hey Victor,
Yes – you bet.
Mark
Hi mark, just got a question.
I have a constant pulling tension stretch feeling right behind my right knee going through my Hamstring and calf When I’m walking..
Also if I’m laying on my back on the floor relaxed legs straight.. my right foot tends to rotate outwards a lot more then the left and when I pivot my right foot off the heel and try rotate it so it’s facing straight I get like really tense through my right knee and lat/back and shoulder it’s strange it’s like my knee tightness is causing Shoulder and lat tightness too can you make any sense of this?
Hey Brad,
If I were to guess what is happening, it may be that your right hip is in external rotation. This is commonly due to tight glutes.
When you bring your foot so that is straight, you are likely pivoting the right hip inwards (aka internal rotation)
If your glute (and perhaps posterior hip joint) is tight, this movement may cause the whole pelvis is twist.
There are muscles that attach at the back of the pelvis (like your lats) to the shoulder.
In terms of what to do in regards to the pain behind the knee… This really depends on what exact structure is hurting. Each structure will have a different plan of attack.
Mark
It’s more the pulling on the shoulder that’s the problem and the back pain it’s causing but yeah the behind knee is just a tight stretch feeling so do you just recommend stretching the glute then? Does something need to be strengthened?
Hey Brad,
Might be hard for me to give you specific recommendations based without a proper assessment.
If the tight right glute is the issue, you can try stretching it out to help increase the right hip internal rotation and see if that helps.
If not – check for pelvis rotation and address if appropriate.
Back of the knee could be quite a few things.(lower Hamstring, upper calf, nerve, popliteus, posterior joint line, bursa, cyst) This could be impacted by the hip and/or pelvis as well
Mark
Pls,sorry to ask but am really scared. Does these exercises really work?? I really want to get rid of my knock knees
Hey Cynthia,
Yes – they work.
(Unless you have structural knee valgus.)
Mark
Sir please make a video or article BOW legs too…. Plzzzzz
Thanks for this! Sorry to be greedy but would you consider making a video for this routine?? Or do you already have one somewhere?
Hey Nia,
I need to get around to do videos.
Mark
So when i stand i have duck feet. Looking like a tibial external rotation but if it make my feet in a forward position it looks like i have knocked knees. Which one should i be focusing on?
Hey Mason,
If you normally stand with external rotation of the tibia, then I would do the exercises mentioned here:
Duck Feet Posture.
Mark
I’m Onuoha from Nigeria, I really appreciate your dedication and detailed instructions. I’ve been using your article for a week now and I have already started seeing massive improvement. Though I was kind of discouraged at the start but now I’m really grateful that I put up with it and now I’m getting better results thanks to you. My knee valgus though minimal is vanishing, I’m so grateful.
Hello Onuha,
Great to hear of your improvement!
All about consistency over time.
Mark
Thanks for this article
It is so great. I have a little bit of this knee valgus. It is not so seen except I am on short. The question here is can this disease be hereditary without any side effects- just natural?
Hey there,
It is possible to have knee valgus and experience no symptoms at all.
Mark
Hi Mark, i really hope u reply to this. I am 18 years old and when i was younger i had a bad habit of squeezing my legs together REALLY hard almost everyday. I have knocked knees right now but no other problems (i dont have anterior pelvic tilt, i am not flat footed and my tibia isn’t rotated outwards). It does not run in the family either. Whenever i try to do the posture exercises at the end, everytime my quads flex my knees cave inwards, making it impossible to stand up with a straight leg. What do i do and is my posture easier to fix since i dont have any other problems really? Sorry for the long post!
Hey Jay,
If you tend to squeeze the legs together, chances are you are using your adductors/internal rotators of the hip too much.
You can release and stretch these muscles to begin with (see post)
Main thing would be to engage the hip abductors/external rotators to bring you out of the knee valgus position.
Mark
Straightening out my foot is good until my quads contract. Then my knee is forced inwards. How do i fix this?
Straightening out my leg*
What happens if you push your knees outwards whilst straightening the leg?
Mark
Hey Mark!
I have saved this article and have been using the info for a few months now to shape my rehap! I cannot thank you enough!!!
My biggest issue is weak external rotators, weak abductors, and also tibial torsion; all of which I am working on!
You mention on your article to release and stretch the lateral hamstring (bicep fem); which I have been doing, plus I have decided to strengthen the medial hamstrings.
Via this logic, would you also recommend releasing and stretching the TFL, ITB and vastus lateralis, to further reduce the lateral pull on the patella and thus reduce external tibial torsion/rotation? Also, perhaps strengthening the vastus medialis?
Again, thank you very much for the truly amazing and informative article; I know from my own research this must have taken HEAPS of time to put together!
Hey Owen,
Great comment. I can tell you have been thinking this through!
Releasing the outer quad region will help with the tibial torsion.
I would also recommend addressing this area if you have pain on the outside (lateral border) of the patella.
Once your knee is in a more neutral position, this should automatically engage the VMO more as well!
Mark
Hi Mark,
Thanks so much for putting this article together. I’ve been trying to help my 13 year old son who has a bit more knee valgus than I did at his age, and this article has a lot of quality info we’re using to allow him to play high level sports without causing a lot of damage. We’ve begun banded bodyweight exercises and light weight training in hopes of making this better.
I’m confused by something and hope you might be able to clear it up for me. You recommend stretching the tensor fascia lata, and I’m wondering if elongating that will exacerbate the valgus issue. Can you help me to understand the mechanics of how stretching that will help pull the knees straight?
Thanks again.
Hey Jeff,
The TFL does mainly 3 actions in the hip: Abduction (good for knee valgus), flexion (potentially not great for knee valgus as it can rotate the pelvis to the other side) and internal rotation (not so great for knee valgus).
From the internal rotation stand point, you would want to stretch it out.
The glute medius should be taking care of most the hip abduction.
However- I feel that the TFL’s main role is for flexion so it’s roll in knee valgus may not be as significant as the other muscles mentioned,.
Mark
Mark,
It means the world to me that you have these exercises here, especially during this period of isolation when I am trying to ‘catch up’ with my body. Thank you so much.
I have always been a daily 1 to 5 mile walker, and tried to find time to exercise when I could but often fell short. I used to be a commuter cyclist but haven’t for a few years. I’ve always had good quads for as little as I do and lower body exercises are SO easy for me on one side. The other side with my bad hip has turned into a big issue the past few years. I can never find any guides on my issue of valgus knee (pretty severe on one side), external tibia rotation, but over supination – not pronation. It makes me feel like any exercise I do balancing on that leg I am falling over to that side, straining so hard, even though my hip is rotated in. Do you think the over supination vs pronation makes any difference in the exercises?
Hi there Sloane,
You must have a very stiff midfoot to have knee valgus! Is our hind foot also supinating?
You can still benefit from the the same exercises as mentioned in the blog post.
You might need to work on getting your arch to collapse more in conjunction with the exercises.
Mark
on the single leg balance do we do all what you said, together as one movement
Hi Im vida.If this exercise are done accordingly pls how many days can it been corrected.
Hi Mark, will you be doing a post for bow legs? I have bow legs that seem to be progressively worsening as I aged and I am worried that it will become worse.
Thank you.
Hi Yilin,
It’s on the to do list!
Mark
Hi Mark
Is it possible to have Hip and Tibia internal rotation at the same time with Ankle pronation ? It looks like what is happening on me. My knee cannot comes together and my ankle will comes together. I have flat feet on both side, and I have a worse arch on my right foot so much more internal rotation on my Tibia. I am not sure If I describe the anatomy mechanics correctly. I did when to physio and he told me it is all starting from my flat feet, he taught me a exercise which is rotating my knee out in standing position. I don’t think it is significant useful as I am still normally getting injury from sports. I did follow your guide about fixing the flat feet and I find out my arch is gradually developing. I wondering If the ‘Knee Valgus’ guide works the same for the people like me? Thank you for sharing your knowledge and experience online :).
Kind regards
John
Hey John,
It sounds like you actually have what is called “bow leg”. This is where there feet can touch and the knees are far apart in a standing position.
Has anyone had a look at the shape of your tibial bone?
Mark
Hi Mark
My tibial bone haven’t been check by physio, or may be they did but have not told me. They did not seem interested in my tibial bone. I will ask my physio next time about this. I also check it by myself by touching the bone and compare it with the anatomy structure of the tibial bone. I know it is not professional for me to say that, but it feel like the bone structure is alright. I will say the tibial bone is pointing to the central of body, from knee to ankle.
Kind regards
John
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
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
Sir how to fix bow legs? please reply
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?
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.
Hey Dee,
I would say most physiotherapists should know how to address a knee valgus.
Mark
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.
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
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 ?
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
Hey Mark,
How many times per week do we have to do this routine please?
Thank you!
Hey Cedric,
Good place to start is 2/week.
See how your body responds and adjust frequency accordingly.
Mark
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.
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
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?
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
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.
Hello Mark! Thank you for these exercises! When I do Releases Of Lateral Hamstring I feel great relief but my trapezius gets really tight. Is it normal? It feels like tension is just moving upwards in my body.
Hey Tuura,
It might be related to the position that your in. (esp. if you are placing your body weight through your hands)
Mark
Hi Mark,
Can knee valgus cause hip rotation or the other way around? My left leg seems normal but obvious valgus on my right knee. Xray indicates a pelvic rotation but doesn’t indicate which direction. I tried using your method of detecting but still need to be sure of the direction of the rotation so that I can follow your excercises correctly. I definitely feel more tightness on my left side and obvious waist crease on right side. Is there possibility of left rotation? I tried observing as you recommended in your post on pelvic rotation but husband keeps saying “they are okay.” Appreciate your advice, thanks.
Hey Kikie,
Yes – the knees can affect the hips, and the hips can affect the knees.
Right waist crease is more likely to be a Right hip hike (lateral pelvic tilt).
It will be hard for me to determine exactly which way your pelvis is rotated to without assessing you in person. Are you able to see a professional?
MaRK
Hi Mark
Thank you for the series of exercises to correct knee valgus, appreciated. I have all the above symptoms to lead to knee valgus and an extremely painful outward facing, plantar fasciitis flat foot (all gained with age ?). However, as I am short on time, what would be the first area of exercise to address and how many times a week – anterior pelvis and then move onto work downwards in separate stages as each stage corrected through the leg? Thank you for your time.
Hi Julie,
If you are in pain, I would start at the place where it hurts the most.
You can roll the foot on top of a massage ball and then start to strengthen it doing the short foot exercise.
Once the symptoms are under control, start to look at other areas that might be contributing to your issue.
Mark
Great, thank you so much for you help.
Hello,
I started these exercises and the knee pain I had for more than 3 years dissapeared almost entirely for less than a week.
I still feel some discomfort when walking long distances (up to 10miles a day sometimes) on a rough terrain, but there has been a huge improvement.
How long do you think it will be until I see some long lasting results? 5-6 months? A year?
Many thanks
Hey P,
Great to hear that your pain has almost gone!
If you improved this much in 1 week, I think in 3 months with consistent progression of the exercises, you should see even more improvements.
Mark
Really great informations, I would like to know your opinion, where should I start in your humble opinion : I have hamstring, hip flexor, glute tightness, and every website I read said your muscle is weak, the other one say this is not weak this is overpowered, I don’t know where to start do you have any idea? because the problem is I keep doing tennis ball and foam rolling on my glutes adductors but they keep getting tight again and again and sometimes a few hours later, thanks!
Hey Alex,
What exact problem are you trying to address? Is it Knee valgus?
Mark
My main problem is muscle tightness that keep coming back, especially on the right side of my body and I don’t know where to start, not knee valgus, more tightness, stretching make my muscle more tight, I have my glute that are tight, adductors, whole hip, hamstrings ect…. so i try to release them one at the time, but I don’t know if I should try to strengthen my hip flexor to see the problem get better? because the tight muscle get tight because they are weak? what would be the first step in your opinion?
….well do you have any idea Mark?
Hi mark!
I just need help identifying the problem. When i point both feet forward, both of my knees lean inward and then from my knees up my leg goes straight up. I can only describe my knees as off centered and more inward. I have a habit of walking with my feet pointed outward but my foot arch is ok. The only thing i’m not flexible at is spreading my legs while standing please. Please help me so i can work to fix my problem accurately. Thanks
Hey Kevin,
You might tibial external rotation?
This is where the tibia (lower leg bone) is rotated outwards on the femur (upper leg bone)
You can try the exercises mentioned in “The knee” section. Keep in mind – many people with this issue may be born like this.
Mark
Hey Mark
Thanks for a great article. My 11-year-old daughter has knee valgus, and is very self-conscious about it. We have noticed a difference after 2 weeks of religiously doing these exercises… hopefully the improvements will continue.
Of note… I can only find this page on your site via Google. It seems near impossible to find it otherwise (no clear navigation to here, and no site search function). Maybe you’ve changed the focus of your site – but please keep this up as it seems to be the best resource out there for knee valgus! I am sure it will continue to help a lot of people.
Zelena
Hello Zelena,
Thanks for the comment!
It would be great to hear how your daughter responds in the upcoming weeks/months.
Mark
Hi, Mark! Could you please, please, please do one on knee varu? Thank you!
Hello sir, I have right rotated pelvis with left side knee vulgus. And i have left side lower back pain with some burning sensation at lower back of left. What is the solution sir? Is my problem is curable sir? Plzzz reply me sir….
Hey there,
I would start with correcting the pelvis and see how that affects your knee valgus.
Check out this post: How to fix a Rotated pelvis.
Mark
Hello Mark,
Sometime around July I did an x-ray and knee measurement ,one was 6° the other was 7° , though the knees from the X-ray film looked like they were curved inwardly ,my ankles can actually touch while I’m standing straight but I have knock knees and it’s visible when I walk, I want to know if it can be straightened with this exercises and stretches
Hi Mark thanks for all your clear writing on this topic. I really understood a lot from you.
Our 13 year old son is in line for a corrective operation for knee Valgus. The surgeon introduces plates that restrict femur growth on one side, correcting the angulation of the knee joint, and then removes them when the correct angle is obtained. The procedure is called temporary hemiepiphysiodesis and seems quite common. His distance between ankles when knees are together is 11cm which qualifies for treatment by the medical guidelines. They’ll do both knees.
As well as weighing up the pros and cons of the operation, we’re trying to understand whether use of physiotherapy offers an alternative. Do you think for a child of this age with this level of symptom we can use muscle strength building exercise from your site to deal with the problem? If so, how many hours of the exercises are we looking at, per week.
In his case there is probably a link to pronated feet since early childhood (which are actually getting a bit better) and a mild lumbar lordosis and pelvic tilt that’s going to be rotating the knees inwards. He didn’t have the valgus or the lumbar symptoms up to the age of about 10/11 when it started to develop, maybe as part of adolescent growth spurts.
Thanks and looking forward to hearing your thoughts.
Hi Stephen,
If the leg bones are physically shaped into a knee valgus position (structural changes), there might be some limitation as to how far these exercises will be able to take you son.
However – if the joint position is the main factor that has lead to the knee valgus, then the exercises will certainly help.
I have listed pretty much all the exercises that I would recommend, but depending what your son specifically needs, he will need to focus on certain exercises. (eg. If the main issue is tightness, he will need to focus on releases/stretches… if it is weakness. then need to focus on strengthening/control.)
Try for at least 10-20 minutes a day to begin with. Increase as appropriate/tolerated/practical.
Before considering surgery – I would strongly recommend someone assess the pelvis, hips, knees and ankle joints.
Mark
Hello mark sir i have a problem of knee valgus. so would you please help me to give some tips to correct knock knees. I have done many physical exercise like as running ,leg workout exercise etc but i have no ideas how to correct knock knees. I have done many exercise related to knock knees but there is no any change .
Hi Amir,
I tend to prescribe the exercises as mentioned in the blog post.
If there has been minimal progress, you might need to work on other areas of the body to help with the knees.
Mark
posturalrestoration and go to find a provider!
Hello, Sir. I would like to ask if it would really fix this knee Valgus of mine so I can keep my hopes up. I have this since I was born and got it from my father. Everytime my condition apears sddenly in my mind, It’ll then lose my confidence and would just stare out of nowhere thinking if this can still be fixed. Thank you in advance, I’ll wait for your reply.
Hi,
Do you know if the knee valgus is due to the shape of your bones? (have you had an xray?)
If it is due to structural changes in your body, there is a limit as to how much we can influence change in the appearance of your knee.
If it is purely due to poor positioning of your joints and related muscles, then it can be fixed.
Mark
Hey!
I’m confused. What’s the difference between ‘hip internal rotation’ & ‘rotated pelvis’?
The excercises for these seem to be opposites;
stretching internal rotators & strenghtening external rotators for internal rotation but strecthing external rotators & strenghtening internal rotators for rotated pelvis?
(both on the left side i.e. a right rotated pelvis)
What am I missing?
Thanks
Hey Shahid,
Good question.
A rotated pelvis is where the whole pelvis is twisted to one side.
A rotation of the hip is referring to the femoroacetabular joint. This basically means how the upper leg bone is orientated within the hip socket.
If your pelvis is rotated to the right AND your feet/knees are forwards, this suggests that the left hip is in External rotation and the right hip is in internal rotation.
This is why there is a difference in what you need to do either sides.
Mark
Hi Mark!
Hope you’re well and thank you for the useful content. I was just wondering if you could give me some advice on my situation?
My right ankle and knee drop inwards , while my foot turnspurwards and it seems like my right hip is anterior tilted, which led to me suffering from Piriformis Syndrome. The right hip also sticks to the side a little more. I’ve also noticed that my right shoulder is dropped down. It’s led to a lot of overcompensation on the left side of my body and lower back and leg pains. Every physiotherapist I’ve seen about this has only ever given me some hip stretches and core exercises to do, which have very short term effects and I know that unless I can fix my posture and muscle imbalances I’ll keep having these problems. I was just wondering if you think all of these issues are connected and which of these exercises I should do and if you could recommend any other exercises you’ve posted on here?
Thank you for your help and sorry for the lengthy comment!
I have same problem, mine started after knee operation and hip surgery after car accident.
I am also interested in the response Mark.
hey mark! I have one side rotatedd pelvis to front..my both legs femur is rotated and knee caves inward…foot are pronated please tell me any solution for this
Hi Amanat,
Here are some resources that might help:
– Rotated pelvis
– Flat feet.
Mark
Hello Mark
Good information thanl you very much!
but my side calves are getting bigger than the inside calves and it looks a bit unattractive, it looks like as if my legs are bowel legs , how should I reduce my side calves?
Hey Anu,
If you have bigger outer calves, it may suggest that you put a lot more pressure on the outside of your foot.
Is this teh case?
Mark
Hi Mark,
My son is 2.5 year old. his right leg knee going inside while walking. he could not bearer weight on right leg while sitting on legs. As per doctors he is having weak mussels due to which he does not have much balance control. we do regularly physiotherapy. Can you please suggest further to overcome this?
Hey Ujvala,
Getting kids to do exercises is tricky.
If he is having issues with weight bearing, try getting him to walk in a very shallow pool. This might help him exercise his weak muscles. You can make it into a game.
Mark
hello Mark,
Thanks for the information.
Son is having tightness in right leg ankle due to which he takes step ahead with straight leg only, knee bending and ankle bending not happen at that time. Not able jump and run also.
So is there any more exercise or option for the same?
Hi mark
If only one knee is valgus (during walking) does that mean that side of the pelvis is rotated forward or that the opposite side is rotated forward?
Tanks
Hey Noura,
The pelvis will usually rotate towards the leg that is at the front when walking. (But I guess it really depends on exactly how you are walking)
Mark
please I need video instruction
That is a good idea!
Thanks Mark , your tips are valuable . I started playing badminton a year after my left knee ACL reconstruction but surprisingly in 3rd month of playing my right knee got slight valgus including 12 degree deviation in lumbar area of spine . It is exactly the same as my right hip internally rotated and tibia externally rotated . I will follow all your exercise . I have 2 Questions , Can I do in gym leg presses and leg extension exercise for my valgus knee apart from your suggested exercises ?? 2) correction exerice such as clamshell , lunges and short should be done on only on affected knee or both the knees ? Pls suggest . Regards
Hey Jatinder,
You can certainly do leg presses and leg extension.
You can do the clam shell and lunges on both if you would like.
Mark
Thanks Marks , appreciate your response!!
Hello Mark,
During the knee exercise where you fully extend the leg and then lift, my knee pops out and tracks laterally. I was wondering if I should still continue the exercise with the extended leg (even though my knee moves) or if I should try to keep the knee in place (but then my leg can’t be fully extended).
Thank you for your time and sorry for any inconvenience!
Hey Aman,
Make sure that you are not hyper extending!
If you are concerned with the lateral tracking of the patella, maybe straighten your knee 90% of the way (but make sure you can engage that quad)
Mark
Hey,
Thank you for the article. I noticed my knees going inward 2 years ago and it accelerated in the past 12 months. Is it possible to reverse the inward look? Everyone commenting here appears to have been born with it or are (were) over weight. I’m neither. The disturbing look of the knee joints going inward is actually new for me.
Hey Wade,
What has caused the knees to go inwards all of a sudden since 2 years ago?
If it is due to a muscular imbalance, these exercises should definitely help with that.
Mark
I don’t know. The orthopedic said inward knee rotation. Witch is funny because my legs have straight my entire life. Could the inward knee rotation be new as well. It was not noticeable until a couple years ago. My knee joints are literally being push inward and it gets worse my the month. It’s almost if I can’t stop it. Doing squats, I think makes it worse. Hey thanks for the replay.
Update: wade here. Correction: an orthopedic said it was *inward Hip rotation* is the cause of the inward knee joint. Could the inward hip rotation be new as well? Because none of this existed in my teens and early 20’s
Hey Wade,
Sounds like Hip internal rotation.
This is would explain the inward knee joint.
Hip internal rotation + Foot pronation = In ward knee joint.
Mark
Hi mark i have a disabillty i think having low vitamin D has led me to knee valgus its since birth i dont know how to sort it
Hi Junny,
Are your referring to Rickets?
If so – This is a structural change in the shape of your leg bones and is unfortunately unlikely to change with exercises.
It is best to focus on general strengthening of the lower limbs (squats, lunges, steps etc).
Mark
Hello Mark,
Thanks for the info. I have knock kneed since about 13 when I was overweight. It bothers me cosmetically. How many times a week do you suggest and do you honestly feel this is any cosmetic hope since I’m 36 years old and don’t growing ? Thanks for the info!
Hey Joseph,
I would start at 2-3/week and see how the body responds to that intensity.
From here – you can adjust accordingly.
Mark
Hi Mark,
It has been almost 2 months since I broke my right leg femur and have been diagnosed with a right knee valgus. With your great website could you give me some tips on which exercise I should focus on for my knee as my leg is still a bit tender so I can’t do all the one’s you have on your website.
Many thanks
Alison
Hi Alison,
Try to focus on weight bearing exercises to her strengthen the right femur bone.
This can be done with squats, lunges steps ups etc.
If you would like to tackle your knee valgus, ensure that the knee tracks in line with the hip and foot as you perform the said exercises.
Mark
Hey Mark,
Is there further explanation on the short foot exercise? Iv been trying to flex the foot while keeping my toes relaxed. This is very hard, possibly because the muscle has not been developed. Any links or a video you could post explaining this?
Hi Mark,
I am a 16 year old boy, I got knee valgus, and also a little bit of flat feet, i dont think it’s genetical, as if I strengthen my muscles, i can fix my knees and ankles a little bit, do you think the exercises would help? If it would, how much it would take to see some changes? How do you recommend doing the exercises? Should i make pause a day beetwen doing them?
Hi Andrei,
You have age on your side so the best time to start the exercises is now.
If your knock knee is not structural, then it will most likely respond to these exercises.
You can start off with 2-3/week and see how your body responds.
Mark
Hi, are there any objects that could replace the massage ball and the massage roll?
Hi Andrei,
You can use your hands/fingers to perform releases as well. Just make sure your fingers are strong!
Mark
Hi Mark!
I am 14 years old and have knock knees. With my knees together I have about a 5cm gap. It’s not horrible but it still doesn’t look great. I don’t really have any pain. I’m pretty sure it is “structural”. I went to an orthopedic doctor and he said I wouldn’t need surgery and it would just fix on it’s own. I’m wary of this claim since I’ve had this since like 10 and it didn’t get better since then. I’ve had collapsed arches which led to outward facing feet, so I got custom orthotics. Do you think that orthotics plus these exercises will help fix my knock knees even though they are “structural” in nature? X-Rays show my growth plates still have a lot of room. Guided growth surgery is still an option because of this, but if possible I don’t want to go that route.
Any help is appreciated! Thank you!
Hi Mark,
Thanks for sharing these solutions. I have one knocking knee and I think it’s genetic cos I know a couple people who have it from my dad’s side of the family. Now I see it in my 2yr old son’s leg too! I want to fix it for him. Since exercise doesn’t seem to be an option, how do I go about it for a person this young?
Thanks again!
Hey Quintina,
It’s really tough when it comes to kids.
The 2 main options being:
1. Let them potentially grow out of it eventually
2. Turning some of the exercises into a game.
Good luck!
Mark
Hi Mark, hope you are doing well!
I have knock knees but it is not the worst knock knees. I don’t experience any knee pain and I have had this knock knees since I was born and my mother also has the same problem. So I am not sure if it is genetic. Will these exercises help me or can this only be corrected with surgery?
Kind Regards
Brendan
Hey Brendan,
If your knee valgus is purely due to the shape of your bones/joints (structure), then there will be a limit as to how much these exercises can influence your knee position.
If you have no symptoms, I would advise not to go for any surgeries.
Mark
Hi Mark – loving these exercises! Really hoping they will help. I’m currently 70lb overweight, but have already lost nearly 50lb and keen to start working on my posture as I lose more weight. I have knock knees and flat feet, and my big toes point towards my other toes (bunions?) I will definitely work on these, but also wondered:
1) would toe separators be useful? And…
2) I can’t sit on my heels/haunches at all, as I cannot point my toes enough; however hard I point, my ankle is still bent – any ideas why or what I can do about it?
Thanks again for a great site!
Hi Corinne,
Thanks for the comment… and big congrats on the weight loss. Awesome!
1. Toe separators are good for mild bunions
2. You are lacking ankle plantarflexion. It may be due to a tight muscle at the front of your chin.
(see stretch)
Hold for a good 30 seconds!
Mark
ps. I am currently working on a blog post for big toe bunions. Make sure to follow me on Facebook to be notified when that is ready :)
Hi Mark – thanks for your reply. What is the ankle plantarflexion exercise you mentioned? I think maybe you meant to insert a link, but it’s missing ? I’m following on Facebook and am looking forward to the bunion blog.
Thanks very much, Corinne
Hello mark i need help before i had straight and normal legs but now the kness ar touching each other
Hi,
The exercises mentioned on this blog post would be where I would start.
Mark
Sir, I’m 22 years old female and kind of overweight. I took an x-ray few days back. And I really wanted to show you that. Please tell me how can I show it to you? Also when I climb the stairs I hear a clicking sound from my left knee. I don’t experience any pain in both my legs. And when I keep my hands on both my knees (I checked alternatively), I feel something moving at my knees while climbing! What could it possibly be? Also my doctor said my knees have started collapsing, especially on my right knee. Please tell me, can these exercises help? Sir, also, please tell me how can I show you my x-ray? Thank you.
Hi there,
You can upload your Xray here in the comments section and I will have a look.
If your main issue is knee valgus, then these exercises should be able to help you out.
I am not too sure what is moving in your knee while climbing. I would only be able to tell if I saw you in person.
Mark
Hi,
My daughter age 5 has knock knees i.e. Genu Valgum can it be rectified by these exercises plz help. I do not wish to undergo surgery for her
Hey Smita,
Yes – the exercises can help.
However- if the knees are structurally formed into the knee valgus position, there may be some limitations on how much you can affect it.
Mark
Hello!
Can you say how much time it takes to remove a valgus?
The distance between the heels is 4 centimeters.
It’s hard to say, DeiL!
Everyone is different!
Mark
Hello
Thank you
U can give me ur whats app no or phone no…
If u…..
Blease can you give me url of a video to do these ex because iam not good in english to understand
Hi Ahmed,
I will need to create videos soon!
Mark
Hi
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. Does that mean my knee valgum is not structural and could be helped with these exercises ?
Hi Hanna,
Sounds like that it is not structural if you can correct it that quickly.
The burning you feel on the outside of your leg is likely due using your weak muscles. (which is a good thing!) Keep at it – it will become easier.
Mark
Mark,
I am a former dancer, and have struggled with slight knee valgus and much more pronounced hypertension for many years. I also have a/flexible feet and achilles tightness, as you’ve described (though dance helped). I will try these exercises, but would love to hear your guidance on hypertension.
Now I have a couple of off topic questions… Judging from your blog, I think you may be able to help me with an issue that I think is postural. Now that I am in my 30s with a desk job, I am dealing with old strains in both inner thighs. The issue imerged all at once when I was doing some teaching, and manifests as a tightrope-like feeling and pain–deep in the thigh, between larger muscle groups-when I attempt seated stretches with my legs out to the side. 1. Based on what I’ve written, do you have any idea what muscle group could be bothering me (it’s not groin…) and 2. Is it safe to stretch “to the point of pain” without “crossing over” as long as I am warm? Thanks
Hello former dancer Allison,
When you say “Hyper tension”, do you mean Knee HyperEXtension? Or are you referring to having a lot of tension in your muscles?
With the area of pain that you mentioned, where exactly in your thigh is it located?
Mark
Thanks for your response, Mark! I am referring to knee hyperextension, yes (cursing my phone’s autocorrect feature for that!). At one time, I thought this might be a gracilis issue, but am not sure. It is deep in my inner thigh, but close to my hamstrings, and the pain/tightness kind of runs the length of my femur–like where you feel a straddle stretch. It doesn’t bother me all the time, but when there’s pain/tightness, it’s pretty strong at attachment near the knee (medial/posterior, where gracilis attaches), but also in the middle of my thigh, which almost feels like hamstring is involved. I am okay doing squats in parallel and even with turned out legs in standing (when i don’t overdo it). The pain is specific to straddle-like stretches, with knees bent slightly (greater than 90 degrees) or straight knees, in neutral or anterior pelvic tilt (posterior’s okay). The pain feels more like a warning than an acute injury, but I want to respect that as much as i can. I hope that is a good enough description to help identify the issue…
Thanks again! If I figure this out, maybe I can rehab it and take a dance class! Allison
If it helps, it’s as if the pain/tightness is along the back side of the inner seam of a pair of pants, but underneath other muscles.
Hey mark. I am sonu and I am 18 yrs old.I read complete article. It was very good.my problem is completely different my one leg (right) Its going on bending I will do rope jumps ,full splits ,ballet etc .. can I get your suggests please .. should I stop doing all those things and start those exercise u prefer . Really its effecting on my career(modelling).when I wear skinny Jean’s or shorts friend started noticing and asking .you can understand my problem .please reply me and give some suggestions
Thank u
Hi Sonu,
You can start with the exercises on the blog post first.
They will strengthen the muscles that will make rope umps and ballet moves easier.
Mark
Thank you. One of the most helpful articles I have read on the subject, and also your article on correcting flat foot / fallen arch. I have been troubled by an inactive tib post and slightly dropped arch for some time causing a host of problems with with running. Realise that some of the subtle but very inpritant points of the correction exercises I’ve been doing have not been fully explained to me. Notably how correctly activate short foot, keeping toes relaxed. I find even the basic progression of this exercise extremely hard to perform without tension toes, but now feel much more confident about to perform this exercises to actually get the benefit from it!
Thanks for the comment, Anne.
A lot of people struggle with toe control. But it is only because we never really “work out” our feet specifically.
Practice practice practice :)
Mark
Hi Mark! Videos of you doing the exercises would help greatly! Also, would you please tell me how often to do the exercises and how many times? I see “20-30 reps” or whatever but do I do three sets or just one of each. And what order from stretching to rolling to strengthening? Really appreciate this page. I hate having knock knees!
Hi Veronica,
Yes – I need to do videos for sure!
You can start doing the exercises once every 3 days or so.
Pay attention how your body responds, and adjust the intensity/frequency from here.
I would do the exercise top to bottom.
Over time – you can pick and choose which exercises are the best for you and stick with those only. But to begin with, try them all!
Mark
my dad is suffering from shoulder fusion .can you give some tips for minimising pain……
Hi Sandarbh,
I don’t have a blog post on shoulder fusion, but if you check out this link, it has some good shoulder exercises that your dad can try.
Mark
Hello. I have a valgus of my knees and maybe because of this, I have arthrosis. Will it help me cure him?
Hey Deil,
The exercises should be able to help you out!
Mark
Hi Mark,
Thank you for taking the time to developer this Website. Not only is it informative but also very helpful.
For now, I only have one question. During a couple of the exercises the term “Short Foot”.Is used, what does it mean?
Thank you,
Lisa
Hey Lisa,
Here is a complete answer to your question: Short foot activation.
Enjoy!
Mark
Hi Mark,
Do you do coaching? If so, what’s your hourly rate?
Best,
Manuel
Hi Manuel,
Not a present.
But please feel free to follow me on Facebook!
Mark
Hey Mark…
Actually I m just 18 and I want to get rid of this problem there is no pain but the knee touches each other and i wanna get rid from this problem …
Plz…help me
Hi Shreya,
Best place to start is with these exercises!
You have age on your side :) Don’t let your knees become a problem.
Mark
I m glad you replied..
Tnx a lot
Mark, thank you sharing for this information, very generous! I am 73 and my knees, back, feet, are all a mess. An orthopedic doctor said he wanted to replace both knees but that it wouldn’t straighten my legs. So I didn’t have the surgery. Now walking is getting harder because my knees hit each other all the time. This is a life long thing with me. So I was very glad to find your post here, and will try to do some of these exercises, to strengthen my legs some. Joy
Hello Joy,
Good luck with the exercises!
Mark
Hi Mark, my mum has had knee valgus all her life and recently had to do a total hip replacement and but the degradation of her hip prior to the operation caused her right knee to cave inwards severely, what type of brace would you recommend? I know I have to get her the articulated knee brace but there are so many (telescoping, hinged ROM, unloader/offloader knee brace etc.) Can you assist in any way?
Hi Jasmine,
Is her main issue pain in the knee whilst walking?
All of those knee braces are fine and provide external support to the knee.
The main thing is that it needs to fit perfectly in order for it to work properly.
Mark
Hey mark!
I am currently a 15 year old and i wanted to know if knee valgus could be eliminated foreever if started correction at an early age? I have noticed that i dont have a severe but noticable case of knee valgus and my knees are now just starting to feel some kind of discomfort. I would also like to adress that when i was doing the popliteus strengthening excercise, my inner part of my feet couldnt help but bend at a 30-40 degree angle. In general, my feet usually is at a 30-40 degree angle facing inward when resting and in motion. Is this another issue that i should be worried about? Also, thanks for this wonderful and helpful article.
Hi Mark
I’m in college and I’m 16.I had really straight legs when I was younger,but when I was about 13 I started feeling like my knees were curving awkwardly.Now I have knocked knees but sometimes I can stand straight,i feel my condition is not bad but its not easy to be cautious all the time.I want to fix it once and for all,but I don’t have the time for all these exercises because of school.Plus I don’t think I might get it right and I don’t want to worsen my legs at all
Can you give me more precise exercises,that would help me and be more effective,i also want something I don’t have to do with tools too.I think more walking and posture tips would help me do.Please I need your help,it makes me feel uncomfortable in clothes and with people.
Thank you,it means a lot
Hi Mark,
Thank you for this insightful article! I would like to book a private coaching session with you via Skype. Would that be possible? How much do you charge for half an hour?
In the following paragraph I’ll elaborate my issue since it’s not regular knee valgus.
For me only my left knee moves inwards, the right leg is fine.
When I for example sit down and my leg muscles relax, some string seems to misalign after some time. When getting up, fully stretching my leg and contracting my muscles, my knee cracks as if some string jumps back into the right place. This does not hurt. However, if don’t do that and walk for a while, my patellar tendon inflames pretty badly and it takes several days to recover.
I have seen many doctors and physiotherapist over the years and have gotten to a point where I know how to avoid severe inflamation, but the cracking persists and the patellar tendon is slightly inflamed most of the time. Nonetheless, I am able to run, do squats and so on.
Best,
Manuel
Hi Manuel,
I currently don’t do online consultations. If I do decide to do them in the future, I will let people know via the facebook page.
The clicking may be due to the patella clicking against the femur bone.
If prolonged knee flexion during sitting is the issue, here are some possible factors:
1. Stiff patella joint
2. Tight anterior knee musculature (such as distal quads)
3. Tracking issues with the patella
4. Sitting with too much knee flexion
5. Sitting on low couches/chairs
Mark
Hi Mark.
How many times per week do you need to do the exercises to see fastest results?
Thanks.
Hi Jorgen,
If your body can handle it, you can perform the exercises every day.
Mark
Hey Mark
I have read your posts, they were really helpful,,
can I ask U for the reference list a bout internal tibial torsion ??
actually I’m working on my thesis proposal .. and I want to know more..
thanks
Re valgus knee: Im almost 66, have had valgus since childhood. Rt knee worse over last few years. Ive done therapy, lost the weight but ended up seeing orthopod last week. My knee is stiff. He says bone on bone and femur is twisting causing hip rotation. He says knee replacement is only fix to get a straight knee. Do you agree that if it gets severe enough that is only solution?
Hi Lou,
If your joint’s structural integrity is completely deteriorated (eg. “bone on bone”), then the only way around this is to get a replacement.
However, that being said, you should try to do as many exercises to address you knee impairments before considering any form of surgery.
Mark
Hey Mark. My two year old, i think he has knock knees ,as i saw in the post above, is there an email or something i can contact you and talk about this??
Hey Zay,
It is probably best to ask your question here :)
Mark
Hi Mark,
Thank you for making this website with incredible information on fixing postural problems. I have been dealing with a mix of APT, knocked knees (or bow legs?) and flat feet for the last few years or so. I remember it all started with the APT from sitting at my desk a lot (playing computer games), and the issues with the knees and feet happened during or shortly after I performed heavy compound lifts at the gym (squats, deadlifts).
I have just tried the exercises on this page for the first time and could feel the target muscle areas in the respective releasing, stretching or strengthening exercises. I am now committed to performing these on a regular basis with the intent of solving these issues as quickly as possible before the issues get any worse.
What would be the correct order of performing these exercises if someone has APT, knocked knees and flat feet (flexible)? Which exercises would be best to focus on if one only has 1-2 hours per day to dedicate to corrective exercises? How many times per week should they be performed? Thank you.
Hey Mike,
If all your issues came from an APT, I would focus my attention there first.
By doing this, you may find the knock knees and flat feet will correct to an extent.
Perform the exercises 3 to 4 times a week and see how you respond. If you can do more, do more :)
Mark
Hi Mark, thanks for your fast reply. I will do the APT exercises on your site today and will keep up with them at least 3-4 times a week :)
No worries, Mike.
Please let me know how it goes!
Mark
Hi Mark,
Thank-you for this. I have had problems with my knees for over 2 years now. My left knee in particular, where lately its been in a lot of pain if I bend it or even straighten it. I used to cycle at gym to strengthen my knees which helped quite a bit but then a few days ago I had done a lot of walking in very flat shoes, and suspect that I had been twisting my feet as I walked. I’ve taped up my arches now, and will most definitely be trying these exercises out.
All the best with the exercises, Phylecia
Mark
Hi Mark,
I have overpronated hip joint internal rotation.
So how to go with it ??
Which exercises should I do ??
Hi Ronnie,
The exercises under the HIP section will be great place for you to start to address you hip internal rotation.
Mark
Thanks! My valgus is so bad that my knees are misshapen and often click when I bend them. (I have very high foot arches and am knock kneed, which likely has pulled the knee cap out of track.)
I haven’t been able to do a full squat for years, and now I’m losing my lunge. So I’m thinking of getting knee braces to keep the kneecaps more centered on my leg as I do strength exercises, especially for the muscle above the knee and inside the knee. I’ll be doing all of your exercises and stretches, too. I feel some of my muscles in the thigh and pelvis have shortened.
Thanks again!
Hey Carol,
Thanks for your comment!
All the best!
Mark
Ps. Have a quick google on “Compensated Forefoot varus”. Do you have this?
(let me know, and we’ll see if we can help you out)
Hello Mark, I am Sarthak , I am 16 year old , i do ave knock knees AND wanted to know that these exercises are not helping and the problem persists . How can i know that it is a structural problem. I really want to correct my knocked knees as I desire to enter the armed forces.
Hello Sarthak,
If you are doing the exercises correctly and at the correct intensity over a long period of time, and there is no improvement at all, I would say that it is more likely to be structural.
You could also get an XR to see the shape of your bones/joints to help determine if it structural.
Mark
Hello, Mark! I am overweight and have been for my lifetime. I have had knee valgus since I could remember. I am on a weight-loss journey, and have lost 50 pounds. I want to begin exercises that specifically target my knee valgus. About how long do you think it takes to show progress with knee valgus using these exercises, and how often should I complete these exercises a week?
Hello Margaret,
It is difficult to say how long it will take to see progress as everyone is different.
You can perform these exercises 2/week to start off with and increase frequency if able.
Mark
Mark,
I believe I am a candidate for Knee Valgus. I have been dealing with a chronic issue with my left leg. My pain started with the knee after running on an uneven surface 2 years ago and has mainly relocated to my hip/lower-back.
Is it possible to only have the issue in one leg? As my right leg seems just fine.
I believe my symptoms check out with your research as I am one that sits for prolonged periods of time and anterior pelvic tilt has turned into knee valgus – but only in my left leg.
I appreciate your thoughts and insights. Thank you.
Hey there Aaron,
Yes – you can have knee valgus on one side only.
I would also check to see if you have a Rotated pelvis as this can influence the knee position. (esp. if you only have knee valgus on one side)
Check this post: How to fix a Rotated pelvis
Mark
Hay mark.
I have anterior pelvic tilt.
When i walk in my right knee caving in.
In order to avoid this problem I change the direction of my feet to the outside.
How to fix this problem?
Hello dear Mark
I’m 18 years old and I have knock knee
If I had these exercise my leg be straight?
Because I don’t like surgery
Thank you
Hey Maee,
Only one way to find out!
Get started on the exercises :)
Mark
Hi Mark,
I’m a 27 year old female (PT masters degree for additional info!)
As a child, I had developed significant knock knees due to an insidious onset of rickets.
My surgeon suggested that I avoid surgery as it’ll be too much of a hassle at such an age. He said that it was okay to stay away from getting under the knife.
However, my valgus is very prominent and creates lots of issues like foot pronation thigh pain. Any thoughts on what I could incorporate in order to strengthen my glutes etc without surgery? Thank you.
Hi Anie,
All of the glute exercises mentioned on the blog post will be great place to start.
It would be a good idea to develop the strength/control in your feet as well.
As the rickets has likely changed the normal curvature of your leg bones, there will be a limitation on how much of the alignment you can actually change.
Focus on strengthening the whole lower limb as to increase the capacity of your joints and muscles.
Good luck!
Mark
Hi Mark,
I’m 39 and in otherwise good health and weight for my age.
I have recently had a tibial plateau fracture which required surgeon on and now have some knee valgus. Do you think the exercises you mentioned can help reduce this, if so how long would you expect to see Improvement??.
Hey Kev,
If the knee valgus started directly after the surgery, then it might mean the surgeon may have changed the alignment of the knee. In this case – you might be limited as to how much you can correct.
If it start to form more so after changing the way you walk, then these exercises should help you out.
Mark
Thank you Mark for advice on knee valgus correction. I am 28yr male. My two friends on getting feet together a diamond space in formed with pubis, knees, and intersection of feet forming the four corners of the diamond shape, for me no space between thighs and there is 8cm distance between the heels of the feet. I started squats to help. Please advise me on what to do to achieve the best I can for knee posture. Thank you.
Hi Senyonjo,
It sounds like you have a Knee Varus?
I don’t have a blog post on this yet!
Mark
I have that same issue
Would love to see an article on this!! I’ve had bowed legs and super high arches all of my life. Even though I have a posterior pelvic tilt. Would love to know if you’re planning to write about this condition. Thank you!
I also have knee varus. I will patiently wait for your article. Thanks !
Just a friendly follow-up request for Knee Varus (bowlegged) article when you get a chance!
Thanks, your site is quite helpful!
Hello Mark,
I am a 71-year-old female who was told I had a limp about 6 years ago and as a result, noticed I have a valgus right knee. Since I have no pain, the surgeon does not believe it warrants surgery. I am now in physical therapy to strengthen all the muscles you have mentioned and I plan to perform all your exercises. I have been active all my life especially with tennis (play 3x/weekly). Everyone notices my crooked leg and I’m very depressed about it, especially since I cannot move or run on the tennis court like I did just 6 years ago. Do you have any suggestions or comments that would help??
Hi Jean,
The exercises mentioned on the blog post will be a great place to start.
It’s also awesome that there is no pain! This means you can really focus on the rehab exercises.
On top of these exercises, I would also encourage you to commence a leg strengthening program which will help you specifically with playing tennis.
Your Physical therapist should be able to devise a program for you. Focus on single leg exercises!
Mark
Hi Mark,
Thank you for explaining this in detail. I do have a question as I have noticed this in my sons leg. He is turning 4 years old next month. When they are this young, do you think this will still be corrected? Thank you in advance for your response.
Definitely – as long as it is not structural.
Mark
While browsing online about knocked knees i saw that toddlers are more prone to knock knees due to their bones being in growing stages. With time they generally correct themselves, so when your son turns 9 or so if the knocked knees still persist then he should start doing these exercises. But for now I think your child is perfectly fine.
Hi again, Mark – well it’s almost been one year since I texted you last. I failed to mention that as a result of my right knee valgus, I have severe left hip bursitis and I cannot seem to improve the problem no matter what I try. Any suggestions? I have tried physical therapy, laser therapy, chiropractic therapies, electrical stimulus, ice, and even acupuncture.
Hey Jean,
Check out this post: How to fix Hip Bursitis.
I go through many exercises you can choose to address that.
All the best!
Mark
Hey Mark,
I am 22 years old, and I have noticed that over the last couple of years my knees have gotten a curvature inwards. I started looking at this because when I was about 20 my girlfriend sat on my knee by accident while I was laying in bed and dislocated my left patella. Ever since I have Noticed this even more. I have also realized that when I lay in bed my legs pull outwards on their own and it’s hard for me to keep them straight. I have read this article and the picture where you show the foot position in the car is literally my foot every day as I drive . I have also noticed a delay in growth of my vastus medialis in comparison to my vastus lateralis in the gym. So my question to you is do you think that I would benefit from performing these exercises daily and how long would it take for me to start seeing some improvement. Thank you and hope to hear back from you soon.
Hey Robert,
Sounds like these exercises will help you out.
The weakness of your vastus medialis, patella dislocation, inward appearance of the knees are issues that are addressed with the exercises.
I would also recommend checking this post out too (if it applies to you): Duck feet posture.
Mark
Hi Mark,
We are very concerned about our thirteen year old grandson who has the worst hip, leg and feet alignment, almost shaped like this )(. His mother is in total denial about his condition and is telling him that all he has to do is wear his orthotics (which have been shaved down to almost nothing, because the more pronounced ones hurt his feet) and all will be fine.
He cant walk too far as his feet hurt badly and to add to all of this he is overweight!
We are based in Melbourne and as grandparents we need someone to help him, at our expense, because if nothing is done for him he will end up severely handicapped.
I have a video of him walking if this might help viewing.
Many thanks,
Relene
Hi Relene,
The exercises will help with his knee valgus, however, it can be quite hard to get the young ones to actually commit to doing them :)
Increased weight will also place more stress on his lower limbs and can potentially compound the issue.
Keep him active. Even if it means simply walking short distances! The muscles can and will adapt eventually.
Mark
Hi, this is extremely insightful to me. I have had foot surgeries to try and correct my foot alignment (flat feet from dad) because it started causing me joint and back pain when I was 12. They have been semi-successful, but they are still sort of flat. Also, my knees have become knock-kneed (which is partly genetic because my mom is slightly knock kneed). Anyway, would you say that the reason my feet are still flat has to do with my knees? I am a 6′ girl who plays volleyball. I also have back pain, knee pain, and ankle pain (my left foot is so stiff and it feels unnatural to walk and move it; Evan’s procedure and they touched the Achilles again with extended boot time bc of wound issue on April 2017; around 2013 I had screws and Achilles lengthening on both feet and had screws removed 2014/15 bc of irritation and growing).
TLDR: do my flat feet issues correlate with my knock kneed issues and can one affect the other especially my foot
Hey Chase,
I like how you put the TLDR there :)
Basically – the knees affect the feet, and the feet affect the knees.
To make it even more interesting, the hips can affect both as well!
Here are some posts that might help you out:
Improve your ankle dorsiflexion
Fix flat feet
Also- maybe check if you have this as well:
Anterior pelvic tilt.
Mark
Hey, Mark!
I’m a high school student noticing some issues developing in my lower body (likely due to being seated a lot at school and not maintaining an exercise regimen). I used to believe I just had flat feet as a kid. Then I went to go get them checked a year ago, and the podiatrist said that my feet were not much of an issue at all, but that the problem lay in my hip/knee/ankle alignment. My femurs tilt inwards, and I have weak hip flexors and tense muscles. Hopefully through following your guidance, I can get back on track. These stretches and exercises may be just what I need.
Also, your book could be very helpful in making sure I maintain good posture even if I have to be at a work station for a long time.
Cheers,
Adah
Thanks for the comment, Adah.
Hope the exercises help you out!
Mark
Hi Mark,
My name is Andrei(Andrew, translated in english), I started going to gym for a while, lost about 13 kg’s, tonified my body, but I recently discovered that my legs look awfu). It could be possible to fix this with your exercises?
Do you think the internal rotation of the femur could cause hip impingement/fai?
Hi Chris,
Definitely – especially if you combine it with Adduction + Flexion.
Mark
Hey Mark,
I’m Leen from Belgium and I’m studying shoe technology. I recently started to do some research about genu valgum for my thesis. My supervising teacher recommended your blog about ‘How to fix your Knee Valgus’. Did you use some references that you want to share with me or did you write this blog from your own experiences?
Some references would really help me to achieve a correct study and your blog is really informative, but still very well explained!
Hi Leen,
A lot of what I blog about is through clinical experience.
But if you find some good studies that flow on with how I treat, I would love to see them!
Mark
hloo i am 21 year old boy and my knees start bending i m having sweeling on my knee and when i movie it become voice of tick tok from the knees and found so pain in leg please help to correct this i m having so much pain my whtsapp number is +917707806683
Good evening mark. I’m 16,does this exercises apply to me since I was told my knocked knees was genetic. My grandma has it.
I also feel pain on my hips and waist.
I’d say see how you go trying the exercises.
If you are truly structural knocked knee, then it is unlikely the shape of your legs will change.
However- if you just have weak/tight muscles and/or poor awareness of your legs, then you may see some good improvement with these exercises.
Good luck!
Mark
Hi Mark,
Thank you for the article, it is amazing!
My grandmother recently underwent TKR and was braced up for a month. When she bears weight on her right leg now, the knee goes in valgum. What are your thoughts about this?
Hi Prachi,
Likely a combination of weak foot/ankle, knee and hip muscles.
She will benefit from strengthening of the same muscles as mentioned in the post.
Mark
I have always been extremely embarrassed about my weird knock kneed legs. I walk and stand so weird, and I hate it. I thought I have finally found a solution, but these exercises did abesolutely nothing. Literally. No affect on my legs. The way I stand, walk, and run is still knock kneed and weird. I am so upset. I thought for once I could finally be normal.
Hi Alexa,
I have 3 suggestions:
1. You may have Structural knock knees which can not be changed.
2. You may require in-person assistance with the exercises to make sure you are performing them correctly.
3. You need more time to allow for change. Think about how long you have had your knock knees, and now think about how long you have done the exercises for.
All the best.
Mark
Hello!
I had ACL reconstruction and a meniscectomy 7 months. Now I’m suffering from inner ankle pain in my good leg! Could this be due to excessive strain and weight? I’ve starting practicing these exercises since my left leg (the one operated on) internally rotates. I appreciate you posting this information. Thank you!
Hi Annina,
Thanks for the comment.
It is fairly common to get issues on the other side due to compensation.
Best way to tackle this is to make sure your ACL leg has been rehabilitated properly as to regain complete confidence in loading that side.
Mark
Hey Mark,
This is very useful post thank you for writing this. I can see that you have positions to avoid but do you also have positions that you recommend when sitting? would you just keep your legs spread and try keep them in correct position while sitting down on a chair?
Since I have knee valgus I cannot align them together in a straight line as of now, when walking but should I prioritize my knees or my foot/toes to pointing ahead first? If knees are pointing straight than my feet goes outwards, if I point my feet straight my knees go inwards. It’s gonna be one or the other for now. Or should I walk without thinking about it? majority of the time my knees will bend inwards when I lift it when walking.
Thanks.
Hi there really interesting and helping blog u posted. I hav problem with the way i walk but i dont really know the actual problem or the cause of it but i would like to write some of the signs which are somehow related to what you posted. Firstly i have never been to a doctor to talk about it. I have being observing myself with The way i walk and i think my left foot is not the same as the right foot. Actually the the problem is with my left foot. From my observing i realise my left foot looks longer than the right foot and not actuali shaped as the right foot. What i mean here is my right leg faces inward at the thigh and at the knee while the foot turned out as out toeing. While the left leg’s thigh faces forward with the knee and toe they all face and move in the same direction. As the right foot rotates inward at the thigh and knee i dont find much dificulty in it during walking and i walk find but with the left leg all the thigh, knee and toe all facing forward i dont walk normally with it and during walking i feel the left leg longer than the right. And as i am walking my left leg moves with the pelvis and drops. I cant move it without the pelvis moving with it. So i once read a blog about gluteus medius and i thing the problem seems to be with my right gluteus medius cus when am walking my left foot always drops and move with the pelvis forward and i always feel that my left leg is longer. So this is it if there is anithing you know to help i would really appreciate it. Thank you.
Hey Mark,
First off thanks so much for this resource, it has helped me understand a lot about how my body works!
From the bottom up I have hallux valgus, collapsed arches, inverted knees and APT. I feel like I am improving thanks to your resources but my left side just won’t budge.
I have an ankle pinching pain that inhibits me from dorsiflexing and therefore I can’t keep my arch up effectively when squatting, running, walking etc. without collapsing inwards.
As a test, I did heel drops on the floor. I start with my heels raised and then try to bring them down to the ground whilst maintaining the arch in my foot. Works fine on my right foot. But on my left, my arch collapses before my heel can reach the ground. This happens because my ankle starts pinching and simply hits a wall, not allowing me to dorsiflex further.
I have tested this also when standing on one leg. The right works fine and I can stand on it with a good arch. Knee tracks straight, glute fire and I can keep a good arch. But on my left, the only way I can stop my arch from collapsing is by pushing my left hip outwards to work around the pinching in my ankle. If I didn’t do that, my ankle would collapse inward and I’d lose balance.
I should also mention that when doing the wall push or kickbacks or deadlifts, I get snapping in the back of my knee when trying to get it to track straight. Also, my femur collapses inwards etc.
After some research, I’m wondering if this is all happening due to an ankle impingement? I also feel a weird snapping sensation on the external malleolus when dorsiflexing. I can kind of push past it but it still snaps a little.
When I do dorsiflexions with banded tallus distraction and/or pulling the fibula back, I feel like I finally get some ROM and can articulate with less pinching and no collapsing! But when I take it off I have stronger pinching pain again.
Would you say I have an ankle impingement and should I be working through the pain?
I’ve pretty much stopped squatting, jumping and running because my ankle keeps collapsing inwards.
Hey Vincent,
It sounds like you are indeed describing ankle impingement.
Check out this post: How to improve ankle dorsiflexion.
You will need to keep mobilising the ankle joint in the pathway where the ankles does not collapse. (The band exercise you described is great for this!)
I would also add stretching the anterior section of the ankle to help open up the joint:
All the best!
Mark
Hello Mark, I suffer from bad posture and I have the opposite of Knee Valgus I have Knee Varus I was impressed on how much detail you made on this post I was wondering on what exercises I would have to do to get rid of my Varus.
Hi Tyrone,
Assuming that your knee varus is not structural in origin, you will generally need to:
– release the popliteus, glutes and arches
– strengthen lateral hamstring, hip internal rotators and evertors
– Address any pelvis position issues
(however- it really depends on your presentation.)
I might need to do a blog post on this. Thanks for bringing it to my attention.
Mark
Hi mark, thank you for this amazing post, i’ve been searching for years for something with quality like this.
Everywhere people who talk about this problem, talks about two possible causes: genetics or posture. As some of my family members have the same problem as me (maybe worse cause of weight), i think I have a structural problem. When i stand with my knees toghether, my feet stand about 5 cm separated. However, thru my life I have learned how to stand in a way that i can look pretty normal, like not a knee valgus look. The REAL problem, the one that makes me suffer, and think all day, occurs when i walk. I have recorded myself walk, and can notice that i walk really weird because of my knock knees. My knees look to the sides while me feet look straight. They dont knock, i mean, they dont get to touch between them, but it looks pretty different than a normal walk. I cant sleep at night because of this. Do you think this excersises can help me?
Thank you for this post. Ive had knock knees since childhood. If i try to keep my ankle straight my knees swell up and if I bend it, it hurts so bad :( not sure why. But love to try your tups and see. May I know how frequently we should do these exercises? And how long would it take to see visible results?
Hello Celine,
Daily practice is the way to go.
In terms of how long it’ll take to correct, it really depends!
(Just make sure that your knock knees is not structural. Forcing movement could cause more injuries!)
Mark
Do these exercises apply to knock knees with foot Supination? A long time ago I intentionally decided to stand this way to prevent the look of knock knees and it has stuck, now it’s a problem.
Hey Alma,
If a foot correction didn’t really resolve the knee valgus, I would assume the issue is coming from the hips. You may need to focus on this areas instead of your feet.
(keep in mind, you can also have structural knocked knees which basically it is due to genetics :))
Mark
Hello there Mark. Few years back I fell with my right leg moved aside. Since then I’ve been feeling some paints there each time I fall. And I’ve alsl discovered I developed knock knees too. Every time I try bend or stretch my right leg, it makes some cracking sounds. What do I need to do pls??
Hi James,
It might be an idea to get a scan to the area to check out for any potential structural issues first.
Mark
Hi Mark
When I put my knees together my feet are also together. Does this mean that I do not have knee valgus ? Also when I sit my feet are not that flat and I have some kind of an arch but when I stand on my feet my arches collapse and my feet become flat. Should I still strengthen the hip external rotators and the hip abduction muscles and stretch the hip internal rotators in order to shift a bit of the weight away from my collapsed arches ?
Regards
Marin
Hi mark, 16/m here and I was wondering if my case can be solved by just exercises. Ever since I was little I could sit w type and point my feet upwards from that position. I am now at the point I can rotate my ankles 270 degrees easily and when i walk i look like a penguin. But i also have knees that are bending inwards at the same time and they face an about 60 degree angle whenever my feet are even close to straight. Is this something more serious or can it be fixed without surgery
Hi Ben,
That is a lot of movement in the hips!
It sounds like you may have what we call femoral anteversion.
If this is the case, you will get improvements with these exercises, however, since the cause of your presentation is due to structural reasons, there will be limitations on how far the exercises will take you.
You can get surgery for it, but I would recommend against it in most cases.
Mark
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Hi,
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Mark
Hi Mark,
Thank you for this informative post. I first recognized that my legs where a little crooked when I was a kid, some 20 years ago. I saw other kids with straighter legs and didn’t know what to do about it. I even walked with my toes pointed inward, “pigeon toed”. Since then I’ve made myself aware of this and always walk with my feet pointed straight or slightly pronated, but my knees have always been slightly bent inward. I thought it must be a genetic issue. I’ve always liked being active though and have had trouble with my knees throughout my life and am now wondering if this is related to other types of pain I experience as well (my inner ankle for example). I tried running a few years ago and would generally experience swelling and pain in my knees at runs of 7 miles or more. I was mindful of running technique, but the pain persisted so I stopped this activity and took up lower impact yogo.
I’m actually surprised to learn that this is such a well known issue and encouraged to learn that it’s potentially correctable. Some of your other readers experienced this condition after a procedure or injury. In my case I’ve been aware of it most of my life. Is it safe to work towards realignment after so many years? Hasn’t my body worn itself into certain positions and mechanics? How much time does it take to improve? Will the condition revert if strength in the specific regions is not maintained?
Thank you for this excellent guide.
Hey Lukas,
If your knee valgus is directly causing you issues, you can definitely start correcting it now.
As your body has based its posture and movement on the knee valgus, it is very likely that you will need to address other areas after the knees too. (eg. the hips, ankles pelvis etc)
Mark
Hi mark,
I’ve been struggling with this problem awhile now but I’m still young I’m 15 years old about to be 16 and I really want to fix this so what is the best most effective way without surgery and for it to happen the fastest? And about how long does it usually take for me to see results?
How long would I need to do this for before I start seeing improvements?
Hello Mark, I just finished reading this and I would like to say that you wrote this very well. I have had flat feet for years now and I have some knee valgus caused by it. However, I am an athlete to trains and does squats. I researched and learned that for squats you need a good amount of hip internal rotation, preferably 45 degrees. I realize I have pretty bad hip internal rotation which therefore causes hip pinching when reaching parallel in a squat. Therefore I started doing some mobility work for the internal rotation to improve it along with ankle mobility work. However, the internal rotation mobility for the hip contradicts what you have here, as you mentioned that people with flat feet and knee valgus like myself should never do that, but rather hip external rotation. I am somewhat confused on what I should do since I am trying to fix my knee valgus while still being able to squat with lots of hip internal rotation since it is an important factor. Any advice would be great. FYI i have really good hip external rotation.
Hey Collin,
Internal rotation for the hip in a deep and narrow squat is very important. This allows the pelvis to move on a stable femur. (if you lack internal rotation and want to go deep on the squat, the knee and foot will cave in as compensation to get more depth in your squat.)
These exercises are more so targeted for the upright position (hip 0-45 degrees flexion) as opposed to the deep squat position (hips ~90 degrees flexion).
If your issue is impingement at the front of the hip:
– work on Internal rotation of the hip (strength and mobility)
– traction your hip
– work on improving pure hip flexion
Also if you have really good external rotation and severely limited internal rotation, have a quick google search on retroversion of the hip.
Mark
Thank you for your reply.
So basically a lack of hip internal rotation can cause a hip pinch feeling/impingement when squatting. However, should I still be doing internal rotation stretches even though I have flat feet? My knees go inward a little when doing lunges or squats. I feel like I need way more internal rotation for my squatting but I dont want it to make my knees even worse. Thank you for your help so far, I really appreciate it.
I would still work on hip internal rotation in your case to get your squat depth.
At the same time, you will need to work on your flat feet.
I feel that your knee valgus is probably from the feet.
Mark
hi, can you do these stretches with double THR and hip bursitis?
Hi,
You can, but you need to be aware of how your body responds to the positions.
Do not push into anything that gives you pain. Be gentle and ease into it. If any doubts, feel free to contact me on facebook :)
Mark
thank you Mark
Hello Mark, a friend of mine is having lastly these problems, she had two car accidents, her legs were beautiful and straight, her problem started about 2 years ago. One day I asked her if she has some problems with her knees, I noticed that she stop using her leggings, skirts, and tide jeans, she said that something is happening and looking on the Internet we found that is KNEE VALGUS, I asked her to exercise. I think she should go to see an orthopedics, she is scared having surgeries, I found this information I am glad to share it with my friend.
Hi Mavi,
I hope that your friend will find the exercises helpful!
Let me know how it goes.
Mark
Hi Mark,
first of all, thank you for the detailed instruction on how we can “fix” ourselves.
Recently, I read an article about TFL relative to the IT Band. As per my understanding, when TFL is overactive, glutes can become somehow weakened and this could cause internal rotation of the tibia, so relasing and steaching TFL, while strenghtening the glutes, is a must, but the ITB also attaches to the knee via tibialis anterior and peroneus longus, which as far as I understand. has the same relation as TFL/glutes, one gets weekened while the other is overactiv. So in this sence, would it be also good to release and streach the peroneus longus while trainig tibialis anterior?
Thanks again for the great article, I find it really usefull, since I am dealing with internat femur/external tibia rotation on my right leg.
Hi Vasil,
Tibialis anterior training will help with improving your foot arch support and releasing the peroneals will help with reducing pronation of the foot.
Addressing both will help with your knee valgus!
Mark
Hi Mark, I don’t know if I have false curvature or knocked knees because my ankles touch but my thighs are moved inwards and my knees too and my calves are far apart, will these exercises help me get straight legs ?
Hi Noran,
Do you mean you have bowed legs?
Mark
Hello Mark my name is Stefan, I had ACL surgery on my right knee about 8 months ago, I have noticed I am experiencing these symptoms on my right knee and my physio said that it will straighten with time and exercise. I am currently doing lunges, leg press, bridges (hip exercise), calf raises, cardio, elastic band small sprints, and a few other exercises. I have been doing the exercises they tell me to do regularly and have not seen any change within the last 2 months. My knee still drastically goes inward when doing things such as: 1 leg squat, walking up/down stairs, exercises with my hamstring and other basic movements. My foot is also facing more outwards such as your C) “Strengthen the Poplitius” section but in your image it seems like it faces inward, mine is outward. If there is any way you have a few minutes to just talk to me over email or even better skype if that works please let me know. This would be mean the world to me Mark, I am a 21 year old Canadian student feeling hopeless with my knee and it really seems like you can help me more then my doctor and physio have..
Hey Stefan,
Feel free to message me on facebook.
Thanks.
Mark
Hi Mark,
I just recently noticed that I have the symptoms for knocked knees and I am trying to correct it as fast as possible before it gets worse.
There may be other factors, but I believe the main causes are my weight, bad leg/knee alignment while driving, and sitting (possibly with bad posture) for long periods of time.
I moved closer to work and started walking to work to get more excersice and help towards weight-loss. Thats when I noticed during walking that my knees rotate inward.
I can’t avoid the time I sit during work, unfortunately.
Is there anything you can suggest that I do, in addition to your excersices, to help improve my posture during sitting? Are there any excercises I can do while sitting at work? Is there a brace I can purchase that could help during walking and sitting? Is there an ideal position during sleep that would help correctly align my knee?
Also, is there an ideal time frame when I should start seeing improvement? I am worried that I should seek professional help from my doctor if I don’t start seeing improvement…
Your feedback is greatly appreciated! :)
-Rae
Hey Rae,
Whilst driving/sitting, keep your knees pushed outwards (hip external rotation/abduction) as knees tend to fall inwards with knee valgus. At work, you could even wrap a resistance band around your knees to challenge yourself
In terms of a brace, I try not to recommend braces as they make your muscles lazy!
These exercises are a great place to start for your issues. But if you still have doubt after going through this blog post, I would still recommend seeing someone in person to make sure.
Mark
I’m a 16 year old girl who has knees that go inward when I walk. What should I do to fix this for good??
Hi Heather,
All of these exercises are a good place to start.
Mark
Hi Mark,
Thank you very much for the detailed and comprehensive post on this issue.
As you can notice, I have knock knees, more on the left leg. In addition to this, my kneecaps are pointing outward and my lower legs are very thin. I am very confused about what the issue might have been and where can I start to fix this. I have started moderate exercising (30mins-60mins/3-5 days a week) since January and now I notice my left knee makes a clicking sound whenever I squat or get up from a squatting position. It does sometimes carry a little pain with it.
Would be very grateful if I hear back from you.
Cheers,
Hi Raby,
Clicking in the knee is usually either:
a) Knee cap rubbing against the bone behind it
b) Cartilage issue
Either way, you would want to perform your squats with your foot,knee and hip aligned.
Mark
Hey Mark,
I was doing the exercises listed, but when it came to the external rotation and hip abductor strengthening ones (clam shell and wall slide) I was unable to feel my butt at all. No matter what I do, my quads activate and complete both exercises. Note that I can activate my butt normally- I just can’t activate it when completing this exercise. Do you have any recommendation to fix this? If it helps, I think I have also have flat feet and my knee has been making crackling sounds whenever I squat for several years now.
Thank you for this blog! It has really helped me.
Hi Hardik,
Try to keep your pelvis slightly rotated AWAY from the direction of your moving leg.
For example, If you are lying on your side with your left side down, rotate the right side (upper side) of the pelvis towards the left (towards the ground).
This will help prevent you from using your pelvis during the exercise and isolate the glutes.
Mark
Hi Mark!
I’m a 21 year old woman and I’m suffering from knee valgus for around 8 years now. Thanks for sharing so much valuable information but I really want you to show all these exercises using videos. May God bless you!
Hi Taruna,
Thanks for your comment.
Videos will eventually come!
Mark
Hey Mark. When I put my feet together my knees do not touch at all but I feel like I have the symptoms you describe. I feel like my left femur rotates inwards and my tibia is rotated outwards. There is a lot of torque in my knee when I walk with my feet straight. Also, when I walk with my feet straight I feel like my left foot spins outward a little when I’m toeing off. Other things I’ve noticed on my left side is when I back squat, I’ve notice that my stance has my left foot not in line with my right. It is further behind it. When I line it up, it feels really unnatural.
Hi Victor,
Do you have tibial torsion?
If this is the case, you can still do the exercises on the blog post, but perhaps focus on the knee exercises.
Also check if your pelvis is rotated. Check out this post: Rotation of the pelvis. This may explain why your feet don’t line up.
Mark
Hello sir,
I recently had PCL Avulsion fracture of grade II in an accident.So i have a brace on my left knee recommended for 3 weeks.But suddenly i observed that my right leg have cave in i.e left was moved outwards.What should i do with one leg tear and other knocked
Hi,
I would say focus on getting your left knee stronger as the right knee may be compensating for it.
Mark
I am a 70 year old female in good health. In 11/17 I went to my primary wirh pain in my right knee. My right leg was also bent and wouldn’t straighten. She gave me a cortisone shot which ended the pain and it has never resurfaced. I was referred to an ortho for the bent leg and eventually diagnosed with a valgus knee. I went to P T and continue to do what strengthening exercises at home. My leg is still bent. No surgery is recommended since I have no pain. I have difficulty standing up from a sitting position, walking up/down stairs, etc. Can anything be done to straighten my leg and eliminate or stop the progress of the valgus knee?
Hello Barbara,
What has caused this bent knee? It sounds like something structural within the joint may be limiting it.
Mark
Hi Mark,
My ankles are 2-3 inches apart when I straighten my legs and knees are touching. But if I bend my knees even a little, my legs seems fine. while squatting and walking my knees move outward like a normal person. Can this be fixed with exercise or is it a bone deformity?
Hi Anurag,
It sounds like you will respond to the exercises.
You will need to work on the standing posture.
Mark
Hi Mark,
Thank you so much for this post! I have had pain in my left knee, beginning 6 years ago, when I was actively running marathons. Since then, various PTs have told me to do different things. All of them decided that my left knee cap comes inwards, so that tracking issue needed to be corrected. Some said I should strengthen my VMO, others said my glutes. I have tried both approaches, and yet, my knee cap still comes inwards. My left foot also goes outwards. This is kind of what you’re describing. My right foot does not go outwards when I walk.
Now, 6 years later, I am getting a lot of swelling in both my knees, and have hip bursitis on my left hip. I really feel it is because the issue with my left knee hasn’t been resolved, and is now affecting my right leg, and left hip. I also noticed that my natural stance does have my stomach protruding outwards. So I think that I might have what you call, anterior pelvic tilt.
I want to try the exercises you describe here, but I just want to ask if you think they all make sense for me, since both of my feet don’t go outwards when I walk, as you describe in your article. However, when laying down, both feet definitely fall outwards.
Thank you again for this article. I feel like if I can understand why my knee is tracking inwards, and why my foot goes outwards, I can get to the root cause of the problem and all the pain. So far, doctors have not been able to figure this out.
Thank you!
Preety
Hi Preety,
If you have tried all the VMO and glute exercises and you are still having issues, I would try to look at what is happening at your PELVIS/HIPS and ANKLES/FOOT.
The knee is usually a VICTIM of poor functioning pelvis/hip or ankle/foot.
Here is a post on: Anterior pelvic tilt
But – I have a feeling you may also have a rotated pelvis. Check out this post: How to fix a rotated pelvis.
If you have flat feet, check out this post: How to fix flat feet.
Mark
Hi! I left a comment about my bunions on the flat feet thread! But I’ve realized I never said I have bow legs as well! I see you have exercises for knees touching… do you have any suggestions for trying to get knees closer together?! So my summary is bow legs, bunions (contemplating surgery on the worst one) and overpronation.
Can..I fix my knees problem by..The help of knee braces…..
Hi Mark!!
I was overweight and obese for most of my life, i was 265 at my heaviest about 4 years ago, I’m at 180 right now, and have noticed my knees and legs. I run a lot but don’t usually do strength training, or clearly stretch as well as I thought. I’m committed to fixing this, and will be doing your exsercises. I will keep you posted on my progress. :) I do have a couple questions. How often do u recommend I do these exsercises? Daily? And do u think I can still run or jog? Or should I focus on this for a while?
Thanks!!
-andi
Hi Andi!
If you can do them everyday, I would recommend that!
You can jog/run, but try to engage the muscles as mentioned in the post. Please note that it is not easy to change running technique quickly :)
Mark
Hey Mark I’m currently 6 months after my right leg ACL reconstruction. My leg is doing fine overall but I notice it is caving in mostly when I squat or even more when I try a 1 legged squat. I also have some pain to the left of my right knee. Do you know if this common after ACL reconstruction? I do not see many articles talking about it specifically after ACL surgery and my physio is just working on strengthening my overall leg and hip. Should I take it into my own hands and start doing some of your exercises? I would appreciate your help so much. I am 21 years old and I’m worried that I won’t have a stable normal leg again. I appreciate your time Mark!
Hi Stefan,
I haven’t seen you squat, but if you wanted some general advice.
Strengthen these:
– Foot arch
– VMO
– Glute medius
Release your:
– Adductors
– Vastus lateralis
– Peroneals
Task specific:
– Work on partial squats/lunge with resistance band to emphasise glute med (hip abduction)
– Master step ups, step downs and leg drops off varying heights . ( you need to learn to load the right knee. otherwise -the body will lean away from this leg causing it to cave in)
-Balance work.
Mark
Thanks so much, this is a great article and well explained exercises. I didn’t even realise that my knees caving in was a condition that could be worked on!! I love the gym and have good technique overall; I feel pretty strong. but what an eye opener your subtle exercises, combined with the stretching are. I could really feel my glute activating a lot more than when doing heavy squats. (Clam shell, wall slide) and love the leg lift for the quads. This is a proper training! I’m going to carry on and look forward to the results. I’m hoping for improved knees and a lifted bum. Also to reduce foot cramping. My feet cramp so easily, have done for years.
Thanks again ;)
Hi Priscilla!
Let me know how it goes!
Mark
I had a fall in November 2016 and injured my right knee. I fell sideways which resulted in a lot of bruising and pain. I didn’t hear a pop although my knee joint was so unstable I needed help to walk across the street to my house. I was walking two rottweilers when this happened. I’ve seen my chiropractor and acupuncturist along with a personal trainer. The acupuncturist got rid of the pain and I’ve been strengthening my muscles in my leg with exercises. I don’t want surgery so I didn’t go to an orthopedist. Now my right knee has genu valgum when I walk. My left knee is straight. I sent my personal trainer a link to this blog so I can add your exercises. I have problem with an internally rotated femur and have had trouble fixing it. I also have over pronation of my right foot. I also have external rotation of my tibia which has been corrected some through exercise. I hope your exercises will help me walk straighter.
Thank you!
Hi MArk, Thank you for this article!
All good, Issa!
Hi Mark, Thanks for the article! I used to be overweight (175 cm ; 108 kg) since I started loosing weight 2 years ago (I went to 75 kg) , I noticed that my legs are not straight from the way I stand and walk.
I can’t tell if I have Knee Valgus because when I stand with my knees touching my ankles touch too. And when I squat my knees do not knees turn inwards. But recently I gained weight (88 kg) and I started feeling a mild knee pain in both of my knees from walking an hour every day trying to loose weight again from diet and walking.
Can you please tell me if I have knee Valgus from my pictures? and do you recommend to start these exercises?
Thank you Again, you are amazing!!
Hey mate,
Do you have flat feet? Looks like you have cut off your feet in the photo so it is hard to see.
Mark
Hey Mark Thanks for replying.
I don’t think I have flat feet, I took a picture of my feet
Hi Mark I am still waiting for your reply!
Have a nice day.
Hey Salim,
Looks like you will benefit from the exercises in the blog post.
Mark
Hi Mark, i´ve been researching a lot of this topic and I foun your page as the most complete, but everyone says the same: “Your femur is internal rotated and your tibia external rotated” But believe me! I dont have this problem, I dont even hack flat feet!. My problem is that my tibia seems to grow outside, like if it was in a lateral plane! Do you know how can I adress this??
I´m from Argentina and my English is not well at all hahah, sorry…
By the way, i´ll be surfing on your page, I also have posture issues!
Hey Marcos,
I am not too sure what you mean by the tibial grows outside.
Do you mean tibial torsion?
Mark
Hi MArk,
I am 27 Years old and i have this knee valgus issue. when i stand staright my knees collide together. And this is more prominent in my right left knee and very minimal in right. I experience weakness in my legs , can’t run much and even can’t exercise. but yes not any other issue in day to day life.
please advice what should be done and by performing exercise can those knees be brought into right shape at this age ?
Hi Mark, that was really very helpful. Plz I need to ask something about my son. He’s Two years old, born with spina bifida and Right club foot. The club foot responded to serial casting and he’s walking very good, Infact runs and plays good. But we notice external rotation of his right foot along with a pronated foot. Also he has a 0.85cm girth difference in both calf area and a bit tightness while dorsiflexing . It looks like a less than 1 CM limb length descripancy too. I’m too much worried for him. Can u please guide me n give your expert opinion.
Thanks
Hi Hina,
Tight calf muscle, limited dorsiflexion, out turned foot are quite common after a serial cast.
It should get better with normal use.
In regards to 1cm leg length discrepancy, if it causing major issues then you can get heel inserts… however I would wait and see how your son goes. He may mobilise perfectly fine with a 1cm difference.
Mark
Thanks for the awesome information. I have been looking for something on knock knees and this seems to be by far the best information i could ask for.
My daugther is 12 years old. We noticed knock knees may be 2 year back. The knock knee was initially in 1 knee only but now it is in both the knees. When she stands with both knees touch, the difference between the two feet is around 15 cms. Can this exercises will help in curing this knock knees. Do we need to have some physiotherapist to get this exercises done.
Doctors are suggesting to go for surgery only. Will surgery help in removing the knock knees totally? Are there any other implications of going for surgery ?
Request you to please reply. Thanks.
Hi Rodrigues,
I would persist with these exercises if the knock knees are solely due to weak and tight muscles.
If doctor is recommending surgery, did they do a Xray scan to determine structural issues of the leg bone?
Mark
Hi Mark,
Thank you so much for making this post. I’m not sure if knee valgus is my primary issue since I just tried the test at the top of this post and when i stand as pictured my knees dont touch. However, when i bend my knees, they move together, rather than moving straight forward in line with my toes. I have had some issues with a lot of stuff i don’t know enough about on the right side of my body from neck and shoulder all through hips/knees/ankles, and the last time I tried to speak to my GP about it he was pretty dismissive. And i’m thinking I should see someone who specializes in something that could help me. Would something like this be something I could see an orthopedic doctor about or would it be a different specialization?
Also
oops hit post early there I was gonna say also I followed you on FB and will be searching through more of your posts. I found this post by googling something like “how to fix knees that turn inwards” bc I recently took up fencing and when doing a lunge the person instructing me pointed out my knee not lining up with my foot. I had already been aware I have some messed up posture issues i’ve been trying to work on the the best of my abilities but honestly doing it with the lack of knowledge I have, i’m a bit nervous im doing more harm than good to myself, so i appreciate the breakdown you posted here.
and another also, I just realized i was doing W sitting as i was typing this! thats an ingrained habit since childhood ive been trying to stop!
Hey Sharon!
If you have knees that go inwards when you lunge during fencing, here some possibilities:
1. Weak glute medius
2. Pronating feet
Check this: How to fix flat feet
3. Stiff leading ankle:
Check this: How to improve ankle dorsiflexion
4. Rotated pelvis
(I’ll have a blog post this sooooon)
5. Tibial torsion
There are more reasons that will be affecting your knee, but these are a good place to start looking for your solution.
Mark
Awesome, thanks for the resources, and I really appreciate you taking the time to find those specific to my issue!
Hey Mark! :)
id really like your article.. i have some question with you about this article..
Im Nihlah.. Student in Physical Therapy Hasanuddin University in Indonesia.. i want to make research about knee valgus and quadricep angle.. your article is good for my reference.. can you give me your email or something like this? I really need reference about knee valgus but when im searching on google..the literature its so minim..please reply in my email.. Thankyouuuu:)))
Hi Mark thanks for sharing useful info,
I dunno how to measure knock knee, my knees and ankles touch each other, Im 23, isnt it too late to wear knee braces and do particular exercises? ( how can i send a pic? It would be great if you could see it)
Hey Dustin,
Feel free to catch me on the Facebook page.
You can send me your photo there.
Mark
Hi Mark,
I have had my anterior tibialis removed from both legs. I cannot control my feet turning inward when I walk. Since then I’ve had torn ligaments in my knee ( I wear drop foot braces) am I screwed or What?
Hi Scott,
Why was the tibialis anterior removed? Did you have club foot?
When the tibialis anterior is dysfunctional, foot drop is the often consequence.
If you are wearing a brace, I would assume the inward placement of your feet may be coming from hip. Does your knees turn towards the midline as you walk as well?
Mark
Hi Mark , I am currently 20 years old. When I stand straight my thighs and knees tough however i have a gap with my ankles. Also when I walk my legs don’t look straight. Basically my legs arent straight the top portion are too inner. Will these exercises help my legs become straight and eliminate my knees being inner.
Hey Simran,
It does sound like these exercises can help providing that it is not caused by a curve in your actual leg bones.
Mark
Hey Mark..
I’m a 21yr. Old female. I have an anterior pelvic tilt in my right hip and my right knee points inwards. So should I do these exercises and stretches only on the right side?
Hi Hemangini,
You might have a rotated pelvis.
I’ll have a post for you by the end of the week!
Make sure you keep up to date by following me on facebook.
Mark
Hi again Mark..I’m following you on Facebook but I cannot find the post for rotated pelvis..
Thank you..?
Hi Mark..I can’t find the post for rotated pelvis..I saw your posts on Facebook..can you help me find it?
Thanks..
Hi again Mark..I’m following you on Facebook..I can’t find the post for rotated pelvis.. thanks..
Hi Hemangini,
I still need to edit the photos.
It will come soon, I promise :)
Mark
Ok..Thanx :)
Hey Mark! Happy New Year! I have knock knees due to bad posture and weak muscles. and it really plays a part in my confidence in how I walk. I walk like a penguin and I wanna wear heels but can’t! Are the exercises above a good solution for my problem?
Hey Tasha,
If your knock knees are due to bad posture and weak muscles, these exercises will help you address that!
Mark
Hi Mark, I am 14/M and I think I have knee valgus and I am very worried. I want to know if it is fixable and also the bone below my knee pains when I walk, does this also happen.
Thanks,
Amey
I have very mild knock knees not sure if it’s structural or from weak msucles but I can force my knees to separate when standing with my feet together and I can also place something between my knees and bring the front part of my feet together, but when I stand up regulary you can barely notice it but barely too much if you know what I mean, do you think it is structural or muscle? the thing I think my legs have been like this for a long time but being able to separate them makes me unsure
Hi,
If you can correct it (even if you can’t maintain it), then is unlikely that is structural.
This means you can fix it!
Mark
I have anteior pelvid tilt but i cant fix it. I think its because since my alignments are off due to knock knees i am unable to perform the stretches and activation exercises correctly. How can i fix this ? Thanks
Hi Mark!
I am 14 years old and i have severe knock knees. When my feet are just 1 inch away from each other my knees touch. It is extremely hard to walk nowadays and i am really worried.
aside from that, i did not notice before but my leg in bends into my ankle. like when my feet are together a slightly smaller tennis ball can fit .
my parents are not paying attention to my pleas and i do not know what to do
could you please help me?
Regards
Sarah
Hi Sarah,
If your knock knee is due to issues with your “tight/weak” muscles, then these exercises should help correct it.
How are the exercises coming along?
Mark
Hi Mark,
Thanks for the post, going to start following this because I have been having this issue for a long time. Was just wondering, when I walk, should it be my toes pointing straight first or my knees? When I lift my leg off when I walk it bends outwards in the air then goes back in line again. Also I think the bottom of my foot turns inwards if I left up my knee when i try to keep my toes aligned to my knee. Thanks!
Hey there,
You want to keep your knees and toes in line.
If your leg goes out to the side, it sounds like something is happening at your hip level.
When you say your leg bends outwards, do you mean the knee goes out or the foot?
Mark
With the general knock knee test you have shown, I dont see the knee valgus symptoms. But one of my knee (left one) is definitely turning/bending little inwards. Does the same exercises apply to me.
Hi,
Do you distribute your weight evenly between both feet?
Favouring one leg may cause this .
Mark
Love this post, Mark! Lots of awesome advice for re-aligning the muscles around the knee. We used your knock-kneed image for our own post on a similar subject, written by a DC and FNP – we’re definitely in agreement on a lot of this
Keep up this awesome information!
Hey Allison,
Checked out your blog post. Awesome!
Mark
Ps. My wife is flattered that her knock knees are on your blog post ;)
has your wife corrected her knock knees using these exercises?
Hi Dan,
She has no interest in fixing it. So, unfortuately no :(
Mark
My daughter is 13, when she stands up strait her knees point inward and her calf’s are about 3 inches apart, she is very self conscious about this. What can she do?
Hey Sandra,
Did your daughter do a lot of W sitting when she was younger?
This can lead to structural changes in the leg/hip complex causing the knees to point inwards.
If the issue is dictated by purely an imbalance of muscles, then the exercises mentioned on the post will help out.
Mark
Hey Mark!
I really need some help.
I am nt so sure if I have knee valgus. I want to ask that in knee valgus, do the muscles at back thigh rotate inwards and the front thigh muscles outwards??
When I slightly flex the muscles while standing, and rotate the knees inwards ( idk how to explain this properly but I rotate the thighs such that the front partgoes inwards and back part goes outwards), the legs look so much better. So is this knee valgus or something else?
Thanks ^^
Hey Rok,
Generally – The outer muscles of the front AND back of thigh rotate the femur outwards (external rotation)…
whereas the inner muscles of the front AND back of the thigh rotate the femur INWARDS (internal rotation)
Do you mean you are push your HIP outwards but bring your knee inwards RELATIVE to the hip outward position? If you are, this is what you want to be doing to fix knee valgus!
(Sorry for the delay in approving this comment! I must have missed it)
Hi Mark can you help me pleas. For 6 months my femur has bent inwards a lot and I think it might be knock knees and I have recently got it am 15 years old and this has only happened to me recently. It is bent a lot inwards and non of my family members have it. Please help.
Hi Bilal,
Was this as a result of some sort of injury?
Mark
I’d like to first thank you for your informative article and your selfless help.
I’m 36/M, I’ve a weird situation. When I stand still with touching my ankle together then my knees have a distance of around 2-3 centimeters and if I try to touch knees together, that leads to the pain in upper femur. The problem occurs when I walk or run then my knee move inwards.
What pattern should I follow?
Thanks.
Hi Sam,
This sounds like knee varus to me.
Does this look like your legs?
If so – you will need to follow another set of exercises. (Unfortunately – I do not have a blog post on this yet)
Mark
Please tell us some exercise for bow legged. Please.
Hi mark!!! My knees touch a few inches before my ankles and I feel like I walk funny, when I workout i feel like alot of stuff i do looks weird cause of this. Doctor told me it’s not bad enough so I can’t get surgery but I’m really really self conscious about this. Is there a way to maybe email or whatsapp you and I can get a bit of help? Youl be a huge lifesaver!
Hey there,
Direct message me on facebook and I’ll see what I can do for you.
Mark
Hi Mark!
I just started doing these stretches last night. I woke up this morning with my knees and legs feeling a little strange (stretched out??) . I’m sure this is due to stretching muscles that needed it. I just want to make sure his is normal .
Any concerns I should be looking out for?
Hey Cece,
If it is painful, then this is not normal!
If it is just strange feeling, it might just be your body getting used to being stretched out.
See how it goes :)
Mark
Hi Mark,
My legs don’t bend inwards like in the picture of knee valgus, but when my right foot faces forward, the knee actually turns inwards at a pretty bad 45 degree angle and it also causes my leg to bend very slightly out. I’ve had this problem since birth and it’s really affecting my progress as an athlete (I do hurdles) because I keep getting injured due to the awkward landing and strain caused by this problem. I’m only 16. What can I do?
Hey Natalie,
It’s hard to say without seeing you in person, but it sounds like your hip is excessively internally rotated. This may also occur with hyper-extended knees.
You can still do these same exercises to help with it.
You can test if you have excessive hip internal rotation by doing the internal hip rotation test.
Normal is around 30-45 degrees (give or take). If you are closer to like 75>, then that could be an issue.
It may also be Femoral Anteversion with your foot in a compensated forward position.
Mark
Hey Mark, and thank you for the effort you do to help people! I’ve had knee valgus for some years now, and believe it comes from Flat feet & bad postures when younger, i was also a bit overweight. Im now 24, i workout 4-5 days a week with 1 legday included minimum, im no longer overweight havent been for the past 3-4 years. Is there any exercises i shouldnt do while having legday?
Hey Cornelius,
As long as you are maintaining reasonable and safe alignment of your foot/knees/hip, you can do any leg exercise!
Mark
Hello Mark I was recently diagnosed with Achilles tendinitis so could that cause knee valgus thank you
Hi Michael,
For sure! It can certainly predispose you to it (among many other things as well!)
To treat your Achilles locally first, I would recommend doing PAIN-FREE heel drops.
Slowly lower yourself down. You may need to use your other leg to help you go back to the starting position if hurts. Make sure there is no/minimal pain! Try to aim for 20-30 reps.
Mark
Hi Mark
Thanks for the exercises and information. How often would you recommend doing the exercises? Daily? And when would you likely to expect improvement?
Thanks
C
Hey Colleen,
I would start Daily and see how you go for the next 4-6 weeks.
You should see improvements almost straight away as you learn to engage the right muscles… but please understand it is going to take some time correct completely!
Mark
Thank you for a very nice and informative article.
I have struggled with jumpers knee (verified with ultrasound) and ankle and lower calf pain (not any imaging taken, but I`m sure it`s tendonitis) for over half a year. It came on really suddenly, as I did not do any strenuous activities in that period due to pain underneath both feet (flexor hallucis longus tendonitis verified with MRI). I do not have a severe case of knee valgus, but they tend to go slightly towards each other.
The thing is that both the knee and ankle problem came after seeing a physiotherapist that strongly argues for an anterior pelvic tilt posture . You write that Anterior pelvic tilt is one of the causes of knee valgus. Now, my knees aren`t pointing more towards each other after changing to a more anterior tilt posture, but do you think the posture change may be the reason for the jumpers knee and ankle tendonitis?
I have done a lot of hamstring exercises, in addition to many of the ones you describe here. But nothing seems to make it better. Just added the popliteus exercise, as my physiotherapis