I Pulled a Calf Muscle Playing Tennis How Long Before I Can Play Again
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
- Meniscal/Cartilage tears
- Knee cap tracking problems (Patellofemoral Pain Syndrome)
- Clicking in the knee
- Anterior Cruciate Ligament (ACL) tears
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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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.
How to perform a Release:
- 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 for30 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 j oint 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.For more information: Medical disclaimer.
Source: https://www.posturedirect.com/how-to-fix-your-knee-valgus/
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