Knock Knees

Knock Knees image
Knock knees x-ray

What are Knock Knees?

Knock Knees posture definition:

Knock knees, also known as genu valgum or valgus knees, is a posture term used to describe the inward angling of the knees when standing, causing the knees to touch or come close to each other while the ankles remain apart. Observed from the front, knock knees create an X-shape from hip to knee in the thigh bone, and knee to ankle in the lower legs.

The bony landmarks commonly used to identify knock knees include the line of the femur from the hip to the knee (center of the lateral and medial condyles of the femur and tibial line to the ankle (shin bone). By comparing the distance between the medial condyles of the femur and the distance between the medial ankles, the severity of knock knees can be determined.

Genu varum, also known as bowlegs, is the opposite condition where the knees are positioned further apart, and the lower legs angle outward.

Anatomy of Knock Knees:

The anatomy of knock knees typically involves a combination of factors that contribute to the misalignment that puts excessive inward pressure on the legs.

The most common include muscle imbalances in the hips and pelvis, and a kinetic chain disruption between hips, knees, ankles, and feet. True structural issues that cause knock knees are less common (and often over-diagnosed).

Many times, compensation mechanisms, such as excessive hip stabilization via the adductors and limited pelvic tilt exacerbate the issue. In today's sedentary society, knock knees is common amongst the less active, including children.

Shortened muscles include the adductors (adductor magnus, adductor longus, adductor brevis, gracilis), medial hamstring muscles (semitendinosus and semimembranosus), and the medial head of the gastrocnemius.

Lengthened muscles include the abductors such as the gluteus medius, gluteus minimus, and tensor fascia latae, the lateral hamstring muscles (biceps femoris), and the lateral head of the gastrocnemius.

Common problems related to Knock Knees:

  • Knee pain: The knee is designed to primarily flex and extend as a hinge joint. The introduction of lateral stress (usually combined with rotational and front-to-back stresses) creates vulnerability to problems. Knee problems include increased risk of knee injuries, knee arthritis, degenerative knee, increased stress on the medial compartment of the knee joint, patellofemoral pain syndrome. 
  • Hip pain: As the hip adductors are normally tight, this impairs mobility of the hip and causes more movement in the knee (designed to be a more stabile joint). Hip problems include hip injuries such as labral tear, hip arthritis, degenerative hip.
  • Ankle pain: As the knee angles in and the lower leg (shin) angles out, the ankle is put in a compromised position that affects normal function. Ankle problems include inversion sprains and eversion injuries, and limited dorsiflexion.
  • Foot pain: Similar to the ankle, many foot problems can occur because of the uneven loading and weight distribution through the foot. Foot problems include plantar fasciitis, bunions, flat feet, oversupination, Morton's neuroma, and 5th metatarsal stress fractures.
  • Gait abnormalities and posture problems: knock knees can cause an abnormal gait and poor posture, which can further contribute to muscle imbalances and pain throughout the body.
  • Balance issues: Knock knees can lead to balance issues because they disrupt the normal alignment of the lower body. The inward angling of the knees affects the distribution of body weight and the overall stability of the legs. This misalignment makes it challenging to maintain balance, particularly during dynamic movements or when standing on uneven surfaces. 
  • Decreased mobility in activities: Knock knees can decrease mobility in various activities due to the abnormal alignment of the lower extremities. This misalignment can limit the range of motion at the knee and hip joints, making it difficult to perform certain movements efficiently, such as squatting, lunging, or jumping. 
  • Reduced athletic performance: The misalignment of the hips can negatively impact an individual's balance, stability, and overall physical performance.

Addressing knock knees through targeted exercises, stretches, and posture therapy can help alleviate these issues and improve overall body alignment.

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