A common problem that needs to be addressed with athletes is what I call the "Weak Knee Syndrome." You'll encounter this movement error in the dip portion of the push press, the hang clean, the jerk, the box jump and even in squats and deadlifts. It mostly occurs in female clients due to the greater width of their hips but you will see it in men too.
Here is what it looks like:
The problem arises when an athlete tries to bend their knees and allows the knees to drop in medially in a knock-kneed-fashion such that the knees no longer track over the toes. To be clear I am discussing a faulty movement pattern not a structural abnormality. Some people are born with knock knees and that is not the same problem although athletes with knock knees are more prone to this error.
Because the movement is fundamental and embedded into so many exercises that we do at Crossfit it behooves you to correct the problem quickly and constantly police it in your clients. Failure to spot and correct this problem will lead to poor performance and to injury. Look at this article discussing how this problem leads to knee injuries for women in sports.
There are several theories as to what causes the knees to knock together, so there is not one quick fix for everyone. One theory is that because women's hips are wider and often their hamstrings are weaker it leads to the instability of knee joint. The hips cannot be narrowed, but the hamstrings can be strengthened and the stance can be adjusted wider so that the feet are directly under the hips. Another theory is that pronated feet lead to instability of the knee. The feet can be strengthened over time and working out barefooted or in lifting shoes will help. Yet another theory is that there is an adductor/abductor imbalance that causes the knees to knock together. This is easily fixed over time with stretching exercises for the adductors and strengthening for the abductors. However the best way to strengthen the muscles involved is to teach your athlete to do the movement correctly and thus do the primary exercises better, i.e. hang cleans and push presses performed correctly will strengthen the muscles needed for those exercises as well as for other sports.
Your task is to assess the problem in yourself or your clients and try all of these things and see which are the best solutions for your particular case....[click to read more]
....Let us look at the problem in greater detail from the ground up. For ease of discussion we are going to address this problem in the context of the dip portion of the push press, but it can show up anywhere, so be on the alert. Some people squat well but express the Weak Knee Syndrome in the hang clean or box jump and others express it in all knee flexion/extension exercises.
Watch the video to see how to fix this problem.
First, the feet. When I encounter an athlete with this Knock Knee Syndrome, I have them take off their shoes and socks and examine their feet. I look to see if they have fallen arches and if they pronate their feet. I want to see if I can get the clients to lift their arches. I ask them to keep their feet planted but to lift and spread their toes. Doing this usually improves contact with their heels onto the floor as well as the outer edges of their feet and lifts the arches. I try to have them do some squats while keeping their toes up. We see if that helps.
Turning the toes out an lifting and spreading the toes can help with pronation.
Second, the adductors. I check to see if they have really tight adductors that are pulling their knees in medially. The easiest way is to have them lie down and slide their legs up a wall and open into a straddle. I can simultaneously check their hamstring flexibility here. If the athlete appears to be tight I will keep them in this position for about 3 minutes and then resume working on dip/drive.
If you are really tight, then it will be easier to stay in the first stretch than the second one. Spend a lot of time there if you need it.
Third, the hamstrings and glutes. Weak hamstrings and glutes can lead to instability in the knees. I will have the athlete do some good morning to see if I can get them to engage their hamstrings.
Once the athlete can move the torso without losing the arch in their back, then I will add some weight for resistance.
This is what the dip should look like. The knees and toes point in the same direction and the athlete is maintaining good posture.
I work the dip over and over again with my clients trying to use as many of these fixes as is appropriate. Because the movement is prevalent in so many exercises I can make them practice dip/drives every session in some form. I prescribe my clients hamstring, glute and foot strengthening exercises and adductor stretches as necessary.
Great article, Keith. I noticed a while ago that my knees come together a little during very heavy DLs. Once I realized that was an issue, I started to focus on keeping my knees out during ALL these "dip" type movements. I'm stronger for it, and the work has helped my squat quite a bit, too.
... written by tim roach,
December 31, 2008
Hi Keith. . . . this doesnt have anything to do with the article above. . . i am curious about wether you consider your asana practice as a wod ? i am 3on 1off and teach two vinyasa classes a week. . one on monday mornings and one tueday evenings. .the classes are very strength oriented and pretty much sweatfests. and most times i practice along with the students so i can be warm enough to demo all of the press ups and arm balances. . lots of the time i go right from the box to the studio and teach. . but when i am on rest day and it lands on a teaching day im not sure wether to count it as a rest or give it one more day. . so far it has worked out and i just listen to my body. . i am just wondering what your experience is with combining yoga/crossfit. . thanks Tim Roach
Great question, thanks. I think of my yoga practice as active rest or recovery or as skill practice. I do not think of it as a WOD. Sure it can be a sweatfest, but it is like playing a sport. I think of my Crossfit training as preparing me for yoga and other sports and challenges. Does that make sense?
However, you should listen to your body. If you are doing WODs and yoga practices on both Monday and Tuesday, you might want to just make Wednesday an automatic rest day. Come back on Thursday and go hard for three days in a row and take Sunday off again. It is often easier to do a 2on/1off + 3on/1off 7-day cycle so that you are always resting on Wed & Sunday. Just keep following the WOD schedule and when your "on" day falls on an official rest day go back and find one of the WODs you skipped and insert it.
A very common problem. I tell people to jam their knees out for all they are worth all the time. Another cue I use a lot (also helpful in wall-ball) is to tell people to think of themselves as a robot that only moves along one track; ie cannot move in any orientation except the knee tracking the foot.
Thanks for the tips, Maximus! Good to hear from you. I hope things are rocking in East Bay!
... written by Christin Street,
January 05, 2009
After watching a vid of myself doing BJs and HPC, I was appalled by the slight knock of the knees. Eek! For me it's about the imbalance of the add/abds. Great article! Thanks!
... written by Stephen Macioci,
January 07, 2009
NJ BOYS AT DAY 93!!! whats up!!??
... written by Luke,
January 13, 2009
Really happy to see someone address this topic.
I have mild knock-knees and completely flat feet. I have been doing Starting Strength for about 4 months and my squat progress has been terrible. My knees move in every rep of my work sets, and it gets worse and worse as the set progresses. Seems pretty clear my adductors can't handle the load and pass it on to my quads by having my knees buckle.
Will try doing them with my toes up next time, hope it helps.
... written by David Whitehouse,
January 14, 2009
Hi Keith,
I can't do a good morning without losing my arch in my back. Would this imply my hamstrings are weak?
I have had a knee problem from karate for sometime, I've been trying to build up my VMO and outer glutes, but its not really helped. Is it possible that weak hamstrings may be to blame? My knees tend to buckle inwards when I squat down to pickup heavy stuff at work.
It'd be so nice to finally find an exercise that fixes my knee! Desperately missing my sport!
Losing the arch in your lower back implies that your back is weak and your hamstrings are tight. The hamstrings and the lower back compete for control of the pelvis. As you do squats, deadlifts and good mornings, you have to be able to inclinate the torso forward while maintaining lumbar extension. As the pelvis tips anteriorly the hamstrings must stretch to allow the movement. If your hamstrings are too tight and your back too weak the lower back muscles will succumb to the tension by rounding. I think that good mornings are good but I think you might be trying to go too deep. You might also try back extensions on a GHD. If your knees are buckling in, it might also be that your adductors are too weak. The adductors must stretch on the way down and contract on the way up in a squat. Basically your adductors are also too weak because they can't handle the eccentric contraction on the way down and fire early thus are unable to help when you come up out of your squats.
Overall, it sounds like you need some squat therapy. Get a video camera and tape yourself doing some squats and let's have a look at it or come in for a squat lesson.
Thanks so much for this article. I think it will come in handy - i too have issues with this; i think the culprits are tight adductors in addition to weak hammies and glutes - particularly on my right side.
You said "I prescribe my clients hamstring, glute and foot strengthening exercises and adductor stretches as necessary."
Can you give an example of specifically which exercises you'd recommend? Thanks!
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