by Stephanie Sharpe, Exercise Science Editor
During the process of earning my Master’s in Exercise Science and Health Promotion, I was taught what to look for in clients in regards to compensations. Compensations refer to unbalanced opposing muscle groups which result from one or more muscles being tighter than their opposing muscles which cause an incorrect posture of movement. Some of the major compensations that were drilled into my brain include upper and lower crossed syndrome, excessive forward lean during a squat, knees and feet turning in or out during a squat, and rising shoulders during a push or pull motion. Whole chapters of my text book were dedicated to these compensations and how to correct them, but there is one posture irregularity that I notice in people everywhere that was only mentioned in one paragraph of my studies with little indication of how it can be corrected. Since this irregularity seems to be so prevalent, I couldn’t help but do a little research and see what’s up. So here it is…
“Genu valgum” is a common posture irregularity more commonly known as “knock-knees.” This is a condition in which the knees angle in and may even touch each other when the legs are straightened. Those with severe valgus are usually unable to put their feet together while their legs are straight. An individual with genu valgum will also swing each leg outward while walking.
Many children have this knock-knee deformity and attain it as a way to help balance when learning how to walk and run. It is normally outgrown by the age of seven or eight. However, some may retain or even develop it as a result of hereditary or genetic disorders, or a metabolic bone disease. Some causes of genu valgum include an injury to the shin bone, osteomyelitis or bone infection, being overweight or obese, Rheumatoid arthritis, and rickets which is a disease caused by lack of vitamin D. Studies have shown that the prevalence of vitamin D deficiency is increasing among adolescents which may be why I have noticed so many people with knock-knees in recent years. Vitamin D is vital during the young adult years to help with bone growth as well as the prevention of osteoporosis and osteopenia later in life.
Genu valgum results in excessive hip-knee angles. The compressive and loading forces that are placed on muscles and joints can put an individual at risk of injury. The joints affected by genu valgum include the knees, ankles, hips, and spine which can result in abnormal posture and in turn affect other joints causing pain and movement difficulties. Other possible complications are difficulty with walking (which is rare), lowered self-esteem due to cosmetic appearance, and early onset of arthritis in the knees. Osteoarthritis may occur in individuals with knock-knees due to the abnormal amount of stress and pressure that is placed on the outer portion of the knee joint. A good analogy to this problem is the wearing of a misaligned car tire; if the alignment is not corrected, the tire will wear out on one side and shorten the lifespan of the tire. Individuals with knock knees often have collapsed inner arches on their feet and the inner ankle bones are also generally lower than the outer ankle bones. Women have a greater chance of being knock-kneed simply because a woman’s hips are normally wider than a man’s. Coaches of female athletes have become more aware of the benefits of training the knees and hips to improve strength at various angles, directions, speeds, and heights. Improved support can also be attained by doing balance and stability training.
There are a wide range of treatment options including lifestyle restrictions, bracing, exercise programs, and physical therapy. Some extreme cases may even require surgery. Mild genu valgum can be corrected by strengthening exercises which help to realign and stabilize the knee.
One exercise for the muscles on the front of the thigh would be straight leg raises in which an individual would sit in a chair with feet touching the floor and then straighten one leg at a time by raising it; hold and then release. This can also be done by lying on the floor and extending one leg at a time straight up with the knee straight; hold and then lower back to floor.
An exercise for the muscles on the back of the thigh would be to stand and bend one leg behind the body trying to touch the foot to the buttocks. This can also be done while lying on your stomach. Other suggested exercises include half squats, step-ups, as well as therapeutic ball and pool exercises. Please note that all exercises should be performed under the guidance of an expert.
If severe forms of knock-knees continue into adulthood, surgical correction can be considered. One corrective surgery for this condition is guided growth, in which a small plate is placed in the knee to correct the growth of the knees. This procedure is performed in growing children during their teens. Another surgery is an osteotomy in which the leg bone is operated upon and realigned to promote the correct angle of the knee and to provide equal weight bearing.
Remember, this is just a quick overview of genu valgum. If you or someone you know suffers from this, please consult a physician before trying the mentioned exercises.