Daily Mobility Exercises by Dr. Kelly Starrett Forums General Toes Forward + Knees Out Squatting and Long-term Knee Health

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    • #70516
      AvatarCraig Laidlaw

      Can anyone explain how squatting with the femurs externally rotated and the tibias relatively internally rotated is healthy for the knees? 

      In other words, Kelly’s recommended squat technique does not line up the angle of the thighs with the angles of the feet as many (including Mark Rippetoe) recommend in order for the knees to hinge correctly and safely. 
      Even with the toes pointed out roughly 9 degrees, the thighs are still outside of that angle when pushed out correctly. 
      I myself, definitely feel my positioning is much tighter with the toes pointed more forward and my hips that were sometimes bothersome, feel much better squatting this way. My biggest concern is the long-term health of the knees, due to the seemingly torque at the knees.
      I’d appreciate any help. Thanks.
    • #72947

      I’ve had the same concern.

      Here’s my understanding:

      If you’re “pushing your knee’s out”, hinging properly, using your hamstrings, and keeping everything tight, then your knee should be moving properly in either situation. Since your femur and tibia have some rotational capabilities (which can be seen clearly when using the popliteus to rotate the tibia) you can get the knee into a good position so long as you have proper mobility. Your ankle and hip then act to create stability and to connect and engage all of the appropriate muscles for the movement.

      Pointing your toes outward is a compensation for tightness (or lack of mobility that most people have) that is usually felt in the hip area.

      Pointing your toes forward increases the amount of torque generated within the hip joint – which increases stability and power. This can be seen in one of Kelly’s video’s where he takes Diane’s legs and tries to bring them together during a squat. He can’t do so when her toes are forward, but can what her toes are pointed out.

    • #72956
      AvatarCraig Laidlaw

      If the toes are more forward than the angle of the thigh, then the knee would not be working as a “simple hinge joint”. 

      The knee itself has a small degree of rotational capabilities, but it is of my understanding that rotating at the knees during a loaded squat would cause unnecessary stress on the ligaments of the knee. 
      I understand the benefit of the hip extensors being more “wound up” squatting with the toes more foward and knees out, but I can’t wrap my head around how this could be good for the knee joint itself.
      Nobody can seem to answer this specifically and it’s a pretty big deal. Again, I’m not biased and if anything, I prefer the feeling of a toes more forward squat. 
    • #72958

      The episode is Foot Position Test: Breaking Diane
      From the episode description:
      Many of us have to turn our feet out a bunch in order to get to full depth.  While this is clearly functional, it’s not optimal.  If you are having to spin your feet much past 15 degrees, chances are you are compensating for poor motor control, missing internal hip rotation, a tight anterior chain (quads, etc.), and stiff ankles.  The further out your feet go, the less effective your hip rotators are at resisting the valgus forces created by the body (read: knees in).  Somewhere between 5-12 degrees is sort of a magic area where you can still get to depth and create freakish amounts of torque.

    • #72961
      AvatarCraig Laidlaw

      I understand ALL of this. I, myself have all the mobility needed to do ALL of this. I also definitely feel tighter and more stable “rebounding” squatting the MWOD style. But none of that answers my original question…

      How can I explain that this is healthy for the knees? 
    • #72962

      One of the key reasons to squat with your feet turned out no more than 10-12 degrees is the exact reason demonstrates in the video Kaitlin linked. This is to help create torque in the hip by engaging the ER group. THis is the key group in not letting the knee drop into a valgus position. 

      Another key reason to squat with the toes relatively straight forward is to use the internal ligaments of the knee to stabilize itself. By this I mean ER of the femur on the planted tibia takes slack out of the ACL and limits the amount of anterior translation the femur can have on the tibia. This basically stops the femur from having excessive sheer force on the meniscus. 
      No doubt Rippetoe is a great coach. Just think of it as a difference in philosophy. 
    • #72967
      Avatar[email protected]

      When trying to externally rotate is it normal to have a great feeling of that freakish torque in the knee? Should that only be felt in the hip?

    • #72985

      If you have flexibility issues in the ankle and hip, you’ll feel some torque at the knee. This can also be attributed to not just tight tissues, but weak tissues at the knee. Once you get the mobility to start working the muscles and tendons/ligaments in the knee area that you weren’t using before, the torque you’re feeling will turn into something much tighter and more stable.

    • #73031
      AvatarJames Roebker

      Following along these lines, is there a point of pushing your knees out too much? I am quite flexible and able to push my knees out and keep my shins vertical for a long time. But I do worry that I am pushing my knees out to far thereby losing some torque or potentially causing knee issues. Is the consensus that you should push your knees out as far as mobility/flexibility will allow? 

    • #73041

      If you are hyper mobile in an area it is treated differently
      The Hypermobile Amongst Us: Spine Edition

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