Pilates Elephants

365. Why you should stop cueing knee alignment


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Everyone "knows" that knees going inwards in a squat is bad, right?

It means the glutes are weak or underactive, and it's not good for the knee.

But is it REALLY?

This episode is a deep dive into the biomechanical, epidemiological, and prospective research on knee alignment during squatting, jumping, running and hopping. Our goal is to answer 2 questions:

  1. Does the knee going inwards indicate weak glutes?
  2. Is the knee going inwards dangerous?

Links:

  • Knees going in during a squat shifts load toward the glute max here
  • Knee extensor effort rises with squat depth, hip extensor effort rises with load here
  • Same depth-versus-load split found again in a separate study here
  • In elite powerlifters, heavier loads shift the work from knee to hip here
  • Elite powerlifters hit ~23x bodyweight at the knee joint at 90% of max here
  • Weightlifters share load between hip and knee; powerlifters are hip-dominant here
  • Sideways knee load in a barbell squat is a consequence of stance width, not a fault here
  • Elite weightlifters produce MORE frontal plane hip moment than lower-level lifters, not less here
  • Elite powerlifters vary widely in how they load their joints, so there is no one ideal form here
  • Lifters who fail a squat above their max show reduced extension and lower muscle activity here
  • The knee falls into valgus in ~77% of ACL injuries on video here
  • But knee valgus does not predict who goes on to tear an ACL here
  • And the drop jump test cannot predict ACL injury in elite players here

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Pilates ElephantsBy Raphael Bender

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