Whether you’re a powerlifter, Crossfitter, Olympic weightlifter, or just someone who likes to squat heavy, you’ve probably experienced your knees caving at some point while squatting. This is called “knee valgus”, and it’s something that over time can cause sore and achy knees.
So, how do you fix knee valgus during squats? Here are my top 7 tips:
- Focus on your toes
- Screw your feet into the ground
- Perform single-leg exercises
- Work on your hip abduction
- Increase ankle mobility
- Narrow your stance
- Use the appropriate weight
In this article, I’ll breakdown each of these tips further and provide a step-by-step plan for fixing knee valgus while squatting. But first, in order to understand which of these fixes you should implement, you need to know why knee valgus happens in the first place. Let’s get started!
What Is Knee Valgus?
Knee valgus is a mechanical deficiency in your squat where your knees cave (rotate) inward. In a normal-looking squat, the knees should track in line with the second toe. When knee valgus occurs, the knees will track inside the foot, bringing your knees closer together.
In another article, I discuss whether it’s safe for the knees to pass in front of your foot while squatting. In short, yes, it’s safe. But, that’s not what we’re talking about here. We’re specifically talking about the knees caving inward (not forward).
Usually, knee valgus occurs when ascending out of the bottom of the squat, and when the weight being used is close to the lifter’s max.
Are Your Knees Caving In The Squat Bad?
Onto the million-dollar question, should you be concerned if your knees cave in the squat?
Squatting with your knees caving isn’t something that is going to cause pain or injury today, tomorrow, or next week. But, if you continue to squat in this way, it’s definitely something that will come back to hurt you in the long-term.
The most common issue that arises when you have knee valgus is patellofemoral syndrome. In other words, general knee pain at the front part of the knee. As well, knee valgus can cause iliotibial band (IT) syndrome, which is pain that occurs on the outer side part of the leg. In rare circumstances, aggressive knee caving while squatting heavy can cause ACL tears.
Also, as I’ll discuss later, one of the main reasons why your knees are caving in the first place is because of a glute weakness. So if your knees are caving, then it’s a sign that you’re probably not lifting as much weight as you could, which should be concerning if you’re a strength athlete.
In order to assess whether knee valgus is something that you should focus on fixing right away, there are two factors to consider:
How severe is the knee caving? Is it a little or a lot?
There is a “normal” amount of movement that the knees can undergo while squatting. So if you see micro-movements of the knee caving inward, it’s likely not a huge priority as there may be other things you may want to correct when it comes to your squat technique.
However, if you notice a huge inward shift of your knees, then it should likely be at the top of your priority list.
When does the knee caving occur? Does it happen under light loads or just heavy loads?
If your knees are tracking in the right position 99% of the time and it’s only when you’re going for a 1 rep max you notice that your knees cave, then it’s not something I would stress about.
I would still implement some of the fixes I recommend below, but I wouldn’t start to think that your squat technique needs a complete overhaul.
However, if your knees are caving under sub-maximal loads (75-85% of your 1 rep max), then I would be much more focused on addressing the issue.
Why Do Your Knees Cave? What Causes Knee Valgus?
Alright, now that you know what knee valgus is and whether you should be concerned or not, let’s discuss why your knees cave in the first place.
Knee valgus occurs for 4 reasons:
- Poor coordination
- Poor hip/ankle mobility
- Weak glute medius muscles
- Weight is too heavy
Poor coordination simply refers to your ability to understand where your body is in space, and placing your limbs in the correct positions while moving.
When we’re talking about knee valgus, it’s your ability to coordinate your hip, knee, and ankle in order to keep your knees in line with your foot.
Often, coordination problems exist because you simply haven’t mastered a specific motor pattern yet.
In the case of the squat, this can occur if you’re new to squatting, i.e. you’re just learning how your hips, knees, and ankle should function together as you perform the movement.
However, if you’ve been squatting for some time, then coordination can also be due to a lack of stability. This can happen by overdeveloping certain muscle groups and underdeveloping other muscle groups.
In order to address poor coordination, you need to use targeted squat cues and implement specific exercises to build your stabilizers. More on this later.
Poor Ankle Mobility
There are a lot of problems that can occur at the level of your feet and ankle that can impact what happens through the rest of your body. One such instance is that tight ankles can cause your knees to cave.
As I discussed in my article on Should You Wear Heels or Flats While Squatting, your ankles need to travel between 75-105 degrees during a full-squat. If you have any restriction at your ankle that prevents this from happening then your body will need to compensate in some way to gain the extra range of motion needed.
What this looks like is that at the start of the squat everything looks fine and your knees track properly. But, as you descend into the squat further, your feet begin to pronate (roll inward), which causes you to lose the arch in your foot. When this happens, your knees follow suit and cave inward as well.
In order to address poor ankle mobility, you need to ensure you have the proper footwear and implement specific ankle mobility drills. We’ll cover this later.
Weak Glute Medius Muscles
Another potential cause for knee valgus is having weak external hip rotators. The muscles responsible for external hip rotation is the glute medius (the upper side part of the glute muscle)
In the squat, your hips need to maintain a certain level of external hip rotation. This is the action of your leg rotating out to the side as you descend into the bottom. The wider you squat, the more external hip rotation that is required.
Make a note if you’re a wide-stance squatter because we’re going to return to this later.
If the demand for your external hip rotators is too great, your glute medius will fatigue and fail to do its job properly. As such, the entire leg will start to rotate inward, which can also look like your knees caving.
In order to address weak glute medius muscles, there are specific exercises that will help you increase strength in this area. I’ll give you these exercises in the next section.
Weight Is Too Heavy
If you’re using a weight that is too heavy for you to handle then the body is going to breakdown at its weakest point first, which for you, may look like your knees caving inward.
If you’ve already identified that you have poor coordination, tight ankles, and weak external hip rotators, then the problem is only going to get worse as the load on the barbell gets heavier.
As I said earlier, if you’re a strength athlete and you notice that your knees are caving inward while you’re going for a max lift in competition, then it’s probably not a big deal. But if you’re constantly lifting loads in training that are too heavy, which causes your knees to cave inward, then it’s something that needs to be addressed.
7 Tips For Fixing Knee Valgus While Squatting
Now that you understand why knee valgus occurs, let’s discuss the more practical solutions that you can start implementing into your squat training.
1. Focus On Your Toes
Focusing on the right weight distribution among your toes can help prevent your ankles from pronating (rolling inward), and as a result, will allow you to keep your knees tracking over your toes properly.
If you’ve never thought about what’s happening with your toes while squatting, then now is the time to start drawing your attention to the floor.
A misguided cue in the squat is to “keep your weight on the heels”. This is not the best cue because it disregards the role of your toes.
You want to have your weight distributed between your pinky toe, big toe, and heel. This is called your “tripod”.
In order to set up your tripod, you need to think about “clawing the ground with your toes”. You literally want to grip the ground by curling your toes down to the floor.
If you find that your ankles are still rolling inward, then it’s likely because you’re losing tension through the floor with your pinky toe. You can practice this foot-to-floor connection while warming up for your squats, and over time it will feel more natural.
Takeaway: Engage your big toe, pinky toe (especially the pinky toe), and heel by clawing the ground with your toes.
2. Cue “Screw Your Feet Into The Ground”
Another foot cue you should implement is to “screw your feet into the ground”. This cue is less focused on what’s happening at your ankle, and more focused on externally rotating your hips prior to squatting down.
Once you’ve found your squat stance, and you’ve clawed the ground with your toes, the next cue you should implement is “screwing your feet outward”.
While this might feel like your feet are going to slide outward on the floor, you actually don’t want your feet to move. You simply want to get the sensation that your feet are rotating out to the side without your feet moving.
If you practice this with just your body weight (no barbell on your back), what you’ll notice right away is that your femurs (upper leg bone) start to rotate outward. As a result, this will naturally open your hips up.
You should also try this cue with your hands on the upper-outer part of your glutes.
As you think about rotating your feet outward, you’ll notice that the muscles in your glutes start to activate. This is exactly what you want because if your glute medius is not engaged prior to squatting, your knees are more likely to cave.
Takeaway: open your hips up by screwing your feet into the floor prior to squatting.
3. Perform Single-Leg Exercises That Challenge Your Coordination
Performing a variety of single leg-exercises such as the pistol squat and medial band split squat can increase your stability and coordination of the knee, which will reduce the amount of knee valgus you experience while squatting.
Performing single-leg exercises can also be a great way to diagnose whether you have a problem with your knees caving. Sometimes when you perform a squat on both legs, other muscle groups can compensate and mask whether you have a problem or not.
However, on a single leg squat variation, you either can keep your knee in line with your toes, or you can’t. There’s no compensation that can occur.
The two exercises below will place greater emphasis on the glute medius muscle. In addition, both can be done with just your bodyweight, and teach you how to improve movement quality in a low-risk manner.
We’ve covered how to progress the pistol squat in another article. For someone with knee valgus, I would do the “box pistol squat variation”, where you sit onto a box when the thigh is parallel.
Here’s how to perform it:
- Set up a box behind you, and when ready, extend your arms in front
- Bend at the ankle knee, and hip and lean forward slightly as you descend toward the box
- Slowly sit onto the box with your glute, don’t “crash down”
- Keeping your knee in line with your foot, drive your torso up to standing
Check out my article on the 8 Best Pistol Squat Alternatives.
Medial Band Split Squat
The medial band squat is one of the single best exercises for targeting the glute medius, which can help build knee stability.
Here’s how to perform it:
- Assume a split stance with your legs
- Place a resistance band around your front leg at the top of the knee joint
- The band should have some tension so that you are forced to ‘push out’ into it
- Perform a single leg squat by righting against the inward pull of the band
Takeaway: Single leg exercises can improve your knee coordination.
4. Work On Your Hip Abduction Strength
Exercises that force your hip into an ‘abducted’ position, such as the cossack squat and weighted clamshell will build greater strength in the glute medius muscles, which are responsible for keeping your knee in line with your toes while squatting.
Once you’ve mastered the single leg exercises with just your bodyweight (or with a light resistant band) mentioned previously, you need to move onto more loaded exercises that challenge your hip abduction strength.
These are exercises that have your leg moving laterally (sideways), which places a greater demand on hip abduction strength. Your hip abduction strength is likely weak, which is why your knees are caving in the first place.
As a result, you should prioritize the following exercises:
The cossack squat is a “side squat” variation. You can start with using your bodyweight, but once you feel more comfortable with the exercise, you can hold dumbbells in your hands or place a barbell on your back.
Here’s how to do it:
- Take a wide stance with your feet and flare your toes
- Shift your weight to one side
- Stay upright and sit your hips down and back
- Go as far down as your mobility/flexibility allows
- Keep your bent knee over your toes and push through the floor to stand back up
Check out my article on the 9 best cossack squat alternatives.
The weighted clamshell is one of the single best exercises for targeting your glute medius muscles.
Here’s how to do it:
- Lay on your side supported by your elbow
- Stack your knees and feet together with your legs bent at 90-degrees
- Place a light dumbbell at the top of your knee
- Seperate your top knee from the bottom while keeping your feet together
- Perform reps using a controlled tempo, squeezing the side of your glute
Takeaway: hip abduction strength can improve knee tracking ability.
5. Increase Ankle Mobility
Having a high degree of ankle mobility can allow you to maintain the arches of your foot while you squat, which will prevent your foot from collapsing inward. As a result, your knees will remain in line with your toes.
You should be working on your ankle mobility prior to squatting as part of your squat warm up. The goal is to loosen your calf muscles and dynamically stretch the tendons and ligaments in your ankle.
Here’s what to do:
- Start by foam rolling your calf muscles. Apply pressure to your calf by having one leg on top of the other. Work your way from the top of the calf to the bottom.
- Perform the downward dog to inch worm exercise. Ensure you’re taking some time to feel the stretch in the back of your calves and ankles. It’s best to do this barefoot.
- Perform a dynamic calf stretch. There are several variations, but my favorite is the version below.
Takeaway: focus on your ankle mobility prior to squatting.
Not only can tight ankles cause your knees to cave in, but they can also cause your heels to rise in the squat.
6. Narrow Your Stance
A narrow stance squat can lessen the demand of the glute medius to externally rotate the hip. If you can reduce the external hip rotation in the squat, you have the potential to keep your knees more in line with the toes and prevent any knee valgus from occurring.
It’s important to note that I don’t recommend this tip for everyone. Picking your squat stance should be based on your individual proportions.
For example, if you have long legs you definitely don’t want to squat in a narrow stance. It would just feel far too awkward.
However, if you are naturally more built toward squatting in a narrow stance (short legs, shallow pelvis), then you’ll want to assess your current squat stance to determine whether you should consider bringing your feet closer together.
The general rule of thumb is that your feet should be just outside shoulder-width apart with your toes slightly flared. If you’re squatting, for example, with your feet twice the distance of your shoulders apart, then you likely have room to modify your stance.
Takeaway: try a narrow stance squat for a few weeks and see if your knee position and stability improve.
7. Use The Appropriate Weight
You should only use weights in training that allow you to maintain efficient technique. When your knees cave while squatting, it’s usually because the barbell load is too heavy for your external hip rotator muscles to handle. As such, reduce the weight to maintain proper knee tracking.
Just because you can lift a weight, doesn’t mean that you should. You should not lift a weight in training at all costs. In other words, if you can lift a weight, but you do so with poor form and technique, the rewards are not greater than the risk.
While you might not experience an injury today while squatting with your knees caving, you are training with a higher risk than you should. The strongest lifters in the world understand that if they can keep their body healthy in the long run they will always out lift the people who seek short term gains.
As I said, if you are a competitive strength athlete, you might experience some technical breakdown in a competition setting. But in training, the goal should be textbook perfect technique.
Knee valgus can be solved by working through a variety of knee stabilization, hip strengthening, and ankle mobility exercises. In addition, proper cueing at the level of the foot is important to keep your ankles and hips working properly while squatting.
Fixing your knee valgus is not a short-term timeline. You will need to work through each of the tips in this article over the course of 10-12 weeks in order to start seeing improvement. It may require a longer time-frame depending on how severe your knees cave to start.