Name: "Knees Bow In" Breakdown
Uploaded: 2023-05-11T09:07:56.000Z
Duration: 7 min 28 s

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https://stream.mux.com/1NLQ02quR7E0198mdIJaWwiNJsbKjiW4JmTt5jLmuj15o.m3u8

Learn how to properly identify and assess knees bowing in during movement assessments in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert coaching on movement observation, alignment, compensation patterns, and corrective strategies. Effectively recognize knee valgus compensation, understand potential biomechanical contributors, and consider evidence-based intervention strategies. Perfect for physical therapy students, strength coaches, fitness professionals, and healthcare providers seeking to improve assessment accuracy, enhance client outcomes, and restore optimal movement mechanics while reducing injury risk.

Understanding Knee Adduction and Hip Involvement

Mechanical Dynamics: Muscle Interactions and Effects

Role of Abductors and External Rotators in Knee Mechanics

Importance of Activation and Corrective Exercises

"Knees Bow In" Breakdown

What do you think most of that comes from? Knees move inward. What do you think the biggest joint responsible for this is going to be? Hip, right. Yeah. We've got a couple things going on at the hip. This one gets a little complicated. I'm going to be honest with you, we'll start with the easy one. Knees moving inward is what joint action? Adduction. What muscles adduct my hip? The adductors. Right? You knew that right? Sometimes we get a "give me" in the whole functional anatomy game. You know, it's like, what is the levator scapulae do? Uh, elevate the scapula? Sometimes we get "give me"s. Adductors. However, here's where things get a little confusing.  The other part that's causing the knees to buckle in, and this is where it's also related to lower leg dysfunction, is what my friend Rick likes to call the bowstring effect. The same muscles that pull on the lateral knee, will also duck the knees in. You kind of follow me? Here's the easy visual. So if these muscles right here pull down this way, like the string on a bow and arrow, if these are on the outside and I shorten that string, what's going to happen to the bow? It's going to go that way, right? Can you kind of see that? If I drew my knee this way, this is my femur, this is my knee, and this is my tibia. I drew a little string right here. I'm dramatizing. If I shorten this string, what happens to my knee? Can you see that? What muscles pull on the outside of my knee? TFL. You're not done yet. Short head of the biceps femoris. Why not the long head? It's actually a little bit more complicated than that. So what ends up happening is it's hip adduction and internal rotation. This is where things get even more complicated. Femoral internal rotation, this is my femur, this is my tibia, this is my knee, if I have femoral internal rotation, it is the same thing as tibial external rotation. So all of the muscles that we listed for externally rotating the tibia, will also turn the femur inward causing this. Are you with me there? So we did TFL, biceps femoris. The reason why it's only the short head of the biceps femoris, is the long head of the biceps femoris crosses the hip, right? Connects  into my ischium. What is my the long head of my biceps femoris do as a joint action at the hip? It extends the hip and externally rotates. Are you with me there? So the long head is actually long, and the short head is short. Darn, crazy muscles. Make up your mind! One head's short, one head's long. But it's true. So TFL, biceps femoris, possibly even what was the other external rotator of our knee? Lateral gastroc, right? We could even, it's not on the next slide, but we could even put lateral gastroc. Crazy, huh? Just gets wilder and wilder. So, if this is the case, adduction internal rotation, what would our long muscles be? My abductors and external rotators which are going to be, you already hit it, who are my big abductor and external rotator? Glute what? Yes. My favorite muscles. They are. They're my favorite muscles. Not saying necessarily visually, although that's not bad either, but they do have extremely important functions. As we start tracking up all of our dysfunctions, you will see the glute max and glute med are almost always weak. And then we wonder why so many people have droopy glute syndrome. You  know droopy glute syndrome, right? No? I know a couple of people in here are going, "uhg, droopy glute syndrome". So, what would we do to these muscles? Activate, and then we would try to integrate. Okay. One thing I need to specify: we have to activate, and we have to isolate and activate as much as we can. If you go, 'well I need stronger glutes', and you decide that you don't do corrective exercise, you decide you're just going to do squats to try to strengthen your glutes, is that going to work? Why isn't it going to work? You're going to continue using the compensation pattern you've always had. You with me there? You can't control that. If your glute max and glute medius is shut down because your knees duck in, your biceps femoris is going to take over, this is something called synergistic dominance. I don't care how many times you do squats, your glutes aren't all of a sudden on your 15th squat going to go, "oh yeah I'm supposed to work now." You've learned to this compensation pattern until you release and stretch the short muscles, and activate these guys, they're not going to get involved. You're just going to keep using that compensation pattern.

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Integrated functional anatomy of the tensor fascia latae (TFL) and IT band. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, and behavior in postural dysfunction. Common foam rolling, injury prevention, and stretches for the TFL.

"Knees Bow In" Breakdown

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