- Bob and Brad,
the two most famous physical therapists on the internet.
- Hi folks I'm Bob Schrupp physical therapist
- Brad Heinceck physical therapist.
- And there we are the most famous physical therapists
on the internet.
- In their opinion of course Bob.
- So what could be causing your knock knees?
Uh This is for adults
and we're gonna talk about how to fix it
If you do have knock knees.
- So, technically that would be "genu varus".
- Valgus.
- Yes.
- Oh, that's right going outwards.
- For the professionals out there.
So we're when we're talking about knock knees,
we're really talking about three circumstances.
Number one,
there's people present with knock these only when they're
doing activities,
like I've seen volleyball players like go like this.
I see people when they squat,
they start bringing the knees in it's collapsing in,
Um basketball,
you might see them jump with the knees going in
- Yeah landing and-
- Yeah.
- Going up and downstairs sometimes,
people know about their knee
translates inward and putting stress on the knee.
- Then there's people present with knock Knees all the time,
but it's due to tight muscles, weak muscles or habit.
Okay. Those are the ones that we can really help.
- Sure right.
- Now the people we can't help are the people who have
knock knees due to bony abnormalities or arthritis.
Like if your arthritic joints just to wear out,
you see that quite often, It might go this way
or it might go bow legged.
- Sure.
- There's nothing we can do about those.
- A lot of times those people will walk and you'll see
the knee kind of going one way or the other,
or, you know, the genetic or the,
you know, congenital things where you're born that way.
- You're born th-
bones attached and you're actually knocked kneed.
- Right.
- You can't help it.
- It doesn't matter how much you tighten or strengthen
the muscle we're not gonna change the bony formation.
- Right. And you often see, like, if you,
if it's due to arthritis after someone's had a knee
replacement, they, they do straighten out.
- Sure right.
- So
so, frequently what is occurring to the knee
It's if you can think about three links,
this is the weakest link, the knee, hip and ankle.
- So the the joint above, the joint bellow and
then the uh the knee.
- So always look upstream and downstream.
So if you have knock knees with Squatty,
so, what that means is quite often external rotators,
the hip muscles that turn the hip out, may be weak
and so you have a tendency when you get down and especially
with a load, that your knees wanna turn in,
and that causes the femur to turn in and also makes you look
like you're knock-kneed.
- And then there's some implications to the ankle as well,
which we'll talk about that in a little bit, right?
- Yep. Um
Yeah. Well, we will talk about that.
But, the quadriceps may also be weak
so as you start to squat down,
you're trying to recruit other muscles to try to help you
and that's often the hip abductors.
- The ones inside those growing muscles.
- And also, yeah, as we talked about on the feet,
if you got flat feet, your feet, I, can you see that mike?
They're gonna turn in like this, and see what that does to
the knee right away.
Yep. It causes it to go in like that.
- What happens here is something's gonna happen below.
- Yeah, so we've got to straighten this,
and if you have flat feet for a long time,
the muscles on the outside actually get tight.
- Right, cause these muscles support the ankle
and have direct implication of what's going on
when the ankle goes flat or the foot goes flat.
- So the first thing if you have flat feet,
you might want to get an arch support,
you also don't want your shoes to wear out.
- No.
- Cause you you see people who have shoes out of worn out,
they're worn out on the inside, it makes it even worse
I mean, it, it, it plays into the knock knees.
- Or it may be the wrong shoe right off the shelf,
It just does not have enough support on the medial or the
inside. My mother just bought a pair of those
and she wore them for about two weeks,
and I literally had to throw them out because they were
breaking down it just wasn't the right shoe for her.
- Sure.
Um so let's talk, we talked about a lot of things here Brad
let's let's first talk about,
let's say your quads just aren't strong enough
and so what's happening is you're actually recruiting the
hip abductors, so one way to squat without using
the hip abductors is to actually do narrow-based squats.
So you can actually
just do some narrow-based squats like this
It's better to do it with like a ball on the wall.
- Sure.
- Brad, you wanna do that?
- Yeah.
- Keep the knees together.
- Yeah, and balance is obviously an issue
if if you have some balance issues,
but doing it this way is really nice 'cause you can-
- Yeah, it supports you.
- Yep and I'm gonna not let my knees touch
I'm gonna keep a gap in there and monitor that
and then go down and up.
The ball really gives some nice support depending on your
level of strength.
- Now this is really quad pacific.
- Yes.
- This is it's really har-
It is virtually impossible to recruit the hip abductors
When you're doing this,
now you could take a goblet and do goblet squats.
- I got to drink something.
- Yeah yeah.
- You mean the uh-
- The kettlebell.
- Yeah.
- Yep
Or you know if you have some dumbbells holding in your hand,
sure.
- And add some weight to it.
- You know the other option you can have
if you don't have that is simply,
you can do one leg at a time when you get stronger,
that really is aggressive.
Or, you know, you can touch with one
and focus on that one thigh and then do the other.
- Now, If your hips are turning in
because they're tight
and they can't turn out like they should,
Brad has the opposite problem,
his hips don't turn in very well,
but he's got a kind of a genetic uh predisposition.
- I'm very comfortable like this but I,
this way they just don't go.
- Right, so there's a lot of people
that are tight you know, they
they can't bring it in very easy
so we're actually going to stretch it out,
so all you do is a figure four stretch like this
very simple to do,
when you're sitting in a chair you just put
the ankle across the other opposite knee and give
a little push down, a little pressure pressure on.
- And this one's very functional,
especially people as they get older
you always have to get your foot up to tie your shoe,
put your socks on um those things so
what I do is when I put my socks on or my shoe
I always give this a few stretches and then go on with it
and actually do it laying down to it uh-
- So maybe we're just saying that by stretching the hip
it's gonna help the knock knees
but it is because no longer will your hips internally
rotate, and that causes the knees to go in,
so that's a good one to do.
The third one is clam shells
I'm going to go ahead and do this. Love the clamshells.
So very simple to do to you can do this in bed or you can do
it on the floor,
you're just going to line up your legs together
I got my knees over knees and my hips over hips,
my ankles over ankles
and I'm going to go ahead and do clamshells.
- So he's just doing one hip right now, just the top one.
How you doing?
- I'm doing fine.
- Yes, It looks like it's really easy
but we need to do it nice and slow, like this
you'll be amazed if you haven't done it before
you're gonna feel that hip get tired.
- Yeah you'll
you´ll want to start with, with no weight or no resistance
and then you can uh move towards the band.
- Yep. - They have the thin bands,
we like these thicker bands because they really fit
they don't roll up onto the side.
- They're yeah they're just so much more comfortable
If you've ever used one of the latex or rubber bands in any
of these, I'd be very surprised if you
would wanna go back cause this are so much more comfortable.
- This are nice.
- They do what they're supposed to do.
- And this is a lot more work Oh my gosh.
- And all you need to do is-
- Is move it up further.
- Yeah.
- It'll be easier to do
but I'm a beast so I want it-
- Yes.
But they make different color bands too,
some are easier some are more difficult.
- And of course, Bob/Brad name is on it, Brad.
- Well, it's because we like them so much.
- Yep. So, now we can also go to,
let's say that you're having knock knees all the time
not just with squats
you're gonna do some of the same things.
- Sure.
- And we'll go over those again, but right now
one of the first things you should do
is if you are knees are knock-kneed all the time
don't stand with your knees hyper extended, so this is,
you should have your knees should be slightly bent
can you see that Brad? or not?
- There?
- Yeah.
- You can see right here, if we, here
let's let's strip you down and show a little leg, Bob,
you know it's gonna make them turn the video off
and some will stick around,
So now go ahead and lock it out.
- Okay now if you lock the knee
it makes the knee look like it's uh knock-kneed
or externally, or it could also be a Val- verus too.
- One or the other one.
- Yeah, but either way you don't want to lock your knees
It's not good for them
and if it does make it look like
it knocked kneed
this'll help.
- Right yeah, knock kneed or bow legged
I think is what we're looking for
if you look at the slang term.
- Yep, so, again we're gonna do the figure four stretch
again we're gonna do the clam shells,
where's my mouse?
- Mouse, we needed the mouse.
- We did all those things already
we don't need to repeat them Brad.
Now the other thing that your on- should try is actually
you could foam roll or take a massager to the outside calf,
because again, if you're flat-footed, over time
these muscles tighten up, can you see what happens here?
My foot turns in because it's tight.
- Flattens out right in here.
- Now this muscle is not being stretched
It's shortened up and over time,
this actually gets tight and that'll play into causing
your foot to be flat.
So you can use a foam roller. Brad, do you want to do that?
- Sure
- I'll show the massager.
- So we're gonna go on the side
it's a little a little awkward, it's not too bad though,
but you can get on there if you want to get more pressure
you.
- Is yours bothering you? by the way.
- Pardon?
- I've been, I've been stretching mine
and mine have really gotten tight,
so, when I do this and I use a really aggressive foam roller
it, I- I mean, I feel it.
- Sure.
- You don't have to have pain with all your exercises
It's up to you.
- Well, actually you might want to have some pain
with the foam roller.
- But I mean you don't have to be screaming
and yelling in pain, but yeah, work it as tolerated.
- This is where the massage gun works really nice Brad
I hit this to my lateral calves every morning.
- Yeah, this is also plays in if you
have to have foot pain on the side of your foot as possible
it's due to these monsters.
- Sure, now you're gonna stay off the bone.
I know right on the fibrillar there,
but I, you can tell where that is.
- Yeah. If you go with the different head
this has got the soft head.
- Yeah you could actually go into the bone-
- And then it doesn't hurt
but that would be a little uncomfortable in the bone
it doesn't do any good to go in the bone.
- This just pop off.
- Yeah. Look at that.
- Pops on.
- Nice interference fit.
- All right, but this, you know,
I can go over a bone and it's not great
but it's, doesn't bother me.
- Right.
- Don't lay your shoes well like we talked about
you know, if there's, if you're flat-footed
you wanna make sure you replace them before they get.
- Right, go to the you know
figure out what kind of shoe, it's called
a motion control shoe are typically what you want
for good support, they have a real thick sole
and they have much more support
they do cost more too however.
- Now, last thing you can actually,
I know this kind of is the opposite of
what we recommended earlier,
but you can actually do Sumo squats too.
So Sumo squats are bringing your knees way out
and that's working on trying to externally rotate your legs.
- Well, I feel extremely comfortable doing that.
This is a right. It makes me feel good.
Yeah. I'm very comfortable, but that's just me.
- You'll have to put a little weight on
to be a Sumo wrestler Brad.
- Yeah, I know I'm gonna work on that
don't worry that'll be the fun part of working out.
- Alright.
A couple hundred pounds you need to put on. So, all right.
Thanks for watching.
- Be careful with those knees.