Squatting is an essential movement that we do every day and that is why it is such a vital part of most workout programs. Over the years there has been a lot of debate about what proper squatting form looks like. For a very long time, the thought was that it was dangerous for you to squat with your knees going over your toes and that squatting deep (below 90 degrees) was also bad for your knees. If you are someone who exercises regularly, I can almost guarantee that you have been told some variation of “you will ruin your knees if you let your knees go over your toes.”
So, let’s break down what good squat form actually looks like. The key points of performance look like this:
1.) Feet shoulder width apart with toes 0-10 degrees out
2.) Neutral spine maintained throughout
3.) Weight balanced on MID FOOT
4.) Hips release down and back, and knees bend
5.) Hip drop below the level of the top of the knee
6.) Knees track in-line with toes
7.) Neutral head position with slight upward gaze
You will notice that nowhere in there does it say to keep your knees from tracking over your toes. If you follow the key points of performance, you will almost always end up with your knees going over your toes. Is this bad? The short answer is NO! It is perfectly normal and healthy for your knees to go over the toes during the squat. Let’s talk about why that is.
During the squat movement we are loading and strengthening multiple muscle groups some of the major ones are glutes, hamstrings, quads, and adductors. The goal with squatting is to not put too much demand on one of these muscle groups. If we completely avoid the knees going over your toes you will certainly decrease that amount of strain put on the quads and the knee joint itself. However, the strain has to go somewhere and what happens is that your hip and lower back are forced to pick up the slack. Continuously loading your hip and back can lead to overuse and overloading of those tissues.
If you are someone who has been scared to squat with your knees over your toes, know that it is perfectly safe and actually recommended to allow your knees to come over your toes. In order to have good squat form and avoid injury, your knees HAVE to go over your toes.
Yours in Health,
Dr. Andrew, PT, DPT, OCS, CSCS
As a physical therapist, I am often asked if running is bad for your knees. Most people typically want to know what the long-term effects of running will have on their body, and want to know if they will develop knee osteoarthritis from running. Running is a simple and accessible option of exercise for most people, and has great overall health benefits. Many of my clients also report huge psychological benefits to running, so I find it important to limit fear based ideas that running is worse for your knees than not running at all.
With the fear of ruining your knees through running, only 3.5% of recreational runners have knee or hip arthritis. While just over 10% of sedentary individuals have knee or hip arthritis. This means you are almost 3x less likely to develop knee arthritis if you perform regular recreational running than if you just sat on the couch and did nothing. Moderate amounts of running may actually be beneficial to the long term health of your knee joints. 1
Continuing to run with a recent diagnosis of knee arthritis is also okay! Running does not appear to increase the speed of knee arthritis. However, if you are having difficulty recovering between runs, you may want to look at training load, cross training, or potentially altering your running mechanics. Running can help you maintain a healthy weight, that in turn will reduce the overall daily stress placed on the knee joints. Finding the optimal frequency, intensity and volume for your running to provide ample recovery time is important.
Overall, runners should feel great about running with proper load progression, volume, and intensity management, as well as proper sleep and nutrition, to help with post run recovery! If you are currently recovering from a running injury, you can progress back while running on a treadmill or outside, as they both create similar reaction forces through the knee joint. You may also want to assess your knee, hip, and ankle joint mobility to ensure proper mechanics.
If you have any questions or need help managing your running injuries, please reach out and we can help answer any remaining questions you may have!
Thanks for reading,
Dr. Sam, PT, DPT, OCS
1 Alentorn- Geli E, Samuelsson K, Musahl V, etal. The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta- analysis. J Orthop Sports Phys Ther 2017;47:373–90
During the month of September we focused our efforts on helping YOU combat nagging knee. It's super helpful to take the time to watch the first video before moving on to the rest. You need to understand the types of knee pain and where yours might be coming from before you can start to solve a problem. As always, reach out to us if you're not getting better, you have questions or you're ready to get out of pain and start living your life.
Knee Pain can be frustrating. However, in order to improve it, you need to know what you're dealing with. Are you having more mobility related issues or stability and control issues? Confused? Watch Dr. Danny walk you through 2 simple tests to see which category you fall into.
What if you don't have enough mobility and you have knee pain? These exercises will give you hope! Walk through these exercises with Dr. Jacob and see if you can improve your mobility and decrease your knee pain.
1. Couch Stretch- one of our all time favorite drills- but focus on the cues.
2. Knee gapping- if your pain is coming from your joints, this is the exercise for you.
3. Hamstring mobility- grab a band and work on your hamstring mobility to help improve your knee pain.
Are you having knee pain? Dr. Marcus is going to walk you through 3 exercises to strengthen your leg to decrease knee pain and get stronger.
1. The first one is a classic- wall sits. He throws in some twists for those of you that think you're too strong.
2. One way to get strong legs is to target your hamstrings with hamstring roll outs. Move out as far as you are comfortable while maintaining form.
3. Last we want you to target your glutes.
Go through these and see if you can help decrease your knee pain. If not, or these are too painful, you need an expert to help you
If you're having knee pain, here are 3 cues to help alleviate some pain.
1.The first one, is the simplest, SIT DOWN! Compare this to your squat and see how much further back your hips AND knees are.
2. Practice squatting without sitting and focus on keeping your knees back. Do not let your knee come over your toes.
3. Focus on pointing your knees out towards your pinky toes. Do not let your knees come into your big toe. Knees out!
Give these a shot and see how you can improve any lingering knee pain. Questions? Give us a call at 470-355-2106.
Dr. Danny and staff's views on performance improvement, injury prevention, and sometimes other random thoughts.