Every year as young athletes start lifting programs in high schools, there is one common issue in both teenage boys and girls: knee caving during weighted and non-weighted squats and lunges. Sometimes you will see knee caving occur when jumping, during a dead lift, and even while running. Knee caving is actually tolerated by world class power lifters, but for athletes that play sports that involve running, kicking, speed, and agility, it is recommended to focus on keeping the knees out during lifting workouts.
|Knees Out Squat|
|Knee Caving Squat|
It is important to correct the knee caving issue by learning proper technique and doing a few easy warmup stretches and lightweight lower body exercises as seen below. This combination will also help the athlete who runs for his or her sport to have a stronger injury prevention foundation. A variety of things can cause knee caving from joint inflexibility (ankle and hip) to muscle imbalances (glutes, hams, thighs). But by correcting the weakness and technique, you will less likely see injuries such as pain in the Illiotibial Band (ITB), Patellofemoral Syndrome (PFS), and maybe even ACL tears in some cases.
Full disclosure – saying something prevents injury is difficult to prove but preventing knee caving definitely will help an athlete's running, power creation, and joint stability and mobility.
Here are a few stretches and exercises that are easy to do:
Ankle Joint Flex – Just as you would lean forward to stretch your calves, place your feet flat on the floor and flex your ankles so your knee is capable of tracking in line with and over your toes.
Hip Flexibility and Mobility – Work on externally rotating the hips while in a deep squat and lunge stretch holds. (Non-weighted.)
The two positions above are stretches, not an exercise done for multiple repetitions (for now).
Lunge Stretch – Step forward and drop your hips as low as you can. Focus on keeping the knee in line with the toes. If you notice a slight inward lean of the knee, use the arm or hand to slightly pull so the knee is tracking with the toes. This also stretches the hips and ankles. Keep your front foot flat on the floor.
Squat Stretch – Some call these 3rd World Squats or Catcher Squats, but the goal is to drop the hips as far as you can while keeping your back straight and feet flat on the floor in a slightly flared out position (11 and 1 o'clock). If you cannot hold this position, it is OK to hold onto a sturdy piece of equipment or bar and work the hips from side to side while in the down position. Focus, always, on keeping the knee tracking with the toes to help break the habit of knee caving.
Thera-Band Exercise: Monster Walk. – Place the strap around your feet, ankles, or knees depending on your ability. The higher the band, the easier the exercise is. Open and close your legs to work the glutes and hips. Move from side to side and shuffle in a forward and backward direction while keeping tension on the bands around your legs. This helps strengthen the muscles that will allow for your knees to stay outward instead of caving inward.
Soccer Split Squat Exercise – This can be done with a dumbbell in each hand or without weight. I recommend practicing without weight at first as you will likely see knee caving without weight when teaching a beginner lifting athlete. If there's no caving, add weight progressively. Take a big forward step onto a box or bench, then drop your hips forward as far as you can and let your knee extend over your toes. As you step backward, keep your knee tracking in line with your foot and toes.
These are just a few exercises out of literally hundreds you can do to strengthen the hips, glutes, and thighs and increase mobility in the hips, knees, and ankles. A simple focus on prevention of knee caving will help you in so many other areas in your athletics and help you in the weight room when building up your strength and power lifts.
Some other exercises that can assist include adding a foam roller to roll out calves, hips, thighs, and more.We have been doing exercises like dirty dogs, side leg lifts, and donkey kicks for years to help with gluteus medius and minimus to help with running overuse injuries such as ITB / PFS. Make sure these are part of your daily warmup and cooldown.
Some science based references:
Stew Smith works as a presenter / editorial board with the Tactical Strength and Conditioning program of the National Strength and Conditioning Association and is Certified Strength and Conditioning Specialist (CSCS). There are also over 800 articles on Military.com Fitness Forum focusing on a variety of fitness, nutritional, and tactical issues military members face throughout their career.