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A Missing Link in the War Against Knee Injuries

One of the most common complaints in sports is Knee pain and / or knee injury.

If you look at injury statistics, most common field sport injury is the knee.

David Moran, from Kerry GAA blew out his cruciate last year

David Moran, from Kerry GAA blew out his cruciate last year

This article in the Independent yesterday for example:

The best part?

The statistic is for non-contact injuries.

How is this so?

Why is the knee so vulnerable?

Is it really that weak, or is there something that we’re missing?

In my opinion, something is being over looked.

And that, my dear reader, the the movement of the joints BELOW the knee.

In most cases I talk to lads coming back from knee injury and their physio has given them hip and glute strength exercises, which is fair enough and necessary. But when I look down, their feet are flat and deformed looking.

Consider how we have 33 joints in each foot.


Consider how the foot should have three arches and the ability to move from pronation though to supination.

And consider what might happen of that ability is lost.

That movement has to happen somewhere.

Then consider how the industry as a whole freak out at the thought of the knees tracking inside of the second toe, ie into Valgus.

And if we don’t let the knee track inwards, how can the hip internally rotate when the foot is planted?

Where does that torque come out if the ball and socket joint of the hip doesn’t take it up?

football knee

The torque has to come out somewhere.

Where might that happen?

The poor old knee.

So what are we going to do about it?

We’re going to reconsider much of what the current fitness model espouses and hopefully bulletproof the knees by getting the joints above and below it to move more freely with strength and control.

And where possible do this in an integrated manner.

One of the fastest ways to achieve this is via the Anatomy in Motion flow motion model and it’s gait phase stretches.

These stretches promote the foot, ankle, knee and hip to load as an integrated system.

This essentially means that when the hip internally or externally rotates, that rotation is matched in the movement of the foot.

Which means that there is LESS torque placed on our knee joint.

And that is a good thing.

We know the Glutes externally rotate and extend the hip, which is is the same as saying they can decelerate flexion and internal rotation.

A look at the arrangement of the quadriceps and we’ll a kind of diagonal set up, from the outside of the hip down. Which suggest s line of pull set up to decelerate the knee moving towards the midline of the body, inside the second toe.


This is often referred to as Valgus, and often Valgus collapse.

Images like this don't tell the whole story

Images like this don’t tell the whole story

Now lets get this straight, Valgus COLLAPSE and Valgus MOVEMENT are two very different things.

Movement is controlled. Collapse isn’t.

Movement is warranted, wanted and necessary. Collapse is unwarranted and potentially injurous.

If we learn to control valgus movement, build strength into that movement so that we can handle loads in valgus without putting excess torque through the knee, or excess lateral forces that only leave our ligaments there to take the strain.

But internal rotation of the hip matched with pronation of the foot puts the load nicely into the muscles and large tendons (achillies, ITB) and out of the poor ligaments, particularly the cruciates.

If you play sport or simply train seriously, look down.

Do your feet have the freedom to move?

Or do you have flat feet, immobile feet. Do you struggle with glute function? How’s your IT band? Would you say it’s tight?

Is your knee picking up the slack for the hip and the foot?

If so, you could be at risk of becoming one of those statistics.

Squats and lunges are a good answer, but if your knee can’t safely travel in past the second toe, are they really helping you?


Dave Hedges 

You can book yourself a full postural assessment using the Anatomy in Motion flow motion model here: 

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