Knee Pain – Should You Try To Keep Your Knees Behind Your Toes?
There are so many “rules” that people follow about how their body should move that are simply myths, and are not backed by any research. One being that when you squat you should never allow your knees to go over your toes. How this myth became the golden rule is not known to me but perhaps the body stress that people were worried about when the knees go over the toes occurs only due to additional mobility deficits that exist, like deficits in the ankle and hips. I am not sure but what I do know is that good squat form is hard to come by in my therapy practice.
During my physical therapy evaluation, I check how well my patients move with a series of tests, looking for both the amount and quality of their movement. I check these movements whether they are seeing me for a neck problem, knee or big toe issue. Everyone gets checked with the same tests because it helps me understand the “movement” health of their body. A squat, and possibly advancing to an overhead squat, is one of these tests.
My direction to them is to squat as if they are using a Porto-potty…they don’t want to sit all the way down but they have to get their bum out far enough so they don’t miss.
9 out of 10 times I see them trying to organize this movement by keeping their legs parallel, their trunk is straight up, they are teetering back and forth on their feet, their knees are caving in towards each other, and then they only make it about ¼ of the way down before they almost fall over backwards.
This is highly dysfunctional and the inability to perform this movement pattern can lead to far more problems than worrying about knee joint stress.
Here are myths about squat form:
- You should never allow your knees to go over your toes.
- Your thighs should be parallel to each other with your feet pointing straight ahead.
- Your legs should be only shoulder width apart.
- Squatting is bad for your knees so you should never go beyond 90 degrees.
To be clear, I would not advise anyone to stay in a full squat, “ass to grass” squat position for any length of time. That is stressful on the body in many places depending upon the mobility of the individual. But, being able to perform a squat with good form is imperative for both normal activities of daily living and sports, such as but not limited to, soccer and ice hockey.
Furthermore, research supports that when trying to keep the knees behind your toes a person will cause increased stress to the hips but not necessarily to the knees.
Everyone's hips (the connection between the femur/thigh bone and the pelvis) are aligned slightly different. For one person they may need to "toe-out" a bit more than another person due to their unique boney alignment of the hips. Trying to work against this alignment to force the thighs to be parallel could result in pain and injury to the hips.
A good squat is when you can drop your bum down to where your crease of your knees is level with the crease in your hips, trunk is flexed forward so that the plane of your trunk is parallel to the plane of the fronts of your shins, chest is “proud” & up, feet are flat, knees are pushing away from your body, your weight is in your heels…and most importantly your are steady on your feet.
If you cannot do this movement pattern well, whether you are 18 or 80, your body could be limited in a multitude of ways that can cause you trouble with working outside in the yard to playing your favorite sport.
- Not sure if you squat well?
- Worried about what other basic functional movement patterns you have lost the ability to perform?
- Concerned that your loss of mobility could cause you injury?
If you answered YES, reach out to BodyFit Physical Therapy for a FREE consultation. We can discuss your concerns and goals, and I will put you through my movement tests to check on your movement quality. From there we can review how the deficits we find could be hurting you and/or causing you issues with sport performance and come up with a plan of care to help you move better, work better, and play better!
Call 860-507-7365 to schedule your Free Consultation or Email firstname.lastname@example.org