Squatting: Keeping Knees Out for Optimal Performance and Joint Health

How do I keep my knees out when squatting?

Keeping your knees "out" during a squat, meaning aligned over your toes and preventing them from caving inward (knee valgus), is crucial for joint health, optimal muscle activation, and force production. This involves a combination of proper cueing, targeted strength training, and addressing mobility limitations.

Understanding "Knees Out": Why It Matters

The instruction to keep your "knees out" during a squat refers to maintaining proper alignment where your knees track directly over your mid-foot or slightly outward, in line with your toes. This prevents a common fault known as knee valgus, where the knees collapse inward towards the midline of the body.

Biomechanical Advantages of "Knees Out":

• Optimal Joint Alignment: Ensures that forces are distributed evenly across the knee joint, reducing shear stress on ligaments (especially the ACL) and cartilage.
• Enhanced Glute Activation: Pushing your knees out encourages external rotation at the hip, which is the primary action of the powerful gluteal muscles (gluteus maximus, medius, and minimus). This allows for greater force production and hip drive.
• Improved Stability: Engages the hip abductors and external rotators, creating a more stable base for the entire lower kinetic chain.
• Reduced Injury Risk: Minimizes stress on the patellofemoral joint (kneecap) and the medial structures of the knee, helping prevent conditions like patellofemoral pain syndrome and ligamentous injuries.

The Root Causes of Knee Valgus (Knees Caving In)

Addressing knee valgus requires understanding its multifactorial nature. Common culprits include:

• Weak Gluteal Muscles: Particularly the gluteus medius and gluteus maximus, which are essential for hip abduction and external rotation.
• Tight Adductor Muscles: Overly tight inner thigh muscles can pull the knees inward, counteracting the desired external rotation.
• Poor Ankle Dorsiflexion Mobility: Limited ankle mobility can force the knees to compensate by caving inward or the heels to lift, disrupting the squat pattern.
• Insufficient Core Stability: A weak core can lead to an unstable trunk, causing compensatory movements in the lower body, including knee valgus.
• Improper Squat Stance or Foot Placement: A stance that is too narrow or toes that are pointed too straight can predispose to inward knee collapse.
• Inadequate Motor Control or Cueing: Simply not understanding how to properly engage the right muscles or execute the movement.
• Excessive Load or Fatigue: Attempting to lift too much weight or continuing repetitions when fatigued can break down form, leading to compensatory knee valgus.

Immediate Cues & Technique Adjustments

These cues can be applied during your squat sets to encourage proper knee alignment:

• "Screw Your Feet into the Floor": This powerful cue encourages external rotation at the hips without actually moving your feet. Imagine you're trying to rotate your feet outward, gripping the floor with your entire foot, particularly the outside edge. This immediately engages the glutes.
• "Push Your Knees Out Over Your Toes": As you descend, consciously drive your knees outward, ensuring they track in line with your second or third toe. Avoid letting them drift inward of your feet.
• "Spread the Floor": Similar to "screw your feet," visualize actively pushing the floor apart with your feet. This engages the hip abductors and external rotators.
• Adjust Your Stance: Experiment with a slightly wider stance and/or a greater toe-out angle (e.g., 15-30 degrees) if it feels more natural and allows for better hip external rotation.
• Use a Resistance Band: Place a mini-band just above or below your knees. This provides an external stimulus, forcing you to actively push against the band to keep your knees out, enhancing proprioception and glute activation.
• Focus on Glute Engagement: At the top of each rep, consciously squeeze your glutes without hyperextending your lower back. This reinforces the mind-muscle connection.
• Reduce the Load: If your knees consistently cave in, you are likely lifting too much weight. Prioritize perfect form with a lighter load before progressively increasing weight.

Strengthening Key Muscles for Knee Stability

Long-term correction of knee valgus requires strengthening the muscles responsible for hip external rotation and abduction. Incorporate these exercises into your routine:

• Glute Medius & Minimus:
  • Clam Shells: Lie on your side, knees bent, and lift your top knee while keeping your feet together.
  • Banded Lateral Walks: Place a resistance band around your ankles or knees and walk sideways, maintaining tension on the band.
  • Side-Lying Leg Raises: Lie on your side and lift your top leg straight up, leading with the heel.
• Gluteus Maximus:
  • Hip Thrusts/Glute Bridges: Excellent for direct glute activation and hip extension strength.
  • Romanian Deadlifts (RDLs): Develop posterior chain strength, including the glutes and hamstrings.
  • Good Mornings: Another effective exercise for strengthening the posterior chain.
• Hip Abductors:
  • Cable Abductions: Use a cable machine to perform leg abductions.
  • Machine Abduction: Use the seated abduction machine.
• Core Stability:
  • Planks (all variations): Strengthen the entire core musculature.
  • Dead Bugs: Improve core control and stability without spinal loading.
  • Bird-Dog: Enhances stability and coordination.

Mobility & Flexibility for Optimal Squat Mechanics

Limited mobility in the ankles or hips can restrict proper squat mechanics and contribute to knee valgus.

• Ankle Dorsiflexion:
  • Wall Ankle Mobility Drills: Place your foot a few inches from a wall and try to touch your knee to the wall without lifting your heel.
  • Elevated Heels: Temporarily use weightlifting shoes or small plates under your heels to compensate for limited ankle mobility while you work on improving it.
• Hip Mobility:
  • 90/90 Hip Stretch: Sit with one leg externally rotated and the other internally rotated, then lean forward.
  • Piriformis Stretch: Improves external rotator flexibility.
  • Frog Stretch: Targets the adductors and improves hip internal/external rotation.
• Adductor Flexibility:
  • Cossack Squats: Improve hip and adductor mobility dynamically.
  • Butterfly Stretch: Gently stretches the inner thighs.
  • Foam Rolling Adductors: Release tension in the inner thigh muscles.

Progressive Overload & Smart Programming

Successfully integrating these strategies requires a thoughtful approach to your training:

• Master Form First: Before adding significant weight, ensure you can perform bodyweight squats with perfect knee alignment.
• Start Light: When introducing new cues or exercises, begin with lighter loads to reinforce the correct movement pattern.
• Consistency is Key: Regularly incorporate strengthening and mobility drills into your warm-ups or as accessory work.
• Listen to Your Body: Pay attention to any pain or discomfort. If a particular exercise causes pain, stop and reassess.
• Video Yourself: Record your squats from various angles (front, side) to objectively assess your form and identify areas for improvement.

When to Seek Professional Guidance

While many individuals can correct knee valgus with consistent effort and the strategies outlined above, some situations warrant professional guidance:

• Persistent Pain: If you experience ongoing knee pain during or after squats despite technique adjustments.
• Inability to Correct: If, despite dedicated effort, you cannot maintain proper knee alignment.
• History of Injury: If you have a history of knee injuries (e.g., ACL tear, patellofemoral pain), professional assessment is highly recommended.
• Complex Movement Dysfunctions: If your knee valgus is part of a larger pattern of movement dysfunction, a qualified physical therapist or certified strength and conditioning specialist can provide a comprehensive assessment and individualized program.

By understanding the biomechanics, addressing underlying weaknesses and mobility limitations, and diligently applying proper cues, you can effectively keep your knees out when squatting, enhancing your performance and safeguarding your joint health.