From Knock Knees to Strong Knees: The Functional Patterns Approach

From Knock Knees to Strong Knees: The Functional Patterns Approach


Knock knees, also known as knee valgus, is a condition where the knees angle inward and touch each other when the legs are straightened. This can result in a misalignment of the entire lower extremity, including the hips, ankles, and feet. In this article, we’ll cover what the causes of knock knees are, why certain knee valgus exercises can exacerbate the issue, and how Functional Patterns can help at a fundamental level.


Knee valgus improvements by Functional Patterns Practitioner Kathy Alvarez


The causes of knock knees can be genetic or developmental. Some individuals are born with a natural tendency towards knee valgus due to one of their parents having knee valgus. Additionally, certain conditions, such as obesity, arthritis, or injuries to the knee or hip, can also contribute to the development of knock knees. While having knee valgus does not necessarily cause pain, it can lead to the development of other postural issues above and below the knees. Issues such as flat feet, duck feet, and an excessive anterior pelvic tilt come from a lack of stability in the knees. It’s these postural dysfunctions that can lead to knee pain, foot pain, and lower back pain.


A major cause for knock knees is muscle weakness, imbalance and a lack of an ability to connect well to other muscles to promote total body movement. One muscle that is not targeted very well in ways that can help knock knees are the glutes, even though most people think they are. The glutes are responsible for stabilizing the pelvis and creating propulsion to move in space. When these muscles are tight, inactive, or imbalanced, the pelvis becomes unstable and can result in caving in the knees, leading to knee valgus. 


While muscle weakness and imbalance are commonly accepted as causes for knock knees, the way most individuals try to fix them is incorrect. One popular exercise for knee valgus and targeting this muscle is the clamshell exercise. The clamshell exercise is a common exercise that targets the gluteus medius muscle, which is located on the side of the hip. To perform the exercise, you typically lie on your side with your knees bent and your feet together. You then lift your top knee away from the bottom knee, keeping your feet together, and then lower it back down. This movement resembles the opening and closing of a clam shell, hence the name.


At Functional Patterns, we view this exercise as a bandaid for a deeper rooted issue. Consequently, we do not recommend it as a staple exercise for knee valgus.  It simply does not take human biomechanics to account on a holistic level. Here we will break down why it is not a good exercise choice.


First, the clamshell exercise primarily targets the gluteus medius muscle, located on the side of the hip. While this muscle is important for stabilizing the pelvis and controlling the movement of the hip, it is only one of several muscles that contribute to the overall function of the hip joint. When addressing something as complex as knock knees, it is better to synchronize activation of the gluteus medius muscle with the rest of the glutes, the adductors, the calves, the hamstrings, the quads, the glutes, the core, and the rest of the upper torso. This is because knee valgus is not just a postural issue, but a movement issue. By synchronizing these muscles to fire together, we are able to improve our movement in space, which will improve how our knee positions itself. We will soon discuss an exercise that Functional Patterns employs to combine these muscles to create a holistic solution for knee valgus.


The second problem with the clamshell exercise is that it does not address biomechanical concepts outside of muscle activation that are crucial for addressing knee valgus. For example, maintaining proper intra-abdominal pressure is key for creating a stable base for movement and helps to position the pelvis optimally for proper weight distribution. Distributing weight evenly between the feet is key for proper balance and alignment, which determines how well the knee will be placed. Additionally, rotation and counter-rotation of the shoulders, torso and hips are required for creating a proper joint position that will prevent a position like knock knees.


The clam shell exercise does not require incorporating these crucial elements of human biomechanics, making it a suboptimal exercise for knee valgus.


If the clam shell is not effective at fixing knock knees, what is?


One innovative movement that Functional Patterns teaches is the one-arm step-press. This movement involves pushing a resistance forward with one arm while taking a step forward.



The one-arm step-press, just like the clamshell exercise, targets the gluteus medius muscle. However, it also includes every muscle in the body, requires joint stacking, abdominal pressure, and rotation in order to propel the body forward in space. This type of exercise directly translates to human movement, which is why we consider it to be a staple exercise for knee valgus.


In conclusion, knee valgus, also known as knock knees, can be a challenging condition to address, as it is often related to poor movement patterns and postural imbalances. While exercises such as the clamshell exercise can target specific muscles, they are not for correcting the root cause. A more comprehensive approach that considers factors such as intra-abdominal pressure, weight distribution, and the flexion and extension cycle of the hips, as offered by Functional Patterns, may be more effective for fixing knee valgus and improving overall movement patterns.


There are important concepts and details to learn when performing the one-arm step-press. A good place to start learning this in a step-by-step process is the 10 Week Online Course. From there, the Functional Training System will progress off the fundamentals into more advanced step presses.

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