Dynamic knee valgus - is it real, and is it a problem?

Lower extremity valgus, also referred to as knee valgus in other literature, is a combination of hip adduction and internal rotation, knee abduction and internal rotation of the tibia.

Excessive lower extremity valgus during dynamic activities (e.g. landing, running) has been linked with the development of lower extremity injuries such as patellofemoral pain and anterior cruciate ligament (ACL) injuries.

A new paper takes a look at this issues, and highlights female athletes because dynamic knee valgus is greater in women (who also have a significantly higher rate of ACL rupture).

The relationship between hip muscle strength and dynamic knee valgus in asymptomatic females: A systematic review,
Dix, J., Marsh, S., Dingenen, B., Malliaras, P.,
Physical Therapy in Sports (2018), doi: 10.1016/j.ptsp.2018.05.015.

Always a bit of a crusty issue, this study challenged some of the long-held beliefs, and concluded:

  • Evidence on a link between hip strength and dynamic knee valgus is conflicting.
  • Strength testing protocols and movement tasks assessed vary.
  • Study designs using single leg, ballistic landings more likely to show correlation.
  • The relationship between hip strength and dynamic knee valgus may be task dependent.

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Simon Bartold
Director of Bartold Clinical