Dynamic Knee Valgus: Root Causes & How to Fix It

Why Fix Valgus Knees? Is Surgery an Option?

By Dr. Erin Boynton, MD, FRCS

dynamic knee valgus thumbnail

If you have dynamic knee valgus, you’re at increased risk for knee pain and injury. We’re going to review why you need to fix it now and how to get started.

If you want to listen to Dr. B (orthopedic surgeon and Chief Medical Officer here at Precision Movement) explaining how to fix knee valgus, click here for our YouTube video Why You Need to Fix Dynamic Knee Valgus NOW.

What is Valgus Knee?

Valgus of the knee is when your knees cave together, or you may have heard the term knocked knees.

There are two types of knee valgus. One is structural, so when I’m examining someone in the office, I would have them stand, and I would look at the alignment of their knees.

To determine if you have valgus knees or varus knees draw an imaginary circle around your knees, if the knees point towards the center of the circle you are aligned in valgus or knock kneed, if they point towards the outside, you have varus or bowed knees.  

Most likely this is because of how you were born. It’s genetic or developmental.

Sometimes, if people have an injury to their knee  as a child, where they have a fracture of their growth plate as a child or an infection of the growth plate, then that can affect the growth of the knee, and you can develop a valgus knee.

But far more commonly, valgus is dynamic, meaning that when you move, your knee caves into a knock-kneed position.

knock knees

knee valgus

This generally occurs because of imbalances of muscles in your foot and your hip. Also, there’s often weakness in these muscles. This results in faulty movement patterns affecting the kinetic chain.

Coach E has done a recent article, which has some excellent exercises and techniques to address the whole kinetic chain. It will help you to prevent dynamic knee valgus, so I highly recommend you check it out.

Valgus knees tend to be more common in women.

There have been many studies looking at why women tend to have valgus knees. Different theories cover the shape of the hips, the strength of their muscles, and general movement patterns. But valgus alignment is far more common in women than in men.

Also, people who suffer from hypermobility (that is, lax joints in general) tend to have more valgus alignment to their knees than people who do not have hypermobility.

Why Fix Valgus Knee?

So why do you need to fix valgus knees?

If you have a valgus knee, you are at increased risk for:

  • Anterior cruciate ligament tears (ACL tears)
  • Patellofemoral problems
  • Arthritis
  • Potential instability
  • Lateral compartment arthritis
  • Meniscus tears

knee pain

This is because, with repetitive valgus loading of the knee, you overload the articular cartilage, the ligaments, and potentially the meniscus on the outside of the joint.

It is imperative that you address the way you’re moving to decrease the load on your knee to protect your knee for the future. Whether or not your knee is structurally or statically aligned in valgus or dynamically moves into valgus, you need to take steps to prevent your knee from breaking down.

Surgical Options

If you have a structural knock-knee, there are surgical procedures that can be done. It’s called an osteotomy, and that’s where you actually cut the thigh bone (the distal femur) and realign the leg. This is rarely done. It’s very painful, and I would highly recommend that you try other alternative routes before you get to this point.

If you have really significant valgus alignment to your leg, it can be very helpful. But I would recommend that you take every non-surgical step possible to avoid having an osteotomy.

What Can You Do To Fix Dynamic Knee Valgus?

If you have a valgus knee, what can you do, and how can we get you started to prevent you from overloading your knee?

If you’ve read our articles before, you know that Coach E and I are very systematic in our approach. We want to establish a foundation for movement.

4 pillars - foundation

There are four pillars for our foundation:

  • Tissue quality
  • Alignment
  • Activation
  • Active range of motion

Alignment, which is valgus alignment of the knee, is one of our pillars. It is really important also to address not just the knee but the joints above and below – the hip, foot, and ankle.

If you would like a more comprehensive approach, the Knee Pain Solution is excellent because it will address all four pillars of our foundation for movement.

Thanks for reading, and happy moving!

I needed to reduce my knee pain due to osteoarthritis.

When I started my pain level was around 5-6. I was walking 3-4 miles a day putting an unnecessary load (intensity) on my knees. I started the program and reduced my walking speed. I also started consciously adding rest days and icing my knees when they felt achy.

My knees slowly began to comfortable and more confident. My legs now feel good and I look forward to what moves the day brings.

The advice from Dr. B was also very useful. The concept of linking the connecting parts of the knee that affect knee health is an effective approach.

– Malcolm

This article was reviewed and updated on July 5, 2023 by our Chief Medical Officer, Dr. Erin Boynton, MD, FRCS to include new research and information on latest surgical developments. Read more about Dr. B here.

About the Author

Dr. Erin Boynton, MD, FRCS is an orthopedic surgeon who was the team surgeon for the Toronto Blue Jays for 10 years and has worked with other professional teams and athletes from many different sports. She currently serves as the Chief Medical Director of the Rogers Cup WTA Tennis Tournament and is the ITF Canadian Champion in tennis for her age group (we won't say which group that is!).