How to Improve Knee Stability

Welcome back to Squat University! This past week we discussed how the knee joint is prone to sloppiness. Many athletes find it difficult to control the knee in a steady position during squats.

The knee needs to stay in perfect alignment with the toes. Any wobble from this position decreases our ability to produce strength and power. Instability also causes harmful forces to be placed on the structures deep inside our knee. This instability not only decreases our potential for performance but also increases our susceptibility for injury.

Today I want to introduce to you my 3-step process for improving knee stability.

  • Correct Technique
  • Touch-Down Progression
  • Strengthen the Hips

Before we start, these tools come with a caveat. Improving knee stability must only be attempted after the ankle and hip joints have been cleared of mobility restrictions. Any stiffness in the ankles and/or hips will cause a breakdown in the stability of the knee. If you have not yet screened your ankles and hips for stiffness, check out our previous two lectures: Ankle Mobility Pt 1 and Hip Mobility Pt 1.

Correct Technique

Our first move in addressing unstable knees is working on correct technique. Some athletes have never been shown how to squat correctly. At times, correcting squat technique is all they need to stabilize the knees.

One of the most common cues that I like to use is “drive the knees out”. This prompt teaches the athlete to engage their hips properly and keep the knees from collapsing inwards as they squat. However, it must be followed with “keep your feet firmly planted”.

FullSizeRender-13.jpg

Pushing the knees out too far without maintaining the tri-pod foot can be an issue as well. Their weight will shift to the outside of their foot allowing the base of the big toe to become unglued to the floor. As long as the foot remains firmly planted on the ground in the tri-pod position the “knees out” cue is a great starting point.

Good Foot Position
Good foot positioning
Bad Foot Position
Bad foot positioning

The second cue I will use to help stabilize the knee is “drive the hips back”. One of the absolutes of squatting is proper engagement of our posterior chain (primarily our glute max) prior to starting the descent. This occurs by driving the hips backwards in a motion called the hip-hinge. You need more hip-hinge with the low-bar squat when comparing to the overhead squat or the front squat.

2014-07-30 22.22.47

Whether you’re performing a low-bar back squat or overhead squat, you must engage the posterior chain prior to starting the squat. Loading our hips (the powerhouse of our body) will take pressure off the knees. Not engaging the posterior chain will increase the likelihood of the knees wobbling around.

Touch Down Progression

If the athlete is unable to correct knee instability with cueing, it’s time to take a different approach. This means moving onto one leg and perfecting the pistol squat. You would be surprised by how many powerful athletes who are capable of squatting a tremendous amount of weight are unable to perform a simple single leg squat.

In the strength game we often forget about training on single leg because we spend so much time working on improving our numbers on the main core lifts: the squat, deadlift, clean and snatch. In doing so it is easy to unknowingly develop weakness in some areas of our body. Challenging yourself with single leg squats can illuminate any deficits you have. Not only that, performing single leg activities will work on balance. Every athlete needs to work on balance.

By starting small and progressing appropriately, we can see a dramatic change in the ability to control the knee. In order to do this we will use a small box or a weight plate. Starting with a lower surface, we can then work our way up to a full pistol squat.

Start by using a 4-inch box. If you’re at the gym, you can stack 2 weighted plates on top of each other. Assume a single leg stance on top of the box or plates. From this position, drive your hips backwards and bring your chest forward. This movement allows you to engage your posterior chain. If you do this correctly you should feel slight tension in your glute and hamstring muscles. Bringing your chest forward while driving the hips back will bring you into a balanced position with your bodyweight over the middle of your foot.

By keeping the knee in line with your foot, squat down until your opposite heel gently taps the floor before returning back to the starting position. If you are doing this exercise correctly you will feel your butt muscles working hard after a few reps. You should not feel any pain or stiffness in your knees.

When you’re performing this exercise, try to keep your shin as vertical as possible. Allowing the knees to slide forward too soon will increase the pressure on the joint and the susceptibility of cave in. Eventually the knee will have to move forward as the depth of the single leg squat increases. However, there should be little forward movement of the knee during this initial small box.

As the 4-inch box becomes easier and easier, increase the difficulty by moving to a higher box or adding more weights. A higher box will demand more control from the knee. Eventually the end goal will be to perform a full pistol squat with good technique.

Do you have trouble with the pistol squat?! Here's a simple 6 step progression to master the pistol! Step 1: touch down off a small box or weight. Make sure to always lead the descent with the hips moving back. Step 2-3: increase the height once technique can be performed perfectly without any balance issues. Step 4: pistol squat with forward foot below box height. This decreases the difficulty of the movement by taking away the requirements of keeping the forward leg in a raised position. Step 5: perform the box pistol. While in the bottom position, raise and lower your forward leg above the box height a few times. Step 6: perform a full pistol from the floor. Stay at each step until you can perform that movement with good quality. It's important to make sure your ankle mobility is also sufficient. Full pistols require adequate ankle mobility. Stiffness at this joint will limit how far you can move through this progression. _________________________________ Squat University is the ultimate guide to realizing the strength to which the body is capable of. The information within these pages are provided to empower you to become a master of your physical body. Through these teachings you will find what is required in order to rid yourself of pain, decrease risk for injury, and improve your strength and athletic performance. _________________________________ #Squat #SquatUniversity #Powerlifting #weightlifting #crossfit #training #wod #workout #gym #biomechanics #exercisescience #fit #fitfam #fitness #fitspo #oly #olympicweightlifting

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Strengthen the Hips

The lateral hip muscles (primarily the gluteus medius) play an important role in stabilizing our knee. When we squat, land from a jump or run, these muscles ensure the knees stays in line with the foot and don’t cave in. Strengthening these muscles can improve the ability to stabilize the knee.

My favorite exercise to strengthen the hips is called the lateral band walk. This exercise is performed exactly how it sounds. To start, place an elastic band around your ankles. I’m a fan of the exercise bands from Perform Better. If you can’t find one, a longer stretch band can be used (tension will just be applied by through the hold).

The starting position is the same 3-step process we go through every time we squat. Place the feet in a comfortable position with the toes relatively straightforward. Next, ensure the feet are in a stable tri-pod position. Drive the knees out to the side to bring them into alignment with the feet. Lastly, engage the posterior chain by driving the hips slightly backwards and bringing the chest forward to remain in balance.

BandWalks(Start).png

From this position, start walking sideways with small steps. Make sure constant tension is applied the entire time from the band. After walking 15-20 ft, stop and come back the other way. Eventually you should start to feel fatigue in your lateral hip muscles.

Another exercise to address hip weakness is the banded kick out to the side. Check out the lecture “Hip Mobility Pt 3” for the full description of this exercise.

The inability to properly activate the glutes (our butt muscles) during the squat is a common finding in athletes. For this reason I recommend athletes perform a quick exercise to prime these muscles during the warm-up. The movement I want to show you today is called Unilateral Abduction or ‘banded lateral kicks.’ To start place an elastic or rubber band around your ankles. Next assume an athletic single leg stance. Once in this position, push the hips backwards and allow the chest to move forward. This small movement allows us to engage our posterior chain and remain balanced. The cue I like to use for every squat (even small ones like this) to solidify this idea is: “squat with the hips – not with the knees.” Once we are in position, kick the non-stance leg out to the side and back in a slow and controlled manner. The distance the leg moves out to the side is not our main concern. Focus on keeping the stance leg in a stable and unwavering position during the entire exercise. This exercise not only primes the glutes for the squatting we will perform after, but will help address core and knee stability problems. Recommended sets/reps: 2-3 sets of 10-15 reps. _________________________________ Squat University is the ultimate guide to realizing the strength to which the body is capable of. The information within these pages are provided to empower you to become a master of your physical body. Through these teachings you will find what is required in order to rid yourself of pain, decrease risk for injury, and improve your strength and athletic performance. To read more check out SquatUniversity.com (link in profile). ________________________________ #Squat #SquatUniversity #Weightlifting #powerlifting #crossfit #wod #workout #fit #fitfam #fitspo #fitness #functionalmovement #Training #instafit #instagood #motivation #olympicweightlifting #oly #gym #trainsmart

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Test-Retest

Improvements in knee stability are not always easily attained. Instability is something that has been learned and programmed into the body for some time. The longer you have moved poorly, the longer it will take to learn how to move correctly.

Until next time,

SquatBottom
Dr. Aaron Horschig, PT, DPT, CSCS, USAW

With

10985901_10152775697961717_3089916301038642033_n
Dr. Kevin Sonthana, PT, DPT, CSCS

 

 

Published by

Dr. Aaron Horschig

Doctor of Physical Therapy, CSCS, USAW coach and athlete.

4 thoughts on “How to Improve Knee Stability

  1. Hi! Doc

    I am a big fan of Olympic squat and has spent considerable amount of time since last two years to know more & more about this so-called most controversial exercise when it comes to depth. This website is just amazing and i am so glad that i found it eventually. Your article is really been great help & i am learning so much to back up my belief that ass to grass squat is what everyone should aim for. Once again thank you very much for your amazing effort to educate people out there about this great lift.

    Regards
    Shuvo

    Like

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