Prefatory note
Depending on your background, this may be one of those posts you have to slog your way through. (I know because writing it made me rethink how I felt about myself.) To some degree, it’s supposed to be. If you get lost at times, don’t feel bad. Especially if you’re lacking anatomy vernacular, there will be some tough spots. Again though, there should be. Stick with it, and you’ll see why.
–
–
Somebody performs a squat and this happens:
“We need to stretch those adductors!”
Off you go performing exercises like this:

Image credit: http://davidlasnier.com/
–
Superficially, the logic here makes sense. If something like the knee(s) come together during a squat, adduction, then these muscles are too tight / stiff / overactive (whatever you want to say -we’ll come back to this), so, we should stretch them. Or get them to relax. Again, whatever you want to call it. Concurrently, we should work the leg into abduction -the muscles which “aren’t working enough.”
–
Anatomy ain’t rocket science, but it ain’t that simple either
Anatomy can be tricky too. Let’s show why more thinking throws a wrench in this stretch the adductors logic. Again, that squat:
Because the femurs are adducting and internally rotating, the other way to view this squat is, “We need to stretch your internal rotators!” Or, “We need to work your external rotators!”
This usually then goes down the line of “We need to work your glutes!” As the glutes are a good external rotator of the hip. Although, that depends. Some parts of the glute can internally rotate the hip!
Sometimes you’ll also hear to work those deep external rotators, the ones nobody can ever remember the names of.
What are some other lateral rotators of the femur though?
- Adductor brevis
- Adductor longus
- Adductor magnus
In case you’re lost, let’s recap all the above. Instead of this,
This happens:
And you could say:
“The femurs are adducting! We need to relax the adductors of the thigh.”
You could also say:
“The femurs are internally rotating! We need to work the external rotators of the thigh…Of which the adductors are included…”
What seemed so obvious on the surface becomes a paradox when looking more in depth. At first, it makes sense to relax the adductors. When we look specifically at what the adductors do, it makes sense to work them…and relax them? Or?
In fact, what else is happening during a knees-caving-in-squat?
The knees -femurs- are going too far in, but the feet -tibiae- are going too far out. The tibiae, especially once the feet turn out and particularly in relation to the femur, are externally rotating. Meaning one could go “We need to work the tibial internal rotators!” And what’s an internal rotator of the tibia? The gracilis (especially when the knee is bent, like in a squat)…which is an adductor.
Who’s right? Who’s wrong? Where can all the lunatic Youtube commenters go to rejoice in their disdain of human flaws?
–
Enough anatomy for now, let’s watch some movement
I know eyes can gloss over and minds can numb when so much anatomy speak is used. Let’s look at some common movements, and typical compensatory strategies.
-Hands and Knees; Leg Extension -colloquially referred to as a Bird Dog:
-A Side Lying Leg Lift:
-On Back (elevated); Hip Extension -sometimes referred to as a Thomas Test:
Tangent: You are a pain in the ass by naming a test or movement after yourself. It makes it harder for people to remember what the test or movement is. Think the difference between Bird Dog versus Hands and Knees; Leg Extension. Or Thomas Test versus Supine (on back) Hip Extension. The latter names tell you what the movement is. It’s in the name. This is how most physicists and engineers name things, and it’s for a reason: It makes life easier. It’s not as ego satisfying, but utility is more important here.
Now, some common compensatory strategies for these three movements.
-In a Quadruped Leg Extension, it’s common to see the leg flare out to the side and or see some opposite rotations going on at the knee:
-In a Side Lying Leg Lift, it’s common for the femur to internally rotate during abduction:
-It’s also common for the leg to not be able to come down -adduct- very far. (I discuss this thoroughly here.)
Note the above is true when the leg is held in extension. If the hip is allowed to flex enough -the TFL often wants to pull things back into flexion, or abduction, to avoid being stretched- then adduction will be no problem. While the adductors do also have a role in hip flexion, we know this is not due to the adductors. I’ll cover why in a few minutes.
-In Supine Hip Extension, it’s common for the leg to either flare out:
-And or the tibia to rotate / move laterally in relation to the femur:
I want to be very clear here. The people whose knees cave in during a squat are the people most likely to engage in the above patterns. (These are extremely common patterns overall.) Hopefully this isn’t tough to conceptualize. If we reorient these images, notice how similar they all look to one another.

While I only put green lines to show where the tibiae would ideally be, in all the above, ideally the knee (femur) would be turned out -laterally rotated NOT abducted- some as well.
This is crucial here, because in these compensatory strategies:
-In the Quadruped Leg Extension:
–The femur is extending and ABducting.
–In this one it’s extension and internal rotation:
-In the Side Lying Leg Lift:
–When the femur abducts and internally rotates, the ADDuctors are being stretched. (Remember, the adductors externally rotate as well as adduct.)
–When the leg is held in ABduction, it shows the ABductors are stiff. The abductors are pulling more than the adductors.
-In Supine Hip Extension:
–When the leg flares out, the ABductors are responsible. The ABductors are illustrating they’re more stiff than the adductors.
–When the femur internally rotates, the ADDuctors are being stretched.
(The main abductor doing all the above: pulling the leg out / internally rotating the femur / laterally pulling the tibia is the Tensor Fascia Latae.)
Do you see what has happened here? All that talk about stretching, loosening, relaxing the adductors…yet in all the scenarios above the ABductors are what need to be relaxed. If anything, in the above scenarios, the ADDuctors need to be working more! They need to be working more as adductors and external rotators.
Because if the adductors were truly overactive, in the Quadruped Leg Extension we’d expect this to happen:
In the Side Lying Leg Lift, we’d expect the leg to either be pulled more into adduction relative to abduction, and or the leg to want to externally rotate during abduction:

The adductors get stretched during abduction, so one way for them to prevent this stretching would be to externally rotate.
In the Supine Hip Extension we’d expect this to happen (orange):
The difference between a squat and the above movements is in a squat the foot is fixed -it’s on the floor- and, for the most part, can’t move. In the Quadruped Leg Extension, Side Lying Leg Lift, and Supine Hip Extension, the foot can move, which gives us a more accurate representation of what’s going on.
Because what’s happening in a squat is the appearance of dominant adductors. But what’s really happening is dominant internal rotators, which cause the adductors to come along for the ride, due to the fixed foot. (Other things can be causative here as well, such as a lack of dorsiflexion.)
That is, when you internally rotate the femurs on fixed feet, the only way to generate significant internal rotation is for the femurs to also adduct, but that doesn’t mean the adductors are responsible. Again, the adductors can play a role in external rotation. If they were so dominant we’d expect the femur to externally rotate and adduct.
-> You could argue here the adductors are so dominant into adduction that the internal rotation is what’s actually coming along for the ride (because the foot is fixed). However, once the foot is not fixed, we clearly see this isn’t the case. On balance, people are dominant into abduction and internal rotation, not adduction and external rotation. It’s just that in a squat these things are mutually exclusive. You can’t adduct and externally rotate, nor can you abduct and internally rotate. On balance, internal rotation is what usually wins in a faulty squat.
–
Understanding the adductors and external rotation
Let’s back up a second. I have a feeling hearing the adductors play a role in external rotation is new for some, or something that’s tough to visualize.
In the interest of accuracy, let’s remember the adductors are not one muscle. And, that all adductors are not the same. Let’s look more closely at the adductor longus.

Image credit: http://www.NetworkFitness.com
The muscle starts at the superior ramus, and ends at the medial lip of the linea aspera of the femur.

Linea Aspera in blue, on right. Image credit: http://www.studyblue.com
The insertion is on the posterior side of the femur. Look at the line of pull. It’s towards adduction and external rotation, because of its posterior insertion. When you pull the posterior aspect of the femur medially, the superior aspect of the femur rotates laterally.
In case the animation is still tough to see in your own mind, I constructed a simple model of the hip and adductor longus.
Here are two slo-motion videos, pulling on the rubber bands to represent the adductor longus contracting. Top view and bottom view:
–
–
Note the similarity in this line of pull compared to what we’re trying to do in the Supine Hip Extension exercise:
To reiterate, if the adductors were stiff, we’d expect when the leg is flared (above) for the hip to go into hip flexion, because the adductors can play a role in hip flexion. That is, when the leg is abducted the adductors are put on stretch, and one way to avoid being fully put on stretch would be to flex the hip (or externally rotate the leg). But this is not what happens.
Instead, when the leg abducts, it then falls into some hip extension, further stretching the adductors. When the leg is adducted though, it then goes into hip flexion (in someone who is stiff in the TFL -an abductor and hip flexor). Something like this:

Notice how high thigh is off bench when leg is in rightful adducted position. (Hip is held in flexion.)
Illustrating the TFL is what’s causing the hip to flex, not the adductors. Not to mention, in these scenarios, you typically see the femur internally rotate or the tibia externally rotate, both things the TFL has a role with. You pretty much never see the femur externally rotate and the tibia internally rotate -both things the adductors can play a role in. (I’m ignoring the long head of the adductor magnus right now. I’ll get there in a second.)
If I had one do a Quadruped Leg Extension, but we fully insure the lower back does not go into extension -we avoid anterior pelvic tilt / hip flexion; we take the hip flexion compensation out of the equation. The leg will then be much, much more prone to abducting than adducting. Illustrating the abductors are stiff relative to the adductors. Again, this:
The adductors, particularly into adduction, are not stiff. The abductors are.
–
Why this matters
We now know, more often than not, we want to be avoiding focusing on abduction exercises. (And internal rotation.) In a squat, abduction is ok -it can help us externally rotate- but we don’t need to go crazy with it. You only cue someone “knees out” to generate the effect of their knees not turning in. There is no need for say, the knees to be outside the feet.
Really, we’re cueing the avoidance of internal rotation. We are NOT cueing abduction. It just happens to be that telling someone who is prone to internally rotating their femurs to “open your knees” often places their femurs in neutral during a squat. (That said, you can often get by with telling someone to “Not let the knees come together.”) This is part of the art of cueing. How your words are interpreted don’t always coincide with their literal meaning.
Beyond a squat though, such as non-feet-fixed exercises, there is no need to be going crazy with abduction. In fact, more often than not, we want to be avoiding it.
When we do a Quadruped Leg Extension, we want the leg going straight back, not out to the side. When we do Supine Hip Extension, we want the leg going straight down, not out flaring out. When stretching the hip flexors / quadriceps in a more conventional manner, we want the knee pointed straight down, not abducted. The green lines, not the red lines.
There’s no need to be doing something like a split stance adductor mobilization:
In this position we’re significantly abducting the leg. So much so, barring the ballet type, not a single person is going to be able to do this without moving their lower back.

Notice one side of back higher than other. (Lumbar spine is rotated to right side to compensate for lack of hip mobility.)
You only have about 45 degrees of abduction to play with. Beyond that, the only way to get the motion is to do something like rotate your lower back. And of course you feel a stretch in your groin when doing the above. You’re at your absolute maximum abduction range of motion. That doesn’t mean it’s a good thing to be doing though.
I randomly found a bunch of videos for “Split Stance Adductor Mobilization.” Video after video mentions keeping the lumbar spine in neutral. But neutral is not just a extension / flexion matter. It’s a rotational one too. As all the photos above depict, nobody is in neutral! But this isn’t the person’s fault, it’s the exercise’s.
There are more issues with this. Looking at how gravity is working here, where is the most vulnerable location in this position? The knee.
Gravity can pull down at the knee in a medial fashion. Where the distal femur and proximal tibia are both moving medially. This is what we’re trying to avoid in a squat.
Notice the feet in the squat and split stance adductor mobilization are both over-pronating too!
To those familiar with the split stance exercise, yes, you could do something like turn the foot up to (somewhat) help with the knee and foot issue:
But then you’re still dealing with the fact the leg is more abducted than 99% of people can achieve, -trying to achieve this is actually a good way to pinch the labrum- the fact one probably has stiff abductors (primarily TFL), and the tibia is still lateral to the femur.
–
We haven’t even talked about timing yet
If knees turn in at the transition stage of a squat -where you are moving from down to up- there is a good chance something like adductor magnus’ long head is contributing to this. Remember how the adductor magnus is a lateral rotator of the femur? I don’t see anything wrong with saying the adductor magnus is also an internal rotator of the femur.
The short, horizontal fibers, connect to the femur much like the adductor longus and brevis.

Anterior view; adductor magnus connecting posterior to femur, but anterior to pelvis. (Dotted line versus solid line.)
But the long fibers, starting on the back of the pelvis, connect distally on the femur, and medially. This is the hamstring portion of the adductor magnus.

Anterior view; adductor magnus long head starting at posterior side of pelvis; connecting to posterior and medial aspect of femur.
We know something like the medial hamstrings, which connect just below the adductor magnus, play a role with internal tibial rotation. Much like the gracilis muscle we went over earlier.
It makes sense then that the adductor magnus long head, which has the same line of pull as the medial hamstrings, but connects at the femur, plays a role with femoral internal rotation. And when is this aspect of the adductor magnus needing to contract? At the bottom of a squat, when we engage the hips into extension.
This is in contrast to someone who immediately upon bending their knees allows them to cave in. That is, the person who engages say, the adductor magnus upon transitioning from down to up, is using the adductor magnus in a faulty way concentrically. Whereas the person who immediately brings the knees together may be using the adductor magnus in a faulty way eccentrically.
So, even if your adductors truly were stiff / short / whatever, how does stretching them help with our timing issue? It doesn’t. Because it doesn’t address the brain’s role in all this. If you take all the muscles which turn the knees in during a squat, and they were as flexible as possible, that doesn’t mean your knees won’t turn in when you squat.
–
Stop the madness
The point of all this is not to take some highly technical path to a deduction of “We need to do this one stretch, for this one muscle.” The point is to illustrate the downsides to this type of thinking.
The point of all this is to illustrate when someone gives you a stretch like the split stance adductor mobilization, or a side lunge, or tells you something like “stretch your adductors” -a group of muscles which don’t all have the same function, all because your knees are caving in, that this advice is flawed. It’s a result of lazy thinking. (We’ve all been there.) Of a malformed philosophy. I understand this type of thinking has been BERATED into people, and it’s tough to come out of.
But think of how nice it is to be able to say our main takeaway from all this is, if you’re someone whose knees turn in when you squat, and you want to correct that…then start with not letting your knees come together when you squat.
–
Bhavani
February 23, 2015
Hi Brian,
My inner thigh muscles are over stretched ,kind of too flexible and I always feel my thigh near the groin area wants to turn out.I cant get it to turn inwards freely.its feels restricted at the groin area and the outer thigh feels so tight.when i do hamstring stretch crossing my left leg inwards,towards my right shoulder, it feels so difficult.this tightness is going all the wy till my buttocks ,perineum and my calves too,making everything tight..I have tried explaining this to some therapists here in india,not really they seem to understand my problem.thye keep giving gluteal stretches,which are not helping me,inturn affecting my knee,my right leg stands straight but the left leg always wants to turn outward.I have tried the butterfly stretch but i really don’t find its helping my internal rotation.Could you please suggest me some stretches.We really have no good physical therapists or at least good gym instructors who understand who these stuff.
reddyb
February 25, 2015
Hey Bhavani,
The first thing I would do is get a feel for the structure of your hip. I would read this carefully: http://b-reddy.org/2013/05/09/talking-about-hip-retroversion/
See if that gives you some answers.
Aaron
April 4, 2015
Hey Brian,
So when I do the supine hip extension to stretch out my TFL (as per another post of yours on proper TFL stretching), my leg wants to move out to the side exactly like the photo. I try and prevent this by making my femer go in line with the green line that you have there. When I do that though, I feel like my leg gets tired and there isn’t much of a stretch anymore because I’m working on alignment..
Added to that, my adductors feel quite tight when doing deadlifts of hip thrusts for example.
Any suggestions?
Love you stuff.
Aaron
reddyb
April 6, 2015
Hey Aaron,
That’s a common sensation. It’s one of the mental hurdles many of with that exercise, and really with the approach of movement over muscles: What you feel isn’t necessarily what’s going on.
With the supine hip extension, it’s common to not feel much of a stretch because other things are taking precedent in the brain. It’s akin to you feeling some discomfort somewhere, but if you’re suddenly scared you don’t feel it anymore. The fear takes precedent over say, a blister.
This has to due with what the brain perceives as important. Feeling a stretch versus feeling fatigue? Fatigue often wins. That doesn’t mean you’re not also stretching something though!
On the flip side, say you’re doing an activity and you’re really tired, but all of a sudden you tear a muscle. Feel a stretch vs feel fatigue? The (excessive) stretch likely wins in that scenario.
Aaron
April 7, 2015
Hey Brian,
Thanks for the reply! I tried the stretch again last night and as I breathed and relaxed my knee must’ve dropped 3 cm or so!
reddyb
April 8, 2015
(I believe you mean dropped an extra 3 cm or so.)
There you go. Could be starting to loosen up some. If you’re trying a different way of breathing to help relax, that can help too.
Christian
September 28, 2015
TFL short – superior anterior force on femoral head in acetabulum – blocks internal rotation particularly when in stretch ( hip and knee extended ie Thomas Test) and prone bird dog as illustrated above.
Into hip flexion (ie deep squat) the direct TFL effect on abducting hip is not as apparent as hip and knee are flexed therefore you don’t get the abduction of the hips in this instance.
The caving of the knee (when purely looking at a healthy, normally verted hip) in a squat is more a reflection of the neuromuscular consequences of driving with TFL posturally – hip abductors and external rotators have “switched off” for lack of a better description and the knee falls into gravity as the person use end range joint position to stabilize rather than the lateral-posterior pelvis.
Adductor “stretching” “mobilizing” may be useful from an antagonist – down regulatory effect just prior to hip abduction/external rotation exercises but I agree aren’t the main driving force for valgus knee collapse into a squat. There my opinion is we should still training hip external rotation/abduction just ensuring we have the technique down.
Thoughts?
reddyb
October 1, 2015
Hey Christian,
I’m not so sure about this. I know this has been getting tossed around online more and more. Something like “anterior pelvic tilt causes a lack of internal rotation range of motion.” Or having the TFL in a shortened position will limit internal rotation ROM. While there are times this happens, it’s not as universal as I’ve seen it stated.
For instance, in this post you can see a scenario where someone’s internal rotation is the same, regardless of how flexed or extended their hip is: http://b-reddy.org/2013/05/09/talking-about-hip-retroversion/
(I know you’ve seen that post before, but want to reference the link for others.)
However, with a particular type of Cam impingement, a more flexed hip can absolutely have limited internal rotation range of motion. Discuss here: http://b-reddy.org/2015/08/03/hip-mobility-issues-in-basketball-players-why-the-lack-of-internal-rotation/
Within the above though, I’m not sure a hip ever has less internal rotation range of motion as the hip moves progressively into extension. If anything, it’s usually more i.e. if a hip has limits into internal rotation range of motion, it will usually be in extension and flexion, or only flexion.
Not sure if I’m reading this correctly, but in a very deep squat, the person will have to open their knees to allow for the butt to sit all the way down. So, in a very deep squat, you may see the knees turn in, but it will be at some point during the squat, not at end range. This goes with the timing element I mention in the post. There may very well not be anything to stiff or needing loosening up. There may simply be an issue of “your knees turn in at this moment of a squat, don’t do that.” Done.
-> It’s important to note here not ALL knee caving in needs to be changed. I’ve seen many, many world class olympic weightlifters have their knees turn in slightly during the front squat of the lifts. I think what happens here is the glutes (and likely adductor magnus) get a little stretch reflex action -internal rotation before external rotation- helping them propel the body upwards. Hard to argue these athletes need to be changing anything. (Although if their knees are hurting them, and the action is excessive, it may need to be changed to some degree.)
I wouldn’t say “hip abductors.” That’s too vague. e.g. The TFL is clearly not turned off. I’d lean more towards external rotators.
This depends. If we’re going to say a person who is having issues with their knees caving in should then be training their legs to externally rotate / abduct i.e. not let their knees cave in, then sure. If we’re saying a ton of abduction exercises should be done, things like monster band walks, placing a band around the knees and opening and closing them, then I don’t think that’s necessary. If a person has a really stiff TFL, then it could be hampering progress as well. That said, it’s very rare I completely avoid specific abduction exercises. But if a TFL is being stubborn, I may.
Jason.p.clement@gmail.com
October 27, 2015
I really enjoyed reading this. Its pretty technical material. The one thing that did stick out at me is the “adductor longus as an external rotater.” I had to review my NASM CES material and also check wikipedia to make sure I wasn’t mis-remembering stuff. They both list this as an internal rotator – although when I look at the insertion and origin, and your argument above. EXRX seems to agree with you…. I can’t help wanting to agree. I’m curoius how these are decided. It seems in a closed chain it could do things that are perceived as internal rotation, especially in flexion. However in an open chain it looks like an external rotator. I’d love to hear a little more on this for some potential clarity.
reddyb
October 29, 2015
Good questions!
One school of thought with the adductor longus is it’s both an external and internal rotator.
Say you’re leg is in extension and you’re about to swing it forward = hip flexor and external rotator.
Say you’re leg is in flexion, maybe a bit externally rotated, and you’re about to swing it backward = potential internal rotator.
One paper discussing this to some degree: http://www.ncbi.nlm.nih.gov/pubmed/17118893
I discuss how anatomy can have dual functions like this in this post: http://b-reddy.org/2013/11/20/rethinking-how-and-why-youre-training-your-glutes/ )
As that paper alludes to, and what I agree with, I think the case for internal rotator is tough, while the case for external rotator is, albeit with some thought, fairly clear.
I’ve seen two primary ways this is all figured out: EMG analysis and then simply looking at the muscles, perhaps making some models, and deducing from there.
In college I had a professor who liked to give his own profession a hard time. One day we were setting up an EMG study, and it was becoming obvious to the class that doing this -getting the electrodes prepared, shaving the subjects, putting the gel on the subjects, getting hardware in the proper musculature, dealing with sweat from whatever exercise was being done, making sure the electrodes were staying on, insuring the software was reading things properly- was an *arduous* process.
At one point the professor, with his heavy British accent, and lovely sarcasm, goes “Hopefully we can all see how reliable EMG studies are!”
I’ve always taken them with a grain of salt since then. Granted, I haven’t been in a lab in 8 years now, but I don’t conceive of a way this has been made any better. (Pictures, cadavers, and models (like the one I constructed for this post), have always resonated more for me.)
This is more reason anatomy needs to not be obsessed over. Movement is what should be obsessed over. Our anatomy isn’t as clear as it’s often taught.
Hope that helped.
Alexander Viglakis
May 12, 2016
I have noticed with all my clients to this point that cueing an upright posture on the way up from bottom of the squat is the only way to keep the knees from caving. This makes sense, shifting the load the posterior muscles forces internal rotation through the adductor Magnus. It makes sense for the body to cave the knees because we are telling it to contract the muscles whos line of pull orients that way. Just a little tip, watch a video of someone whos’s knees cave, or even an olympic lifter. Coming up from the hole the knees will collapse while the femurs are at 90 degrees. This is the point at which the hips are furthest from the center of gravity and the demand from the posterior muscles is greatest. If you watch knee angle in correlation with torso angle they are generally moving with each other 1:1.
reddyb
May 17, 2016
I’ve long thought about the propensity for olympic weightlifters knees to turn in during the ascent of their squats. While I get what you’re saying, I think what’s likely going on is, as you allude to, you want to get those big muscles -glutes (specifically maximus)- to really kick in. One way to help them do this is to get a stretch reflex action.
Ala, glutes pull / turn the knee out (especially after 90 degrees of hip flexion), so by having the knees turn in some, the glutes get a nice stretch reflex to help them finish the squat ascent. (Collapse of the knees is probably too strong a term for this.) You see this in many sprinters when coming out of the blocks too. While the adductor magnus is thick, it’s not the glutes.
Can’t say I agree or have seen the only way to prevent the knees from caving in in a squat is to cue an upright posture. Simply telling people “Don’t let your knees turn in” is sufficient. (A mirror or some feedback can be helpful.)
Alexander Viglakis
May 18, 2016
That’s an interesting theory, I hadn’t thought about the stretch reflex’s role in the action.
Here are some things I have observed that may shed light on the issue.
Olympic Lifters are trained to shift the load back onto their quads above parallell, likely due to a front squat (rack position) becoming limited by torso angle when the lift becomes too posteriorly dominant. So in a way it’s better to be slow and upright. The more pronounced knee in/out is with lifters executing this well.
I see many videos of olympic lifters doing a high bar squat that do not shove the hips through and reobtain an upright posture in the top half of the lift, on these videos the knees tend to stay tracking on the inside.
Heavy raw powerlifting squats tend look the same way IF the lifter descends upright and is forced to shift torso forward to complete the lift.
Lifters the descend with a forward inclined torso who then stay forward inclined tend to not track in, unless the weight pitches them even further forward.
Because a close/medium stance deep squat leaves you more upright than is possible at 90 degrees and squatting to this depth tends to exaggerate the knee in/out action it makes me wonder if there is something inherent about shifting from upright to a forward inclined torse angle that works at the knee position.
I have a fulltime business and have made a study of this issue with clients, i’m not being indignant at all by the way and I always try to keep learning. For my clients I was able to fix knee tracking issues using the cue to try to stay upright, for many, myself included, focusing on knee in/out only helped during submaximal efforts. My clients who tend to not have this issue are clients who are better able to maintain an upright posture anyhow, whether it be femur length or strong quads. Time and time again however, whenever the weight gets heavy enough to pitch them forward, the knees will begin to track in, it’s lined up with the forward torso tilt and they come back out exactly in time with the forward knee shift/upright posture in the top half of the lift.
One more note, i’ve captured on video previously that my clients whom were able to fix knee position with just knee out cues, or by using a band around the knees, they actually pitched forward less during these squats also.
I could do some coaches eye video analysis if you want.
I love your site and value your opinion, I’m not an internet warrior by any means at all. If anything is being presented as emitional or “hot” it’s not. I am happy to be able to engage in an informative discussion.
reddyb
May 20, 2016
Hey Alexander,
Didn’t sound emotional at all :).
-I was referring to just a typical ol squat movement pattern. When things get to be very heavy, a different cue may very well work better. That makes sense.
-I think you hit on an important point in the first comment which ties in with this one. When something gets heavy, someone may end up leaning forward more than they otherwise would. One reason for this could be to help get the posterior chain more involved. You get some more hip action this way.
Said another way, it’s another variation of helping get more of a stretch reflex. By leaning forward some more the hips get more flexed temporarily -and knees may come in too- which help the glutes get that bounce effect.
-The idea of someone having relatively weak quads so they rely on leaning forward rather than being upright to complete the lift certainly makes sense here too.
-I’ve found the band around the knees to work well too.
-This is one of those things where performance may not relate well to health. While you likely don’t want to mess with an olympic level caliber lifter knee’s coming in some -would they lift less weight if the knees didn’t come in?- for every day people it’s probably not worth the risk / possible knee pain of letting the knees come in. But in general, when performance is the priority, some turning in action is likely preferable. You can see NBA guys have this happen a decent amount when jumping. If they’re jumping for max height it could very well be preferable. But if you want them to have longterm knee health??
-Would be happy to see some videos. Out of curiosity, where are you located?
Some good points. Thanks for bringing them up. Haven’t thought about some of this stuff in a while!
Alexander Viglakis
May 22, 2016
Hey I totally spaced on the videos, I will put sticky notes up this week. I run a personal training studio out of Billings, MT as well as advising & a programming software(sort of) for barbell based small group focused studios.
reddyb
May 24, 2016
Very cool! Thanks for letting me know. I like to have an idea of where some other trainers are located in case I’m asked. Will keep it in mind if anyone in that area asks if I know someone.
Jason.p.clement@gmail.com
July 6, 2016
Hey Brian,
I have read a few studies (or rather summaries of studies) that suggest side lying hip abduction with a slight internal rotation is better at activating gmed over tfl. You may have written about this somewhere but it didn’t jump out at me.
This is confusing to me, because I’d expect an externally rotated side lying abduction movement to reduce TFL activity – since the TFL of course is an internal rotator. I’m wondering if you might be able to explain what’s going on here?
Jason.p.clement@gmail.com
July 6, 2016
I actually just found this –
“From our experiences and informal querying at professional meetings, we have learned that many clinicians have patients perform the ABD exercise with the hip externally rotated and the toes pointed toward the ceiling (ABD-ER) (Figure 3). The theoretical rationale is that introducing hip external rotation will engage the GMax and also minimize the activity of the TFL because it is an internal rotator. This theory has little anatomical basis because the external rotator muscles are not acting against gravity in this position. Furthermore, because the hip is externally rotated, the anterior hip flexors (AHF) are more in the line of action to resist gravity and therefore might be more active during the ABD-ER task. We did not find empirical evidence to support the clinical rationale for using the ABD-ER exercise, so further examination is necessary.”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418110/
reddyb
July 8, 2016
This is basically what I was going to reply with. If you externally rotate the hip and keep it there, then the TFL, acting as a hip flexor, is lined up to do the job. If you internally rotate some, and especially if you externally rotate *while* doing the movement, you’ll typically notice a person feels some more burning in the PGM.
One thing I try to do if targeting the PGM, is during side lying abduction, focus on trying to get some hip extension as well.
If also trying to stretch the TFL, I’ll elevate a person so they can get some more adduction on the way down. Example:
You’ll notice in that picture how the person’s hip is flexed some. It’s very common during abduction for the hip to flex. This is what I mean by having the intention of getting some extension. Many will be too stiff to get much, if any, though.
At the end of the day, side lying abduction is a form crucial exercise, one which has *much* more going on than most. Pelvis can move, knee can rotate, patella can translate laterally (tight IT band), foot may turn out, hip may flex, and all of this is common. I’m really not sure how many researchers are really looking at all this, and pretty much have never had someone I was assessing who didn’t immediately do this movement where they “Jane Fonda’d” it aka just threw their leg to the ceiling.
In my experience this exercise is often a nightmare to teach people. It’s one reason I tend to start with clamshells instead, where if I want the TFL calm, I simply have people place their hand on the TFL and say “Don’t let that muscle get hard.” (Then once I do get to abduction, I bend the leg, so people don’t think of it like a Jane Fonda exercise. It seems new and different, so they don’t make the same assumptions. Easier to start a new habit than break an old one into a new one.)
Jason
December 15, 2016
Love the post however I still would have to wonder how the TFL comes into play… seems to me the TFL would be on slack ( in the sagittal and frontal plane at least) as one moves into flexion during a squat. I usually see excessive knee valgus as a eccentric control issue of the external rotators. Thoughts?
reddyb
December 16, 2016
Hey Jason,
Glad you liked it.
The last few paragraphs are essentially saying eccentric control of the external rotators could be better in a knees-caving-in squat, yep.
The idea of the post is to take that mindset more than “We need to stretch X muscle group to help the knees from caving in.” That to work on eccentric control of the external rotators in a squat…work on eccentrically controlling external rotation during a squat.
I’m not sure what you mean by the slack comment. When muscles shorten, they effectively slacken.
Perhaps another way to look at it- the very starting stance of a squat exercise places the TFL -an abductor- into abduction. The feet are spread apart, right? So while the knees caving in during the eccentric of a squat may cause adduction *relative* to the starting stance, the femur is unlikely to go into absolute adduction- cross the midline of the body.
Therefore, if the knees cave the femur will in an absolute sense be in hip flexion, internal rotation, and most likely still some aBduction (perhaps neutral), which are all TFL hip actions (and the tibia will be externally rotated, something the TFL / IT band deal with too) => TFL in shortened position.
So if we did want to stretch a muscle to try and help with a knee-caving-in squat, if anything, it’d be the TFL, an abductor, not the adductors. That’s very unlikely to be enough though. (And the TFL may even be irrelevant. Might not be stiff at all, more the person has a bad habit.) Squat form needs to specifically be addressed, per above.
In those who have this issue squatting and are also suffering from knee pain one way or another, loosening up the TFL typically helps the knee feel better though. (Lessens likelihood of lateral glide of patella.)
Hope that’s clear.
Maja Moritz
October 25, 2017
Hi Brian,
I am a Yoga teacher and use a block between the thighs to make people aware of the different functions there inner thigh musles (adductors) can exercise – pushing inwards, external rotation and internal rotation. With the block between your thighs you can witness the effect of external and internal rotation of the inner thigh muscles and then apply this movement in other postures for more alignment. I was taught opposing view about the internal & external rotation of the inner thighs and would like to know what you think of this little exercise and how it can be utilized for different situations?
Thank you.
Maja
b-reddy
February 6, 2018
Hey Maja,
Sorry for the delay. I had a technical issue where I missed some comments.
With squatting, I never use a block between the legs. I know some do this 1) as a means to work the adductors by squeezing the knees together 2) as a means of preventing the knees from coming together.
In brief, I view it from a movement perspective. Movement wise, you rarely want a person bringing their knees closer together while squatting. Typically, we’re trying to avoid that.
Furthermore, I tend to prefer people make the effort avoid a motion, opposed to having an external object do it for them. (This is more exercise oriented. With activities of daily living, I’m much more amenable to an external object preventing motion.)
Lastly, I find an object between the thighs often brings the legs closer together than a person would normally squat with. That is, you need an awfully big block to get properly between a person’s comfortable squat stance. (This is certainly different in yoga, or the barre method. I’m referring more to conventional resistance training.)