Looking Beyond Knee Valgus (angled inwards): Understanding Where Movement Loses Control: Article by Alex Drummond B.Sc (Hon’s). MCSP. 

Watch a group of people perform a single-leg squat and you’ll almost certainly notice one movement that immediately attracts attention. As the body lowers towards the floor, the knee drifts inward. For many instructors and movement professionals, this instantly raises alarm bells. The familiar search for explanation quickly follows: weak glutes, poor hip stability, collapsed arches, tight calves or weak feet.

Perhaps…….. But perhaps not.

The real danger lies in arriving at an explanation before we have fully understood the movement. The moment we decide why the knee has moved, we often stop observing the movement itself. Our assessment becomes a search for evidence to support our first impression rather than an exploration of what the body is actually doing. 

Instead of asking, 

“Why is the knee collapsing?” 

perhaps we should begin with a different question.

“Where did the loss of control begin?”

That single question changes everything.

A Joint Built for Adaptation

The knee is often viewed as a joint that bends and straightens, yet its real purpose is far more important than producing movement alone.

Its role is to help the body manage changing loads while connecting two highly adaptable systems—the pelvis above and the foot and ankle complex below. Every step, squat and landing requires the knee to continually respond to information arriving from both directions as the body organises its movement strategy.

When we understand the knee as part of a larger movement system, we stop asking whether the knee is the problem and start asking what movement strategy the body is trying to achieve and where did the loss of control, if there is loss of control, begin.

The Knee Is Rarely the Beginning of the Story

The knee occupies an interesting position within the body. Unlike the hip, it contributes relatively little rotational control. Unlike the foot, it has no direct relationship with the ground. Instead, it sits between two highly adaptable systems that are constantly negotiating how the body accepts and transfers load.

Above the knee, the pelvis and trunk organise the position of the body’s centre of mass. Below the knee, the foot continuously adapts to the changing demands of the ground beneath it.

Every step we take represents a conversation between these regions.

The knee simply sits in the middle and is therefore a slave to what is above and what is below.

This is why the knee often becomes the place where movement strategies become visible rather than the place where they originate. It reflects the combined behaviour of everything happening above and below it.

In many respects, the knee is less the problem and more the messenger.

When viewed from this perspective, observing a valgus knee becomes less about identifying a faulty joint and more about understanding the movement strategy the nervous system has selected to complete the task.

Every Movement Has a Beginning

One of the greatest skills a movement professional can develop is learning to observe movement as a sequence rather than as a collection of isolated positions.

By the time the knee has visibly moved inward, something has almost certainly happened beforehand.

Perhaps the foot gradually lost its ability to manage load, allowing pronation to increase and the tibia to rotate internally.

Perhaps the pelvis drifted laterally as the body struggled to control the centre of mass.

Perhaps the trunk altered its position to maintain balance.

Or perhaps several of these events occurred together.

The important point is that movement rarely begins at the knee itself. The visible knee valgus often represents the final expression of a movement strategy that started somewhere else entirely. Our role is not simply to observe where the movement finishes. Our role is to know and understand where it began.

Stop Looking for Weakness

For many years, movement education has encouraged us to search for weak muscles.

Weak gluteals.

Weak vastus medialis.

Weak intrinsic foot muscles.

Weak hip abductors.

Although strength clearly plays an important role in movement, clinical practice repeatedly reminds us that strength alone rarely explains movement quality. Many individuals demonstrating excellent strength still lose control when challenged by balance, speed, fatigue or complex movement tasks.

Conversely, many individuals with relatively modest strength demonstrate exceptional movement control.

This suggests that movement quality is governed by something much broader than force production alone. Successful movement depends upon timing, neural coordination, sensory information, adaptability, force regulation and the ability of multiple body regions to work together under changing conditions. Strength contributes to that system, but it is not the system itself.

Perhaps we should spend less time asking whether a muscle is weak, and more time asking whether the movement strategy is effective.

Distal or Proximal? Perhaps the Question Is Wrong

A common debate within rehabilitation asks whether dynamic knee valgus originates from the foot or the hip. The body rarely thinks in such simple terms.

The foot does not operate independently of the pelvis, nor does the pelvis ignore information arriving from the ground. Every region constantly influences every other region.

An unstable foot changes the demands placed upon the hip.

A poorly controlled pelvis changes how the foot accepts load.

The nervous system continuously reorganises these relationships in order to achieve the task in front of it. Rather than asking whether the problem is distal or proximal, perhaps we should ask a different question.

Which region appears to have become the greatest influence on this individual’s movement strategy?

That question encourages observation rather than assumption.

It shifts our attention away from anatomical labels and towards movement behaviour.

In Summary: Become a Movement Detective

Good assessment is rarely about proving that our first theory was correct.

Instead, it is a process of gradually removing uncertainty.

  • Every observation generates a hypothesis.
  • Every intervention becomes an experiment.
  • Every reassessment provides another clue.

If altering foot position immediately changes knee behaviour, we have learned something. If improving pelvic control produces an immediate change, we have learned something else. If neither intervention alters the movement, our investigation simply continues.

Assessment and outcomes for change therefore become part of the same continuous process.

Become Curious and Change your Approach.

The body tells us whether we are moving closer to understanding the problem.

  • Observe.
  • Hypothesise.
  • Intervene.
  • Retest.
  • Refine.

Change the Movement, Not the Knee

It is tempting to believe that rehabilitation is about correcting joint movement.

In reality, we are rarely correcting joints at all.

We are helping the nervous system discover more efficient solutions for managing load.

  • Sometimes that begins at the foot.
  • Sometimes at the pelvis.
  • Sometimes through improving trunk control.
  • Sometimes by changing nothing more than the individual’s confidence in the movement they are performing.

The specific intervention matters less than the principle behind it. We are not attempting to force the knee into a particular position. We are expanding the body’s available movement options so that the knee no longer needs to compensate in the same way. When movement options improve, movement quality often follows.

A Different Way of Looking at Knee Valgus

Perhaps the greatest lesson dynamic knee valgus can teach us is not about the knee itself. It reminds us that the body behaves as an integrated system rather than a collection of independent joints and muscles.

The next time you observe a knee drifting inward during movement, resist the temptation to immediately decide what needs strengthening or correcting.

Instead, become curious.

Watch the movement unfold.

Ask where the story began.

Because the place where the body reveals its loss of control is not always the place where that loss of control first occurred.

And perhaps that shift in thinking is the beginning of better movement reasoning.