Hip Strength Again: Correcting Knee Valgus

by Mary on November 13, 2017

Recently my patellofemoral pain flared up and I sought the help of Emily, a PT with a dance background who specializes in rehabbing dancers, gymnasts, and the like. She’s moving in a month so our time together will be brief.

I shared some video with her of my skating and she immediately spotted this especially egregious moment where my knee is in a knocked-in or ‘valgus’ position.


Despite my previous efforts at rehab I still get into this valgus position quite often. I can’t expect my knees to feel good when I’m doing this to them. It happens particularly with single-leg activities, and of course skating is virtually all that.

I’ve worked to resolve this problem several times. The most recent time before this was the ill-fated knee PT that caused my back injury. The problems likely go in the other direction, too. The assistant to my previous PT thought that spinal nerve issues might be making it harder for me to build up the necessary hip muscle strength to resolve my knee problems. I certainly have done plenty of clamshell exercises in my life.

The larger issue underlying it all is my hypermobility, and I’ll have more to tell you about that soon. Meanwhile, back to those clamshells and other exercises. Here’s my current worksheet:

hip strength exercise worksheet

I do a much easier modified version of the first exercise. Bending plus twisting is not my friend, in fact a freestanding version of this first exercise is how I blew out my back last year.

The squats, even though they are supported, are problematic for my knees, doubtless I need to work harder on form. I’m jealous of all the folks I see squatting around the gym with weights.

For the side-stepping I don’t use a band. I use the banana sling that I bought from QTEK to use it on my own with cable machines, like so:

The side-lying ball press mentioned is a way to exercise my hips similar to a squat. But it’s very controlled, so not irritating to my knees, and it’s single leg so I can make sure the left side gets worked as much as the right.

{ 6 comments… read them below or add one }

Jo November 14, 2017 at 2:31 am

Mary, you and I definitely share some issues as far as knees are concerned! I have been doing different exercises targeting the adductor muscles (inner thigh) and it seems to help this issue as well as my overall alignment. Thanks for the videos–those look like great alternatives to squats.
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Mary November 15, 2017 at 1:50 am

Thanks for the tip. Strengthening the adductors would be a good idea for skaters since we use the outside of the legs so much. I hear ballet dancers are the opposite and tend to overwork the insides of their legs.

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Eva at Eva Bakes November 14, 2017 at 1:23 pm

I’ve done those side stepping exercises except the band was placed on my shins. I had to build up hip strength after I tore my meniscus so I totally understand what you’re going through here. I hope you get some great PT time with Emily before she moves!
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Mary November 15, 2017 at 1:57 am

I’ve done it that way too. I have to work really hard to keep my knees facing straight when I do it that way. It’s very counterproductive to let them turn in!

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Melissa November 18, 2017 at 2:04 am

Mary, I’m glad you’ve got some good exercises to work on for the knee pain. Interesting to see the side steps with the band at the thighs. I will have to try that. And the ball exercise looks good to try, too. Hope you can make the knee pain stay away!

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Mary November 19, 2017 at 10:15 pm

If you try the band one make sure your knees are facing forward as you step sideways, otherwise it will make them worse. Thanks! I haven’t been on the ice much this past week, that in itself helps.

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