loading

Dynamic knee valgus (DKV) as an incorrect movement pattern, that is recognized as a risk factor for lower limb injuries. Dynamic knee valgus (DKV) has been described as a combination of hip adduction, hip medial rotation, knee abduction, and knee lateral rotation. DKV or its components have been identified as movement impairment risk factors for the development of a variety of musculoskeletal pain problems.

DKV, however, also is thought to be a potential contributing factor to insidious or chronic knee pain conditions such as patellofemoral pain (PFP). Given dynamic knee valgus demonstrated during some tasks like single-limb squat, running, or vertical drop jump, is considered a risk factor for an acute injury, such as an anterior cruciate ligament tear, that occurs during sport activity.

CAUSES:

This is typically the result of strong hip adductor muscles (located on the inner thigh) overpowering the weak hip abductors (gluteus minimus and gluteus medius). Existing exercise programs to reduce knee valgus are mainly based on a large number of exercises at various stages (warm-up, plyometrics, strength), visual biofeedback exercises (for example, monitor or mirror), and balance training. The cause of excessive knee valgus can be a combination of the muscular imbalance between hip abductors and adductors, external and internal rotators, and foot pronators and supinators. It’s assumed that players with observed DKV may have a muscular imbalance predisposing to hip adduction, external tibia rotation and foot pronation in single-leg movement tasks.

PREVENTION AND TREATMENT:

Has been hypothesized that muscles responsible for moving in the opposite direction to those predisposing to DKV should be strengthened to compensate for the knee’s axial alignment. Therefore, injury prevention programs should include exercises to increase the activity of hip abductors. Gluteus medius is the strongest hip abductor is most often described in the context of DKV. Side-lying hip abduction exercise is classified as high-level activation of the gluteus medius. Some authors recommend interventions to improve knee valgus using ankle exercises such as the tibialis posterior. This muscle performs the functions of foot adductor, invertor, and plantar-flexor. Selective and effective activation is achieved by resisted foot adduction. The popliteus muscle as an internal rotator of the shin during the knee acts as a dynamic stabilizer to control subtle movements in frontal plane, supporting balance in single leg tasks. Due to the function and anatomy of this muscle, Nyland et al., 2008 proposed non-bearing exercise to improve activation of popliteus and effect on lower extremity injury preventions, also by reducing knee valgus and increasing knee stabilization (1).

Apart from this, Adjustable Orthotic Insoles is another popular treatment for this condition. It is adaptable pad support that kicks the foot arch as you move. According to some studies, this treatment delivers up to 89% greater arch support. Hence, it is ideal to allow continual misalignment correction. On the contrary, if your condition is severe, your doctor may recommend a more drastic treatment, e.g., knee replacement surgery. This treatment is generally common in people aged 50 years and above. A surgical procedure can amend knock-knee deformity or osteoarthritis that has affected your knee joint. However, the doctor may recommend osteotomy surgery in younger patients that involves cutting the thigh bone to realign the knee and improve the positioning (2).

Resources:

  1. Nyland J, Lachman N, Kocabey Y, Brosky J, Altun R, Caborn D. Anatomy, function, and rehabilitation of the popliteus musculotendinous complex. J Orthop Sports Phys Ther. 2005 Mar;35(3):165-79.
  2. George, M. J. , 2019, ‘Valgus Deformity Correction in Total Knee Replacement: An Overview’, in J. B. S. Nogueira et al. (eds.), Knee Surgery – Reconstruction and Replacement, IntechOpen, London. 10.5772/intechopen.89739.

Write a Reply or Comment

Your email address will not be published. Required fields are marked *