Dynamic Valgus a Common Enemy
The term “valgus” is one where a distant point in the body moves away from the midline. When referring to the knee joint, valgus means that the knee itself heads toward the midline, compared to the foot, which heads away from the midline of the body. This is commonly referred to as a knock kneed posture. Dynamic valgus is when this type of alignment occurs during walking, running or other sporting activities. Dynamic valgus is an important culprit in the genesis of knee and hip pain. It is also an important factor for anterior cruciate ligament tears. It is this posture that the knee is forced into that ultimately tears the ACL.
Clinicians can evaluate their patients to see if they manifest dynamic valgus. Simply doing a one legged squat will demonstrate whether the individual has a tendency to adopt this posture. People with flatfeet, generalized ligament laxity and weak hip abductors often demonstrate dynamic valgus.
There is an epidemic of dynamic valgus in adolescent age girls, particularly the tall, long and lean variety. These are the exact same young women that are at risk for tearing the anterior cruciate ligament of the knee. A moment of dynamic valgus coupled with knee rotation actually tears the anterior cruciate ligament in the vast majority of cases.
Dynamic valgus can be prevented and there is evidence in the research literature which indicates that so-called neuromuscular training can decrease dynamic valgus and decrease the incidents of ACL tears. An excellent website known as the FIFA 11 is designed with soccer players in mind but can be integrated into all court-based athletes who have to pivot and stop and start in a rapid fashion.
The hip abductor muscles, particularly the gluteus medius, are important in minimizing dynamic valgus. Weakness in these muscles is a common risk factor for patellofemoral pain, ACL tears and hip impingement syndromes. Becoming aware of dynamic valgus, the means to prevent it, as well as the importance of pre-season neuromuscular training can help prevent many problems with the lower extremity of athletes. Visit the FIFA 11 website for some excellent videos.