KNEE VALGUS AND THE GOLF SWING, A PRECURSOR TO INJURY?
Bob Forman
Certified Golf Fitness Instructor
Director, The Golf Fitness Academy at High Point Regional
Knee valgus, knock kneed, is a condition that exists when the knees are not aligned properly. It’s characterized by an inward turning of the knee(s) and is more prevalent in women than men. In extreme cases, the knees will actually touch each other.
The Q-angle (quadriceps angle) is usually used to identify knee valgus and is formed between the quadriceps muscle, in the front part of your thigh, and the patellar tendon. Women tend to have wider Q-angles due to the fact that their hips are a bit wider. A larger Q-angle is often associated with knee valgus.
It’s believed that knee valgus puts much more stress on the ACL (anterior cruciate ligament) and is responsible for a greater incidence of ACL tears. This misaligned stance can also apply added stress to both the inner and outer part of the knees and increase injury potential to those respective tissues and structures. The lateral movement characteristics of the golf swing, whereby the golfer is loading up on the trail leg during the backswing and then shifting the weight to the target leg during the downswing and follow-through, would appear to increase this potential.
Along with the knock kneed stance, knee valgus also promotes internal rotation of the femur (thigh bone). This malalignment could promote a shortening of the muscles responsible for internally rotating the hip while elongating and weakening the muscles that externally rotate it.
For a golfer, knee valgus is a condition that may hamper the golf swing and detract from swing efficiency. Try swinging a golf club with your knees bent slightly toward each other. You’ll quickly feel the stress applied to both the knees and the hip as you go through the motion.
Tightening of the internal hip rotators is counter productive to an effective golf swing. Most often, this limits the range of motion in the hips and can lead to a shortened backswing, straightening of the trail leg, a greater need for rotation in the lower back, limited hip turn at impact or a combination of two or more of these swing faults.
A simple assessment to determine whether or not you have knee valgus is to stand facing a full-length mirror and lift the left knee up until the thigh is parallel to the floor. Slowly do a half squat with the right leg and watch to see what happens to the leg. If the right knee and leg rotates inward, as pictured in the positive assessment below, while performing the half squat, chances are you have right knee valgus. Check the left side while performing a half squat with the left leg.
Negative Assessment Positive Assessment
Correcting knee valgus requires that you stretch the tightness and strengthen the weakness. Begin by working on flexibility of the internal hip rotators. Exercises like the knee drop, dishrag, and reverse clam will help in that regard.
You’ll also need to strengthen the external hip rotators and abductors. That includes exercises like the bridge, bridge with extension, lateral leg lifts, and side planks.
For those who have knee valgus and are flat-footed and/or rolled in ankles, the stress to the medial or inner knee could be compounded. Swinging a golf club with this combination would more than likely impede the golf swing and increase the likelihood of injury.
Female golfers could, perhaps, be more at risk for lower body injury due to a higher prevalence of knee valgus in women. A Sports Medicine physician would be able to evaluate and help remedy if you suspect you have this condition. Exercises to correct the imbalances could prevent and/or alleviate the condition and the accompanying potential for injury.
