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Fixing Knee Pain in the Split Squat | Week 78 | Movement Fix Monday

Happy 4th of July! First off, today is the LAST day to save 20% in our online store on TMF t-shirts and TMF bands using coupon code july4.

This week what I want to share with you is how I use a split squat, either on the ground or front foot elevated, as an assessment when someone has pain on the front of their knee.

There are two times when people typically complain of this pain or tightness on the front of the knee: when they're at the bottom of the split squat and it's painful in the front of the forward leg knee OR when they're in the bottom of the split squat and it's painful on the front of the BACK leg knee.

For when it is the front leg knee

I think doing standardize movement assessments can be valuable, but I also think we rely on them too much without looking at how someone is executing the actual lift or movement that causes them issues.

For example, if someone is having pain in their knee with lunging and I do a knee exam and the knee exam is normal, I HAVE to watch how they are doing a lunge. This step is actually skipped a lot, seeing how someone actually performs the lift that bugs them.

What I look for in the split squat in regards to the front leg is the shin angle.

I will have the person do a split squat with each leg forward and I look to see how the shin angle compares on their right side vs left side.

vertical-shin

Vertical shin angle

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Excessive shin angle

 

 

 

 

 

 

 

As you can see above in these two pictures, someone on one side may have a more vertical shin angle, but on the other side have an excessive shin angle. Or they could have an excessive shin angle on both sides. You never know until you watch.

What I want to do, though, is cue the athlete to keep a move vertical shin angle and see if that allows them to perform the movement without pain. If it does, well, the proof is in the pudding.

You can cue that by either just telling the person to not let their knee come forward or you can put a dowel rod in front of their foot and instruct them not to let their knee touch the dowel.

For when it is the back leg knee

I get surprised a lot (and maybe I shouldn't be surprised anymore) by someone saying, 'yeah I have knee pain during lunging', and I assume it's the front leg, but then they say 'oh no, its the back leg that hurts, when I am down at the bottom'.

What I have found is that we a lot of athletes push too hard with their back leg into the ground during the descent and ascent of the lunge or split squat.

I tell them to imagine a scale underneath their front foot and back foot and see what percentage of their pressure is in each foot.

I tell them to envision they are putting more weight and load into the front leg and lightening up weight on the back scale.

Then we re-evaluate their level of discomfort in the back leg knee with this. More times than not, it substantially reduced.

What is the %age of front to back leg you should try for? Personally, I attempt to drive only out of the front leg, so I'd guess I'm at 80 front / 20 back. I have many athletes tell me that they are pushing primarily from their back leg during the split squat and lunge. No one ever instructed them that it is a front legged exercise.

Sometimes the most simple things are overlooked because complicated seems fancy and we like fancy. Fancy isn't always better. Sometimes fancy is just fancy for no reason.

Clean up the simple things first before you worry about there being scar tissue in the quad you have to release when the answer is changing how the knee is loaded in this movement.

Thanks for reading and I hope you found this helpful!

-Ryan