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I noticed a few weeks ago that my right foot, when I stand relaxed and normal, rotates outward about 30 degrees. When I do squats, I start with both feet slightly rotated outward, but my right foot likes to keep sneaking out further. When I stand in front of a mirror with both feet pointing straight forward, I notice that my right knee rotates inward slightly. I'm not quite sure what the problem is and how to fix it. Any ideas? I'd be happy to post more information if needed, just let me know.
Weak adductors? particular on the side that rotates.
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More likely either tight external rotators (in the hip) or a congenital thing called femoral torsion (which is normal to some degree). Since it seems to be one sided, I'd vote more for tight external rotators. Do you stretch?
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Hi, thanks for the replies thus far...I do a lot of the dynamic warmup and flexibility exercises from Magnificent Mobility. I do some static stretching at the end of workouts, but not all that much. What kind of stretches should I be doing and how much?
Intersting topic... I've got the same thing going on with my right leg. It's been like this for a couple years now. UI've pinointed that it starts at the hip, but I haven't done any research into it. At times, I've even wondered if my right leg is longer than the left, although I doubt that's the case.
I noticed the same thing about three years ago. Then I got rid of my car and it went away. Then I got a car again and outward creep of the right foot came back. I think it's from driving -- the way I position my right foot on the gas pedal. The more driving I do, the more I notice it. The stretches detailed above seem to have helped. That and being more aware of it.
Very common problem. You probably have either or both a tight / weak Piriformis muscles or a loose SI (Sacroilliac Joint). The stretches that UConnJulie suggest will help. Certain quadricep exercises will help you gain hip stability. Another abduction rotator exercise is lean yourself against a wall standing straight up, chest up, with your feet pointed forwards. Now take your right foot and angle it the left. That’s your starting exercise position. Rotate your thigh to the center line between both feet. That’s one repetition.
More likely either tight external rotators (in the hip) or a congenital thing called femoral torsion (which is normal to some degree). Since it seems to be one sided, I'd vote more for tight external rotators. Do you stretch?
If his femur is internally rotated when standing with feet pointed straight, why would you think tight hip external rotator, as opposed to tight hip internal rotator?
I'm not a health care professional, just a guy trying to understand this stuff so I can better rehab my own injuries.
If his femur is internally rotated when standing with feet pointed straight, why would you think tight hip external rotator, as opposed to tight hip internal rotator?
It's because the knee turning in is a result of the body compensating for external rotation of the femur, in an attempt to maintain a straight foot. Femur turns out, which would cause the foot to turn out along with it, but brain wants foot straight so the knee gets rotated inward to compensate.
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Mike Pipes
Massive fat loss survivor and aspiring trainer in training
Great topic. I have the same condition. I sit on my butt at work and drive an hour each way for work. Seems like a common problem so I'd like to pile on to this thread
I also have ITB pain and some psoas pain on the right side. It seems like this would all be related. Is that a correct assumption?
How does the knee point in by itself? Shouldn't it follow the femur and point out?
The knee cap floats in place and while it should follow the femoral groove, muscle imbalances and other factors such as pronated feet can cause it to go off track.
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Mike Pipes
Massive fat loss survivor and aspiring trainer in training
If the femur rotates out, would that cause pain in the psoas? It seems like it would cause extra tension.
I have some psoas pain recently and I'm wondering what's the best course to fix it. I sit all of the time so I'm not sure strengthening it would help since it's short from sitting and this would make the problem worse.
I stretch pretty frequently, but not so much the outside hip muscles. Does it make sense that this would help?
If the femur rotates out, would that cause pain in the psoas? It seems like it would cause extra tension.
I have some psoas pain recently and I'm wondering what's the best course to fix it. I sit all of the time so I'm not sure strengthening it would help since it's short from sitting and this would make the problem worse.
I stretch pretty frequently, but not so much the outside hip muscles. Does it make sense that this would help?
If the femur is rotating outward that would indicate an imbalance with the posterior chain overpowering the psoas, which could place strain on the psoas. It's kind of odd that someone who sits all day would have externally rotated hips because they tend to get stretched while sitting, but if you're not stretching the hips after training that could lead to the issue.
Stretching, foam rolling and massaging *everything*, not just "one side" or the other, is required to relieve the tension that's causing pain.
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Mike Pipes
Massive fat loss survivor and aspiring trainer in training
If the femur is rotating outward that would indicate an imbalance with the posterior chain overpowering the psoas, which could place strain on the psoas. It's kind of odd that someone who sits all day would have externally rotated hips because they tend to get stretched while sitting, but if you're not stretching the hips after training that could lead to the issue.
Actions.—The Psoas major, acting from above, flexes the thigh upon the pelvis, being assisted by the Iliacus; acting from below, with the femur fixed, it bends the lumbar portion of the vertebral column forward and to its own side, and then, in conjunction with the Iliacus, tilts the pelvis forward. When the muscles of both sides are acting from below, they serve to maintain the erect posture by supporting the vertebral column and pelvis upon the femora, or in continued action bend the trunk and pelvis forward, as in raising the trunk from the recumbent posture.
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The Psoas minor is a tensor of the iliac fascia.
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It does not do much rotation ... anatomically it appears as if it should do external rotation, but that movement is not it's primary function.
Agreed.
Neither mpipes or I meant to suggest that rotation was the psoas' primary function. I was just reacting to mpipes post that seemed to imply that the psoas was a minor internal rotator, whereas I was under the impression that it was a minor external rotator.
Well, to agree with Mike, I remember from anatomy class way back when that it is a minor internal rotator. But when I went searching last night, what I found stated it was a minor external rotator.
I remember because in cadaver class I fought with our professor. Looking at the anatomical landmarks and the orientation of the muscle, I couldn't possibly understand how it could IR the femur. But I memorized it for testing purposes.
I'll have to dig through my copy of Grays (what I quoted above came from an online version) and my old anatomy notes - if I can find them. They might have been lost in a purge.
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Well, to agree with Mike, I remember from anatomy class way back when that it is a minor internal rotator. But when I went searching last night, what I found stated it was a minor external rotator.
I remember because in cadaver class I fought with our professor. Looking at the anatomical landmarks and the orientation of the muscle, I couldn't possibly understand how it could IR the femur. But I memorized it for testing purposes.
I'll have to dig through my copy of Grays (what I quoted above came from an online version) and my old anatomy notes - if I can find them. They might have been lost in a purge.
Since it's a minor rotator, I suppose it's not going to have earth shattering implications either way.
That stretch you suggested in the 5th post in this thread - what is that stretching - the glute medius?
I find that if I lay on my side and bend my top log such that my foot is on the ground (either in front or in back of my bottom leg), and then internally rotate the bottom leg, I can only take my foot from 0* (laying flat on the floor, toes pointed to side) to 45*, but not 90* (toes pointed up). This is done by rotating the leg, but not the ankle. I was told that ideally, one should be able to rotate the foot to 90*. I suppose this would confirm that I have tight external rotators?
Generally those stretches are for piriformis ... but in reality they stretch many things, depending upon what is tight/short. They are not specifically a glute medius stretch, which is best tackled with some degree of hip adduction.
I'm not sure exactly what position you are in from your description.
Usually we measure hip IR in two positions ... sitting, and prone. This gets the hips in two different positions of flexion and can reveal different information.
In prone, generally around 45 degrees is considered "normal".
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The issue isn't so much rotation caused by the psoas, it's because a shortened psoas tilts the pelvis forward, and because of the shape of the hip socket and anatomy/ligaments in the area, the femurs rotate internally. Conversely, externally rotated femurs may indicate a posterior pelvic tilt, but in this case the psoas can be tight yet not shortened. That means it's inactive while being stretched which makes it succeptible to strain or injury.
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Mike Pipes
Massive fat loss survivor and aspiring trainer in training
The issue isn't so much rotation caused by the psoas, it's because a shortened psoas tilts the pelvis forward, and because of the shape of the hip socket and anatomy/ligaments in the area, the femurs rotate internally. Conversely, externally rotated femurs may indicate a posterior pelvic tilt, but in this case the psoas can be tight yet not shortened. That means it's inactive while being stretched which makes it succeptible to strain or injury.
OK, so I can understand this as it relates to me, and I imagine to lots of people as my situation is common - when I stand with feet pointed straight, my knees point inward. I also have APT, so we know my psoas is short/tight. So are my femurs rotated internally or externally?
OK, so I can understand this as it relates to me, and I imagine to lots of people as my situation is common - when I stand with feet pointed straight, my knees point inward. I also have APT, so we know my psoas is short/tight. So are my femurs rotated internally or externally?
If you have ATP and your knees are pointing inward, it sounds like your feet/ankles are more of an issue than your femurs.
Typically with ATP the femurs will rotate internally and the knees will track to the outside.
Since you have ATP you probably do have some degree of internal rotation, but more importantly, your ankles are pronating, ie: leaning to the inside, which is what's causing the knees to turn inward like that, despite the ATP.
Do you have fallen arches? Recurring ankle, knee or hip problems? Severe shinsplints?
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Mike Pipes
Massive fat loss survivor and aspiring trainer in training
If you have ATP and your knees are pointing inward, it sounds like your feet/ankles are more of an issue than your femurs.
Typically with ATP the femurs will rotate internally and the knees will track to the outside.
Since you have ATP you probably do have some degree of internal rotation, but more importantly, your ankles are pronating, ie: leaning to the inside, which is what's causing the knees to turn inward like that, despite the ATP.
Do you have fallen arches? Recurring ankle, knee or hip problems? Severe shinsplints?
Just to be clear, my knees point inward when my feet are pointed straight ahead. So you're suggesting that the issues with my feet are overriding the APT.
I think I have this too. My foot is rotated externally, specially if I flex the hip to 90 degrees and flex the knee to 90 degrees also. The foot is pointing outward, but the knee is pointing straight ahead, aswell as the tibia tuberosity, so I'm guessing it's not the lower leg, but the foot itself that is actually rotated.
If I sit with my leg straight out in front of me and then start flexing the hip as I flex the knee, I can actually see the foot rotate externally..
good thread...i am glad some attention turned to the feet and ankles...along with juile's stretches for the piriformis ect..i would definitely be stretching my calf complex. it will really help.
It's because the knee turning in is a result of the body compensating for external rotation of the femur, in an attempt to maintain a straight foot. Femur turns out, which would cause the foot to turn out along with it, but brain wants foot straight so the knee gets rotated inward to compensate.
Hi, I ride horses competitively. Although one would think "duck feet" would be advantageous, it's not at all because it puts the back of the calf and heel on the horse. In English riding/jumping, the toe should only point out a maximum of 45 degrees, ideally less. One really wants even contact with the thigh on down to the bottom of the calf.
I have extreme turnout. It is very easy for me to turn my feet out at 180 degrees. My knees turn in. I remember from a doctor from when I was a kid that he said my hips turned out.
Unfortunately with riding, simply turning your toes in doesn't work as it tends to turn the knee in. This causes the knee to pinch and especially cantering and jumping one loses contact with the calf.
Am I just doomed to be an average rider because of my own conformation or can I improve my "angles," as we say.
Here's an more ideal position. (Note this is an Olympic Level rider ...)
In this picture my foot is out the max it should be. But you can see my ankle has twisted and there is too much of the back of my calf on the horse.
This is how is should be (note this is a former Olympic medalist). You can see how her toe is in line with her knee and the side of her calf, not the back is on the horse's side so her heel/spur only comes into contact with the horse when she wants to use it.
Here's a more extreme example. My leg is worse because I'm standing in the stirrups more. The shorter the stirrups or the more I "stand"/get out of the saddle, the more severe the problem:
Obviously I'm fighting conformational faults I was born with, but can anyone explain WHY my body does this. And why I have so much trouble compensating?
If I roll my foot so my weight is more on the outside of my foot, turn my toe in, and I ride like that for any length of time, the soft tissue down the outside of my calf gets very, very sore (whether it is tendon, ligaments, muscle or all 3). Also this take my leg off the horse by making me too bowlegged.
So if there's away to teach my body to turn my toe in, but not go bowlegged that would be ideal.
Julie - I went to UCONN, too. I'm from Old Lyme. I graduated in 1994 with an English major!
I was so glad to be shown these stretches by a therapist 10yrs or so ago. I was suffering from Sciatica and back surgery was recommended. A substitute therapist that had experience with collegiate sprinters immediately found the cause of my pain. A piraformis muscle in permanent contraction aggravating my Sciatic nerve. They were very unpleasant to do initially but had immediate results.
As for all the everted feet out there, another good sourse of information regarding body mechanics / muscle imbalances etc. is Pete Egoscue. I found out about him on a Fit Nation episode featuring John Lynch & Junior Seau. He has a couple of books out one of which I think is titled Pain Free.
Foot Externally Rotated
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