Currently, there is a debate amongst healthcare and fitness professionals of whether we should allow our knees to go over our toes during exercise. This debate is usually focused on squats specifically. So who is right?

There are some very experienced doctors, physiotherapists, and personal trainers who will swear that ‘going over your toes is bad for your knees’. A significant flaw of this ‘rule’ is that our knees go over our toes every day without thinking about it. Running, walking downstairs or downhill, squatting down to get something out of the cupboard. With all of these daily tasks, your knees go over your toes.

Why does knees over toes sometimes hurt?

I believe that this common rhetoric that ‘knees over toes’ is bad for your knees, stems from patients who are currently suffering from acute knee pain. Whether someone has had a flare up of arthritis, or a new football injury, going into a squatting pattern may be painful on the knee. But why is this? When we put our knees over our toes, we lengthen the ‘moment arm’ between our knee and our ankle. This increased moment arm places increased biomechanical stress on the knee, which during an acute injury can be painful. This can also be painful in someone who’s knee doesn’t have the strength or capacity to handle this extra force. So what do we do?

‘‘I’m right and you’re wrong!’

It is true that ‘knees over toes’ can be painful for someone who hasn’t trained that position, but that is where physiotherapy or strength & conditioning programs can build up your body’s ability to handle these movements. Unfortunately, if a lie is repeated by enough people with a sense of credibility or prestige (ie. having a certain occupation or degree) then it becomes believable. It becomes “true” by repetition, as “expert” after expert hears it and then repeats it without ever questioning it. But the knees-over-toes rule is in fact based on nothing substantive — not on any evidence of a link between squat or lunge form and injury nor even on any anatomical rationale.

Allowing the knee to pass in front of the toe when squatting or lunging is completely natural. Humans do it automatically from the time they are old enough to squat down to pick up a ball. Ask any two-year-old to do that and watch her knees.

What should I do?

Not everyone should aim to get their knees past their toes when squatting or lunging, however. It’s a matter of individual anatomy. People with shorter legs often squat and lunge quite naturally without excursion of the knees beyond the toes. Taller folks tend to naturally push the knees beyond the toes. You need to let your individual body move as it was designed to do. For a variety of reasons, most people do squat or lunge with bad form. So it’s a good idea to learn correct technique from someone who knows what he’s talking about. If the person teaching you correct squat or lunge technique tells you not to let your knees past your toes, you now know that he doesn’t know what he’s talking about.

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.