Feet Position and Angle in the Squat

[Tarun Suri]

While performing Ido's Squat Clinic for the past week or so, I've realised some differences between our technique:

1) My feet are placed further apart from each other, slightly past shoulder width.

2) The angle of my feet are approximately 45 degrees.

3) When attempting to perform a static bottom squat hold with a narrower stance, the more the muscles tire, the more they tend to get further from themselves while opening in angle.

I would like to know if this is an indication of some sort of imbalance or weakness in muscles, mobility or flexibility issue, or simply normal based on my anatomy?

Some factors that may play a key role:

1) I have performed back squats for a 6-12 months (not in a row) using a description that Mark Rippetoe advised (just outside shoulder width and with feet angle of about 30 degrees.

2) I have flat feet, very flat feet.

3) I consider my lower body very inflexible/immobile (more so than my upper :roll: ). I cannot sit on my knees and even crossing my legs isn't the most natural of positions for me in long-periods.

I'm 5'9, 135 lbs, ectomorph.

I hope that someone can enlighten me

[Seiji]

It's always best to point your feet directly in front of you. I've never heard anyone suggest otherwise o.O

Shoulder width is the best for squats.

I doubt your flexibility has anything to do with this, but you are incredibly inflexible. I would suggest working on that. Even if you don't plan on doing anything with it. It's a great way to prevent any sort of injury.

[Blairbob]

I'm not familiar with Ido's squat clinic but a deck squat is very different from ANY barbell squat.

When we lunge in gymnastics, the feet are turned out. Deck squat ideally is feet together not shoulder width apart.

Ido turns his feet out slightly.

Feet forward on squat. I'm not gonna go there.

[Neal Winkler]

Havok,

A wide squat stance, compared to a narrow stance, involves the adductors (groin) more and the quads less. It's also easier to go deeper with a wide stance.

From your point number (3), I think you mean that as you tire your knees want to push out? If that is correct, it means that your body is trying to bring the adductors into the movement in order to bear some of the load. If this happens right away, then I guess it could mean that your quads are weak. If it takes a while, then this could just mean that your quads are getting tired so your body is trying to compensate.

If you can't sit while on your knees, this could be a toe inflexibility problem, a quad inflexibility problem, or both. Try sitting your knees with your toes pointed towards each other. If your butt touches your heels, then its probably a toe in flexibility problem. If you can't touch your butt to your heels, then you have inflexible quads. That probably means your quads don't touch your butt when in the toe stretch position either.

If tight quads is your problem, then it could be that your body is forcing your knees out because it doesn't have the quad flexibility to get proper depth. Like i said above, knees out allows for easier depth.

Neither stance, narrow vs. wide, is right or wrong. It just depends on the goals. If you need adductor strength, then you should do a really wide stance (wider than what Rippetoe recommends). If your adductors are injured, you can do narrow stance until they heal. Or maybe you adductors are overpowering your quads, in which case your can do a narrower stance. Overall strength, Rippetoe width is the way to go. It just depends.

On the issue of foot angle, it depends in the width of the squat. The wider the squat, the more angled the foot has to be because you want to the foot and femur to be parallel.

[Razz]

It's always best to point your feet directly in front of you. I've never heard anyone suggest otherwise o.O

Shoulder width is the best for squats.

Most people can not squat without rounding their back if their feet are not pointed out and the stance a bit wider.

[Seiji]

Ah, but a rounded back in a squat is dangerous.

I can't sit down all the way with my toes pointed in... but I naturally have about a 20 degree outward foot position when walking.

[Neal Winkler]

That's not natural. You have tight external rotators.

[Razz]

Exactly it is dangerous Seji, also the reason that the recommendation of shoulder width toes pointing forward is not good, unless you have extremely good dorsi flexion mobility, which in the end may hurt your knees

[Tarun Suri]

Thank you for the informative posts so far.

I understand that the wider the width, the larger the angle since the shins should be in line (parallel) with the foot. Yesterday, my beliefs where shattered by Loui SImmons: http://media.crossfit.com/cf-video/Cros ... Stance.wmv

http://media.crossfit.com/cf-video/Cros ... Stance.mov

I really don't know what to make of his super wide squat with toes pointed forward :?

But going back to my condition, while performing the squat clinic's brutal tow stretch, I am much better able to sit on my knees I still can't, but there's a huge improvement. There is the aways painful quad feeling, so I can infer that it was a combination of both quad and toe flexibility issue.

I can squat down in a narrower stance, like Ido, with toes at 15 degrees, however it takes a lot of concentration. It s while I rest in a squat position or stretch in the squat position that my stance and angle are most visible.

So that leaves me with an almost confirmed quad inflexibility and possibly an imbalance between my adductors and external rotators (abductors?).

How should I go about my assessment now? I believe I should figure out if I should either stretch the adductors or strengthen the external rotators. How should I go about this?

I should also add that my butt "winks" near parallel level. Since we're discussing my mobility issue with the squat, maybe that needs some assessment too. Is that a weak glutes, or inflexible glutes or even hamstrings for that matter?

I appreciate the responses so far and hope that you will continue to help me assess my condition

[Emil Brannmark]

Well butt wink is a classic sign of short hammies.

[Neal Winkler]

RandomHavok,

Another possibility is that you have poor ankle mobility. If you have poor dorsiflexion range of motion, then you body will compensate by out toeing.

Do this test: Perform the squat with toes forward while your heel is lifted two inches or so (books, weight plates, 2x4, whatever). Can you now perform the squat with greater ease? If so, ankle mobility is a problem for you. Also, this may solve your "butt wink" problem as well.

A final possibility is lack of hip internal range of motion. Do you walk with an out toeing like Seiji? If so, this could be poor hip internal range of motion, or due to poor ankle mobility, or both.

[Seiji]

Butt wink sounds incredibly sexual... what is this?

[Blairbob]

http://www.youtube.com/results?search_query=squat+butt+wink&search_type=&aq=f

Seiji. No butt wink, isn't exactly popping or locking your posterior.

[Joshua Naterman]

RandomHavok,

Another possibility is that you have poor ankle mobility. If you have poor dorsiflexion range of motion, then you body will compensate by out toeing.

Do this test: Perform the squat with toes forward while your heel is lifted two inches or so (books, weight plates, 2x4, whatever). Can you now perform the squat with greater ease? If so, ankle mobility is a problem for you. Also, this may solve your "butt wink" problem as well.

A final possibility is lack of hip internal range of motion. Do you walk with an out toeing like Seiji? If so, this could be poor hip internal range of motion, or due to poor ankle mobility, or both.

Seiji's problem isn't flexibility. It's dysfunctional neural learning. His body has learned to use the hip adductors for walking instead of the vastus medialis, and as a result he is slowly building up chronic foot, knee, and lower back problems. People who walk like this get told often that they have "flat feet." Their feet flatten because they are shifting weight across the arch instead of through it, so it can't do its job. This leads to shearing forces in the knee, which eventually cause cartilage degeneration due to excessive wear and tear with insufficient time for regeneration. At the same time, because the feet point outwards the hips tend to tilt forward, leading to lumbar lordosis and lower back pain. There are many people who have gotten spinal fusions because of pain that started with this problem. It's probably asymptomatic right now, and could remain so for 10 or 20 years, but sooner or later this leads to cartilage degeneration, knee pain, back pain, and if you listen to a surgeon it will lead to surgery. Instead of keeping this up, teach your legs how to walk properly. It's easy, this will take you 1-2 minutes a day.

The most effective treatment is wall squats, done very specifically. Pay attention, there are 3 special conditions.

1) feet hip width, knees above heels, gap between big toe and second toe in line with heel and hips, feet parallel, top of legs parallel with ground. Your legs should be in perfect alignment. Shins perpendicular to floor, top of thighs parallel. Pretty is perfect.

2) The back of your head, your back, and your butt must all be touching the wall for the whole time.

3) YOU MAY NOT TOUCH YOUR BODY WITH YOUR HANDS. AT ALL! Your arms must dangle at your sides. Why? Get into position, and test the difference. Lay your arms on your legs, and then put them down to your sides where they can't touch you. You will feel a noticeable difference in the body tension and the muscles working. This will only be effective when you are not touching.

You must keep your legs in perfect position and hold this for 30 seconds to 1 minute, with the goal being 1 minute. Do it twice a day until you're walking right, and then do it once a day. For most people the problem is permanently corrected in about a month, but maintenance should be done indefinitely, ideally But for at least 2 months after a proper gait is established. There are stretches that can help, like static back and static hip, but this exercise is the most important because it trains the body to use the proper muscles, which is functional neural learning.

Also, pay attention to how you walk and try to go to to heel, feet straight. It will rapidly become easier as days pass until you don't even think about it.

Also, a rounded back is not bad. An UNSUPPORTED rounded back is bad. There is a huge, huge difference. When you are in a low squat with feet close together, you have no choice but to round your back as your abdomen hits your quads. As long as you maintain spinal tension, this will not hurt you. The key is to keep tension so that as you come up you straighten your back as your abdomen raises back up off of your thighs. To keep a straight back you have to move feet far enough apart to allow your abdomen to not rest on the thighs. As long as there is a perfectly straight line from your hip to your knee to your ankle to your gap between the big to and the second toe(as seen from a top down view, which you should be able to see from your viewpoint in the squat), you will have no problems with full range of motion. The width of your feet will determine the range of motion, as you cannot go down as far when you get wide. This will, in turn, change the degree to which the various muscle groups are worked. Butt works much harder in wide squats compared to just barely being wide enough to do full ROM.

As always, if something you do hurts, don't do it! You may just need to correct musculo-skeletal dysfunctions first, which has happened to me many times before. Once I taught my body to move correctly and use the right muscles, like I just explained for people with Seiji's problem, I was not only pain free but also able to perform exercises that I simply couldn't do before.

[Neal Winkler]

Seiji's problem isn't flexibility. It's dysfunctional neural learning. His body has learned to use the hip adductors for walking instead of the vastus medialis,

The only two explanations for out-toeing that I have heard of are hip internal range of motion deficit (HIRD) and poor dorsiflexion range of motion. Of course its certainly plausible that there are other reasons of which I am unaware.

I don't see how the vastus medialis contributes to out toeing, nor how wall-squats relieve any dysfunction of the VM. Do you have any links to educate myself on this connection?

How do you know that seiji's problem is not poor dorsiflexion range of motion, and how would wall-squats correct this?

[Joshua Naterman]

Seiji's problem isn't flexibility. It's dysfunctional neural learning. His body has learned to use the hip adductors for walking instead of the vastus medialis,

The only two explanations for out-toeing that I have heard of are hip internal range of motion deficit (HIRD) and poor dorsiflexion range of motion. Of course its certainly plausible that there are other reasons of which I am unaware.

I don't see how the vastus medialis contributes to out toeing, nor how wall-squats relieve any dysfunction of the VM. Do you have any links to educate myself on this connection?

How do you know that seiji's problem is not poor dorsiflexion range of motion, and how would wall-squats correct this?

Vastus isn't the direct problem, it doesn't contribute to "out-toeing." The problem is that vastus is supposed to be the primary mover when walking, and since his feet are pointing out his hip adductors are doing the work. Try it yourself, keep your feet pointed out 30 degrees and start walking for about 15 feet. You'll feel that the quads, vastus medialus specifically, is no longer doing the work. That's called a dysfunctional neural pattern. It's dysfunctional in the sense that it is not how the body is designed to move, because it introduces shearing forces at the knee and does not utilize the arch of the foot for proper transfer of weight. The hips tend to tilt forward, which puts excessive arch in the lumbar region, or excessive tension, or both. These end up leading to degenerative conditions of the spine, knee, and foot. Specifically, degenerative discs(and herniated discs if someone with this condition should choose to move something heavy when Lady Luck is not smiling), degenerative cartilage in the knee(not to mention the increased risk of damaging ACL, MCL, LCL due to stretching of the ligaments over prolonged periods of dysfunctional walking, which decreases knee structural integrity), plantar fasciitis, and flat feet.

I have seen this and guided I can't even tell you how many people because I honestly don't know, but well over a hundred, in correcting basic dysfunctions. I honestly learned most of the basics from a book by Pete Egoscue called "Pain Free." I found it while training to be a SEAL and it was a godsend. Using what I learned I literally fixed my body in about 3 weeks. I went from pain just about everywhere, from the bottom of my feet to the middle of my upper back and literally everywhere inbetween to feeling brand new, and it's lasted for almost 8 years now because if I ever see myself developing a dysfunction I know how to correct it before it ever becomes a problem. I have since had a lot of personal experience with injury and recovery as well as being surrounded by competitive athletes and helping them recover. I read and assimilate everything I learn into a functional knowledge base. I highly recommend everyone get that book. It is worth it's weight in gold, even at current gold prices

As for why the wall squats will help, when done exactly as I have outlined the vastus medialus and the rest of the "quadruceps" will be doing all the work. If you try them out, you will feel that for yourself. By doing this several times a day for 30 seconds, eventually building up to one minute, you are building new neural patterns. Over a period of weeks, especially if you pay attention to how you walk, you will notice that your stride changes back to normal until that is just the way your body "naturally" moves once again. There are a few stretches that enhance the effectiveness of the squats, but they are hard to describe. I should probably make a video for this. I have a few others that I'm making first, but I will get to this eventually.

Edit: The important thing is that the wall squats, done as I outlined, prevent the hip adductors from supporting the load. This causes the body to start shifting automatic neural impulses from the adductors to the quadruceps when supporting the body in forward standing locomotion. The repeated exposure to the new stimulus ends up programming the body to adopt those neural patterns as the "default" patterns to use. That is how dysfunctions are properly corrected. It doesn't happen overnight. The single WORST thing you can do is relieve the pain without correcting the dysfunction. Without the pain to keep the body from exerting maximum force in a dysfunctional motion, severe damage can and will occur. That tends to be how people tear cartilage. If they corrected the dysfunction the injury never would have happened. Pain relief that comes from stretching and decompression without correcting the dysfunction is only accelerating the journey towards serious injury.

Think about what "HIRD" implies. If there is a range of motion "deficit" then something is getting in the way of the hip moving. Unless seiji can not touch his big toes together, his range of motion is fine. I have seen him do this in pictures. So the range of motion is not it.

Dorsiflexion doesn't even begin to play into this. Dorsiflexion is pulling your toes towards your knees, and plays no role in foot rotation, only elevation. Pronation/supination could, but like I said, unless he can not move his foot in a normal range of motion upon request, it is not part of the problem.

Because he can do these things, range of motion is not part of the problem. If it was, it would CERTAINLY have to be addressed, but it would not fix things without simultaneous re-training of the neural signals the brain sends to walk. When I say neural learning, that's what I mean. As the body gets used to supporting itself with the proper muscles, the neural patterns used in walking change as well, because walking is also a support movement. It is how we support the body through a forward motion. Thus, there are two things to focus on. One, and the most important, is to re-train the body to use the proper nerual patterns when walking. This restores functional movement, which means movement with no negative side effects, short or long term. Two, and still important, is to address additional dysfunctions that may have been unknowingly acquired through the original dysfunction of the walking gait. That is a separate issue, and similarly dealt with. When you really get an in depth understanding of how the body works and how levers and angles move loads and distribute force you will understand how simple it is to correct the majority of problems, because you will see how so many come from musculoskeletal dysfunctions. It is mind boggling.

Lack of knowledge in this area is a large part of why there are so many unecessary surgeries. I don't mean to be demeaning when I say that, because I know medical professionals study hard and learn a lot. That does not mean that they are studying the right things. Courses are hand-picked and put together by a board of (we hope) professionals who, just like everything else in America, have been influenced by a handful of organizations/corporations. We are behind the curve with treatment options because our medical profession is controlled by economics, not by patient results. For an example of this research the types of spinal fusion and which is most expensive. You will find that using hardware is over twice the cost, and accounts for more than 70% of all fusions, even though in MOST cases it is not the best choice for the patient. In fact, the old fusion done 50 years ago is far more successful in terms of patient results, yet it is not used as often because it is less profitable. In the same vein, it is far more profitable for the companies that supply services and tools to the medical profession to teach and provide services that are stop-gap in nature and are known to not be the best option for the patient. But, doctors have to make money. They get told by whoever comes up with the new procedures that they are the best, and how is the doctor supposed to know better? They aren't researchers!

It is important to learn exactly how the human body works and to understand the mechanics that lead up to and cause musculoskeletal problems. This is not well-taught in american schools because you simply can't make as much money when you fix people without pills, devices, or surgeries. That doesn't mean that those methods are always the best to use, yet we almost always use them. And then, sometimes, they ARE the best thing. But there are no honest assessments that professionals are required to use, no progression of therapy methods required for our professionals. It is up to the doctor, and the doctor is usually going to pick what makes him or her the most money. This is American medicine, not effective medicine. It has been created over the years by corporations and insurance, and the professionals are, in a way, prisoners of the system. That doesn't make it right in my opinion, and I'll be doing what I can to change things. I will carve out a small niche, as others have, and perhaps one day we will be able to sway the big boys, but I don't think so. It will always be an uphill battle, but it's right.

[Tarun Suri]

Infinite thanks on the book recommendation. I was only able to find "Health through Motion" by the same author, but this is the type of knowledge I have been seeking for in a very long time!

I've been really busy during the holiday seasons, but I'll need to revisit this thread (as well as look up many definitions), to come up with some sort of diagnosis and choose methods to correct my squat. Obviously, I'll ask everyone here if I'm on the right track. Thanks for all the great information

[Joshua Naterman]

You're welcome! I found the Pain Free book on the best seller's shelf at Barnes and Noble back in 2002. It had already been there for over a year. It's no bullshit. Health through motion is more in depth, and in my opinion slightly less helpful to someone who has no idea what any of this stuff means. Pain free can be read by anyone and be understood perfectly. I own both, and would recommend both to anyone who really cares about their body, but I have to give Pain Free the edge in ease of reading. Regardless, they are both outstanding.

[Neal Winkler]

slizzardman,

Out-toeing is a compensation patter for poor dorsiflexion range of motion because it opens up the ankle.

See this article here:

The midtarsal joint—consisting of calcaneocuboid and talonavicular joints—also plays an important role in dorsiflexion and understanding how it works is essential to understanding a very common compensation pattern with restricted dorsiflexion. The midtarsal joint consists of two axes of motion—the oblique and the longitudinal axis. Of utmost consideration to this article is the oblique axis of motion because it allows a large amount of movement to occur including dorsiflexion and abduction. The oblique axis of the midtarsal joint has a one to one ratio of abduction and dorsiflexion. This means that for every one degree the joint abducts, one extra degree of dorsiflexion is created.

Herein lies the problem. This additional dorsiflexion created at the midtarsal joint is only possible with increased pronation at the subtalar joint. Thus, you’ll often observe overpronation and abducted feet in those lacking good dorsiflexion range of motion at the true ankle joint.

[Joshua Naterman]

That's partially true, but misleading. Poor dorsiflexion is often a symptom of the dysfunction I described, and as such should receive whatever acute treatment is necessary to alleviate pain if possible and practical, but treatment of this alone will not change the overall dysfunction that causes the out-toeing.

You took two sentences out of context in the article:

This additional dorsiflexion created at the midtarsal joint is only possible with increased pronation at the subtalar joint. Thus, you’ll often observe overpronation and abducted feet in those lacking good dorsiflexion range of motion at the true ankle joint.

You quote this thining it is saying that out-toeing is a function of poor dorsiflextion ROM, when in fact they happen to be two conditions that often occur together but do not always have the same root cause. You can have very poor dorsiflexion ROM and still have functional hip alignment in the stride. My friend Pat has this, though he refuses to do anything about it.

Trying to treat out-toeing with dorsiflexion work is like treating the flu with steam. Sure, it helps sometimes, but the most effective treatment is to attack the flu virus itself with Tamiflu(for viruses it can affect, of course).

Do an experiment for me. Don't worry, you can do this at home. Try to walk with abducted feet without pointing rotating the leg outwards. It's not possible. You know why? Because the ankle itself has almost zero range of motion on the x axis, as viewed looking at a standing person. The x axis is horizontal. You can't hardly move it at all without rotating in or out at the hip. You can pronate or supinate, but that's not x axis movement. That's what you call roll, or yaw. It is not moving WITHIN the horizontal plane, but rather rotating vertically THROUGH the horizontal plane. Try it. Without rolling your foot sideways(pronation or supination, depending on which direction), your ankle effectively has zero horizontal movement capabilities.

So, now use just pronation to point your toes out. Try to walk like that. Can't do it, can you? No one can. We don't have anywhere near enough strength in the active tissues(muscles/tendons/ligaments) in the ankle to do it. Try it again supinated, you'll find the same thing is true. We simply don't have the strength to do it for even 10 steps. You could spend your whole life training to do this unnatural movement and never be able to do it for more than a short period of time, because the forces involved are too much for our bodies to handle for even a few minutes straight. This means that toes pointing out are actually a result of external hip rotation. This, in many cases LEADS to poor dorsiflexion, but that is an effect, not a cause. Our little sequence of events here proves that this is not going to happen the other way.

Often, what happens is that when the ankle is sprained, we limit the range of motion with tape and crutches, which leads to tightening of the tissues. Then to compensate for weakness and pain the foot gets rotated out a little as we limp(however slightly) during healing. This rotation, as we have just discovered through our little experiment, actually happens at the HIP.

To get a good tactile feel for what does the work in this position, stand up straight. Turn your toe out 30 degrees, and keeping it in that position lift your foot off the ground. Swing it back and forth slowly, in front of you and then behind. What muscles do you feel moving the leg? If you're doing this like I told you you will feel the work on the inside of your knee, where the hip adductors connect, as well as the inner head of the quadruceps. These are not what you are supposed to be walking with. Why? Look at the angle, just look down at your knee. All the force of each step has to move sideways across the knee. That's bad. That leads to a ton of other problems, but we're talking about feet right now. I have just led you through a short experiment, and given the scenario that accounts for nearly all problems of this type, though there are other circumstances, like playing lots of soccer, that lead to the same dysfunction. In all cases, it starts at the hip. You can not truly fix this until you take care of the hip, which is the root of the problem. This is done by retraining the body to use the right muscles.

If poor dorsiflexion DOES develop, it may have to be handled as outlined in the article you referenced, which is quite good for that. However, restoring the stride usually allows natural recovery of dorsiflexion. Sometimes you have to retrain that as well, and if that is a problem I suggest you all look at the article Triangle referenced, it's got great videos!

The problem is that doctors as a group here don't have a good understanding of where these dysfunctions actually start and progress, or how to identify, much less treat the root problem. This baffles me a bit, but it is true. I've run into it personally, even with the doctors that treat the Atlanta Falcons(pro football team). I just don't understand why we insist on being so ignorant.

[Neal Winkler]

slizzardman,

I have to respectfully disagree.

Firstly, I'm not saying that poor dorsiflexion is the only cause of out-toeing. If you have out-toeing and adequate dorsiflexion, than improving dorsiflexion will do nothing.

Where we disagree is that you claim dorsiflexion can never cause out-toeing. If a person develops poor dorsiflexion ROM (say from wearing high heels, or Nike shox, taping the ankle(s), or whatever), then pronation can occur to increase dorsiflexion.

What you're missing is that the pronation causes the hips to be tight. Why? Because when the feet/ankle is pronated, there will be increased internal rotation of the tibia and femur. With each step a person takes, the external rotators will now have to work harder to decelerate this extra internal rotation. This overuse will cause the external rotators to be tight, and now the femurs are in a permanent position of external rotation, which affects the tibia, which affects the position of the feet.

So, it all started back with the poor dorsiflexion, and that's how poor dorsiflexion can cause out-toeing.

[Joshua Naterman]

slizzardman,

I have to respectfully disagree.

Firstly, I'm not saying that poor dorsiflexion is the only cause of out-toeing. If you have out-toeing and adequate dorsiflexion, than improving dorsiflexion will do nothing.

Where we disagree is that you claim dorsiflexion can never cause out-toeing. If a person develops poor dorsiflexion ROM (say from wearing high heels, or Nike shox, taping the ankle(s), or whatever), then pronation can occur to increase dorsiflexion.

What you're missing is that the pronation causes the hips to be tight. Why? Because when the feet/ankle is pronated, there will be increased internal rotation of the tibia and femur. With each step a person takes, the external rotators will now have to work harder to decelerate this extra internal rotation. This overuse will cause the external rotators to be tight, and now the femurs are in a permanent position of external rotation, which affects the tibia, which affects the position of the feet.

So, it all started back with the poor dorsiflexion, and that's how poor dorsiflexion can cause out-toeing.

It can happen that way, but once you've got out-toeing you're going to have to re-train the primary movers of the walking gait.

Also, generally what ends up happening is that a slight out-toeing, which something like 70% of america has, if you just watch people walk you'll see it in almost everyone, ends up leading to a slight reduction in dorsiflexion, since once your toes are sticking out even slightly you stop using full range of motion in dorsiflexion. This sequence keeps repeating until there is finally pain. But you're right, as I've seen in my friend Pat the lack of dorsiflexion ROM CAN come first.

You will find, if you get two groups together and try treating the dorsiflexion versus treating the out-toeing you will find greater improvement in symptoms with the wall squats and accompanying exercises versus what is shown in the article you referenced, because all of that does nothing to re-train the walking motion, which is perpetuating the problems.

Dorsiflexion can come first, but that's not anywhere near as common. In the end it doesn't matter much, because either way you have to treat the dysfunction starting at the hip. If you don't deal with that you don't handle the whole problem and you run a much higher risk of regression.

I didn't mean to say that dorsiflexion NEVER causes out-toeing, but it's much more common for it to be a symptom. And you're absolutely right about the shoes causing problems, I totally missed that when i read at first!

[terpol]

I have slight out-toeing in my right foot, my left is perfect from what i can see, it doesn't cause me any problem now but of course it probably will at some point. I remember falling on my knees as a kid and going to a physio and she had me do an exercise of placing my big toe on a book and leaning forward with my knee over my big toe. I don't know if this was to treat my knees or if she had just noticed the out-toeing while treating me. I don't think i stuck with it though and so i still have some out-toeing. I tried the wall squats for 3 weeks but i don't see much improvement. Should I be trying to relax in the position or trying to push my feet into the floor?, each way feels a lot different.

I have good flexibility throughout my lower body, passive and active, no tight hips or ankles. No flat feet either. Standing on my right leg feels different from the left and more unbalanced. My gait looks okay from what i can see aside from the slight out-toeing and a little more weight on the outside of the foot. Occasionally i feel a very slight pain in the front of my right knee when landing on my right leg from a jump or stopping quickly, i feel it sometimes in the wall squats too.

slizzardman you mentioned other stretches besides the wall squats, i'd guess the lean over the toe was one of them. could you share them?

thanks

[MCem222]

1) feet hip width, knees above heels, gap between big toe and second toe in line with heel and hips, feet parallel, top of legs parallel with ground. Your legs should be in perfect alignment. Shins perpendicular to floor, top of thighs parallel. Pretty is perfect.

2) The back of your head, your back, and your butt must all be touching the wall for the whole time.

3) YOU MAY NOT TOUCH YOUR BODY WITH YOUR HANDS. AT ALL! Your arms must dangle at your sides. Why? Get into position, and test the difference. Lay your arms on your legs, and then put them down to your sides where they can't touch you. You will feel a noticeable difference in the body tension and the muscles working. This will only be effective when you are not touching.

You must keep your legs in perfect position and hold this for 30 seconds to 1 minute, with the goal being 1 minute. Do it twice a day until you're walking right, and then do it once a day. For most people the problem is permanently corrected in about a month, but maintenance should be done indefinitely, ideally But for at least 2 months after a proper gait is established. There are stretches that can help, like static back and static hip, but this exercise is the most important because it trains the body to use the proper muscles, which is functional neural learning.

So, Slizzardman, you're basically saying to do 1-2 sets of perfect wall sits till failure a day?

I believe a similar walking problem to what is being described runs in my family. My father, for example, walks with his feet out at a noticable angle, perhaps 30 degrees, and now, in his 50s, has bad knees.

I don't walk like that, but I've been told that my outer quads overpower my inner leg, and my feet tend to point outward while squatting as a result

[Neal Winkler]

Your feet are supposed to be angled out in the squat, unless you are specifically doing a variation that requires feet forward.