10 Year Old with Knocked Knees

My 10 year old daughter has knocked knees. It is very easy to see with her just standing standing still with feet shoulder width apart. My wife took her to an pediatric orthopedic specialist who suggested that she does some physical therapy to correct it. She is always complaining about her ankles hurting, which is why my wife wanted to take her in.

Anyways, I'm a 42 year old male who has been doing Starting Strength for about 2.5 years at this point. I'm in intermediate programming for all of the main lifts. I have done physical therapy twice for two different reasons and have come away with a feeling that they have a total lack of understanding of the strength adaptation recovery model. A physical therapist did help me with my lack of shoulder flexibility when I was starting out with Starting Strength back in the spring of 2019, which helped make it possible for me to get under the bar to do low bar squats and press with a vertical bar path. After the first couple weeks of loosening up the capsule and prescribing stretches, they moved on to giving me rubber bands to "strengthen" my supporting muscles, which was a complete waste of time and money. I did say that I wanted to stop after I had regained my shoulder flexibility, but they talked me out of it. In hindsight I should have simply said "thank you... I'm done".

I know that Rip has mentioned over and over that we can't train kids until they hit Tanner Stage 4, since they can't recover like adults will and will get injured if we try to do it anyways. And that kids simply by growing are naturally getting stronger anyways. Is it possible to fix knocked knees with squats and deadlifts, once my daughter is of the right age? Or will physical therapists actually be able do something in this area and not waste our time and money? If squats and deadlifts would help, I feel like I would be competent enough to help her run through a linear progression when she does reach Tanner Stage 4. This wouldn't cost any money at all, except a pair of lifting shoes. Just trying to figure out the right approach to correct this.

What did the doctor say about the cause of the valgus knees?

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Originally Posted by Mark Rippetoe

What did the doctor say about the cause of the valgus knees?

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I didn't take her to the appointment. My wife did a few weeks ago and said that the doctor said, "It is common in kids." and did not give any reason as to the cause of it. We live about an hour and a half south of Chicago, so it was a bit of a drive getting there and my wife was not all that impressed by the doctor and said the whole appointment was very brief. We thought it would be worth the effort of going there, since the doctor is a pediatric orthopedic specialist. I have the contact information of the doctor and plan to call to see if there is anything specific written in the records, as to the cause. But, they are not open again until Tuesday.

I did have my daughter do a squat so that I could see if it is even possible to do a squat without knee cave. You are right about kids really lacking in the ability to control the eccentric or even just about anything else in the movement. I ended up having her is at a coffee table, where her hips are at around parallel and put her feet hip width apart with toes angled outward and then slowly stand up. For the entire motion I didn't see any knee cave at all. But, when she is nearly standing up with straight legs you can see the knees are caved in. When she is just standing upright though her knees can touch each other, with her feet maybe 3 to 5 inches apart (I didn't measure). I'm not starting to train her on the squat, but simply curious if it was even possible for her to squat without knee cave.

It may be nothing more than abductor weakness, but if there is a bony defect it would be important to know. But as usual, pediatricians are inadequate.

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Originally Posted by Schrodinger23

My 10 year old daughter has knocked knees. It is very easy to see with her just standing standing still with feet shoulder width apart. My wife took her to an pediatric orthopedic specialist who suggested that she does some physical therapy to correct it. She is always complaining about her ankles hurting, which is why my wife wanted to take her in.

Anyways, I'm a 42 year old male who has been doing Starting Strength for about 2.5 years at this point. I'm in intermediate programming for all of the main lifts. I have done physical therapy twice for two different reasons and have come away with a feeling that they have a total lack of understanding of the strength adaptation recovery model. A physical therapist did help me with my lack of shoulder flexibility when I was starting out with Starting Strength back in the spring of 2019, which helped make it possible for me to get under the bar to do low bar squats and press with a vertical bar path. After the first couple weeks of loosening up the capsule and prescribing stretches, they moved on to giving me rubber bands to "strengthen" my supporting muscles, which was a complete waste of time and money. I did say that I wanted to stop after I had regained my shoulder flexibility, but they talked me out of it. In hindsight I should have simply said "thank you... I'm done".

I know that Rip has mentioned over and over that we can't train kids until they hit Tanner Stage 4, since they can't recover like adults will and will get injured if we try to do it anyways. And that kids simply by growing are naturally getting stronger anyways. Is it possible to fix knocked knees with squats and deadlifts, once my daughter is of the right age? Or will physical therapists actually be able do something in this area and not waste our time and money? If squats and deadlifts would help, I feel like I would be competent enough to help her run through a linear progression when she does reach Tanner Stage 4. This wouldn't cost any money at all, except a pair of lifting shoes. Just trying to figure out the right approach to correct this.

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Would you be willing to accept that perhaps her knee valgus has nothing to do with her ankles hurting?

Quote:

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Originally Posted by Mark Rippetoe

It may be nothing more than abductor weakness, but if there is a bony defect it would be important to know. But as usual, pediatricians are inadequate.

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I was thinking the same thing about possibly weak abductors, after seeing her squat.

I talked with the doctor's office today and asked if they could read for me what the doctor had written in the chart. All that the doctor wrote was that it was caused by overuse and they suggested physical therapy to correct it. If the physical therapy doesn't work, then the doctor recommended coming back in again. I asked about whether or not there was a mention of any bony defect and there was nothing written in the chart. Basically, there is not much substance to what the doctor said or had written in the chart. Just about anyone off the street would likely say that physical therapy might be a good solution to the problem, without knowing anything at all.

For background information my daughter did do gymnastics from age 4 through age 8. She worked with a coach just once per week, but was always practicing cartwheels and handsprings throughout the week. She wasn't in a competitive league.

I talked with other adults that have gone through physical therapy in the area and there is one person that they recommend as good. I was thinking taking my daughter in for a single visit to see what they think might be the cause and what they suggest as a solution. If they can suggest things that sound reasonable then we might proceed with treatment, but I'm not holding my breath.