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Debunking the myth - Knees over toes (KOT)

The problem

This idea of talking about the importance of knees over toes came from a discussion with a coach that was constantly repeating athletes to not have their knees passing their toes. You would maybe tell me that it isn’t a myth anymore, we learned and studied the importance of KOT for decades already. Yes, but I would also strongly argue with you that it is in the same boat as the acid lactic & lactate myth (i.e., Lactate has the negative charge and create acidity in bloodstream, not acid lactic), where many inexperienced trainers would simply repeat the fake statement over and over again, so much, than it become common sense amongst them. But what’s the problem with coaches cueing to avoid knees passing the toes during exercises? Well, according to the Agency for Healthcare Research and Quality, more than 790,000 knee replacements are performed each year in the United States and who knows how many CrossFitters are suffering from knee pain. Right here, that’s a real pandemic. Cedric, that’s ridiculous, it doesn’t mean it’s because they don’t squat & lunges with KOT? Of course not, but what if I tell you that most of these surgeries came from accidental fall and the strongest your knees are, the less change of falling you have…

The science of KOT

The position is actually as functional as it gets, we need to use this skill, this motor pattern while jumping, walking backward, walking downstairs, being in knee flexion’s full ROM and now you know, squatting and lunging – Well you should. Most studies are one-sided and those are the main performance benefits from KOT exercises:

Healthier Knees: A study shown that people that are able to get into a full knee flexion have 37% thicker knee tendons than the ones that can’t get in that full ROM – By having stronger and thicker tendon, you’ll be more stable and therefore, less change of falling and injuring yourself. That’s the reason why Chinese Weightlifters that has knee pain, squats with heel elevated on small plates to reinforce the KOT position and make their tendon stronger and knees healthier. In fact, many studies I found with a simple Google search shown a greater knee longevity for people being stronger and more stable in the KOT position.

Healthier Hips: You don’t need to be a geek to understand that squatting or lunging with the KOT will increase joint torques within the knee and reduce hip torque, the opposite is also true. Theoretically, squatting with shins perpendicular to the floor, keeping knees over ankles, will increase joint torques within the hip and reduce pressure within the knee. In fact, a study shown (Schoenfeld, 2010) only 20% of knee torque increase when squatting with KOT compared to approximately 1000% hip torque increased when squatting with knee over ankle. You’re actually only shifting the problem from knee to hips. I’m the living proof, I started a strength program in April 2020 and decided to squat low bar because I felt stronger in that position, but it caused me to lean over and not squat with KOT, after 6 weeks of squatting at a moderate volume, I had to stop because I got a left-side hip bursitis and a right-side hip FAI. This could be linked to my new way of squatting.

Stronger Quads: The VMO, known by no one as the Vastus Medialis Oblique, is 1 one the 4 quadriceps muscles, it only fully contract when the knee is at full extension or full flexion and it also has a role of knee stabilizer - You see where I’m going right? This mean that to get greater adaptations of this muscle, you need to exercise with your knee over your toes. The VMO has a higher proportion of fast-twitch fibers (Type 2x & 2a) than slow-twitch (Type 1) which mean it’s a powerful muscle that would help your lift heavier weight, sprint faster, jump high and add some stability to the knee which increase agility and decrease chance of injuries. Sound kinda important to me.

Ankle Mobility: I’ve read a study (Rabin, Portnoy and Kozol, 2016) that shows a strong correlation between reduced ankle dorsiflexion and knee disorders. In fact, they concluded that a more limited ankle dorsiflexion (DF) is linked directly to a decrease in knee flexion during a lateral step-down test - Which mean that to get all the benefits from the skill of knee over toes training, your ankle DF has to be significantly functional. Yes, training with KOT will indirectly improve your ankle DF mobility, but probably won’t be enough by itself.

Achilles Protection: We see a lot of Achilles tendon tear in the sport, even at the highest level: Julie Foucher, Alexis Johnson, Jean-Simon Roy-Lemaire, Alethea Boon – Just to name a few out of my head. Sadly, high intensity dictates the sport of CrossFit and with this comes a higher rate of injuries. The solution comes from strengthen the Soleus, a calf muscle responsible for the plantar flexion and protecting your Achilles. Having a strength imbalance between the Gastrocnemius (i.e., the more transparent calf muscle) and the Soleus leads to higher rate of Achille tendinopathy and tear. Fortunately for us, there’s an easy way to strengthen this small, yet so important, muscle.…. KOT exercises.

How to apply KOT in your training routine?

You can always hire one of our experienced trainers or contact us to get a full training program, but here’s some great exercises you could implement:

  • KOT split squats

  • Patrick step-ups

  • Stretching your Ankle DF

  • Walking backward

  • Reverse sled drag

  • Nordic curl up

  • Voodoo floss your knees (LIFE SAVER FOR ME)

  • Cyclist squat

  • Wall Sit

  • Tibialis raises on wall (Will protect knees)

*Those aren’t in a particular order. If walking backward hurts your knee, don’t perform KOT split squats for example.

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