Are your knock knees knocking your confidence? Have you been labelled with miserable malalignment syndomre? Perhaps it is not your fault, perhaps you don't have weak hip abductors and hip external rotators (well, not primarily anyway). Perhaps you have a structural issue causing the alignment. Could it be Femoral Anteversion...?

Femoral ante-version is a condition in which the acetabulum of the hip joint - the socket, faces backwards. In order for the ball of the ball and socket hip joint to be in the centre of the backwards facing acetabulum, the femur will have a changed angle when viewing from the front. Even though the ball is centred in the socket, the backwards facing socket means the femur is in a constant position of internal rotation. No amount of cueing, orders to keep your knees out, or strength work will change that starting position.

In addition, patients with this issue display an increased range of motion of internal rotation with a decrease in external rotation. They commonly sit with their knees together, and as children often sat in the classic 'W' type position. If I have this what can I do?

Unfortunately it is structural, meaning only surgical intervention will change the alignment, with re-aligning the socket. However, these patients develop exceptional weakness in their long, stretched external rotators, Glute max and anterior core. So, as to help improve potential symptoms, core work, hip control and Glute max strength exercises are the treatment of choice. An unfortunate condition that can be frustrating for both patient and practitioner, but very worth assessment to clarify the diagnosis as structural or biomechanical/weakness driven.

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