Excessive Genu Valgum(Knock-knees) with

Squats band exercise

Group member:
1-Aya Saed Azroun U20102041
2-Azah Alali U19100063
3-Dorsa Etehadi U17100864
4-Farah Almohammad U19101466
5-Hind Alharmoodi U19100353
Supervised by: Dr. Meeyoung Kim
o Table of content
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 Cover page…………………………………………..1

Table of content…………………………………...2

True story……………………………………………3

Aspects of the condition……………………..4-7

About the article……………………………….8-10

Description…………………………………………..11

References…………………………………….……..12

Appendix……………………………………………...13

True story

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The patient's name is Nicole she’s 30 years old she played basketball in college and she has developed
knee pain over the last several years she’s also conscious about the appearance of her knees and she’s
concerned about the future. We can see from the x-ray that shows the hips the knees and ankles you’ll see
that line between the hip and the ankle goes out through the outside part of the knee and that is a way of
measuring the knock-kneed deformity and shows how the outside part of the knee or the lateral side of the
knee is being overloaded.

When we look at the X-ray's front views and side views and merchant views of her knees we’re able to
see the lateral side of a joint represented by the blue arrow has some narrowing even at the age of just 30.

planning the correction follows a variety of steps first we have to know where the location of the
deformity is and these joint orientation angles show us that it’s coming from the femur which is the most
common situation and this animation with my packs allows me to create a virtual osteotomy which is
shown here as an opening wedge osteotomy at the distal femur or just above the knee joint and you can
see with a 9-degree correction I’m able to achieve in nice realignment. We will take these plans to the
operating room where we perform an osteotomy or cut the bone it’s partial cut and I wedge through the
distal femur we you can see we put in a temporary spacer trial with the exact size that I had planned and I
can confirm that alignment from hip to ankle now goes through the center of the knee this is stabilized
with the titanium plate and screws and the wedge is filled with synthetic bones graft.

Before After

Other true story:

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https://www.youtube.com/watch?v=es26MY4Ws0E .
https://www.youtube.com/watch?v=lin3pGRlKiE .

To describe the most salient aspects of the condition.

The normal condition in biomechanical aspects:

Genu Valgum, also referred to as "Knock Knees" or Valgus Knee, is a joint misalignment marked
by the knees' inward bending. An individual with knock knees (genu valgum) has an enormous
hole between their feet when they're remaining with their knees together. Moreover, numerous
small kids have knock knees, which will generally be generally clear at around the age of 4.

It's pretty often a specific piece of their turn of events, and their legs will regularly fix by the age
of 6 or 7. However, slight knock knees can proceed into adulthood. However, this additionally
isn't generally anything to stress over except if it causes different issues.

Nonetheless, knock knees can sometimes indicate an essential condition that needs treatment,
mainly if the state creates more established youngsters or grown-ups or improves with age. In
other words, this condition is most often seen in young kids, but this potentially painful condition
will continue into adulthood in some cases. The knee valgus is likely to have many other known
causes. These are underlying imperfections, for example, rheumatoid joint inflammation or
distortion of the knee joint, femur, or tibia. Ordinarily, individuals with outrageous valgus
distortions can't contact their feet together while fixing their legs simultaneously. Genu Valgums
can show up more regrettable clinically than with radiographic pictures because the agony is
frequently the most applicable patient grumbling. In Sports, Knock Knees are a reason for worry
for most competitors. As the competitors develop genuinely, they start to apply more power on
the knees. However, the energy created can be more in one compartment than the other. On
account of Valgus Knees, this power happens at the "lateral compartment," which can cause
extending of the average tendons. For the most part, females have more extensive hips, which
causes a more considerable increment of the point at which the femur coordinates towards the
centerline of the body. Competitors have figured out how to deal with such issues by utilizing
lower leg groups/sleeves simply over the knee during a squat session.

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 Genu valgum is ordinarily found in more youthful youngsters and, for the most part, rectifies
itself as they develop. Up to 75% of kids in the range of 3 to 5 years have thump knees. It has
been demonstrated that genu valgum typically addresses itself when it is found in more youthful
youngsters. However, it requires a couple of years as Boston Children's Hospital reports that in
around 99 % of these cases, thump knee adjusts itself when influenced by kids are 7 or 8 years of
age.
The biomechanics introductory of the condition:
The typical knee joint articulates between the femur, tibia, and patella in the middle portion of the
human leg. A tibiofemoral angle of more than 10 degrees is called valgus knee deformity.
Metaphyseal valgus remodeling of the femur and tibia can occur over time. Valgus braces were
found to minimize direct measures of medial knee compressive force, indirect measures of
mediolateral load distribution around the knee, quadriceps/hamstring, and
quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait,
according to various biomechanical methods.

What causes this condition?

This deformity happens as a result of heredity, genetic disorders, or metabolic bone disease.
Knock knees can be caused by:
In children:
•Idiopathic (unknown cause), sometime seems in adolescence.
•Nutritional rickets and alimentation vitamin D-deficiency.
•Renal rickets (associated with renal failure and renal osteodystrophy—a bone disease that
happens ones your kidneys fail to maintain correct levels of calcium and phosphorus in the blood)

In adults
•Trauma.
•Arthritis or residual effects from pediatric orthopedic disease.
•Other bone diseases
•An injury or infection in your leg or knee
•Obesity, which also puts extra pressure on your knees

As indicated by the Journal of Pediatric Orthopedics Reliable Source, the weight will make genu
valgum more extreme. The diary recorded that 71% of youngsters with genu valgum have been
demonstrated to be hefty in a new report, which shows that in ordinary cases, heftiness will make

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 genu valgum more genuine. That indicates that stoutness can make genu valgum more extreme
than in normal circumstances.

What are typical symptoms that characterize the condition:

The most noticeable knock knee sign is a separation of the person's ankles when their knees are
close together. Other symptoms include pain, which is usually the result of the gait (manner of
walking) adopted by people who have knock knees. A person may also have other symptoms that
cause knock-knee syndrome from an underlying condition. One or both knees are abnormally
overloaded in people of all age groups who have knock-knees. Excessive force can cause pain,
bone knock-kneed for a long time, in particular. These symptoms may include: knee or hip pain
foot or ankle pain feet not touching while standing with knees together stiff or sore joints a limp
while walking reduced range of motion in hips difficulty walking or running knee instability
progressive knee arthritis in adults patients or parents may be unhappy with aesthetics.

How to diagnose the condition?

When an older child or adult has genu valgum, it's critical to determine if there's an underlying
cause. There may be a need to treat a bone disorder or arthritis. Your doctor will inquire about
your medical history and whether you are experiencing any discomfort. If you are, they would
want to know where you are experiencing pain.Your doctor will examine how you stand and walk
during a physical examination.

They'll still be looking to see if:

inconsistency in leg length

the angle of your knee alignment

the soles of your shoes have uneven wear

Your doctor may order an X-ray or an MRI scan to examine your bone structure in some cases.

How is the condition treated, and what is the treatment prognosis:

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 The condition is treated with several exercises that may help people who find it difficult to walk or
continue their daily routines. The many activities that could be useful are Exercise Band Squats
which help strengthen the quads and hamstrings while also adding the exercise band involves your
hip flexors. The steps to this exercise are as following firstly, stand with your feet hip-width apart,
the band is placed around the thighs, the bar should be close-fitting, but you shouldn't face trouble
standing with your feet apart. Secondly, start with doing the squats, which is bending your knees
gently and keeping your thighs apart, making sure to keep your back straight this would give you
the sensation of burning or throbbing. Lastly, keep your posture for several seconds before
returning to a standing position. Repeat it about 15 times per set, aiming to complete three sets
daily for better results. The treatment prognosis is that it helps realign and stabilize the knee.

About the article:

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 What is the aim of the study?

To stabilize and realign the knees, the therapist will evaluate the gait to recommend exercises to
strengthen the muscles of the leg, hip, and thigh. Squats are one of the activities that can be
proposed. Squatted Hip Abduction:

Begin with feet hip-width apart with a mini circle band around the upper leg, slightly above knee
level. We should maintain the static squat throughout the exercise. With the feet should be
parallel to each other and facing forward, we start with a slight hip abduction where the right knee
moves somewhat to the external 1-2 inches. Play out a parallel development with the left knee in
the wake of returning the knee to the beginning position. Keep alternating and repeating till the
desired number is performed for/ each leg.

To prevent the shift of the hips from happening, perform this exercise in front of a mirror to
ensure that the only moving part is the knee. As the body wants to compensate and utilize other
muscles to assist with the movement looking at the mirror can prevent this.

This exercise helps in pushing the kneecap and, therefore, the different muscles to their correct
location, and that's why this exercise is considered one of the best when it comes to rectifying
knock knees. The squat is apparently the most mainstream practice utilized by competitors and
wellness devotees the same, and in light of current circumstances. There is plentiful proof
portraying its utilization for improving lower body solid perseverance, strength, muscle size, and
force.

This article examines the conventional hand weight back squat from a wellness viewpoint. It
doesn't examine the squat as it identifies with execution, for example, contending in powerlifting
or Olympic Weightlifting. Or maybe, the reason for this article is to give an outline of the
development necessities, included musculature, normal procedure mistakes, and proposals to
boost security and execution.

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 What are the methods?
genu valgum will generally rely upon the reason and seriousness or severity of the condition.
Common treatment alternatives include the following: Regular exercise: A specialist may suggest
some basic activities based on the person's gait, such as stretches and exercises, strengthening
muscles of the legs, and realigns the knees. Weight loss: if the patient has excessive body weight,
it may contribute to genu valgum. More consequences cause the knock knees to get worse. The
doctor will advise the patient to lose weight by a combination of both diet and exercise. Surgery:
Doctors do surgery for these cases: Severe genu valgum, and when stretching, exercising, and
weight loss don't relieve the pain. For kids, doctors do a surgery called guided growth surgery.
The surgeon puts a piece of metal into the patient's knees. The metal assists in the growth of the
bone in the right direction. After they did this surgery, they will do another one to remove the
metal plate. In adults and teenagers, they use osteotomy, which is similar to guided growth
surgery, but this involves a doctor that inserts a small metal plate into the patient's knee. The scale
is utilized as lasting support to keep the knee effectively adjusted, and it won't be taken out.

What do you suggest for further investigations and why, using your biomechanical knowledge?
We recommend an AP standing long length film in evaluating mechanical axis,It permits for
appraisal of the mechanical pivot and joint deviation. The mechanical axis of the lower extremity
is characterized as the line from the center of the femoral head through the center of the lower leg
mortise, and goes through the medial tibial spine of the knee. The proximal tibia can be separated
into 4 equal-width separation based upon a centerline between the tibial spines. The sidelong 2
partitions are alloted positive values though the medial 2 allotments are relegated negative values.
An ordinary mechanical axis passes through the center half of the knee (Zone +1 or -1). Genu
valgum that causes a mechanical pivot to pass horizontal to the tibial level (Zone +3) is
considered pathologic. Redress of pathologic genu valgum will not as it were progress
appearance and mechanical pivot, but too will by and large move forward torment within the
symptomatic patient. Furthermore, On account of genu valgum, the hip is inside turned, so
reinforcing the inverse (which are the hip external rotators) will help forestall injury. The outside
rotators' most grounded muscle turns out to be the gluteus medius, yet by reinforcing the whole
gluteal gathering, you will see an outcome too. How could this be finished? By focusing on the
gluteus medius and the adductors and driving the knee into kidnapping and inner revolution. By
driving the knee into this position, you will really make the body turn on the external rotators to
hold the joint back from falling.

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 The results and conclusion?
In conclusion, Ankle dorsiflexion, glute activation, hip stability, motor control, and discipline are
all needed for the proper squat form. You won't be afflicted by ugly squat syndrome for the rest
of your life if you have it. Knee valgus can be treated with a series of exercises that include knee
stabilization, hip strengthening, and ankle mobility. Additionally, proper foot cueing is necessary
to keep your ankles and hips functioning properly when squatting. Fixing your valgus knee is a
long-term process. In addition, its tracked down that one of the major causative components of
ACL tears (explicitly in female competitors) had to do with the Q point. The Q angle is the point
that exists between the pelvis and the femur. Exorbitant Q points lead to what in particular's
called genu valgum, or what's all the more ordinarily known as knock knees.

In this image have been utilized as the obscure (This picture has
been obtained from the patient) which the neural organization

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doesn't know about. Regularly, here the picture is of the outside organ arrangement whereas the dataset
which have been altered are "X-Ray" Images.

This shows the quantity

of right results for each obscure picture of the patient. So there has been a 60 percent exactness
accomplished in this model which can propose that CNN can really plan a portion of the highlights from
the x-ray pictures to the ordinary human knee to make significant forecast. Anyway further investigations
on various cases other than the one referenced should be directed to learn the theory. Be that as it may,
this exactness can be additionally improved by utilizing more pictures of X-ray of knees as preparing sets.

References:
 Genu Valgum: Causes, Treatment, and More (healthline.com)

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  Genu Valgum (physiotherapy-treatment.com)
 https://www.healthline.com/health/genu-valgum#causes
 https://www.sciencedirect.com/science/article/pii/S1063458414013417#:~:text=Various
%20biomechanical%20methods%20suggested%20valgus,medial%20joint%20space%20during
%20gait.
 https://www.limblength.org/conditions/knock-knees/

 https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.99B1.BJJ-2016-
0340.R1#:~:text=Valgus%20knee%20deformity%20is%20defined,tissue%20components
%20around%20the%20knee.&text=Finally%2C%20over%20time%20the%20femur,may
%20undergo%20metaphyseal%20valgus%20remodeling.
 https://www.merriam-webster.com/dictionary/knee
 https://www.nhs.uk/conditions/knock-knees/
 https://www.healthline.com/health/genu-valgum#symptom
 https://bretcontreras.com/knee-valgus-valgus-collapse-glute-medius-strengthening-band-hip-
abduction-exercises-and-ankle-dorsiflexion-drills/

With the article that will be sent via email

Appendix:
We all as a group we discuss and choose the condition with the rehabilitation method:

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  Hind Alharmoodi: Did what is the normal conditions in biomechanics aspects, gather the
information’s from the group members and put it in one organized report, in addition the
description and appendix, checking plagiarism with correction.
 Farah Almihammad:True story, Did what causes the condition, and What is aim of the study.
 Dorsa Etehadi: What are the typical symptoms that characterize the condition, and What are the
methods.
 Azah Alali: What is the biomechanics basis of the condition, diagnosis of the condition and What
are the results and conclution. Final organization of the report.
 Ayah Saed Azroun: How is the condition treated and what is the treatment prognosis, and What
do you suggest for further investigation and why, using your biomechanical knowledge.

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