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Published by John Nunez on June 26, 2022
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Physical Therapy Knee

Your Knees Will Not Explode!

Yes, your knees can, in fact, go over your toes. I promise you that your knees will not explode if they go in front of your toes when working out. The reason I know this is because your knees actually have to go over your toes and end up in front of your toes during many normal daily activities or movements. 

Do you even go up stairs? Have you even bent down to pick something up off the ground? Oh you have? …well then keep reading because we’re about to put that archaic notion to rest once and for all. 

The conversation about “knees over toes” (KOT) is nothing more than simple biomechanics. As the knee moves forward, stress increases. For some people, this stress exceeds what the knee joint and muscles are capable of and there can be pain. This is common. But as with many injuries we discuss, it is about demand and capacity, and which is greater. So for other people, their capacity in the knee joint and muscles is able to handle the increased stress as the knee moves forward and we have no issues or red flags. 

Why are you concerning yourself with this blog then? Well as I mentioned, there are plenty of daily movements that place KOT increased stress at the knee and they are often where people experience some knee discomfort. When going up stairs your knees absolutely advance past your toes, and most of the time we are on our toes. Bending down to tie your shoes…sitting in a low seat or trying to get up from that seat…squatting down to get something out of a low cabinet…1/2 kneeling on the ground…etc. These are all times when the normal biomechanics of the knee are in a KOT position but these are also times when people experience pain. 

So instead of avoiding these positions like the plague, they should be addressed head-on. We shouldn’t consider these motions as impractical. Instead, we should emphasize increasing one’s tolerance for the knees over toes position so the movements won’t be an irritant. The knee is one of the workhorse joints in the body and it is imperative that we maintain strength and stability (capacity) so that the simple demands of everyday movements don’t exceed our ability (capacity) and cause pain or difficulty. 

Unfortunately, there seems to be this divide among clinicians and fitness individuals where KOT is either definitively good or definitively bad and no one is using any sort of clinical reasoning or discretion with when or how it is appropriate. This becomes confusing and counterproductive for the ultimate goal of facilitating better health for each individual. 

Ultimately, if you find yourself performing tasks that result in knees going over your toes, then you are probably in the category of people who will benefit from some structured health training to improve that movement. You don’t have to go to extremes and individuals who do often end up with issues regardless. But you should embrace the notion that your knees are in fact supposed to go in front of your toes for certain motions. It’s basic physics and it will help in the long run. 

Maybe we should discuss how to train for this next time? 😉

Happy Training!

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John Nunez
John Nunez

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All treatment at Feldman Physical Therapy and Performance is provided by Doctors of Physical Therapy. Because of this, you DO NOT need a physician’s prescription to attend physical therapy. Your therapist is well trained in recognizing conditions that are not appropriate for physical therapy, and, if necessary, will refer you to the proper specialist for treatment.

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