How does genu varum and genu valgum affect skiers?

Skiing is a demanding sport for the joints, especially the knees. That is why it is especially useful that the transmission of forces from the whole body to the skis is as efficient as possible thanks to the correct alignment of all the body’s axes. Deviation in any of these anatomical axes conditions not only movement and stability, but also the efficiency of execution of any technical sporting gesture.

In the world of skiing, it has been observed that the incorrect alignment of the lower limb axes means that skiers with genu varum (outwardly bowed legs) or genu valgus (legs in the shape of an X) can experience heterogeneous pressure on the joints during the descent, which can lead to more frequent injuries or performance difficulties.

“Knee misalignments can limit skiing performance and even lead to injury.”

So if you are genu varum or valgus, you have a handicap that you should pay attention to and for that, we will give you some tips and exercises. In any case, don’t forget that including specific Core training in your exercise routines to improve your physical preparation will help you to ski better. If you also include certain healthy habits in your daily routine, you will bring out the best skier in you. On the other hand, regulating the canting of your ski boots will help you ski more comfortably and transmit weight better. But let’s start at the beginning.

How do you know if you have genu valgus or valgus?

A simple method to determine if you have genu valgum or varus ( or have your legs in proper alignment) is to stand in front of a mirror with your trousers off and barefoot, and observe the position of your knees when you stand with your legs together.

If your knees touch but your ankles are apart, you may have genu valgum ( X-knees). On the other hand, if the ankles meet but there is a significant gap between the knees, you may have genu varum ( bowlegged).

If you want to be more precise and see if the angles are too sharp, you can use tape to draw a straight vertical line on the mirror or use the side frames as a reference. This visual test can give you a general idea, but for an accurate diagnosis it is always advisable to have a specialist perform a biomechanical gait analysis.

Genu Varus in skiers

Genu varum, commonly known as bowleggedness, causes the knees to move outward, which alters the body’s natural alignment and causes us to walk on the outsides of our feet. This misalignment primarily affects the stabilising muscles in the knees and hips, which are essential for maintaining stability and control during skiing.

In skiers who practice carving turns or who wish to apply genu varum (bowlegged) ski racing techniques, the knees tend to shift outwards, resulting in more weight on the outer edges of the skis when sliding in a straight line, making a direct descent or in a schuss position. Also in high speed turns or in hard snow conditions, where a firm edge grip is needed, the skier with genu varum may have difficulty maintaining stability or exerting the correct pressure.

In people with genu varum, the tibia may tilt outward from the knee, while the femur remains in a straight position. This can cause strain on the adductor muscles on the inside of the thigh, while the abductor muscles on the outside may weaken. Also the quadriceps, which is dedicated to eccentrically absorbing the impact when skiing, should receive a great deal of attention. As you know, the quadriceps is made up of four portions: the vastus lateralis, vastus medialis, vastus medialis, vastus intermedius and rectus femoris. A misalignment in the knees increases the uneven load on the quadriceps, which can lead to fatigue and decrease their ability to stabilise the knees. In the case of genu varum, it is the vastus lateralis quadriceps that suffers the most because it is located on the outside of the thigh. This is because the knees are displaced outwards, requiring greater activation of the vastus lateralis to stabilise the knee and prevent further outward deviation. Therefore, skiers with genu varum should pay special attention to specific work on the vastus lateralis quadriceps as well as the abductors and adductors.

When skiers with genu varum do not have adequate strengthening of these muscles, the lack of stability in the knees can lead to an increased likelihood of injury, such as torn ligaments, especially the anterior cruciate ligament (ACL), or meniscus injuries.

Genu Valgus in skiers

Genu valgus, or knock knees, is a condition in which the knees tend to collapse inwards and is very common in women. Genu valgus causes us to walk on the insides of our feet. For skiers, this posture can be especially problematic, as fast turns and descents require good leg alignment to maintain stability, transfer weight well and control edge catching.

As in the case of genu varum, in genu valgum you should be aware that the most important stabilising muscles most affected coincide in some cases. Let us explain. In the case of the quadriceps, we will have to pay attention to the vastus medialis, given that in genu valgus, this portion of the quadriceps, particularly the oblique portion known as the vastus medialis oblique (VMO), is the one that is stressed the most. The VMO is crucial in preventing the knee from collapsing inward. However, in people with genu valgum, this part is often weaker, which contributes to medial collapse of the knee, accentuating the problem. Therefore, it is essential to work on balanced quadriceps strengthening, with special attention to the vastus medialis oblique in cases of genu valgus.

Skiers with genu valgum tend to distribute their weight unevenly, which can overload the inside of the knees. In addition, they are more likely to carry weight on the inside of the feet and experience difficulty controlling movements, especially on off-piste or steep slopes (red and black runs) or in situations that require rapid changes of direction. This can lead to injuries to ligaments, such as the ACL (anterior cruciate ligament) or the internal lateral ligament, which are particularly vulnerable in sports such as skiing as we saw in the article on skiing and snowboarding injuries.

Prevention and treatment for skiers

For skiers with genu varum or genu valgus, it is crucial to follow a regimen of strengthening and stabilisation exercises for the legs, led by a licensed Physical Activity and Sports Scientist in collaboration with a good physiotherapist. Strengthening the core and stabilising muscles (core, quadriceps, hamstrings, abductors, adductors and glutes) is essential to improve knee alignment and reduce the risk of injury.

In addition, the use of orthopaedic insoles can help correct weight distribution and better align the legs when skiing, improving technique and reducing pressure on the joints. For professional or amateur skiers with more severe misalignments, a biomechanical study is also recommended to identify points of improvement in posture and movement.

Finally, in severe cases where significant joint damage has already occurred, surgical intervention may be necessary to realign the knees. However, with proper preventative treatment, many skiers with genu varum or genu valgum can continue to enjoy skiing without major complications.

And finally, we propose a series of exercises that you can do to mitigate the effects of genu varum or valgus. We hope you find them helpful and enjoy the ski season to the fullest.

By the way, if you liked this article, we invite you to subscribe to our monthly newsletter to receive directly in your inbox the most relevant news from the world of skiing every month.

Specific exercises for Club Legs and X-Legs

Here is a list of specific exercises that skiers with genu varum or genu valgus, differentiating between hamstrings, hip muscles and calf muscles, can perform to improve knee stability and prevent injury. As always, we recommend doing them under the supervision of a qualified professional.

Exercises for the hamstrings

Genu Varus:

1. Fitball hamstring curl: Lie on the floor with your heels on a fitball, raise your hips and roll the ball towards you by bending your knees. This exercise strengthens the hamstrings and improves stability.
2. Gluteal bridge with sliders: Place sliders under the feet, perform a gluteal bridge while sliding the heels towards the body, activating the hamstrings.

Genu Valgo:

1. Romanian deadlift: Keep your legs slightly bent and your back straight while lowering and lifting a barbell or dumbbells, intensely activating the hamstrings and strengthening the posterior chain.
2. One-legged pelvic raise: Lie on your back, raise one leg and raise your hips, contracting the hamstrings of the supported leg. This helps to balance the strength between the legs.

Exercises for the hip muscles

Genu Varus:

1. Clamshell (with elastic band): Lie on your side with an elastic band around your knees. Open and close your legs like a shell, activating your abductors and gluteus medius.
2. Lateral leg raises: Standing or lying on your side, raise one leg outwards. This exercise helps strengthen the hip abductor muscles.

Genu Valgo:

1. Squats with an elastic band: Place a band around your thighs and perform squats. The band forces you to activate your gluteus medius and keep your knees aligned, preventing them from collapsing inwards.
2. Lateral step-up: Step up onto a box or step sideways, with the outside leg doing the work. This exercise improves strength in the gluteus medius, which is essential for stabilising the knees.

Exercises for the calf muscles

Genu Varus:

1. Heel raises: Standing, raise and lower the heels, concentrating the work on the outside of the foot. This strengthens the gastrocnemius and improves ankle control.
2. Plyometric jumps on one foot: Perform controlled jumps with one leg, making sure to land softly to activate both the calf and stabiliser muscles.

Genu Valgo:

1. Toe-in heel raises: In this variation, the toes point slightly inward as you perform the lifts, focusing the work on the inner calf and improving ankle alignment.
2. Soleus Stretch: Hold a lunge position with the back knee bent to stretch and strengthen the soleus, an important muscle for ankle and knee stability.

Exercises for the abductors, gluteus medius and gluteus minimus.

Genu Varus:

1. Elastic band side walk: Place an elastic band around the thighs or ankles and take side steps, keeping tension on the band. This exercise strengthens the abductors, helping to prevent the knees from rolling outward.
2. Side kick on pulley or band machine: Standing, hook your leg over a low pulley or use a rubber band and perform side kicks, activating the abductor muscles to improve lateral hip stability.

Genu Valgo:

1. 1. Lateral leg raises: Lie on your side and raise one leg upwards. This exercise strengthens the gluteus medius, a key muscle in preventing the knees from collapsing inwards.
   2. Banded sumo squats: Place an elastic band over your knees and perform a squat with your feet wider apart than usual, activating your abductors to keep your knees aligned.