Knee pain – or a lack of faith in your knees’ ability to withstand hard training or intense competition –puts a cap on your athletic potential. Here are the keys to a joint strategy that will reap rewards.
Bad knees. The words conjure images of popping joints, morning runs turning into jogs and walks, and pizza-box-height vertical leaps. You probably know a few people who have bad knees – an estimated 1 in 5 Australians who are over the age of 40 fight chronic knee pain. You might even have a pair of less-than-stellar knees yourself.
Ben Patrick, 30, knows bad knees well. Patrick is Knees Over Toes Guy, a social-media sensation/knee-rehab guru whose training methods promise to end knee pain and juice athletic ability. Patrick himself suffered from bad knees, and he says he still remembers being called the “old man” of his high school hoops team, back when he had knees so bad he could barely jump 60cm high. You’d never know that from checking his Instagram (@kneesovertoesguy) now, though. His 1.4 million followers watch him drag sleds, train with elite CrossFitters and weightlifters, and throw down dunks.
Patrick’s secret: he regularly pushes his knee’s range of motion to its max, bending the joint so deeply that hamstring touches calf, his knee extending so far in front of him that it goes beyond the tips of his toes (hence his “knees over toes” handle). The way he sees it, every foundational athletic movement (running, jumping, lunging, squatting) requires you to move knees over toes. Watch your knees as you descend a flight of stairs and you’ll notice that Patrick is right. But if it’s so natural, what makes his advice so special? Well, his advice runs counter to what doctors and trainers have long recommended: when you lower into the bottom of a squat or lunge, you should never let your knees pass beyond the tips of your toes. The reasoning for this conventional wisdom is relatively simple. Imagine a straight line shooting up from your toes; keeping your knees behind this line helps them stay safe by never stressing the joint. In limiting your knee’s range of motion, you build strength without ever running the risk of aggravating it.
Patrick disagrees. “The knee that can go farthest and strongest is the most protected,” he says, quoting the late Charles Poliquin, a legendary strength coach. “The moment I read that, I knew it was true because of everything I’d been through.” So he encourages his clients and online subscribers to do exercises that actively drive knees in front of toes, like extreme split squats and reverse sled pulls.
The social-media explosion around Patrick has refocused the fitness conversation onto the knee joint itself – and exercises that help stabilise it. But Patrick has no formal training in medicine or physical therapy, and qualified experts don’t fully embrace his theories.
You can learn plenty from his approach – but not every move will erase your knee pain.
The risks
Traditional methods of knee strengthening start with the joint above your knee, the hip. Many experts value knees-over-toes movement but only if you have hip and glute control.
Brad Schoenfeld, a renowned trainer and muscle researcher, says he’s “not aware of any evidence showing that intentionally forcing the knees to go over the toes during squatting and other lower-body exercise improves joint health”.
And personal trainer Dan Giordano, the chief medical officer of Bespoke Treatments, can’t rationalise pushing a painful knee to its limits to kick-start healing. “Medically speaking,” he says, “you should offload the joint and transfer mechanical stress to the hip to allow the knee to start healing itself.”
Translation: at some point, yes, you can drive knees over toes, but if you’re recovering from a knee injury, strengthen your glutes first as a nonnegotiable first step.
The rewards
If you’ve already built that glute strength, Patrick’s exercises can help you take your knee strength to the next level and bulletproof the joint, too. “He’s done a great job of bringing significant parts of training to the forefront,” says trainer Brian Harrington, who works with high school and university hoops athletes.
That starts with his singular focus on knee flexing. His extreme split squats, for example, ready your knees to handle the awkward positions you might land in during games of pickup basketball or even tag with your kids.
His exercises also serve to cushion your knees against impact. That’s the beauty of the tibia raise. You’ve done calf raises before, but the tibia raise, which Patrick has helped popularise, strengthens the front of your lower legs, which work to decelerate your body on every stride and jump – and protect those knees.
Another Patrick favourite is the reverse sled pull, which gently works your quads every time you straighten your legs and pull the sled back, building muscle to help stabilise your knee. All these moves subtly enhance your athleticism, too, letting you build the same spring and stability that Patrick showcases regularly on Instagram.
Your key: don’t start with moves like Patrick’s extreme split squat. Ease into knees-over-toes training with the four moves above. (And keep strengthening those glutes.) Don’t let your knees dictate terms!
Beef Up Your Leg Day
These four exercises from Patrick are worth mastering to build leg strength and athleticism. Start with the first move and gradually work to learn the others over the course of your training.
1.Reverse Sled Pull
WHY: Each step back forces you onto the balls of your feet, before you straighten your knee and drive into your heel. “With each step backward,” says Patrick, “you are loading the knee for greater strength.” But the sled provides gentle resistance, since it’s delivering only horizontal force.
DO IT: Load a sled. Wrap a harness around your waist. Walk backwards. Take 20-30 steps per leg; do 2 or 3 sets. You can do this daily as part of your warm-up.
2. Tibia Raise
WHY: The tibialis, a muscle that starts under the knee and runs to the bottom of your foot, is a key decelerator of your foot – but it rarely sees direct weight-room work. “A stronger tibialis means less stress on the knees and more protection for your shins and ankles,” says Patrick.
DO IT: Stand with your butt against a wall. Without bending your knees, lift your toes. The further your feet are from the wall, the harder it gets. Do 3 sets of 20 reps; you can do this move daily.
3. Heels-Elevated Goblet Squat
WHY: If you struggle to flex your ankles, you likely can’t drive your knees over your toes during standard squats. But by elevating your heels, you erase that limitation and can squat low. “You build strength with a full range of motion,” Patrick says.
DO IT: Stand with your heels on weight plates, a weight at your chest. Bend at the knees and hips, lowering your torso as low as you can. Pause, then stand. Do 3 sets of 15.
4. Reverse Nordic Curl
WHY: This isn’t a regular part of your training, but it is a solid test of your knee’s range of motion. Do it once a month.
DO IT: Sit on your shins, abs and glutes tight, knees wide. Maintain a straight line from shoulders through knees as you lower backwards. Stop lowering if you feel any pain in your knees, pause, then return to the start. Do just a few reps (2-4 is plenty), and focus on lowering slowly.
