🦵Knees over toes!

Welcome to another week of Move to Improve! This week’s edition will be the first installment of a two-part series.

But before we dive in, I want to share one of my “Drew’s Picks” with you right at the top, because it’s just that good. Decades of longevity and health research are summed up in the advice and routines of these four experts.

These guys are the Mount Rushmore of longevity. The best of the best.

“The Workouts Longevity Experts Swear By for a Longer, Healthier Life” Read this article! Save it! Share it with your loved ones! You can trust their advice. Until I find new evidence that convinces me otherwise, I am confident in advising you to follow their advice wholeheartedly.

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Let me tell you about the time I herniated a disc in my low back.

To this day, I am still unable to sit comfortably in a full-depth squat.

But that was likely the cause of my low back pain—not a result.

The primary reason I can’t squat deeply very comfortably is because my ankle mobility is lacking. I don’t quite have enough ankle dorsiflexion (the movement when you pull your foot up toward your shin). When you go down in a squat, your ankles have to dorsiflex to drive your knees forward and keep your center of gravity balanced. The more you can drive your knees forward, the easier it is to stay upright. Elevating your heels helps. That’s why it’s easier to drop it low in heels! 👠

Trying to squat with limited dorsiflexion is even worse if you have long femurs, which I really do. Since my knees don’t go forward enough, I have to bend at the waist more to keep from falling backwards. (Act it out yourself if this isn’t making much sense.) This results in increased stress and pressure on my low back. And I believe this is the very reason I herniated a disc when I was squatting heavy my senior year of college.

So why don’t I have enough dorsiflexion? Because I was always afraid to squat with my knees over my toes.

All through 7-12th grade athletics when I was lifting weights, we were taught that squatting with our knees going past our toes was dangerous. That you’d “hurt your knees!” So we learned to squat, lunge, etc. without our knees traveling too far forward.

Training this way for 6+ years, especially since it was my first years of exercising, unsurprisingly had some lasting effects. It’s hard to undo and overcome a motor pattern and range of motion that my body learned for the better part of a decade.

So when I strained really hard on a heavy back squat my senior year of college, it was more stress than my back could handle at the time, and I herniated a disc.

It was torture. I hobbled out of the gym, bent over and whimpering in pain that only grew worse as the inflammation set in. I won’t go into more detail, but it was rough. Took a good amount of PT to get over, and to this day I still have issues with it if I’m not careful. Thankfully, I know how to be intentional enough with my movement practice to catch myself before things get bad, or rehab myself back to function when they do.

Please, for the love of everything, don’t be afraid of exercising with your knees going past your toes. We’ve known it for awhile now, but no one has popularized this concept more than “Knees Over Toes Guy,” himself, Ben Patrick. Scroll through his Instagram for some examples and inspiration.

He does a particularly great job of scaling exercises with levels of difficulty, from “so easy his elderly mom can do it” to “extreme feats of athleticism that would destroy most people’s knees in their current state.” But that’s the key. He wasn’t always this athletic. He had severe knee problems in his past. Just check the guy out and learn for yourself!

Where did this myth that “Your knees should never go past your toes, especially when squatting,” come from? There was a study in the 70s that measured stress, or “shear forces” on certain joints in various positions throughout a squatting movement. They observed that when we squat and our knees travel forward past our toes, the “stress,” or amount of shear force, on the joint significantly increases. They jumped to conclusions and recommended keeping your shins vertical and knees further back in a squat.

Where the translation of this into real-life application went wrong is that people interpreted “Stress = Bad!” and drew the conclusion that our knees should never go past our toes in squatting movements.

We shouldn’t look at stress as good or bad, necessarily. Stress can both harm us or make us grow; it all depends on the magnitude and what we’re prepared to handle.

Too little stress will not have much of an effect on us. More stress than we’re ready to handle in a given moment will usually hurt or injure us. But the ~just right~ amount of stress (there’s that Goldilocks principle again) is enough for our body to adapt and become stronger. That’s how we can better handle stress that’s near the threshold of our maximum tolerance, and can do more over time.

By trying to reduce stress on the knees in this way, we inadvertently increased stress on other joints. Your body will figure out a way to squat, one way or another. So instead of training our knees to be resilient, many of us learned to “protect” our knees, and suffered the repercussions in other joints that were forced to compensate.

Look at almost any decently athletic sport, and try to find an athlete whose knees don’t go past their toes while playing. Any powerful, driving, explosive motion where we’re leaning forward and pushing forward off the ball of our foot will put our knees in a loaded position past our toes.

• A basketball player driving into the lane

• A football lineman exploding out of his stance to block

• A sprinter taking off the starting blocks

• A soccer player pivoting to steal the ball

• Heck, even going up or down stairs puts our knees over toes!

We will certainly encounter activities in our lives that require our knees being over our toes. But if we never train in that position when we’re exercising in the gym, we won’t be strong and athletic in it during sport or life. That makes us likely to get injured, or to compensate with other body parts/joints.

This applies to any range of motion at any joint. You not only need “flexibility” (think passive stretching) in those joints, but also mobility, stability, and strength—the ability to produce force and safely use your body parts at the end-ranges of motion.

The phrase “use it or lose it” applies here. “Move to Improve” is the other, more positive side of that coin. Sure, you can lose it if you don’t use it. But I sincerely believe you can always move to improve it. Motion is lotion, baby!

Start slowly and be patient with yourself if you’re newer to this. If you’ve been sedentary and stiff for years, you’re not going to immediately be able to undo all of that in one workout and perform incredible athletic feats. It can take a long time to build back up, but you can get there!

Elevating your heels even just an inch or two can be a great starting point to help you practice knees-over-toes positions in squats and lunges if you don’t yet have great ankle mobility (🙋🏼‍♂️).

Don’t be afraid of your body’s capabilities. If you train and stress your body just the right amount, progressively over weeks and months and even years (and you recover properly), you’ll be amazed at what you can accomplish at your body’s full potential.

✅ Take Action

Every newsletter's Take Action section will invite you to take small steps to improve your health. Recognizing that we all have different capabilities, I'll offer three different levels of action you can choose to take.

Level 1: Check out @kneesovertoesguy on Instagram and learn a bit about his philosophy.

Level 2: Try to incorporate a few of Ben Patrick’s key exercises, like reverse treadmill walks, Poliquin step-ups, ATG split squats, etc.

Level 3: Don’t be afraid of movement. If you’re confident in your biomechanics and are good at listening to your body, ease into training deeper ranges of motion than you’re used to. Start with bodyweight and progress to weighted movement. You might be surprised at how supple and resilient you begin to feel!

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✍️ Drew's Picks:

• The Workouts Longevity Experts Swear By for a Longer, Healthier Life. Here’s that article again. READ IT! :)

• Remember to follow the Move to Improve Instagram!

• Podcast: Real food and the science behind healthy lifestyles. This episode of “All the Hacks,” another favorite of mine, was a great listen that really aligned with my philosophy on food.

• Podcast: “A mind-expanding conversation about human history and happiness with Tim Urban.” Can you tell I like podcasts? This one was fascinating and put things in perspective. The past few centuries have truly been unlike the vast majority of human history. I can’t wait to read his new book!

• Apply here to be a volunteer at the 2024 Paris Olympics! I’ll be there! 🥇

Stay tuned for next week’s follow-up about why I think permanently labeling body parts (e.g. “bad back”) is a detriment to our health and potential healing. I’ll offer a new way of thinking about the aches and pains we face, and of course provide hope and solutions. A lot of it has to do with our mindset.

If you liked this newsletter, share with a friend so we can continue to grow!

Keep moving,

Drew

The content in Move to Improve is meant to be informative in nature, but it should not be taken as medical advice. It is always a good idea to consult with a trusted health professional before making any major lifestyle changes that could have a significant impact on your health. This is not a medical resource, and any opinions and articles are not intended for use as diagnosis, prevention, and/or treatment of health problems. They are not substitutes for consulting a qualified medical professional. Please think critically and take what I say with a grain of salt (aka don’t sue me).