The age old debate, knees out or knees in for the best squat stance? Well if you ask a PT, you will get the classic answer that “it depends.” But what does the answer depend on? We can consider individual anatomy such as leg length and torso length, variation in rotation at the hip (femoral anteversion or retroversion), and specific muscles targeted with the exercise among other things. Here is a brief overview of what to consider when choosing your squat stance.
Anatomy: Squat stance is not a one size fits all approach. As a general rule, standing with feet approximately shoulder width apart and toes turned slightly out is a great starting point. For those members of the long femur club, attempting a stance that is a bit wider may be more comfortable. There are a number of specific tests that a Physical Therapist can perform to determine how your individual anatomy impacts your ideal squat stance. The key is that you identify the stance width and amount of toe out that enables you to comfortably squat with the hip crease going below the knee and minimal change in spinal position during the repetition.
Specific muscles being targeted: Recent research by Chiu1 looked at differences in muscular demand at the hip compared to typical squat stance based on knees in (volitional medial rotation of the hip) versus knees out (volitional lateral rotation of the hip). The study found that when an individual performed a knees in squat they actually increased the demand on the hip lateral rotators and decreased the demand on the hip adductors and hip extensors. Conversely, a knees out squat increased the demand on the hip adductors while decreasing demand on both the hip extensors and lateral rotators.
Pain with squats: Some amount of discomfort is expected when performing high intensity strength training, however; discomfort and pain are not the same thing. Pain does not always mean complete avoidance of an exercise. More often than not, pain means temporary modification or changing the approach. For example, if you are dealing with lateral hip pain when squatting, try a knees out approach to reduce the demand on the lateral rotators. Modifying range of motion and reducing load with the addition of slower tempo are other great options to continue training with pain.
If you are interested in diving deeper into your specific issues with squatting, looking to identify your ideal squat stance, or unsure of how to get started with squats, schedule an appointment today with one of the experts at Rise!
References:
Chiu LZF. "Knees Out" or "Knees In"? Volitional Lateral vs. Medial Hip Rotation During Barbell Squats. J Strength Cond Res. 2024 Mar 1;38(3):435-443. doi: 10.1519/JSC.0000000000004655. Epub 2023 Dec 13. PMID: 38416444.