Exercises For Hyperextended Knees - Posture Direct

This blog post contains effective exercises and strategies to help fix the postural presentation of Hyperextended Knees.

What Are Hyperextended Knees?

Hyperextended Knees is where the knee joints are bent backwards further than the normal amount whilst in the standing position.

(It is also referred to as Genu Recurvatum or having “Banana knees”.)

Table Of Contents

• Causes
• Is it “bad”?
• Test to determine if you have it
• Hyperextended Knees Exercises

What are the Causes?

In my opinion – a combination of the following factors are the main causes of Hyperextended Knees.

a) Laxity/Hypermobility

An excessive amount of flexibility/laxity in the structures behind the knee can predispose the knee joint to hyperextend.

This causes the knee joint to rest on the passive structures of the knee (as opposed to relying on the muscles).

b) Poor Control Of Muscles

Over extension of the knee can result from an imbalance in the muscular forces that are involved with stabilization of the knee.

c) Weak and/or Overstretched Muscles At The Back Of The Knee

The muscles which are located behindthe knee are responsible for minimizing the amount of hyper-extension available in the knee.

These include:

• Lower Hamstrings
• Upper Gastrocnemius
• Popliteus

d) Certain Postures

There are certain postures that tend to encourage the hyperextended knee position.

These include:

• Anterior Pelvic Tilt
• Sway Back Posture
• Rotated Pelvis
  • Pelvis rotates towards the side with the hyper-extended knee)

e) Poor Ankle Dorsiflexion

Ankle Dorsiflexion is the movement where the foot bend back towards the shin bone.

Limited ankle dorsiflexion can force the knees to over extend to compensate for the lack of mobility in the ankle.

f) Structural

Due to the shape of the bones and joint, some knees are genetically in the hyperextended position.

Although we are not able to change the structure of your bones and joints, the exercises mentioned in this blog post can still help control the position of the knee.

Is it bad to have Hyperextended knees?

No posture is inherently “bad”. It really depends on how the body is able to adapt and respond to the posture.

However- If you have naturally hyperextended knees, it is very likely that your body weight is resting on the passive structures in the knee joint.

This may lead to injuries to certain structures:

a) BACK of the knee

There is overstretching of the following knee structures:

• Ligaments (ACL, PCL)
• Posterior Capsule
• Distal Hamstrings
• Popliteus
• Upper Gastrocnemius

b) FRONT of the knee

There is compression of the following knee structures:

• Front portion of the Meniscus
• Patellofemoral joint

Hyperextended knee test

Not sure if your knees are hyperextended? Try this quick test.

Instructions:

• Take a photo of your side profile whilst standing.
• Draw a line between the ankle and hip joints.
• Locate the center of the knee joint.
• What is the position of the knee joint relative to this line?

How to tell if you have Hyperextend Knees: The knee will be positioned behind the line between the ankle and hip.

(Note: It is completely normal to have the ability to hyperextend the knee to 5-10 degrees. Issues may arise if you overly lock your knee in this position whilst standing/walking/moving.)

Exercises to fix Hyperextended knees

Steps involved:

STEP 1: ReleasesSTEP 2: StretchesSTEP 3: Activation ExercisesSTEP 4: Taping for Hyperextended KneesSTEP 5: Neutral Knee PositionSTEP 6: Anti-Hyperextension ExercisesSTEP 7: Check Ankle DorsiflexionSTEP 8: Address PostureSTEP 9: Tips

1. Releases

The first step is to release the tight and/or overactive muscles that tend to encourage the overextension of the knee.

a) Front Thigh Muscles

Instructions:

• Lie facing downwards on the floor.
• Position the front of the thigh on top of a foam roller.
• Apply as much of your body weight on the foam roller as you can comfortably tolerate.
• Relax your leg.
• Make sure to cover the entire thigh.
• Continue for 2 minutes.

Note: Keep your knee in a slightly bent position to avoid it hyperextending.

2. Stretches for Hyperextended knees

Tightness and/or overactivity of the following muscles need to be stretched to minimize overextension of the knee.

a) Quadriceps Stretch

Instructions:

• Stand up.
• Hold onto something for balance.
• Bend your knee backwards.
• Hold onto your ankle and pull your foot towards your buttock.
• Keep your knees together and aligned with one another.
• Engage your buttocks and push your hips forwards.
• Aim to feel a stretch at the front of the thigh.
• Hold for 30 seconds.

For more thigh stretches

See Post: Quadriceps Stretches

3. activation Exercises

The next step is to activate and engage the muscles that help bring the knee out of hyperextension.

Muscles Involved:

• Popliteus
• Hamstring
• Gastrocnemius

Popliteus

The Popliteus is a muscle that is located behind the knee.

a) Tibial Internal Rotation

Instructions:

• Sit down on a chair with your hip/knees bent at 90 degrees.
• Hold your knee straight with your hands.
• Without moving the knee, pivot your lower leg inwards.
  • (Internal rotation of the Tibia bone)
• Make sure your foot does not lift off the ground.
• Repeat 30 times.

(For more exercises to encourage this movement: Tibial Internal Rotation.)

Hamstrings

The Hamstrings are the main muscles which will resist the hyperextension of the knees. It is important that you know how to activate them!

Note: If you are not used to engaging your Hamstrings, it is possible that you may get a cramp with some of these exercises. Be careful!

a) Standing Leg Curl

Instructions:

• Whilst standing, hold onto something for support.
• Keep your knees together.
• Lift your foot and bend the knee as firmly as you can.
• Aim to feel a firm contraction in the back of the thigh.
• Hold this contraction for 30 seconds.

b) Heel Drag

Instructions:

• Sit down on a chair.
• Place your heel on the ground in front of you.
• Dig your heels into the floor and drag your heel backwards as hard as you comfortably can.
• Aim to feel the activation of the Hamstring.
• Repeat 30 times.

c) Heel Drive With Knee Extended

Instructions:

• Sit down on a chair.
• Place your foot onto a support that is the same height as your chair.
• Keep your leg slightly bent.
• Dig your heels downwards as hard as you comfortably can.
• Aim to feel the activation of the Hamstring.
• Hold this contraction for 30 seconds.

For more exercise like this:

See Post: How To Strengthen Hamstring Muscles

4. Taping to limit hyperextended knee

Taping the knee can help limit the amount of Hyperextension occurring in the knee.

a) Knee Taping

(You will need tape and some help from a friend to apply the tape for you.)

Instructions:

• Lie down on your stomach.
• Place a pillow underneath your ankles.
• Apply 2x tape in a cross pattern to the back of the knee.

Note: The skin behind the knee tends to be a sensitive area. Irritation may occur if your knee is sensitive to the adhesive in the tape.

5. Neutral Knee Position

Increase your awareness of your knees.

It is essential to know and feel where the ideal position of your knee is.

Here’s how to find it:

Instructions:

• Start in the standing position with both knees slightly bent.
• Slowly straighten your knees.
• Gain a sense of the exact moment when the knees are just about to transition into the hyperextended position.

Remember this position! This is the knee position that you will need to maintain with the following exercises.

6. Anti-Hyperextension Exercises

These exercises will help balance out the muscular control around the knee joint.

a) Controlled Leg Drop

Instructions:

• Lie on your stomach.
• Place a foam roller underneath the top part of knee.
• Slowly lower your leg down withouthyperextending the knee.
• Perform 20 repetitions.
• Progression: Place an appropriate amount of weight on your ankle.

b) Heel Drive With End Range Extension (Sitting)

Instructions:

• Sit down on a chair.
• Place your foot on a chair that is approximately the same height as the chair
• Drive your heel down into the chair to engage your hamstring muscles.
• Whilst keeping the hamstrings activated, slowly bring your leg into end-range extension.
• Do not hyperextend the knee.
• Perform 20 repetitions.

c) Heel Drive with End Range Extension (Standing)

Instructions:

• Whilst standing, place your foot in front of you.
• Keep your leg straight.
• Lean forwards.
• Drive your heel down into the ground to engage your hamstring muscles.
• Whilst keeping the hamstrings activated, slowly bring your knee into end-range extension.
• Do not hyperextend the knee.
• Perform 20 repetitions.

d) Heel Raises

Instructions:

• Stand up right.
• You can hold onto something for balance.
• Keep your legs as straight as possible without over extending the knee.
• Lean slightly forwards.
• Move onto your toes.
• Slowly drop your heel downwards.
• Perform 20 repetitions.
• Progression: Perform the exercise standing on one leg only.

e) Alternating Leg Lift

Instructions:

• Sit on the floor with your legs straight in front of you.
• Place your hands on the floor behind you to support your torso.
• Drive your heels into the floor through the exercise.
• Lift your hips upwards.
• Alternate lifting your foot off the floor.
• Do not allow the knees to hyperextend.
• Perform 20 repetitions.

f) End Range Extension in Single Leg Stance

Instructions:

• Stand on one leg.
• Whilst keeping the hamstring muscle activated, slowly straighten the knee as much as possible without hyperextending.
• Perform 20 repetitions.

g) End Range Extension with Resistance Band

Instructions:

• Wrap a resistance band around the front of your knee.
• Tie the other end of the band to a stationary object that is behind you.
• Step away from the anchor point as to increase tension on the resistance band.
• Lift the other knee off the floor so that you are balance on the leg with the resistance band wrapped around it.
• Engage the hamstring muscle.
• Slowly straighten the knee without hyper extending.
• Perform 20 repetitions.

h) Single Leg Balance

Instructions:

• Stand on one leg.
• Engage your hamstring muscle.
• Straighten your leg as much as possible without overextending the knee.
• Maintain your balance.
• Continue for 30 seconds.

7. Check your ankle

If the ankle is locked in a degree of plantarflexion (pointed foot), the body is going to have a difficult time getting the body on top of the base of support. This can force the knee to compensate by hyperextending.

Does your ankle have the ability to assume the neutral position?

If you have tight ankles: Here is a blog post which goes through a complete list of exercises to help improve your ankle mobility.

You can start with these:

a) Lower Calf Muscle Release

Tightness in calf muscles can limit the amount of ankle dorsiflexion which may cause the knees to hyperextend as a compensation.

Instructions:

• Sit on the floor with your legs straight in front of you.
• Position the back of the lower calf muscle on top of a foam roller.
• Place your other leg on top and apply a downward pressure.
• Keep your foot completely relaxed.
• Rock your leg from side to side over the foam roller.
• Make sure to cover the entire lower portion of the calf muscle and the Achilles Tendon.
• Continue for 2 minutes.

Note: Be careful not to over extend the knee in this position.

b) Soleus Stretch

Instructions:

• Assume the lunge position with back leg bent. (see above)
• Sink your body weight onto your back leg.
• Think about getting your shin bone as close to the floor as possible.
  • Do not lift your heel!
• Aim to feel a stretch in the back of your calf.
• Hold for 30 seconds.

c) Ankle Traction

(To perform this exercise, you will need assistance. So – go grab a friend!)

Instructions:

• Lie on the floor.
• Instruct your friendly helper to firmly grasp your ankle below the bony bits on the side. (see above)
• Relax your leg as your assistant pulls your foot away from you.
• Hold for 30 seconds.

d) Dorsiflexion With Band

Instructions:

• Attach a resistance band to something behind you. (Make sure it doesn’t move!)
• Loop the band around the front of the ankle.
  • Make sure the band is below the bumps on side of the ankle.
• Move away from the anchor point as to increase tension in the band.
• Assume the lunge position with your ankle on a bench. (see above)
• Lunge forward.
• Repeat 30 times.

e) Ankle Dorsiflexion Strengthening

Instructions:

• Whilst sitting, slightly slide your foot underneath you whilst keeping your foot flat.
• Lift the front part of your foot off the floor.
• Aim to feel the activation of the muscles in the front of your shin.
• Hold for 10 seconds.
• Repeat 10 times.

8. Address posture

The following postures tend to encourage the knees to hyperextend in the standing position.

a) Anterior Pelvic Tilt

Anterior Pelvic Tilt is where the pelvis tilts forwards.

This can angle the femur bone backwards and result in the over extension of the knees.

For more information: Exercises for Anterior Pelvic Tilt

b) Sway Back Posture

Sway Back Posture is where the pelvis is pushed forwards relative to the feet.

With this posture, it is common to see the thigh muscles over contracted which can lead to hyperextended knees.

For more information: Exercises for Sway Back Posture

c) Rotated Pelvis

The twisting of the pelvis towards one side can result in having only one knee that is hyperextended.

For more information: Exercises for Rotated Pelvis

9. Quick Tips

• When standing, keep your knees soft and relaxed.
• Do not lock your knees straight.
• Stand with your hips directly on top of your ankles.
• If you tend to sleep with hyperextended knees, place a pillow underneath your knees whilst sleeping on your back.

Conclusion

Having knees that bend further than they normally should does not necessarily mean that you will have issues. However – it does potentially place more strain on the structures of the knee.

If you are having issues related the Hyperextension of the knees, this can be effectively addressed with the exercises mentioned on this blog post.

I encourage you to persist with these exercises for at least 12 weeks.

What to do next

1. Any questions?… (Leave me a comment down below.)

2. Come join me:

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3. Start doing the exercises!

Disclaimer: The content presented on this blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. It exists for informational purpose only. Use of the content is at your sole risk. Seek guidance from a health care professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.