Specialista in Ortopedia Pediatrica
Valgus/varus knee (functional)
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Clamshell
Strengthens hip external rotators that control knee position
Lying on side, knees bent 90°, feet together. Open top knee like clamshell opening, keeping feet in contact. DON'T rotate pelvis backward. Hold 2-3 seconds at top. To increase difficulty, use band above knees.
3 × 15 reps each side
2.Side-lying hip abduction
Strengthens gluteus medius, essential hip stabilizer
Lying on side, bottom leg bent for stability. Lift top leg straight toward ceiling, keeping it in line with body (don't bring forward). Toe slightly rotated down. Lower with control. To progress, add light ankle weight.
3 × 15 reps each side
3.Monster walks with band
Dynamic glute activation during movement
With band above knees (or at ankles for more difficulty). Semi-squat position, feet shoulder-width. Walk sideways in small steps, maintaining constant band tension. Then walk in other direction. Knees must stay over feet, not collapse inward.
10-15 steps each direction × 2-3 sets
4.Single-leg glute bridge
Advanced glute strengthening with pelvis control
Supine, knees bent. Extend one leg. Lift pelvis using only support leg, keeping pelvis LEVEL (don't let unsupported side drop). This exercise requires gluteus medius control and strength besides gluteus maximus.
3 × 10-12 reps each side
5.Motor control (single-leg stance)
Learning to maintain correct alignment on one leg
Stand on one leg in front of mirror. Observe alignment: hip - knee - ankle should be on vertical line. Knee shouldn't "collapse" inward (valgus) or bend outward (varus). Activate glutes to correct. Start holding support, then release.
3 × 30 seconds per leg focusing on alignment
6.Mirror-controlled squat
Practice correct movement with visual feedback
In front of mirror, feet shoulder-width. Squat down ensuring knees stay aligned over 2nd-3rd toe. FOR VALGUS: activate glutes to "push" knees out. FOR VARUS: focus on not spreading excessively. Slow movements!
3 × 10 focusing on correct technique
7.Controlled step-down
Functional exercise for dynamic valgus control
Standing on step, facing mirror. Slowly lower with one leg touching floor with heel, then rise. Observe that support leg knee stays aligned and doesn't collapse inward. If knee gives way, lower step height.
3 × 10 per leg
8.Ankle mobility (knee-to-wall)
Stiff ankle can cause knee compensations
Foot 10 cm from wall. Bend knee trying to touch wall with kneecap, heel firmly planted. If easy, move foot further. If heel lifts, bring closer. Often limited dorsiflexion causes knee "collapse" during squat.
10-15 reps each side
9.Lateral step-up with pelvic control
Functional weight-bearing glute strengthening with alignment feedback
Standing sideways to a low step (10-15 cm), step up with the leg on the step pushing through the heel, without pushing off with the other foot. Watch two things: the knee must stay over the foot and the pelvis must stay level. Lower in 3 seconds. Increase height only when alignment is perfect for all reps.
3 × 10 per leg, progressive height
10.Controlled landing (drop jump)
Trains the knee not to collapse inward during fast sporting movements
Standing on a low step, step down (do not jump) and land on both feet at the same time, absorbing with soft hips and knees, silently, knees aligned over the feet. Filming the landing with a phone helps a lot: if the knees move toward each other, lower the height and focus on technique. Neuromuscular training programmes including these exercises significantly reduce knee injuries in young athletes.
3 × 8 landings, 2-3 times a week
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
Versione Web
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MioDottoreBefore You Start
Who is this guide for?
Children with knee angular deviation beyond physiological limits for age. Exercises support but don't replace any treatment needed.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
Usually 1-2 times daily, as directed during the visit. Consistency is more important than intensity.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Clamshell
Strengthens hip external rotators that control knee position
Lying on side, knees bent 90°, feet together. Open top knee like clamshell opening, keeping feet in contact. DON'T rotate pelvis backward. Hold 2-3 seconds at top. To increase difficulty, use band above knees.
3 × 15 reps each side - 2
Side-lying hip abduction
Strengthens gluteus medius, essential hip stabilizer
Lying on side, bottom leg bent for stability. Lift top leg straight toward ceiling, keeping it in line with body (don't bring forward). Toe slightly rotated down. Lower with control. To progress, add light ankle weight.
3 × 15 reps each side - 3
Monster walks with band
Dynamic glute activation during movement
With band above knees (or at ankles for more difficulty). Semi-squat position, feet shoulder-width. Walk sideways in small steps, maintaining constant band tension. Then walk in other direction. Knees must stay over feet, not collapse inward.
10-15 steps each direction × 2-3 sets - 4
Single-leg glute bridge
Advanced glute strengthening with pelvis control
Supine, knees bent. Extend one leg. Lift pelvis using only support leg, keeping pelvis LEVEL (don't let unsupported side drop). This exercise requires gluteus medius control and strength besides gluteus maximus.
3 × 10-12 reps each side - 5
Motor control (single-leg stance)
Learning to maintain correct alignment on one leg
Stand on one leg in front of mirror. Observe alignment: hip - knee - ankle should be on vertical line. Knee shouldn't "collapse" inward (valgus) or bend outward (varus). Activate glutes to correct. Start holding support, then release.
3 × 30 seconds per leg focusing on alignment - 6
Mirror-controlled squat
Practice correct movement with visual feedback
In front of mirror, feet shoulder-width. Squat down ensuring knees stay aligned over 2nd-3rd toe. FOR VALGUS: activate glutes to "push" knees out. FOR VARUS: focus on not spreading excessively. Slow movements!
3 × 10 focusing on correct technique - 7
Controlled step-down
Functional exercise for dynamic valgus control
Standing on step, facing mirror. Slowly lower with one leg touching floor with heel, then rise. Observe that support leg knee stays aligned and doesn't collapse inward. If knee gives way, lower step height.
3 × 10 per leg - 8
Ankle mobility (knee-to-wall)
Stiff ankle can cause knee compensations
Foot 10 cm from wall. Bend knee trying to touch wall with kneecap, heel firmly planted. If easy, move foot further. If heel lifts, bring closer. Often limited dorsiflexion causes knee "collapse" during squat.
10-15 reps each side - 9
Lateral step-up with pelvic control
Functional weight-bearing glute strengthening with alignment feedback
Standing sideways to a low step (10-15 cm), step up with the leg on the step pushing through the heel, without pushing off with the other foot. Watch two things: the knee must stay over the foot and the pelvis must stay level. Lower in 3 seconds. Increase height only when alignment is perfect for all reps.
3 × 10 per leg, progressive height - 10
Controlled landing (drop jump)
Trains the knee not to collapse inward during fast sporting movements
Standing on a low step, step down (do not jump) and land on both feet at the same time, absorbing with soft hips and knees, silently, knees aligned over the feet. Filming the landing with a phone helps a lot: if the knees move toward each other, lower the height and focus on technique. Neuromuscular training programmes including these exercises significantly reduce knee injuries in young athletes.
3 × 8 landings, 2-3 times a week