Bulgarian Split Squat – Knees over toes?

 In Lower Limb

As a physiotherapist that treats knee pain day in and day out, I love prescribing the bulgarian split squat. The bulgarian is an excellent exercise aimed at strengthening the quadriceps, glutes and hamstrings. Some knee conditions I’ll prescribe this exercise for include, but are not limited to, Patellofemoral Pain, Knee Osteoarthritis, middle stage ACL/MCL/LCL rehab, meniscal injuries and ITB Syndrome.

When my clients attempt the Bulgarian for the first time, they will almost always bring their front knee over their toes. As I state in the video, this is NOT a problem for those without knee pain. Studies have shown that when allowing the knee to come over the toes during a squat, more force is placed on the knee [1]. This can be problematic at times for an angry knee.

Clinically, I have found that by keeping the shin vertical (knee behind toes) during the bulgarian, my clients tend to notice less knee pain. This is a huge win for my clients rehabilitating their knee pain.

So how do you actually bring the knee behind the toes during a bulgarian? I’ll often be giving this exercise to clients that have never tried a squat before, so minor technique changes can feel very foreign. 2 cues that work well for me are:

  1. Bring your front foot a lot further forward than you initially anticipate
  2. While at the bottom of the bulgarian, try to shift your body backwards onto your back leg

These 2 changes allow my clients to perform a relatively difficult exercise with minimal knee pain and gain confidence in their body. Moral of the story: don’t throw the baby out with the bath water! If you can tinker with an exercise to reduce pain and ultimately achieve the same goal, then you’re going to have good outcomes.

George Dooley (APAM)
Master Physiotherapist

George Dooley

Click Here to book an appointment with George today.

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[1] Fry, A. C., Smith, J. C., & Schilling, B. K. (2003). Effect of knee position on hip and knee torques during the barbell squat. The Journal of Strength & Conditioning Research, 17(4), 629-633.

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