 Hello everybody, Lance Goyki here. Today I want to talk about tibial torsion. Now what is that? Torsion is like this twisting, I guess, but it's not a rotation, right? So my shoulder can rotate, but that is a rotation. That is not a torsion. Let's say, for example, if I broke the middle of my humerus bone, my upper arm bone, my brachium, and then it healed where my thumb was kind of pointing outward a little bit, that would be a humeral torsion. There is, like it wouldn't change how this proximal joint, this shoulder joint is oriented, but it would change the twisting or the outcome of later on down the joint. So with the tibia, the tibia is the shin bone, and this can be really important for our lower body exercises, right? Our squats, our deadlifts, our single leg movements, all of these things can be affected by a tibial torsion. And I'm a really good person to show this to you because I actually have some on my left tibia here, but not on my right one. So double cool, right? If I line my knees up just like this, let me try to be right here on the camera here. So if I, let's say, I'm gonna point both my toes directly forward. If this is not comfortable for me, my back is tight, my knee here feels torqued. That is because my tibia, my left tibia down here is twisted along the shaft. And so my knee alignment, if it were to be like my right one, would have to be in a way that turns my toe outward, okay? So it looks like I'm externally rotating my hip, but in this case, I'm actually a little more neutral. Both my hips are in a like relative zero standpoint, or relative zero position. So we can look down and we can look at both of my knees and they're both maybe 15 degrees pointed outward. So what I would suggest, if you're wondering if you have tibial torsion, stand in a way that you feel comfortable and check your knees, okay? If they look to be symmetrical and your hips are squared on something, for me right now, I'm squaring them to the camera, then I can say, oh, well, if my toe is still turned out, then it sure looks like I have a tibial torsion. What does this mean? So we just have to consider the change in the mechanics that I have to deal with on my left leg, relative to my right leg. So my right leg works really well when it walks, works really traditionally, I guess we'll say. As I come through a step and I have my heel coming off the ground and my toe coming off the ground, my foot can stay in line, like it's walking on a railroad track. My left one turns out a little bit and I have to come over my big toe. So if we think about the dynamics of that, okay? If my tibia is rotated, my foot can be properly positioned, but it will deal with forces differently than my right foot. So if my right foot comes down like this, my left foot comes down like this and they both have their good foot arches, then as I step forward, the left one is going to flatten more than the right one flattens, okay? So my left foot will look like I have a flatter foot or flat feet on my left foot. I would not want orthotics, like foot orthotics to treat both of these feet the same way because they don't act the same way and they don't have the same structure and they don't deal with the same biomechanics, forces with the ground. Let's get to a more like exercise theme here. So now if I'm squatting, let's say I have a really narrow squat and I'm just doing this as like a mobility test. Now I need to, if anybody's watched me before, this is kind of what I do. I just do this little hip dance. Helps me really feel where I'm at and get in the zone. I don't know, maybe it's just because the camera's rolling. So this is my comfortable position. And now when I come down, I need to try to maintain some sort of comfortable position. If I line my feet to where they both look the same and they both look parallel or symmetrical to one another and I try to squat down, I'm gonna do a couple reps and I'm gonna find that my left foot rotates out. Okay, do you see that? I hope you saw that happen. If not, play the video back, you'll be able to see it. So what I instead wanna do is I wanna find a knee position that will be okay for me and then I wanna come down again. Now when we talk about knee alignment, there are a few ways to explain it to people. Oftentimes the easiest way to see it is you want a straight line from your hip through your knee down through your toes, okay? And this works really well here on my right leg. That cue makes a lot of sense. I got my hip, I got my knee, I got my toes, valgus, varus, normal, neutral alignment. If I do that on this side, it's not going to work. It's gonna look like my toes are too far outward, I'm going to have to put my knee into varus and put my ankle into extra supination to get this alignment, okay? If this is a normal knee position, this is hip, knee and foot in alignment, okay? Those are not the forces that I want on my knee. I don't want varus. I want a stacked position so that my bones, my knee joint can deal with compression instead of with twisting and torquing and bending. So for squatting, if I'm looking at knee alignment, what I need to look at is the knee relative to the ankle. Okay, so even if the tibia is twisted, that won't affect where the ankle sits because the heel is the next extension after the tibia. So I can look down and I can say, okay, let me take a comfortable stance, take a little wider than before stance and we'll come down and I'll feel around a little bit. That feels like it's too wide, that's too narrow. And something like that, I can feel both my heels pretty well. If I hold here any longer, I'm gonna start shaking. Geez. So I sit here and I can look and I see, you know, my toes look like they're outside, but my heel is directly in line here with my hip and my knee. So that's your like knee alignment consideration for tibial torsion. The same thing applies when you're deadlifting. Your stance is just a little more narrow. What about single leg stuff? So we talked about walking, we talked about the tibial torsion, the torqued side getting flatter, that foot getting flatter. If I do a split squat and I come on down and I gotta look for the same knee alignment, right? This is too much varus, too much supination. My knee is in line with my toes, but not with my ankle, okay? So that's not what I'm looking for. But if I keep my knee in line with my ankle and remove the varus, remove the torque that's going through my knee, I still have that torque through the tibia. So I have different forces from gravity that I need to deal with now. And those forces, if I'm not really diligent about staying on my heel, if I'm not staying as far back on my foot as possible, as those forces move forward on my foot, my foot is flatter, it will push me this way, okay? This is kind of convoluted. This is not something that I tell everyone about, so consider yourself privileged, I guess. I don't go into this with everyone, but I'm always thinking about it with everyone if I see someone like this. Whether they have both feet are tibially torqued, whether they just rotate their tibia out to gain extra stability, or whether they actually have a tibial torsion through the shaft of their tibia. Okay, I'm always considering this. So as I come down, I have these forces trying to push me forward and remember, that's the biggest mistake people make in these squatting variations, they fall forward. Okay, we've talked about that ad nauseam, no reason to go into it too far, too much more. But as I come down, I need to make sure that I stay back and I stay on the outside of my foot and I be really diligent about pushing my big toe down in the ground to keep my foot supported so that it doesn't collapse, so that my knee doesn't collapse so that I don't fall forward, okay? There's this chain reaction that will get set off. So I can be pretty particular about my foot position and stability, and then I can come back up. Keep that in mind, what's another way to get around it? What if I elevated the heel? So if I elevate the heel, I change that lever. That lever is no longer quite as long. That lever at my ankle, from ankle to foot, if it goes here, ankle to toe, I mean, is not as far as it is when it's here, this is longer. So I can minimize some of this by giving the ankle a different position, putting myself up on my toes, not necessarily up on my toes, but planar flexing my ankle, letting my heels rest on a weight or on weightlifting shoes, and then I can sit down and deal with those torques a little bit better because they are smaller. To deal with those like knee varus valgus, knee torques better because I'm in a better position now, okay? So I hope that's helpful. I hope that gives you some sort of a semblance of an idea of a path that you can go down. I know this one is a little bit longer of a video, but this is a complicated topic. And one thing that I wanna stand for is I don't want to oversimplify things that can't be oversimplified. This is about as simple as you need. Walk back through it again if you need to. If you don't have tibial torsion or you don't work with anyone with tibial torsion, don't worry about it now, come back to it later. But I want you to kind of keep this in the back of your mind, right? Keep this biomechanics, this how does gravity affect me perspective while you're working through your exercises.