It makes sense that our feet are the beginning place in the kinetic chain of our body’s motion. We stand, walk, run and if the starting place of that motion is out of whack, it makes sense that those misalignments will cause problems further up the chain. A simple measurement can tell us if you are likely to develop knee, hip and other pain problems associated with your gait – or walking style. It’s called the q-angle and it is simply, the angle that your quadriceps makes between your hip and your knee. Measured correctly it give important information regarding the alignment of the pelvis, leg and foot. Determination of the Q angle is particularly important for patients who are involved in competitive or recreational sports. It is also necessary to measure this angle in female patients who walk for health or climb stairs frequently. The effects of excessive pronation on the Q angle also deserve attention, since controlling foot pronation can often reduce the detrimental effects of an abnormal Q angle.

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Normal ranges: When measured standing, the Q angle should fall between 18 degrees and 22 degrees.4 Males are usually at the low end of this range, while females (because of a wider pelvis) tend to have higher measurements. Q-angles greater than 20 degrees in males and 25 degrees in females are considered abnormal. Generally speaking, when it comes to the quadriceps angle, less is better than more.

High Q-angles cause Knee Pain:

A high Q angle in an individual means that there is added stress on their knee joint particularly during strenuous or repetitive activities using the knee. This includes even low impact activities such as walking or cycling, climbing ordinary stairs and even shopping. When the measurement is above normal limits, the probability of developing knee joint symptoms increases rapidly.  Why? A high Q angle interferes with the smooth movement of the knee in the knee joint also known as patellar tracking. Over time, with normal daily activities and especially with sports and excercise, this constant misalignment wears down the cartilage in the knee. It also leads to muscle imbalances which further damage the knee joint.

Orthotic supports: The most effective way to decrease a high Q angle and lower the biomechanical stresses on the knee joint is to prevent excessive pronation with custom-made, foot orthotics. Studies have shown that using corrective orthotics was more effective in reducing knee pain than a traditional exercise program and Q angle abnormalities can be effectively controlled or corrected with custom-made orthotics.