The Relationship between Serum Relaxin Concentrations and Knee Valgus

2020 ◽  
Vol 41 (03) ◽  
pp. 182-188
Author(s):  
Gabrielle G. Gilmer ◽  
Michael D. Roberts ◽  
Gretchen D. Oliver
Keyword(s):  
Anterior Cruciate Ligament ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Ligament Injury ◽  
Knee Valgus ◽  
Clinical Tests ◽  
Anterior Cruciate Ligament Injuries ◽  
Anterior Cruciate ◽  
The Relationship

AbstractFemale athletes are at an elevated risk for tearing their anterior cruciate ligament, compared to their male counterparts. Though injury screening clinical tests and neuromuscular training programs have been widely implemented, injury rates remain high among female athletes. The purpose of this study was to examine the relationship between serum relaxin concentrations and knee valgus during three clinical tests (single leg squat, drop vertical jump, and single leg crossover dropdown). Twenty-two female athletes volunteered. Participants were scheduled for collection during the mid-luteal phase, when serum relaxin concentrations are known to be measurable. Blood samples were collected, and serum relaxin concentrations were quantified. Kinematic data were collected while participants performed the three clinical tests. Regression analyses revealed statistically significant relationships between serum relaxin concentrations and knee valgus throughout all tests. These findings suggest that serum relaxin concentrations and knee valgus are not independent of each other and more holistic approaches may be necessary to truly map out the risk for injury and ultimately reduce the rate of anterior cruciate ligament injuries. Thus, concluding that knee valgus, a highly utilized modifiable biomechanical risk factor, and relaxin, a hormone that has been associated with anterior cruciate ligament injury in female athletes, are related to each other.

scholarly journals Recognizing Anterior Cruciate Ligament Tears in Female Athletes: What Every Primary Care Practitioner Should Know

2007 ◽  
Author(s):  
Sarah Hirst ◽  
Elin Armeau ◽  
Thomas Parish
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Future Research ◽  
Ligament Injuries ◽  
Anterior Cruciate Ligament Injuries ◽  
Proprioceptive Training ◽  
Anterior Cruciate

Purpose: Women have a much higher rate of anterior cruciate ligament injury than men. Anterior cruciate ligament injuries are very expensive as well as physically and emotionally debilitating. Understanding why anterior cruciate ligament injuries are more prevalent in women as compared to men is crucial and addressing these issues to possibly prevent their high occurrence is important. Review of Literature: Hormonal differences, structural differences, musculature differences, and mechanical differences between men and women leave women more susceptible to anterior cruciate ligament injury. While there are many factors contributing to the higher rate of anterior cruciate ligament injury in women versus men, newer research has been devoted to addressing the issues that can be corrected and the discrepancies that can be decreased. Investigators are now taking the results from such research and applying them to women to decrease the occurrence of anterior cruciate ligament injury among this group. Results: Promising outcomes have occurred in neuromuscular and proprioceptive training programs designed to help women strengthen and train the muscles around their knee thus leading to better stabilization and therefore decreasing the incidence of anterior cruciate ligament injury. Conclusion: Future research should be devoted to finding all of the possible factors of the increased incidence of anterior cruciate ligament injury in women and all potential avenues for preventing these injuries should be studied.

Association Between the Menstrual Cycle and Anterior Cruciate Ligament Injuries in Female Athletes

1998 ◽  
Vol 26 (5) ◽  
pp. 614-619 ◽  
Author(s):  
Edward M. Wojtys ◽  
Laura J. Huston ◽  
Thomas N. Lindenfeld ◽  
Timothy E. Hewett ◽  
Mary Lou V. H. Greenfield
Keyword(s):  
Anterior Cruciate Ligament ◽  
Menstrual Cycle ◽  
Anterior Cruciate Ligament Injury ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Injury Rates ◽  
Anterior Cruciate Ligament Injuries ◽  
Anterior Cruciate

Anterior cruciate ligament injury rates are four to eight times higher in women than in men. Because of estrogen's direct effect on collagen metabolism and behavior and because neuromuscular performance varies during the menstrual cycle, it is logical to question the menstrual cycle's effect on knee injury rates. Of 40 consecutive female athletes with acute anterior cruciate ligament injuries (less than 3 months), 28 (average age, 23 11 years) met the study criteria of regular menstrual periods and noncontact injury. Details concerning mechanism of injury, menstrual cycle, contraceptive use, and previous injury history were collected. A chi-square test was used to compute observed and expected frequencies of anterior cruciate ligament injury based on three different phases of the menstrual cycle: follicular (days 1 to 9), ovulatory (days 10 to 14), and luteal (day 15 to end of cycle). A significant statistical association was found between the stage of the menstrual cycle and the likelihood for an anterior cruciate ligament injury (P 0.03). In particular, there were more injuries than expected in the ovulatory phase of the cycle. In contrast, significantly fewer injuries occurred in the follicular phase. These hormones may be a factor in the knee ligament injury dilemma in women.

The Incidence of Anterior Cruciate Ligament Injuries among Competitive Alpine Skiers

2007 ◽  
Vol 35 (7) ◽  
pp. 1070-1074 ◽  
Author(s):  
Nicolas Pujol ◽  
Marie Philippe Rousseaux Blanchi ◽  
Pierre Chambat
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Ligament Injury ◽  
Ligament Injuries ◽  
Injury Rates ◽  
Anterior Cruciate Ligament Injuries ◽  
Alpine Skiers ◽  
Anterior Cruciate

Background Little is known about the evolution of anterior cruciate ligament injury rates among elite alpine skiers. Purpose To evaluate epidemiologic aspects of anterior cruciate ligament injuries among competitive alpine skiers during the last 25 years. Study Design Descriptive epidemiology study. Methods Data were collected from elite French national teams (379 athletes: 188 women and 191 men) from 1980 to 2005. Results Fifty-three of the female skiers (28.2%) and 52 of the male skiers (27.2%) sustained at least 1 anterior cruciate ligament injury. The overall anterior cruciate ligament injury incidence was 8.5 per 100 skier-seasons. The primary anterior cruciate ligament injury rate was 5.7 per 100 skier-seasons. The prevalence of reinjury (same knee) was 19%. The prevalence of a bilateral injury (injury of the other knee) was 30.5%. At least 1 additional anterior cruciate ligament surgery (mean, 2.4 procedures) was required for 39% of the injured athletes. Men and women were similar with regard to primary anterior cruciate ligament injury rate (P = .21), career remaining after the injury (P = .44), and skiing specialty (P = .5). There were more anterior cruciate ligament injuries (primary, bilateral, reinjuries) among athletes ranking in the world Top 30 (P < .001). Anterior cruciate ligament-injured athletes had a career length of 7.5 years, whereas athletes with no anterior cruciate ligament injury had a career of 4.5 years (P < .001). Finally, injury rates remained constant over time. Conclusion Anterior cruciate ligament injury rates (primary injury, bilateral injury, reinjury) among national competitive alpine skiers are high and have not declined in the last 25 years. Finding a way to prevent anterior cruciate ligament injury in this population is a very important goal.

Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.2-S22
Author(s):  
Ryan Moran
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Jump Landing ◽  
Eyes Closed ◽  
Eyes Open ◽  
Anterior Cruciate ◽  
The Relationship

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: A Prospective Study

2005 ◽  
Vol 33 (4) ◽  
pp. 492-501 ◽  
Author(s):  
Timothy E. Hewett ◽  
Gregory D. Myer ◽  
Kevin R. Ford ◽  
Robert S. Heidt ◽  
Angelo J. Colosimo ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Injury Risk ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Knee Abduction ◽  
Anterior Cruciate ◽  
Dynamic Valgus

Background Female athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes. Hypothesis Prescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk. Study Design Cohort study; Level of evidence, 2. Methods There were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament. Results Nine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 who did not have anterior cruciate ligament rupture. Knee abduction angle (P <. 05) at landing was 8° greater in anterior cruciate ligament-injured than in uninjured athletes. Anterior cruciate ligament-injured athletes had a 2.5 times greater knee abduction moment (P <. 001) and 20% higher ground reaction force (P <. 05), whereas stance time was 16% shorter; hence, increased motion, force, and moments occurred more quickly. Knee abduction moment predicted anterior cruciate ligament injury status with 73% specificity and 78% sensitivity; dynamic valgus measures showed a predictive r2 of 0.88. Conclusion Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes. Clinical Relevance Female athletes with increased dynamic valgus and high abduction loads are at increased risk of anterior cruciate ligament injury. The methods developed may be used to monitor neuromuscular control of the knee joint and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions.

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