Sex-Specific Relationships Between Hip Strength and Hip, Pelvis, and Trunk Kinematics in Healthy Runners

2018 ◽  
Vol 34 (1) ◽  
pp. 76-81 ◽  
Author(s):  
James J. Hannigan ◽  
Louis R. Osternig ◽  
Li-Shan Chou

Weak hip muscle strength and excessive hip motion during running have been suggested as potential risk factors for developing patellofemoral pain syndrome (PFPS) in females, but not males. There is conflicting evidence on the relationship between hip strength and hip kinematics, which may be partly due to sex differences in the relationship between these parameters. Hip, pelvis, and trunk kinematics were collected while 60 healthy, habitual runners (23 females, 37 males) ran overground, and isometric hip abduction and external rotation strengths were measured bilaterally. Pearson correlation coefficients quantified sex-specific correlations between hip strength and kinematics, and unpaired t tests assessed sex differences in hip strength and kinematics. Hip abduction strength was moderately and inversely correlated to hip adduction excursion in females, and pelvic internal rotation excursion in males. Hip external rotation strength was moderately and inversely correlated to trunk flexion excursion in females. Finally, females displayed less hip external rotation strength and greater excursion at the hip and trunk during running compared to males. Despite the significant correlations, the relatively low r2 values suggest that additional factors outside of strength contribute to a substantial portion of the variance in trunk, pelvis, and hip kinematics.

2019 ◽  
Vol 40 (8) ◽  
pp. 969-977 ◽  
Author(s):  
Ryan S. McCann ◽  
Masafumi Terada ◽  
Kyle B. Kosik ◽  
Phillip A. Gribble

Background: Chronic ankle instability (CAI) is associated with hip strength deficits and altered movement in the lower extremity. However, it remains unclear how hip strength deficits contribute to lateral ankle sprain (LAS) mechanisms. We aimed to compare lower extremity landing kinematics and isometric hip strength between individuals with and without CAI and examine associations between hip kinematics and strength. Methods: Seventy-six individuals completed 5 single-leg landings, during which we collected three-dimensional ankle, knee, and hip kinematics from 200 milliseconds pre–initial contact to 50 milliseconds post–initial contact. We calculated average peak torque (Nm/kg) from 3 trials of isometric hip extension, abduction, and external rotation strength testing. One-way analyses of variance assessed group differences (CAI, LAS coper, and control) in hip strength and kinematics. Pearson product moment correlations assessed associations between hip kinematics and strength. We adjusted the kinematic group comparisons and correlation analyses for multiple comparisons using the Benjamini-Hochberg method. Results: The CAI group exhibited less hip abduction during landing than LAS copers and controls. The CAI group had lower hip external rotation strength than LAS copers ( P = .04, d = 0.62 [0.05, 1.17]) and controls ( P < .01, d = 0.87 [0.28, 1.43]). Effect sizes suggest that the CAI group had deficits in EXT compared with controls ( d = 0.63 [0.06, 1.19]). Hip strength was not associated with hip landing kinematics for any group. Conclusion: Altered landing mechanics displayed by the CAI group may promote mechanisms of LAS, but they are not associated with isometric hip strength. However, hip strength deficits may negatively impact other functional tasks, and they should still be considered during rehabilitation. Level of Evidence: Level III, case-control study.


2018 ◽  
Vol 27 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Benjamin R. Wilson ◽  
Kaley E. Robertson ◽  
Jeremy M. Burnham ◽  
Michael C. Yonz ◽  
Mary Lloyd Ireland ◽  
...  

Context: The Y Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower-extremity injury. However, the relationship between hip strength and performance on the Y Balance Test has not been fully elucidated. Objective: The goal of this study was to identify the relationship between components of isometric hip strength and the Y Balance Test, to provide clinicians better guidance as to specific areas of muscle performance to address in the event of poor performance on the Y Balance Test. Design: Laboratory study. Setting: Biomechanics laboratory. Participants: A total of 73 healthy participants (40 males and 33 females) volunteered for this study. Intervention: None. Main Outcome Measures: Participants completed the Y Balance Test on the right leg. The authors then measured peak isometric torque in hip external rotation, abduction, and extension. Correlations were calculated between torque measurements, normalized for mass and Y Balance Test performance. Significant relationships were used in linear regression models to determine which variables were predictive of the Y Balance Test performance. Results: The authors found significant positive correlations between Y Balance Test performance and hip abduction strength. They also found correlations between the Y Balance Test and hip extension and external rotation strengths. Linear regression analysis showed hip abduction to be the only significant predictor of Y Balance performance. Conclusions: The authors found the strongest association between the Y Balance Test and hip abduction strength. They also showed smaller but significant associations with hip extension and external rotation strength. When entered into a linear regression analysis, hip abduction strength was the only significant predictor of Y Balance performance. Using this information, practitioners should look to hip abduction strength when patients exhibit deficits in the Y Balance Test.


2009 ◽  
Vol 18 (1) ◽  
pp. 104-117 ◽  
Author(s):  
John H. Hollman ◽  
Barbara E. Ginos ◽  
Jakub Kozuchowski ◽  
Amanda S. Vaughn ◽  
David A. Krause ◽  
...  

Context:Reduced strength and activation of hip muscles might correlate with increased weight-bearing knee valgus.Objective:To describe relationships among frontal-plane hip and knee angles, hip-muscle strength, and electromyographic (EMG) recruitment in women during a step-down.Design:Exploratory study.Setting:Laboratory.Participants:20 healthy women 20 to 30 years of age.Interventions:Frontal-plane hip and knee angles were measured. Gluteus maximus and medius recruitment were examined with surface EMG. Hip-abduction and -external-rotation strength were quantified with handheld dynamometry.Main Outcome Measurements:The authors analyzed correlation coefficients between knee and hip angles, gluteus maximus and medius EMG, and hip-abduction and -external-rotation strength.Results:Hip-adduction angles (r = .755, P = .001), gluteus maximus EMG (r = −.451, P = .026), and hip-abduction strength (r = .455, P = .022) correlated with frontal-plane projections of knee valgus.Conclusions:Gluteus maximus recruitment might have greater association with reduced knee valgus in women than does external-rotation strength during step-down tasks. Gluteus medius strength might be associated with increased knee valgus.


Author(s):  
Maxwell L. Albiero ◽  
Wesley Kokott ◽  
Cody Dziuk ◽  
Janelle A. Cross

Abstract Context: Inadequate hip active range of motion (AROM) may stifle the energy flow through the kinematic chain and decrease pitching performance while increasing the risk for pitcher injury. Objective: To examine the relationship of hip AROM and pitching biomechanics during a fastball pitch in adolescent baseball pitchers. Design: Cross-Sectional study. Setting: Biomechanics laboratory. Participants: A voluntary sample of 21 adolescent baseball pitchers (16.1 ± 0.8 yrs.; 183.9 ± 5.2 cm; 77.9 ± 8.3 kg). Main Outcome Measure (s): Bilateral hip internal rotation (IR), external rotation (ER), flexion, extension, and abduction AROM were measured. Three-dimensional biomechanics were assessed as participants threw from an indoor pitching mound to a strike zone net at regulation distance. Pearson correlation coefficients were used to determine correlations between hip AROM and biomechanical metrics. Results: Statistically significant negative correlations were found at foot contact between back hip ER AROM and back hip abduction angle (p=0.030, r=−0.474), back hip ER AROM and torso rotation angle (p=0.032, r=−0.468),and back hip abduction AROM and lead hip abduction angle (p=0.037, r=−0.458). Back hip extension AROM was positively correlated with increased stride length (p=0.043, r=0.446). Lead hip abduction AROM was also positively correlated with normalized elbow varus torque (p=0.034, r=0.464). Conclusions: There were several relationships between hip AROM and biomechanical variables during the pitching motion. The findings support the influence hip AROM can have on pitching biomechanics. Overall, greater movement at the hips allows for the kinematic chain to work at its maximal efficiency, increasing pitch velocity potential.


2020 ◽  
pp. 1-7
Author(s):  
Shogo Takano ◽  
Yoshitaka Iwamoto ◽  
Junya Ozawa ◽  
Nobuhiro Kito

Context: Previous studies have reported that the incidence of patellofemoral pain in women is 2.2 times higher than that in men. Lower hip frontal dynamic joint stiffness in women may be related to the magnitude of hip adduction and internal rotation associated with patellofemoral pain. Objective: To identify sex differences in hip frontal dynamic joint stiffness and examine the relationship between hip frontal dynamic joint stiffness and hip adduction and internal rotation during gait. Design: Cross-sectional study. Setting: University campus. Participants: A total of 80 healthy volunteers (40 women and 40 men) participated in this study. Intervention(s): Kinematic and kinetic data during gait were collected using a motion capture system and force plates. Main Outcome Measures: Hip frontal dynamic joint stiffness, hip adduction, and hip internal rotation were calculated during gait. Results: Women demonstrated lower hip frontal dynamic joint stiffness than men during gait (P < .01). They also displayed decreased hip frontal dynamic joint stiffness associated with increased hip adduction (r = −.85, P < .001) and internal rotation (r = −.48, P < .001). Conversely, in men, decreased hip frontal dynamic joint stiffness was associated with increased hip adduction (r = −.74, P < .001) but not internal rotation (r = .17, P = .28). Conclusions: Sex differences between hip frontal dynamic joint stiffness and hip internal rotation during gait may contribute to the increased incidence of patellofemoral pain in women.


2014 ◽  
Vol 23 (1) ◽  
pp. 56-64 ◽  
Author(s):  
David A. Krause ◽  
Mathew D. Neuger ◽  
Kimberly A. Lambert ◽  
Amanda E. Johnson ◽  
Heather A. DeVinny ◽  
...  

Context:Hip-muscle impairments are associated with a variety of lower-extremity dysfunctions. Accurate assessment in the clinical setting can be challenging due to the strength of hip muscles relative to examiner strength.Objective:To examine the influence of examiner strength and technique on manual hip-strength testing using a handheld dynamometer.Design:Repeated measures.Setting:Research laboratory.Participants:30 active adults (age 24 ± 1.4 y).Interventions:Three examiners of different strength performed manual muscle tests (MMT) in 2 different positions for hip extension, abduction, and external rotation using a MicroFet handheld dynamometer. Examiner strength was quantified via a 1-repetition-maximum leg press and chest press with a Keiser A420 pneumatic resistance machine.Main Outcome Measures:Intrarater reliability (ICC3,1), interrater reliability (ICC2,1), and measured torque values.Results:Intrarater reliability for all measurements ranged from .82 to .97. Interrater reliability ranged from .81 to .98. Main effects for hip extension revealed a significant difference in torque values between examiners and between techniques. For the short-lever hip-abduction and seated hip-external-rotation tests, there was a significant difference between examiners. There was no significant difference in measured torque values between examiners with the long-lever hip-abduction or the prone hip-external-rotation tests.Conclusions:MMT of the hip may be performed with high reliability by examiners of different strength. To obtain valid MMT measurements of hip muscles, examiners must consider their own strength and testing techniques employed. The authors recommend a long-lever technique for hip abduction and a prone position for testing hip external rotation to minimize the influence of examiner strength. Both positions appear to provide mechanical advantages to the examiner compared with the alternative techniques. The authors are unable to recommend a preferred hip-extension-testing technique to minimize the influence of examiner strength.


2017 ◽  
Vol 45 (9) ◽  
pp. 2142-2147 ◽  
Author(s):  
Timothy E. Hewett ◽  
Kevin R. Ford ◽  
Yingying Y. Xu ◽  
Jane Khoury ◽  
Gregory D. Myer

Background: The effects of targeted neuromuscular training (TNMT) on movement biomechanics associated with the risk of anterior cruciate ligament (ACL) injuries are currently unknown. Purpose/Hypotheses: To determine the effectiveness of TNMT specifically designed to increase trunk control and hip strength. The hypotheses were that (1) TNMT would decrease biomechanical and neuromuscular factors related to an increased ACL injury risk and (2) TNMT would decrease these biomechanical and neuromuscular factors to a greater extent in athletes identified as being at a high risk for future ACL injuries. Study Design: Controlled laboratory study. Methods: Female athletes who participated in jumping, cutting, and pivoting sports underwent 3-dimensional biomechanical testing before the season and after completing TNMT. During testing, athletes performed 3 different types of tasks: (1) drop vertical jump, (2) single-leg drop, and (3) single-leg cross drop. Analysis of covariance was used to examine the treatment effects of TNMT designed to enhance core and hip strength on biomechanical and neuromuscular characteristics. Differences were also evaluated by risk profile. Differences were considered statistically significant at P < .05. Results: TNMT significantly increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. Athletes with a high risk before the intervention (risk profile III) had a more significant treatment effect of TNMT than low-risk groups (risk profiles I and II). Conclusion: TNMT significantly improved proximal biomechanics, including increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. TNMT that focuses exclusively on proximal leg and trunk risk factors is not, however, adequate to induce significant changes in frontal-plane knee loading. Biomechanical changes varied across the risk profile groups, with higher risk groups exhibiting greater improvements in their biomechanics.


2019 ◽  
Vol 47 (4) ◽  
pp. 922-927 ◽  
Author(s):  
Jun Kawakami ◽  
Nobuyuki Yamamoto ◽  
Toshimitsu Etoh ◽  
Taku Hatta ◽  
Mitsuyoshi Mineta ◽  
...  

Background: The glenoid track concept has been widely used to assess the risk of instability caused by a bipolar lesion. The mean glenoid track width is reported to be 83% of the glenoid width. However, this width seems to be affected by the range of motion of the shoulder. By clarifying the relationship between the range of shoulder motion and the glenoid track width, a more precise determination of the glenoid track width for each individual could be possible. Purpose: To determine the relationship between the glenoid track width and the range of motion of healthy volunteers. Study Design: Descriptive laboratory study. Methods: Magnetic resonance imaging was taken in 41 shoulders of 21 healthy volunteers (mean age, 32 years) with the arm in maximum horizontal extension, with the arm kept in 90° of abduction and 90° of external rotation. Three-dimensional surface bone models of the glenoid and the humerus were created with image analysis software. The distance from the anterior rim of the glenoid to the medial margin of the footprint of the rotator cuff tendon was defined as the glenoid track width. Active and passive ranges of shoulder motion were measured in the supine and sitting positions. The correlations between the glenoid track width and the ranges of shoulder motion were investigated with Pearson correlation coefficients. Intra- and interobserver reliabilities based on the intraclass correlation coefficient were also analyzed to assess the reliability of the glenoid track measurement. Results: The intra- and interobserver reliabilities for the glenoid track measurement were excellent (0.988 and 0.988, respectively). Among all the measurements, the glenoid track width and the active range of motion in horizontal extension in the sitting position showed the greatest correlation coefficient ( r = −0.623, P < .0001). A correlation between the glenoid track width and this angle was expressed as Y = −0.49 X + 90, where X is the horizontal extension angle (degrees) and Y is the glenoid track width (percentage of glenoid width). Conclusion: The present data demonstrate that the greater the horizontal extension angle in abduction and external rotation, the smaller the glenoid track width. An individualized glenoid track width can be obtained by measuring the active horizontal extension angle with the arm in abduction and external rotation in the sitting position. Clinical Relevance: An individualized glenoid track width enables selection of a more precise surgical option by the on-track/off-track concept.


2018 ◽  
Vol 27 (4) ◽  
pp. 364-370 ◽  
Author(s):  
Brent I. Smith ◽  
Denice Curtis ◽  
Carrie L. Docherty

Context: Deficits in ankle and hip strength and lower-extremity postural control are associated with chronic ankle instability (CAI). Following strength training, muscle groups demonstrate increased strength. This change is partially credited to improved neuromuscular control, and many studies have investigated ankle protocols for subjects with CAI. The effects of isolating hip musculature in strength training protocols in this population are not well understood. Objective: To examine the effects of hip strengthening on clinical and self-reported outcomes in patients with CAI. Design: Prospective randomized controlled clinical trial. Setting: Athletic training facility. Participants: Twenty-six participants with CAI (12 males and 14 females; age = 20.9 [1.5] y, height = 170.0 [12.7] cm, and mass = 77.5 [17.5] kg) were randomly assigned to training or control groups. Intervention: Participants completed either 4 weeks of supervised hip strengthening (resistance bands 3 times a week) or no intervention. Main Outcome Measures: Participants were assessed on 4 clinical measures (Star Excursion Balance Test in the anterior, posteromedial, and posterolateral directions; Balance Error Scoring System; hip external rotation strength; and hip abduction strength) and a patient-reported measure (the Foot and Ankle Ability Measure activities of daily living and sports subscales) before and after the 4-week training period. Results: The training group displayed significantly improved posttest measures compared with the control group for hip abduction strength (training: 446.3 [77.4] N, control: 314.7 [49.6] N, P < .01); hip external rotation strength (training: 222.1 [48.7] N, control: 169.4 [34.6] N, P < .01); Star Excursion Balance Test reach in the anterior (training: 93.1% [7.4%], control: 90.2% [7.9%], P < .01), posteromedial (training: 96.3% [8.9%], control: 88.0% [8.8%], P < .01), and posterolateral (training: 95.4% [11.1%], control: 86.6% [9.6%], P < .01) directions; Balance Error Scoring System total errors (training: 9.9 [6.3] errors, control: 21.2 [6.3] errors, P < .01); and the Foot and Ankle Ability Measure-sports score (training: 88.0 [12.6], control: 84.8 [10.9], P < .01). Conclusion: Improved clinical and patient-reported outcomes in the training group suggest hip strengthening is beneficial in the management and prevention of recurrent symptoms associated with CAI.


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