Sex Differences in Eccentric Hip-Abductor Strength and Knee-Joint Kinematics When Landing from a Jump

2005 ◽  
Vol 14 (4) ◽  
pp. 346-355 ◽  
Author(s):  
Cale Jacobs ◽  
Carl Mattacola
Keyword(s):  
Sex Differences ◽  
Knee Joint ◽  
Outcome Measures ◽  
Peak Torque ◽  
Knee Valgus ◽  
Valgus Angle ◽  
Peak Knee ◽  
Knee Joint Kinematics ◽  
Hip Abductor ◽  
Abductor Strength

Context:Decelerating movements such as landing from a jump have been proposed to be a common mechanism of injury to the anterior cruciate ligament (ACL).Objective:To compare eccentric hip-abductor strength and kinematics of landing between men and women when performing a hopping task.Setting:Research laboratory.Patients:18 healthy subjects (10 women, 8 men).Main Outcome Measures:Eccentric peak torque of the hip abductors and peak knee-joint angles during a 350-millisecond interval after impact.Results:No significant sex differences were present, but there was a significant inverse relationship between women's eccentric peak torque and peak knee-valgus angle (r= –.61,P= .03).Conclusions:Women with larger eccentric peak torque demonstrated lower peak knee-valgus angles. By not reaching as large of a valgus angle, there is potentially less stress on the ACL. Increasing eccentric hip-abductor strength might improve knee-joint kinematics during landing from a jump.

The Effect of Hip Abductor Muscle Fatigue on Frontal Plane Knee Projection Angle During Step Landing

2014 ◽  
Vol 19 (4) ◽  
pp. 38-43
Author(s):  
Lee Herrington
Keyword(s):  
Muscle Fatigue ◽  
Outcome Measures ◽  
Frontal Plane ◽  
Initial Contact ◽  
Knee Valgus ◽  
Joint Mechanics ◽  
Abductor Muscle ◽  
Valgus Angle ◽  
Hip Abductor ◽  
Projection Angle

Context:A number of acute and overuse knee pathologies share a mechanism involving a poor dynamic alignment of the limb creating increased stress in the tissues. Inappropriate execution of a correct strategy during landing has been suggested to involve insufficient activity of the hip abductor and external rotator muscles. Limited data describing the relationships between hip-abductor muscle fatigue and hip/knee joint mechanics exists.Objective:To investigate the effect of fatigue of the hip abductor muscles on knee valgus angle.Design:Repeated measures.Participants:30 asymptomatic subjects: 15 female (age 20.4 ± 1.4, range 18–26 years; height 1.66 m, range 1.60–1.76 m; weight 63.9 kg, range 58–68 kg) and 15 male subjects (age 22 ± 3.2, range 18–28 years; height 1.84 m, range 1.65–1.90 m; weight 82.1 kg, range 69–93 kg).Main outcome Measures:Knee valgus (frontal plane projection) angle was assessed during a step landing task before and following a fatiguing protocol of the hip abductor muscles involving repeated 10 s maximal isometric contractions of the hip abductor muscles, until strength was recorded as 50% of preintervention score.Results:Males showed no significant change in knee valgus angle at initial ground contact (p = .9 ES 0.1) or in maximum knee valgus (p = .64 ES 0.5) following the fatiguing. Females showed a significant increase in maximum knee valgus angle following the fatiguing (p = .0018 ES 1.0), though the knee valgus angle at initial contact was not changed (p = .12 ES 0.67). They also demonstrated a significant increase in the change in knee valgus angle between initial contact and maximum following the fatiguing (p = .0004 ES 0.88).Conclusion:Females appear more susceptible to the effects of hip muscle fatigue, leading to a detrimental change in landing kinematics which may then predispose them to knee injury.

scholarly journals Changes in Knee Biomechanics After a Hip-Abductor Strengthening Protocol for Runners With Patellofemoral Pain Syndrome

2011 ◽  
Vol 46 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Reed Ferber ◽  
Karen D. Kendall ◽  
Lindsay Farr
Keyword(s):  
Muscle Strength ◽  
Knee Joint ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Genu Valgum ◽  
Abductor Muscle ◽  
Muscle Strengthening ◽  
Peak Knee ◽  
Hip Abductor

Abstract Context: Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running. Objective: To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Design: Cohort study. Setting: University-based clinical research laboratory. Patients or Other Participants: Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated. Intervention(s): The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not. Main Outcome Measure(s): The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance. Results: At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline. Conclusions: A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.

Effects of Drop-height and Surface Instability on Jump Performance and Knee Kinematics

2017 ◽  
Vol 39 (01) ◽  
pp. 50-57 ◽  
Author(s):  
Melanie Lesinski ◽  
Olaf Prieske ◽  
Rainer Beurskens ◽  
David Behm ◽  
Urs Granacher
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Surface Condition ◽  
Joint Kinematics ◽  
Surface Instability ◽  
Knee Valgus ◽  
Drop Height ◽  
Valgus Stress ◽  
Jump Performance ◽  
Knee Joint Kinematics

AbstractThe purpose of this study was to examine the combined effects of drop-height and surface condition on drop jump (DJ) performance and knee joint kinematics. DJ performance, sagittal and frontal plane knee joint kinematics were measured in jump experienced young male and female adults during DJs on stable, unstable and highly unstable surfaces using different drop-heights (20, 40, 60 cm). Findings revealed impaired DJ performance (Δ5–16%; p<0.05; 1.43≤d≤2.82), reduced knee valgus motion (Δ33–52%; p<0.001; 2.70≤d≤3.59), and larger maximum knee flexion angles (Δ13–19%; p<0.01; 1.74≤d≤1.75) when using higher (60 cm) compared to lower drop-heights (≤40 cm). Further, lower knee flexion angles and velocity were found (Δ8-16%; p<0.01; 1.49≤d≤2.38) with increasing surface instability. When performing DJs from high (60 cm) compared to moderate drop-heights (40 cm) on highly unstable surfaces, higher knee flexion velocity and maximum knee valgus angles were found (Δ15–19%; p<0.01; 1.50≤d≤1.53). No significant main and/or interaction effects were observed for the factor sex. In conclusion, knee motion strategies were modified by the factors ‘drop-height’ and/or ‘surface instability’. The combination of high drop-heights (>40 cm) together with highly unstable surfaces should be used cautiously during plyometrics because this may increase the risk of injury due to higher knee valgus stress.

scholarly journals Sex Difference in Hip Adduction during Running: Influence of Hip Abductor Strength, Activation, and Pelvis & Femur Morphology

2021 ◽  
Author(s):  
Jia Liu ◽  
Kristi L. Lewton ◽  
Patrick M. Colletti ◽  
Christopher M. Powers
Keyword(s):  
Sex Differences ◽  
Femoral Neck ◽  
Muscle Activation ◽  
Femoral Anteversion ◽  
Femur Length ◽  
Computed Tomography Scanning ◽  
Hip Abductor ◽  
Independent Variable ◽  
Tomography Scanning ◽  
Abductor Strength

Purpose: To examine the influence of hip abductor strength, neuromuscular activation, and pelvis &amp; femur morphology in contributing to sex differences in hip adduction during running.Methods: Fifteen female and 14 male runners underwent strength testing, instrumented overground running (e.g., kinematics and muscle activation), and computed tomography scanning of pelvis and femur. Morphologic measurements included bilateral hip width to femur length ratio, acetabulum abduction, acetabulum anteversion, femoral anteversion, and femoral neck-shaft angles. Sex differences for all variables were examined using independent t-tests. Linear regression was used to assess the ability of each independent variable of interest to predict peak hip adduction during the late swing and stance phase of running. Results: Compared to males, females exhibited significantly greater peak hip adduction during both late swing (8.5 ± 2.6° vs 6.2 ± 2.8°, p = 0.04) and stance phases of running (13.4 ± 4.2° vs 10.0 ± 3.2°, p = 0.02). In addition, females exhibited significantly lower hip abductor strength (1.8 ± 0.3 vs 2.0 ± 0.3 Nm/kg, p=0.04), greater femoral neck-shaft angles (134.1 ± 5.0° vs 129.9 ± 4.1°, p=0.01), and greater hip width to femur length ratios than males (0.44 ± 0.02 vs 0.42 ± 0.03, p=0.03). Femoral anteversion was the only significant predictor of peak hip adduction during late swing (r=0.36, p=0.05) and stance (r=0.41, p=0.03).Conclusion: Our findings highlight the contribution of femur morphology as opposed to hip abductor strength and activation in contributing to hip adduction during running.

Hip Abductor Rate of Torque Development as Opposed to Isometric Strength Predicts Peak Knee Valgus During Landing: Implications for Anterior Cruciate Ligament Injury

2021 ◽  
pp. 1-6
Author(s):  
Kristen M. Stearns-Reider ◽  
Rachel K. Straub ◽  
Christopher M. Powers
Keyword(s):  
Cruciate Ligament ◽  
Muscle Performance ◽  
Ligament Injury ◽  
Knee Valgus ◽  
Rate Of Torque Development ◽  
Peak Knee ◽  
Hip Abductor ◽  
Isometric Torque ◽  
Anterior Cruciate ◽  
Torque Development

Peak knee valgus has been shown to predict anterior cruciate ligament injury. The purpose of the current study was to compare peak rate of torque development (RTD) to peak isometric torque as a predictor of peak knee valgus during landing. Twenty-three healthy females participated. Hip abductor muscle performance was quantified using 2 types of isometric contractions: sustained and rapid. Peak isometric torque was calculated from the sustained isometric contraction. Peak RTD was calculated from the rapid isometric contraction (0–50 and 0–200 ms after force initiation). Kinematic data were collected during the deceleration phase of a double-leg drop jump task. Linear regression was used to assess the ability of hip abductor muscle performance variables to predict peak knee valgus. Increased peak RTD during the 0 to 50 milliseconds window after force initiation was found to significantly predict lower peak knee valgus (P = .011, R2 = .32). In contrast, neither peak RTD from 0 to 200 milliseconds after force initiation window (P = .45, R2 = .03) nor peak isometric torque (P = .49, R2 = .03) predicted peak knee valgus. The inability of the hip abductors to rapidly generate muscular force may be more indicative of “at-risk” movement behavior in females than measures of maximum strength.

scholarly journals DOES A COMBINED INTRA-ARTICULAR AND EXTRA-ARTICULAR ACL RECONSTRUCTION EFFECT EXTERNAL KNEE VALGUS MOMENT ASYMMETRY?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0008
Author(s):  
Aaron J. Zynda ◽  
Henry B. Ellis ◽  
Kirsten Tulchin-Francis ◽  
Anthony Anderson ◽  
Parker Mitchell ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Iliotibial Band ◽  
Knee Valgus ◽  
Clinical Difference ◽  
Valgus Angle ◽  
Drop Landing ◽  
Peak Knee ◽  
Significant Difference ◽  
Patient Reported ◽  
Physeal Sparing

Introduction: Peak external knee valgus moment can predict future ACL injury and is, often times, asymmetric following anatomic intra-articular ACL reconstruction. The purpose of this study is to evaluate the external knee valgus moment during a drop landing and a single limb squat 2 years following an iliotibial band (ITB) intra-articular and extra-articular physeal-sparing ACL reconstruction. Methods: Fourteen study subjects (mean age: 14.3 ± 2.6 yrs) who had previously undergone a physeal-sparing ACL reconstruction, as originally described by McIntosh using an ITB autograft, were enrolled in this IRB-approved study. All subjects were seen at a minimum of 24 months after surgery (mean follow-up: 55.0 ± 28.9 mos) and clinical, radiographic, and patient reported outcomes were collected. During functional testing, subjects underwent drop landing (DL) and unilateral squat (US) tasks. Isokinetic muscle strength of the hip and knee was collected using an isokinetic dynamometer at 60°/s. Paired student’s t-tests evaluated differences between affected (AFF) and unaffected (UNAFF) limbs. Results: During a drop landing, the AFF limb, compared to the UNAFF limb, did not demonstrate a difference in external knee valgus moment (0.50° vs. 0.51°, p=0.736). However, in the AFF limb, the mean knee peak knee valgus angle was 2.8 degrees less than the UNAFF limb during a drop landing (p=0.039). This difference was not considered within the range of a minimal clinical difference (MCD) of 5.1 degrees. Similar trends were found during a single limb squat with no significant difference seen in peak knee valgus moment between AFF and UNAFF (0.14° vs. 0.07°, p=0.150) with a statistical, yet not minimal clinical difference, in knee valgus angle at 45° squat position (-2.4° vs. 0.7°, p=0.033; MCD = 5.2). Thus, no asymmetry in peak knee valgus moment during a drop landing or a single limb squat following an ITB intra- and extra-articular ACL reconstruction was observed. In this series at 2 years’ post-op, the Pedi-IKDC and HSS Pedi-FABS were 96.54 ± 5 and 22.6 ± 5, respectively. Subjects demonstrated return to pre-operative Tegner Activity scores (8.42 vs. 8.17, p=0.33). Normalized hip abduction strength was significantly stronger in AFF (1.05 Nm/kg) vs. UNAFF (0.93 Nm/kg, p=0.02). Conclusion: Overall, there were no clinically significant differences, or asymmetry, in functional knee valgus in subjects following combined intra- and extra-articular iliotibial band ACL reconstruction during a drop landing or single leg squat. Young athletes can be expected to return to pre-operative activity levels and demonstrate appropriate knee valgus control following this physeal-sparing ACL reconstruction.

Visual-Spatial Memory Deficits Are Related to Increased Knee Valgus Angle During a Sport-Specific Sidestep Cut

2019 ◽  
Vol 47 (6) ◽  
pp. 1488-1495 ◽  
Author(s):  
Scott M. Monfort ◽  
Jared J. Pradarelli ◽  
Dustin R. Grooms ◽  
Keith A. Hutchison ◽  
James A. Onate ◽  
...  
Keyword(s):  
Spatial Memory ◽  
Visual Memory ◽  
Neuromuscular Control ◽  
Knee Valgus ◽  
Soccer Ball ◽  
Visual Spatial ◽  
Valgus Angle ◽  
Peak Knee ◽  
Biomechanical Parameters ◽  
Visual Spatial Memory

Background: Identifying athletes at an increased risk of injury is a promising approach to improve the effect of injury prevention interventions; however, it requires first identifying the potential athlete-specific risk factors. Cognitive ability was recently shown to correlate with noncontact anterior cruciate ligament injury rates and lower extremity mechanics, marking an underexplored area. A better understanding of how individuals’ cognitive ability is associated with neuromuscular control during sport-specific tasks may improve injury prevention. Hypothesis: Athletes with lower cognitive performance on a standardized cognitive assessment would demonstrate greater increases in knee valgus angle and moment when performing a sidestep cut with soccer ball dribbling versus without. Visual-spatial memory was expected to demonstrate stronger relationships than reaction time or processing speed. Study Design: Descriptive laboratory study. Methods: Fifteen male collegiate club soccer players participated (mean ± SD: 20.7 ± 2.0 years, 1.78 ± 0.07 m, 76.5 ± 8.9 kg). Participants performed anticipated 45° run-to-cut trials with and without a dual task of dribbling a soccer ball. Peak early-stance knee valgus angle and moment for the plant limb were calculated. Participants also completed a cognitive assessment to evaluate visual memory, verbal memory, reaction time, and processing speed. These composite scores were entered as candidate predictors for a stepwise regression analysis on the dual-task change scores in lower extremity biomechanical parameters (ie, ball handling – non–ball handling). Results: Visual memory composite score (a measure of visual-spatial memory) was the only cognitive outcome significantly associated with the change in biomechanical parameters. Each unit decrease in the visual memory composite score was associated with an increase of 0.21°± 0.05° in peak knee valgus angle during the ball-handling task as compared with the non–ball handling task ( R2 = 52%, P = .003). Conclusion: Visual-spatial memory was associated with neuromuscular control during a sidestep cutting task during soccer ball dribbling, with deficits in this cognitive domain being associated with increased peak knee valgus angle. Clinical Relevance: Assessing visual-spatial memory ability may provide useful information to better understand conditions associated with impaired neuromuscular control and to potentially identify athletes at an elevated risk for musculoskeletal injury.

Kinematic Differences Between Those With and Without Medial Knee Displacement During a Single-leg Squat

2014 ◽  
Vol 30 (6) ◽  
pp. 707-712 ◽  
Author(s):  
Timothy C. Mauntel ◽  
Barnett S. Frank ◽  
Rebecca L. Begalle ◽  
J. Troy Blackburn ◽  
Darin A. Padua
Keyword(s):  
Motion Tracking ◽  
Tracking System ◽  
Three Dimensional ◽  
Control Group ◽  
Knee Valgus ◽  
Medial Knee ◽  
Lower Extremity Injuries ◽  
Valgus Angle ◽  
Peak Knee ◽  
Single Leg Squat

A greater knee valgus angle is a risk factor for lower extremity injuries. Visually observed medial knee displacement is used as a proxy for knee valgus motion during movement assessments in an attempt to identify individuals at heightened risk for injury. The validity of medial knee displacement as an indicator of valgus motion has yet to be determined during a single-leg squat. This study compared three-dimensional knee and hip angles between participants who displayed medial knee displacement (MKD group) during a single-leg squat and those who did not (control group). Participants completed five single-leg squats. An electromagnetic motion tracking system was used to quantify peak knee and hip joint angles during the descent phase of each squat. MANOVA identified a difference between the MKD and control group kinematics. ANOVA post hoc testing revealed greater knee valgus angle in the MKD (12.86 ± 5.76) compared with the control (6.08 ± 5.23) group. There were no other differences between groups. Medial knee displacement is indicative of knee valgus motion; however, it is not indicative of greater knee or hip rotation, or hip adduction. These data indicate that clinicians can accurately identify individuals with greater knee valgus angle through visually observed medial knee displacement.

scholarly journals Timing of Frontal Plane Trunk Lean, Not Magnitude, Mediates Frontal Plane Knee Joint Loading in Patients with Moderate Medial Knee Osteoarthritis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Freyja Hálfdanardóttir ◽  
Dan K. Ramsey ◽  
Kristín Briem
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Frontal Plane ◽  
Joint Loading ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Hip Abductor ◽  
Knee Joint Loading ◽  
Abductor Strength ◽  
Rate Of Loading

The purpose of this study was to examine the influence of trunk lean and contralateral hip abductor strength on the peak knee adduction moment (KAM) and rate of loading in persons with moderate medial knee osteoarthritis. Thirty-one males (17 with osteoarthritis, 14 controls) underwent 3-dimensional motion analysis, strength testing of hip abductors, and knee range of motion (ROM) measures, as well as completing the knee osteoarthritis outcome score (KOOS). No differences were found between groups or limbs for gait cycle duration, but the osteoarthritis group had longer double-limb support during weight acceptance (p<0.001) and delayed frontal plane trunk motion towards the stance limb (p<0.01). This was reflected by a lower rate of loading for the osteoarthritis group compared to controls (p<0.001), whereas no differences were found for peak KAM. Trunk angle, contralateral hip abductor strength, and BMI explained the rate of loading at the involved knee (p<0.001), an association not found for the contralateral knee or control knees. Prolonged trunk lean over the stance limb may help lower peak KAM values. Rate of frontal plane knee joint loading may partly be mediated by the contralateral limb’s abductor strength, accentuating the importance of bilateral lower limb strength for persons with knee osteoarthritis.

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