Relationships between Knee Valgus, Hip-Muscle Strength, and Hip-Muscle Recruitment during a Single-Limb Step-Down

2009 ◽  
Vol 18 (1) ◽  
pp. 104-117 ◽  
Author(s):  
John H. Hollman ◽  
Barbara E. Ginos ◽  
Jakub Kozuchowski ◽  
Amanda S. Vaughn ◽  
David A. Krause ◽  
...  
Keyword(s):  
Muscle Strength ◽  
External Rotation ◽  
Frontal Plane ◽  
Gluteus Maximus ◽  
Knee Valgus ◽  
Outcome Measurements ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Step Down ◽  
Rotation Strength

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.

scholarly journals Reliability of hip muscle strength measured in principal and intermediate planes of movement

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11521
Author(s):  
Basilio A.M. Goncalves ◽  
David J. Saxby ◽  
Adam Kositsky ◽  
Rod S. Barrett ◽  
Laura E. Diamond
Keyword(s):  
Muscle Strength ◽  
External Rotation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Hip Strength ◽  
Minimum Detectable Change ◽  
Hip Muscle ◽  
Flexion Extension ◽  
Hip Abduction ◽  
Muscle Actions

Background Muscle strength testing is widely used in clinical and athletic populations. Commercially available dynamometers are designed to assess strength in three principal planes (sagittal, transverse, frontal). However, the anatomy of the hip suggests muscles may only be recruited submaximally during tasks performed in these principal planes. Objective To evaluate the inter-session reliability of maximal isometric hip strength in the principal planes and three intermediate planes. Methods Twenty participants (26.1 ± 2.7 years, 50% female) attended two testing sessions 6.2 ± 1.8 days apart. Participants completed 3-5 maximal voluntary isometric contractions for hip abduction, adduction, flexion, extension, and internal and external rotation measured using a fixed uniaxial load cell (custom rig) and commercial dynamometer (Biodex). Three intermediate hip actions were also tested using the custom rig: extension with abduction, extension with external rotation, and extension with both abduction and external rotation. Results Moderate-to-excellent intraclass correlation coefficients were observed for all principal and intermediate muscle actions using the custom rig (0.72–0.95) and the Biodex (0.85–0.95). The minimum detectable change was also similar between devices (custom rig = 11–31%; Biodex = 9–20%). Bland-Altman analysis revealed poor agreement between devices (range between upper and lower limits of agreement = 77–131%). Conclusions Although the custom rig and Biodex showed similar reliability, both devices may lack the sensitivity to detect small changes in hip strength commonly observed following intervention.

scholarly journals Is Hip Muscle Strength Associated with Dynamic Knee Valgus in a Healthy Adult Population? A Systematic Review

2021 ◽  
Vol 18 (14) ◽  
pp. 7669
Author(s):  
Ali Mohammed Alzahrani ◽  
Msaad Alzhrani ◽  
Saeed Nasser Alshahrani ◽  
Wael Alghamdi ◽  
Mazen Alqahtani ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Adult Population ◽  
Knee Valgus ◽  
Journal Articles ◽  
Hip Muscle ◽  
Hip Abductor ◽  
Hip Muscles ◽  
Analysis System ◽  
The Relationship ◽  
External Rotator

This study aimed to systematically review research investigating the association between hip muscle strength and dynamic knee valgus (DKV). Four databases (MEDLINE, PubMed, CINAHL, and SPORTDiscus) were searched for journal articles published from inception to October 2020. Seven studies investigating the association between hip muscle strength and DKV using a two-dimensional motion analysis system in healthy adults were included. The relationship between hip abductor muscle strength and DKV was negatively correlated in two studies, positively correlated in two studies, and not correlated in three studies. The DKV was associated with reduced hip extensor muscle strength in two studies and reduced hip external rotator muscle strength in two studies, while no correlation was found in three and five studies for each muscle group, respectively. The relationship between hip muscle strength, including abductors, extensors, and external rotators and DKV is conflicting. Considering the current literature limitations and variable methodological approaches used among studies, the clinical relevance of such findings should be interpreted cautiously. Therefore, future studies are recommended to measure the eccentric strength of hip muscles, resembling muscular movement during landing. Furthermore, high-demand and sufficiently challenging functional tasks revealing lower limb kinematic differences, such as cutting and jumping tasks, are recommended for measuring the DKV.

Hip and ankle strength and range of motion in female soccer players with dynamic knee valgus

2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim
Keyword(s):  
Range Of Motion ◽  
Female Athletes ◽  
External Rotation ◽  
Preventive Measure ◽  
Control Group ◽  
Knee Valgus ◽  
Strength Ratio ◽  
Flexion Extension ◽  
Hip Abduction ◽  
Single Leg Squat

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.

Effect of side-sling plank exercise on trunk and hip muscle activation in subjects with gluteus medius weakness

2021 ◽  
pp. 1-9
Author(s):  
Seung-Min Baik ◽  
Heon-Seock Cynn ◽  
Chung-Hwi Yi ◽  
Ji-Hyun Lee ◽  
Jung-Hoon Choi ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Erector Spinae ◽  
Lumbar Multifidus ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Medial Rotation ◽  
Hip Muscles ◽  
Tensor Fasciae Latae

BACKGROUND: The effectiveness of side-sling plank (SSP) exercises on trunk and hip muscle activation in subjects with gluteus medius (Gmed) weakness is unclear. OBJECTIVE: To quantify muscle activation of the rectus abdominis (RA), external oblique (EO), erector spinae (ES), lumbar multifidus (LM), Gmed, gluteus maximus (Gmax), and tensor fasciae latae (TFL) during SSP with three different hip rotations compared to side-lying hip abduction (SHA) exercise in subjects with Gmed weakness. METHODS: Twenty-two subjects with Gmed weakness were recruited. SHA and three types of SSP exercises were performed: SSP with neutral hip (SSP-N), hip lateral rotation (SSP-L), and hip medial rotation (SSP-M). Surface electromyography was used to measure the activation of the trunk and hip muscles. RESULTS: The trunk and hip muscles activations were generally significantly higher level during three SSP than SHA. SSP-M showed significantly lower EO activation while significantly higher ES and LM activation than SSP-L. Gmed activation was significantly higher during SSP-M than during SSP-L. TFL activation was significantly lower during SSP-M than during SSP-N and SSP-L. CONCLUSIONS: SSP could be prescribed for patients who have reduced Gmed strength after injuries. Especially, SSP-M could be applied for patients who have Gmed weakness with dominant TFL.

scholarly journals Hip Muscle Activity During 3 Side-Lying Hip-Strengthening Exercises in Distance Runners

2012 ◽  
Vol 47 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Joseph M. McBeth ◽  
Jennifer E. Earl-Boehm ◽  
Stephen C. Cobb ◽  
Wendy E. Huddleston
Keyword(s):  
Muscle Activity ◽  
Repeated Measures ◽  
External Rotation ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Electromyographic Activity ◽  
Maximal Voluntary Isometric Contraction ◽  
Strengthening Exercises ◽  
Hip Abduction ◽  
Hip Strengthening

Context: Lower extremity overuse injuries are associated with gluteus medius (GMed) weakness. Understanding the activation of muscles about the hip during strengthening exercises is important for rehabilitation. Objective: To compare the electromyographic activity produced by the gluteus medius (GMed), tensor fascia latae (TFL), anterior hip flexors (AHF), and gluteus maximus (GMax) during 3 hip-strengthening exercises: hip abduction (ABD), hip abduction with external rotation (ABD-ER), and clamshell (CLAM) exercises. Design: Controlled laboratory study. Setting: Laboratory. Patients or Other Participants: Twenty healthy runners (9 men, 11 women; age = 25.45 ± 5.80 years, height = 1.71 ± 0.07 m, mass = 64.43 ± 7.75 kg) participated. Intervention(s): A weight equal to 5% body mass was affixed to the ankle for the ABD and ABD-ER exercises, and an equivalent load was affixed for the CLAM exercise. A pressure biofeedback unit was placed beneath the trunk to provide positional feedback. Main Outcome Measure(s): Surface electromyography (root mean square normalized to maximal voluntary isometric contraction) was recorded over the GMed, TFL, AHF, and GMax. Results: Three 1-way, repeated-measures analyses of variance indicated differences for muscle activity among the ABD (F3,57 = 25.903, P&lt;.001), ABD-ER (F3,57 = 10.458, P&lt;.001), and CLAM (F3,57 = 4.640, P=.006) exercises. For the ABD exercise, the GMed (70.1 ± 29.9%), TFL (54.3 ± 19.1%), and AHF (28.2 ± 21.5%) differed in muscle activity. The GMax (25.3 ± 24.6%) was less active than the GMed and TFL but was not different from the AHF. For the ABD-ER exercise, the TFL (70.9 ± 17.2%) was more active than the AHF (54.3 ± 24.8%), GMed (53.03 ± 28.4%), and GMax (31.7 ± 24.1 %). For the CLAM exercise, the AHF (54.2 ± 25.2%) was more active than the TFL (34.4 ± 20.1%) and GMed (32.6 ± 16.9%) but was not different from the GMax (34.2 ± 24.8%). Conclusions: The ABD exercise is preferred if targeted activation of the GMed is a goal. Activation of the other muscles in the ABD-ER and CLAM exercises exceeded that of GMed, which might indicate the exercises are less appropriate when the primary goal is the GMed activation and strengthening.

The Influence of Sagittal Plane Hip Position on Lower-Extremity Muscle Activity and Torque Output

2020 ◽  
pp. 1-9
Author(s):  
Neal R. Glaviano ◽  
David M. Bazett-Jones
Keyword(s):  
Muscle Activity ◽  
Sagittal Plane ◽  
External Rotation ◽  
Gluteus Maximus ◽  
Muscle Testing ◽  
Lower Extremity Muscle ◽  
Hip Muscle ◽  
Hip Flexion ◽  
Hip Extension ◽  
Adductor Longus

Context: Hip muscle strength has previously been evaluated in various sagittal plane testing positions. Altering the testing position appears to have an influence on hip muscle torque during hip extension, abduction, and external rotation. However, it is unknown how altering the testing position influences hip muscle activity during these commonly performed assessments. Objectives: To evaluate how hip sagittal plane position influences hip muscle activation and torque output. Study Design: Cross-sectional. Setting: Laboratory. Patients or Other Participants: A total of 22 healthy females (age = 22.1 [1.4] y; mass = 63.4 [11.3] kg; height = 168.4 [6.2] cm) were recruited. Intervention: None. Main Outcome Measures: Participants completed isometric contractions with surface electromyography on the superior and inferior gluteus maximus; anterior, middle, and posterior gluteus medius; biceps femoris, semitendinosus, adductor longus, and tensor fascia latae. Extension and external rotation were tested in 0°, 45°, and 90° of hip flexion and abduction was tested in −5°, 0°, and 45° of hip flexion. Repeated-measures analysis of variances were used for statistical analysis (P ≤ .01). Results: Activation of gluteal (P < .007), semitendinosus (P = .002), and adductor longus (P = .001) muscles were lesser for extension at 90° versus less flexed positions. Adductor longus activity was greatest during 90° of hip flexion for external rotation torque testing (P < .001). Tensor fascia latae (P < .001) and gluteus maximus (P < .001) activities were greater in 45° of hip flexion. Significant differences in extension (P < .001) and abduction (P < .001) torque were found among positions. Conclusions: Position when assessing hip extension and abduction torque has an influence on both muscle activity and torque output but only muscle activity for hip external rotation torque. Clinicians should be aware of the influence of position on hip extension, abduction, and external rotation muscle testing and select a position most in line with their clinical goals.

scholarly journals Hip-Muscle Activity in Men and Women During Resisted Side Stepping With Different Band Positions

2018 ◽  
Vol 53 (11) ◽  
pp. 1071-1081 ◽  
Author(s):  
Cara L. Lewis ◽  
Hanna D. Foley ◽  
Theresa S. Lee ◽  
Justin W. Berry
Keyword(s):  
Muscle Activation ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Lower Extremity Injury ◽  
Band Placement ◽  
Men And Women ◽  
Trunk Inclination ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Few Data

ContextWeakness or decreased activation of the hip abductors and external rotators has been associated with lower extremity injury, especially in females. Resisted side stepping is commonly used to address hip weakness. Whereas multiple variations of this exercise are used clinically, few data exist regarding which variations to select.ObjectiveTo investigate differences in muscle-activation and movement patterns and determine kinematic and limb-specific differences between men and women during resisted side stepping with 3 resistive-band positions.DesignControlled laboratory study.SettingLaboratory.Patients or Other ParticipantsA total of 22 healthy adults (11 men, 11 women; age = 22.8 ± 3.0 years, height = 171.6 ± 10.7 cm, mass = 68.5 ± 11.8 kg).Intervention(s)Participants side stepped with the resistive band at 3 locations (knees, ankles, feet).Main Outcome Measure(s)We collected surface electromyography of the gluteus maximus, gluteus medius, and tensor fascia lata (TFL) for the moving and stance limbs during the concentric and eccentric phases. We also measured trunk inclination, hip and knee flexion, and hip-abduction excursion.ResultsHip-abductor activity was higher in women than in men (P ≤ .04). The pattern of TFL activity in the stance limb differed by sex. Women performed the exercise in greater forward trunk inclination (P = .009) and had greater hip excursion (P = .003). Gluteus maximus and medius activity increased when the band was moved from the knees to the ankles and from the ankles to the feet, whereas TFL activity increased only when the band was moved from the knees to the ankles. Findings were similar for both the stance and moving limbs, but the magnitudes of the changes differed.ConclusionsCompared with placing the band around the ankles, placing the band around the feet for resisted side stepping elicited more activity in the gluteal muscles without increasing TFL activity. This band placement is most appropriate when the therapeutic goal is to activate the muscles that resist hip adduction and internal rotation.

scholarly journals Differential Effects of Hip Rotation Range on Knee Abduction Biomechanics during Double-Legged Landing between Males and Females

2020 ◽  
Vol 22 (4) ◽  
pp. 34-47
Author(s):  
Tadashi Yasuda ◽  
Keiichi Oyanagi ◽  
Miyu Nakagaki ◽  
Hiromitsu Itoh
Keyword(s):  
Muscle Strength ◽  
External Rotation ◽  
Muscle Mechanics ◽  
Abduction Angle ◽  
Drop Landing ◽  
Peak Knee ◽  
Hip Abduction ◽  
Knee Abduction ◽  
Males And Females ◽  
Hip Rotation

OBJECTIVES Dynamic knee valgus is composed of hip-knee coupling. While females differ from males in passive hip motion, hip rotation range may alter muscle mechanics and neuromuscular activity. This study aimed to compare knee abduction biomechanics during double-legged drop-landing between males and females with different hip rotation ranges.METHODS This study included five females with the range of hip internal rotation (IR) > the range of hip external rotation (ER), five females with ER>IR, four males with IR>ER, and five males with ER>IR. There was no difference in other hip motions among them or no difference in hip muscle strength between the same sex groups. Three-dimensional motion analyses of the hip and knee joints were performed during double-legged drop-landing.RESULTS Multiple regression analysis of females with IR>ER showed that peak knee abduction moment (KAM) was associated with maximal hip abduction moment before detecting peak KAM whereas peak knee abduction angle (KAA) correlated with no variable. In females with ER>IR, peak KAM was associated with maximal hip ER moment before detecting peak KAM, hip ER muscle strength and hip adduction range while peak KAA correlated with peak hip abduction moment before detecting peak KAM. In males with IR>ER, peak KAM was associated with hip ER range and hip adductor strength whereas peak KAA correlated with maximal hip ER moment and maximal hip IR angle during landing. In males with ER>IR, peak KAM was associated with hip extensor strength, hip abduction range and hip flexion range whereas peak KAA correlated with hip ER moment before detecting peak KAM, hip ER muscle strength, and hip adduction range.CONCLUSIONS Hip rotation range may differentially affect hip-knee coupling strategy for knee abduction control during double-legged drop-landing between males and females.

scholarly journals On the importance of the hip abductors during a clinical one legged balance test: A theoretical study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242454
Author(s):  
Payam Mirshams Shahshahani ◽  
James A. Ashton-Miller
Keyword(s):  
Peripheral Neuropathy ◽  
Muscle Strength ◽  
State Space ◽  
Healthy Aging ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Clinical Test ◽  
Plane State ◽  
Hip Abduction ◽  
Abduction Strength

Background The ability to balance on one foot for a certain time is a widely used clinical test to assess the effects of age and diseases like peripheral neuropathy on balance. While state-space methods have been used to explore the mechanical demands and achievable accelerations for balancing on two feet in the sagittal plane, less is known about the requirements for sustaining one legged balance (OLB) in the frontal plane. Research question While most studies have focused on ankle function in OLB, can age and/or disease-related decreases in maximum hip abduction strength also affect OLB ability? Methods A two-link frontal plane state space model was used to define and explore the ‘feasible balance region’ which helps reveal the requirements for maintaining and restoring OLB, given the adverse effects of age and peripheral neuropathy on maximum hip and ankle strengths. Results Maintaining quasistatic OLB required 50%-106% of the maximum hip abduction strength in young and older adults, and older patients with peripheral neuropathy. Effectiveness of a ‘hip strategy’ in recovering OLB was heavily dependent on the maximum hip abduction strength, and for healthy older women was as important as ankle strength. Natural reductions of strength due to healthy aging did not show a meaningful reduction in meeting the strength requirement of clinical OLB. However deficits in hip strength typical of patients with peripheral neuropathy did adversely affect both quasistatic OLB and recoverable OLB states. Significance The importance of hip muscle strength has been underappreciated in the clinical OLB test. This is partly because the passive tissues of the hip joint can mask moderate deficits in hip abduction strength until it is needed for recovering OLB. Adding a follow up OLB test with a slightly raised pelvis would be a simple way to check for adequate hip abductor muscle strength.

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