Rethinking Dynamic Knee Valgus and Its Relation to Knee Injury: Normal Movement Requiring Control, Not Avoidance

2019 ◽  
Vol 49 (4) ◽  
pp. 216-218 ◽  
Author(s):  
Steven L. Dischiavi ◽  
Alexis A. Wright ◽  
Eric J. Hegedus ◽  
Chris M. Bleakley
Keyword(s):  
Knee Injury ◽  
Knee Valgus ◽  
Normal Movement

scholarly journals Change of Direction Biomechanics in a 180-Degree Pivot Turn and the Risk for Noncontact Knee Injuries in Youth Basketball and Floorball Players

2021 ◽  
pp. 036354652110269
Author(s):  
Mari Leppänen ◽  
Jari Parkkari ◽  
Tommi Vasankari ◽  
Sami Äyrämö ◽  
Juha-Pekka Kulmala ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Injury Risk ◽  
Knee Injury ◽  
Reaction Force ◽  
Knee Injuries ◽  
Flexion Angle ◽  
Knee Valgus ◽  
Change Of Direction ◽  
Increased Risk ◽  
Peak Knee

Background: Studies investigating biomechanical risk factors for knee injuries in sport-specific tasks are needed. Purpose: To investigate the association between change of direction (COD) biomechanics in a 180-degree pivot turn and knee injury risk among youth team sport players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 258 female and male basketball and floorball players (age range, 12-21 years) participated in the baseline COD test and follow-up. Complete data were obtained from 489 player-legs. Injuries, practice, and game exposure were registered for 12 months. The COD test consisted of a quick ball pass before and after a high-speed 180-degree pivot turn on the force plates. The following variables were analyzed: peak vertical ground-reaction force (N/kg); peak trunk lateral flexion angle (degree); peak knee flexion angle (degree); peak knee valgus angle (degree); peak knee flexion moment (N·m/kg); peak knee abduction moment (N·m/kg); and peak knee internal and external rotation moments (N·m/kg). Legs were analyzed separately and the mean of 3 trials was used in the analysis. Main outcome measure was a new acute noncontact knee injury. Results: A total of 18 new noncontact knee injuries were registered (0.3 injuries/1000 hours of exposure). Female players sustained 14 knee injuries and male players 4. A higher rate of knee injuries was observed in female players compared with male players (incidence rate ratio, 6.2; 95% CI, 2.1-21.7). Of all knee injuries, 8 were anterior cruciate ligament (ACL) injuries, all in female players. Female players displayed significantly larger peak knee valgus angles compared with male players (mean for female and male players, respectively: 13.9°± 9.4° and 2.0°± 8.5°). No significant associations between biomechanical variables and knee injury risk were found. Conclusion: Female players were at increased risk of knee and ACL injury compared with male players. Female players performed the 180-degree pivot turn with significantly larger knee valgus compared with male players. However, none of the investigated variables was associated with knee injury risk in youth basketball and floorball players.

scholarly journals The Effects of the Functional Garment on the Biomechanics During the Single Leg Drop Landing.

2021 ◽  
Author(s):  
Shintarou Kudo ◽  
Ayane Yamamoto ◽  
Sho Katayama ◽  
Toshinori Miyashita ◽  
Raita Takasaki
Keyword(s):  
Lower Limb ◽  
Knee Injury ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Human Movement ◽  
Knee Valgus ◽  
Drop Landing ◽  
Significant Difference ◽  
Study Characteristics

Abstract Background: Female athletes with an anterior cruciate ligament (ACL) injury should decrease both dynamic valgus of the knee and related kinematics of the lower limb during single leg drop landing (SLDL). A functional biomechanics garment (FBG) may help prevent injury by improved kinematics during motion. The purpose of this study was to investigate the effects of the FBG on the biomechanics of SLDL.Methods: Seventeen female university basketball players participated in this study. Characteristics of the FBG were designed based on biomechanics during weight-loaded performance of human movement such as gait, running, and jumping. Lower limb kinematic and kinetic data were calculated using a three-dimensional motion analysis system during a SLDL task with and without the FBG. The hip, knee, and ankle angles and joint moments were automatically calculated from the standard plug-in gait lower body model. The average values of lower limb kinematics and kinetics in the sagittal and frontal planes from 3 SLDL with and without FBG were measured and compared.Results: The maximum varus angle of the knee showed a significant difference between with FBG (15.3±15.1 degrees) and without FBG (5.9±15.4 degrees). (p<0.01; effect size 0.6) Conclusion: Use of the FBG decreases dynamic knee valgus, which reduces risk of knee injury. The FBG can reduce dynamic knee valgus during SLDL in athletic rehabilitation and to play a role in the prevention of knee injury.

scholarly journals RELIABILITY OF A NEW LANDING ERROR SCORING SYSTEM: THE LESS-RMC

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0009
Author(s):  
Ryan S. Wexler ◽  
Sean Higinbotham ◽  
Danny Blake ◽  
Carlie Harrison ◽  
Justin Hollenbeck ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Scoring System ◽  
Injury Risk ◽  
Knee Injury ◽  
Assessment Tool ◽  
Acl Injury ◽  
Knee Valgus ◽  
Jump Landing ◽  
Acl Injury Risk ◽  
The Mean

BACKGROUND Several biomechanical deficits have been shown to increase non-contact knee injury risk of the anterior cruciate ligament (ACL). The Landing Error Scoring System (LESS) is a clinical assessment tool that has been successfully used to predict the individuals that are at a high risk for injury and evaluate changes in landing technique after participation in a neuromuscular preventive training program. The LESS-RT is a shortened version of the LESS and is a method to score landing technique without the use of video. The current study proposes a new tool for the evaluation of landing technique and ACL injury risk that blends the LESS and LESS-RT protocols but emphasizes the movement features that contribute to high knee valgus moments including movement asymmetry. The LESS-RMC (Rocky Mountain Consortium) consists of evaluating 11 comprehensive landing errors that are related to ACL injury risk. Consolidating questions pertaining to the opposite ends of joint motion such as “toe in” and “toe out” into “maximum foot rotation position” and adding a global asymmetry score were performed to reduce the time demands for evaluation yet capture the salient factors of the LESS; whereas the penalty for knee valgus severity was pulled from the LESS-RT but implemented for both knees in the new LESS-RMC to ultimately stratify knee injury risk during the jump landing task. The purpose of this study was to determine the reliability of the new LESS-RMC assessment tool. METHODS Thirty-seven, elite female soccer athletes (13.2 +/- 0.4 y) performed three drop-jumps from a height of 30 cm. Front and side views of the landing were recorded with digital video cameras. Movement quality was rated by 4 researchers evaluating 17 components of the landing with the LESS and a modified, 11 component version of the LESS (LESS-RMC). The 4 raters were novel to the evaluation of both scoring systems. Each rater was trained how to score each test and was instructed to evaluate the landing trials from the first 10 participants. After a group video review and discussion, the raters repeated the scoring procedures for the same 10 participants 48 hours after the original review. After another 48 hours, the raters evaluated the landing trials for all 37 participants (111 trials). Inter-rater reliability of the LESS and LESS-RMC were determined using the ICC (3,1) equations and the output from a two-way ANOVA (SPSS, version 25). RESULTS The mean LESS score was 6.45 +/- 0.55 (rater 1, 6.42; rater 2, 7.15; rater 3, 5.79; rater 4, 6.45). The ICC agreement between raters of scoring the LESS was .389 whereas the ICC agreement for the mean of the four raters was .718. The ICC for scoring consistency was .382 and Cronbach’s a was .735. The mean LESS-RMC score was 6.19 +/- 0.74 (rater 1, 5.65; rater 2, 6.99; rater 3, 5.48; rater 4, 6.64). The ICC agreement of scoring the LESS-RMC was .585 whereas the ICC agreement for the mean of the four raters was .849. The ICC for scoring consistency was .574 and Cronbach’s a was .884. CONCLUSION On average, the raters scored the LESS and the LESS-RMC with moderate reliability across the group of athletes. The LESS-RMC was scored with greater reliability than the LESS for this group of relatively novice raters. This is likely due to the simplification of the overall protocol in terms of quantity of questions, the ability of a novel rater to understand scenarios which elicit specific scores and the clear separation of body segments (e.g. hip and trunk flexion). In conjunction with this, it was reported by the raters that LESS-RMC was less redundant and more effective at assessing crucial aspects of a jump landing pattern. Overall, LESS RMC was objectively and subjectively more reliable and easier to use than the LESS for the four raters involved in this study. It is concluded that the LESS-RMC is a quick, easy and reliable clinical assessment tool that may be used to stratify individuals who may be at risk for ACL injury.

Bilateral Floating Knee Injury—Management of a Complex Injury

2019 ◽  
Vol 29 (1) ◽  
pp. 1-6
Author(s):  
Alexandros P. Apostolopoulos ◽  
Stavros Angelis ◽  
Salma E. Elamin ◽  
Glenn Clewer
Keyword(s):  
Knee Injury ◽  
Injury Management ◽  
Complex Injury ◽  
Floating Knee Injury

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.

scholarly journals What Does the Future Hold? Health-Related Quality of Life 3–12 Years Following a Youth Sport-Related Knee Injury

2021 ◽  
Vol 18 (13) ◽  
pp. 6877
Author(s):  
Christina Y. Le ◽  
Clodagh M. Toomey ◽  
Carolyn A. Emery ◽  
Jackie L. Whittaker
Keyword(s):  
Quality Of Life ◽  
Knee Injury ◽  
Youth Sport ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Knee Trauma ◽  
Strenuous Physical Activity ◽  
Eq Vas

Knee trauma can lead to poor health-related quality of life (HRQoL) and osteoarthritis. We aimed to assess HRQoL 3–12 years following youth sport-related knee injury considering HRQoL and osteoarthritis determinants. Generic (EQ-5D-5L index, EQ-VAS) and condition-specific (Knee injury and Osteoarthritis Outcome Score quality of life subscale, KOOS QOL) HRQoL were assessed in 124 individuals 3–12 years following youth sport-related knee injury and 129 uninjured controls of similar age, sex, and sport. Linear regression examined differences in HRQoL outcomes by injury group. Multivariable linear regression explored the influence of sex, time-since-injury, injury type, body mass index, knee muscle strength, Intermittent and Constant Osteoarthritis Pain (ICOAP) score, and Godin Leisure-Time Exercise Questionnaire (GLTEQ) moderate-to-strenuous physical activity. Participant median (range) age was 23 years (14–29) and 55% were female. Injury history was associated with poorer KOOS QOL (−8.41; 95%CI −10.76, −6.06) but not EQ-5D-5L (−0.0074; −0.0238, 0.0089) or EQ-VAS (−3.82; −8.77, 1.14). Injury history (−5.14; −6.90, −3.38), worse ICOAP score (−0.40; −0.45, −0.36), and anterior cruciate ligament tear (−1.41; −2.77, −0.06) contributed to poorer KOOS QOL. Worse ICOAP score contributed to poorer EQ-5D-5L (−0.0024; −0.0034, −0.0015) and higher GLTEQ moderate-to-strenuous physical activity to better EQ-VAS (0.10; 0.03, 0.17). Knee trauma is associated with poorer condition-specific but not generic HRQoL 3–12 years post-injury.

scholarly journals An Investigation of Knee Injury Profiles among Iranian Elite Karatekas: Observations from a Cross-Sectional Study

2021 ◽  
Vol 18 (13) ◽  
pp. 6888
Author(s):  
Hamidreza Naserpour ◽  
Julien S. Baker ◽  
Amir Letafatkar ◽  
Giacomo Rossettini ◽  
Frédéric Dutheil
Keyword(s):  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Cross Sectional Study ◽  
Lower Extremity Injury ◽  
Sectional Study ◽  
Positive Health ◽  
Sports Activity ◽  
Cross Sectional ◽  
National Team

Karate training, despite the many positive health benefits, carries a risk of injury for participants. The current cross-sectional study aimed to investigate knee injury profiles among Iranian elite karatekas. Participants who attended the national team qualifiers, which included 390 male Kumite karatekas (age 24 ± 3 years old and weight 63 ± 12 kg), participated in this study. Information on knee injuries (injury history, type of injury mechanisms, and effects of knee symptoms on the ability to perform daily activities and recreational activities) were obtained using the Knee Outcome Survey (KOS). Using Pearson’s correlation coefficient, the study examined the relationships between different variables, including KOS subscales and levels of self-reported knee joint function. Our findings indicated that 287 karatekas (73.6%) experienced knee injuries. The anterior cruciate ligament (ACL) rupture (6.9%), articular cartilage (5.4%), and meniscus damage (3.8%) were the main typology of injury. In addition, there were no differences in knee injuries between the non-dominant and dominant legs. Most injuries occurred during the preparatory period (n = 162, 50%), especially during training periods. The KOS subscales scores (Mean ± Sd) for activities of daily living (ADL) and sports activity (SAS) were, respectively, 89 ± 11 and 91 ± 9. The self-reported scores for both the ADL and SAS subscales were, respectively, 89 ± 11 and 90 ± 10. Pearson coefficients of ADL and SAS subscales with their self-reported score were r = 0.761 (p < 0.0001) and r = 0.782 and (p < 0.0001), respectively. The profile of knee injuries in the current investigation is similar to previous surveys that reported lower extremity injury patterns. The findings of this study could be adopted to inform practice aimed at planning interventions for the reduction and prevention of knee injuries among karatekas.

Sign in / Sign up

Export Citation Format

Share Document