Biomechanical Differences in Knee Valgus Angles in Collegiate Female Athletes Participating in Different Sports

L. Derek Gerber, Evan V. Papa, Eydie A. Kendall

Abstract


Background: Dynamic knee valgum is a major risk factor in ligamentous injuries of the knee. Different sports have higher rates of knee ligament injury than others and females experience knee non-contact ligament injuries at higher rates than their male counterparts. Objectives: The purpose of this study was to investigate the lower extremity biomechanics of genu valgum in female collegiate athletes of various sports while performing a drop jump test. This information may provide those designing individualized prevention programs assistance in reducing risk of knee ligamentous injury during jumping tasks. Methods: Current members of Idaho State University’s women’s basketball, soccer, and softball teams were evaluated for this study. Thirty-seven athletes participated. Motion capture reflective markers were placed bilaterally on the lower extremities to allow for analysis of knee biomechanics during a double-leg drop jump test. The angles of knee valgum in the frontal plane were calculated and analyzed between sport groups. Results: Female athletes of different sports displayed statistically significant differences in knee angles for both right, and left knees. Post hoc analysis with a Bonferroni adjustment revealed that basketball players utilized a more valgus right knee angle compared to both soccer and softball players and a more varus left knee angle compared with softball players. Conclusions: Our study suggests that collegiate-level female basketball players have an increased risk of right leg non-contact knee ligament injury during jump landing maneuvers when compared to collegiate level softball and soccer players due to increased knee valgus movements during the drop jump test. Collegiate-level female basketball players may benefit from biomechanical exercise interventions designed to decrease right knee valgus moments in jumping and landing to decrease their risk of injury.

Keywords


Knee, Female, Athletes, Ligaments, Genu Valgum, Knee Injuries

Full Text:

PDF

References


Agel, J., Rockwood, T., & Klossner, D. (2016). Collegiate ACL injury rates across 15 sports: National Collegiate Athletic Association Injury Surveillance System data update (2004-2005 through 2012-2013). Clinical Journal of Sport Medicine, 26(6), 518–523. https://doi.org/10.1097/JSM.0000000000000290

Aizawa, J., Hirohata, K., Ohji, S., Ohmi, T., & Yagishita, K. (2018). Limb-dominance and gender differences in the ground reaction force during single-leg lateral jump-landings. Journal of Physical Therapy Science, 30(3), 387-392. https://doi.org/10.1589/jpts.30.387

Boden, B. P., Sheehan, F. T., Torg, J. S., & Hewett, T. E. (2013). Non-contact ACL injuries: Mechanisms and risk factors. Journal of the American Academy of Orthopedic Surgeons, 18(9), 520-527. https://doi.org/10.5435/00124635-201009000-00003

Brophy, R., Silvers, H. J., Gonzales, T., & Mandelbaum, B. R. (2008). Gender influences: the role of leg dominance in ACL injury among soccer players. British Journal of Sports Medicine, 44(10), 694-697. https://doi.org/10.1136/bjsm.2008.051243

Chappell, J. D., Creighton, R. A., Giuliani, C., Yu, B., & Garrett, W. E. (2007). Kinematics and electromyography of landing preparation in vertical stop-jump: risks for noncontact anterior cruciate ligament injury. The American Journal of Sports Medicine, 35(2), 235-241. https://doi.org/10.1177/0363546506294077

Chappell, J. D., & Limpisvasti, O. (2008). Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks. The American Journal of Sports Medicine, 36(6), 1081-1086. https://doi.org/10.1177/0363546508314425

Cowan, S. M., & Crossley, K. M. (2009). Does gender influence neuromotor control of the knee and hip? Journal of Electromyography and Kinesiology, 19(2), 276-282. https://doi.org/10.1016/j.jelekin.2007.07.009

Distefano, L. J., Blackburn, J. T., Marshall, S. W., & Padua, D. A. (2009). Gluteal muscle activation during common therapeutic exercises. The Journal of Orthopaedic and Sports Physical Therapy, 39(7), 532-540. https://doi.org/10.2519/jospt.2009.2796

Ford, K. R., Myer, G. D., & Hewett, T. E. (2003). Valgus knee motion during landing in high school female and male basketball players. Medicine & Science in Sports & Exercise, 35(10), 1745-1750. https://doi.org/10.1249/01.MSS.0000089346.85744.D9

Ford, K. R., Myer, G. D., Toms, H. E., & Hewett, T. E. (2005) Gender differences in kinematics of unanticipated cutting in young athletes. Medicine & Science in Sports & Exercise, 37(1), 124-129. https://doi.org/10.1249/01.MSS.0000150087.95953.C3

Gornitzky, A. L., Lott, A., Yellin, J. L., Fabricant, P. D., Lawrence, J. T., & Ganley, T. J. (2016). Sport-specific yearly risk and incidence of anterior cruciate ligament tears in high school athletes: A systematic review and meta-analysis. The American Journal of Sports Medicine, 44(10), 2716-2723. https://doi.org/10.1177/0363546515617742

Herrington, L., & Munro, A. (2010). Drop jump landing knee valgus angle; normative data in physical active population. Physical Therapy in Sport, 11(2), 56-59. https://doi.org/10.1016/j.ptsp.2009.11.004

Hewett, T. E., Ford, K. R., Hoogenboom, B. J., & Myer, G. D. (2010). Understanding and preventing ACL injuries: Current biomechanical and epidemiologic considerations – update 2010. North American Journal of Sports Physical Therapy, 5(4), 234-251.

Hewett, T. E., Ford, K. R., & Myer, G. D. (2006). Anterior cruciate ligament injuries in female athletes: part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. The American Journal of Sports Medicine, 34(3), 490-498. https://doi.org/10.1177/0363546505282619

Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R.S. Jr., Colosimo, A. J., McLean, S. G.,…Succop, P. (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. The American Journal of Sports Medicine, 33(4), 492-501. https://doi.org/10.1177/0363546504269591

Hewett, T. E., Paterno, M. V., & Myer, G. D. (2002). Strategies for enhancing proprioception and neuromuscular control of the knee. Clinical Orthopaedics and Related Research, 403, 76-94. https://doi.org/10.1097/00003086-200209000-00008

Hootman, J. M., Dick, R., & Agel, J. (2007). Epidemiology of Collegiate Injuries for 15 Sports: Summary and Recommendations for Injury Prevention Initiatives. Journal of Athletic Training, 42(2), 311-319.

Hutchinson, M. R., & Ireland, M. L. (1995). Knee injuries in female athletes. Sports Medicine, 19(4), 288-302. https://doi.org/10.2165/00007256-199519040-00006

Jackson, K. M., Beach, T. A. C., & Andrews, D. M. (2017). The effect of an isometric hip muscle strength training protocol on valgus angle during a drop vertical jump in competitive female volleyball players. International Journal of Kinesiology and Sports Science, 5(4), 1-9. https://doi.org/10.7575/aiac.ijkss.v.5n.4p.1

Johnson, T. M., Brown, L. E., Coburn, J. W., Judelson, D. A., Khamoui, A. V., Tran, T. T. & Uribe, B. P. (2010). Effect of four different starting stances on sprint time in collegiate volleyball players. The Journal of Strength & Conditioning Research, 24(10), 2641-2646. https://doi.org/10.1519/JSC.0b013e3181f159a3

Joseph, A. M., Collins, C. L., Henke, N. M., Yard, E. E., Fields, S. K., & Comstock, R. D. (2013). A multisport epidemiologic comparison of anterior cruciate ligament injuries in high school athletics. Journal of Athletic Training, 48(6), 810-817. https://doi.org/10.4085/1062-6050-48.6.03

Kay, M. C., Register-Mihalik, J. K., Gray, A. D., Djoko, A., Dompier, T. P., & Kerr, Z. Y. (2017). The Epidemiology of Severe Injuries Sustained by National Collegiate Athletic Association Student-Athletes, 2009–2010 Through 2014–2015. Journal of Athletic Training, 52(2), 117-128. https://doi.org/10.4085/1062-6050-52.1.01

Lam, K. C., McLeod, V., & Tamara, C. (2014). The impact of sex and knee injury history on jump-landing patterns in collegiate athletes: A clinical evaluation. Clinical Journal of Sport Medicine, 24(5), 373-379. https://doi.org/10.1097/JSM.0000000000000053

Magee, D. Knee. (2014). Knee. Orthopedic Physical Assessment. 6th ed. (765-859). St. Louis: Elsevier Saunders.

Mandelbaum, B. R., Silvers, H. J., & Watanabe, D. S., Knarr, J. F., Thomas, S. D., Griffin, L. Y.,…Garrett, W. (2005). Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. The American Journal of Sports Medicine, 33, 1003-1010. https://doi.org/10.1177/0363546504272261

Mizner, R. L., Kawaguchi, J. K., & Chmielewski, T. L. (2008). Muscle strength in the lower extremity does not predict postinstruction improvements in the landing patterns of female athletes. The Journal of Orthopaedic and Sports Physical Therapy, 38(6), 353-361. https://doi.org/10.2519/jospt.2008.2726

Mokhtarzadeh, H., Ewing, K., Janssen, I., Yeow, C. H., Brown, N., & Lee, P. V. S. (2017). The effect of leg dominance and landing height on ACL loading among female athletes. Journal of Biomechanics, 60, 181-187. https://doi.org/10.1016/j.jbiomech.2017.06.033

Munro, A., Herrington, L., & Comfort, P. (2012). Comparison of landing knee valgus angle between female basketball and football athletes: Possible implications for anterior cruciate ligament and patellofemoral joint injury rates. Physical Therapy in Sport, 13(4), 259-264. https://doi.org/10.1016/j.ptsp.2012.01.005

Myer, G. D., Ford, K. R., Khoury, J., Succop, P., & Hewett, T. E. (2010). Development and validation of a clinic- based prediction tool to identify female athletes at high risk for anterior cruciate ligament injury. The American Journal of Sports Medicine, 38(10), 2025-2033. https://doi.org/10.1177/0363546510370933

Nilstad, A., Krosshaug, T., Mok, K. M., Bahr, R., & Andersen, T. E. (2015). Association between anatomical characteristics, knee laxity, muscle strength, and peak knee valgus during vertical drop-jump landings. Journal of Orthopaedic and Sports Physical Therapy, 45(12), 998-1005. https://doi.org/10.2519/jospt.2015.5612

Noyes, F. R., Barber-Westin, S. D., Fleckenstein, C., Walsh, C., & West, J. (2005). The drop-jump screening test: difference in lower limb control by gender and effect of neuromuscular training in female athletes. The American Journal of Sports Medicine, 33(2), 197-207. https://doi.org/10.1177/0363546504266484

Numata, H., Nakase, J., Kitaoka, K., Shima, Y., Oshima, T., Takata, Y., …Tsuchiya, H. (2018). Two-dimensional motion analysis of dynamic knee valgus identifies female high school athletes at risk of non-contact anterior cruciate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy, 26(2), 442-447. https://doi.org/10.1007/s00167-017-4681-9

Okazaki, V. H. A., Rodacki, A. L. F., & Satern, M. N. (2015). A review on the basketball jump shot. Sports Biomechanics, 14(2), 190-205. https://doi.org/10.1080/14763141.2015.1052541

Padua, D. A., DiStefano, L. J., Hewett, T. E., Garrett, W. E., Marshall, S. W., Golden, G. M., … Sigward, S. M. (2018). National Athletic Trainers’ Association position statement: Prevention of anterior cruciate ligament injury. Journal of Athletic Training, 53(1), 5-19. https://doi.org/10.4085/1062-6050-99-16

Pollard, C. D., Sigward, S. M., Ota, S., Langford, K., & Powers, C. M. (2006). The influence of in-season injury prevention training on lower-extremity kinematics during landing in female soccer players. Clinical Journal of Sport Medicine, 16(3), 223-227. https://doi.org/10.1097/00042752-200605000-00006

Pollard, C. D., Sigward, S. M., & Powers, C. M. (2010). Limited hip and knee flexion during landing is associated increased frontal plane knee motion and moments. Clinical Biomechanics (Bristol, Avon), 25, 142-146. https://doi.org/10.1016/j.clinbiomech.2009.10.005

Tate, J. J., Milner, C. E., Fairbrother, J. T., & Zhang, S. (2013). The effects of a home-based instructional program aimed at improving frontal plane knee biomechanics during a jump-landing task. Journal of Orthopaedic and Sports Physical Therapy, 43(7), 486-494. https://doi.org/10.2519/jospt.2013.4229

Taylor, J. B., Ford, K. R., Schmitz, R. J., Ross, S. E., Ackerman, T. A., & Shultz, S. J. (2017). Biomechanical differences of multidirectional jump landings among female basketball and soccer players. The Journal of Strength & Conditioning Research, 31(11), 3034-3045. https://doi.org/10.1519/JSC.0000000000001785




DOI: http://dx.doi.org/10.7575/aiac.ijkss.v.7n.2p.8

Refbacks

  • There are currently no refbacks.




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2019 (CC-BY) Australian International Academic Centre PTY.LTD.

International Journal of Kinesiology and Sports Science

You may require to add the 'aiac.org.au' domain to your e-mail 'safe list’ If you do not receive e-mail in your 'inbox'. Otherwise, you may check your 'Spam mail' or 'junk mail' folders.