Studies in Sport Medicine

Relationship between lower extremity anatomical alignment and core muscle endurance with peak knee valgus angle during landing-jump in female athletes

Document Type : Research Paper

Authors

Bu-Ali Sina University

Abstract
The aim of this study was to evaluate the relationship between lower extremity alignment and endurance of core with maximal knee valgus during drop landing jump in female athletes. In the present cross-sectional study, 44 female athletes aged 16 to 26 years participated. The knee valgus angle was recorded using video camera during landing jump. Q angle, navicular drop, hip anteversion, tibia torsion, knee hyperextension and core stability endurance were assessed using standard clinical procedures. Data were analyzed by Pearson correlation test. The findings of the present study showed that there is a significant relationship between Q angle, endurance of right and left lateral flexor muscles with maximum knee valgus (P≤0.05). According to results of this study, assessing the Q angle and endurance of the lateral flexor muscles of the trunk can help identify athletes at risk for ACL injury and provide programs for the prevention of lower extremity injuries.

Keywords

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    1. Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understanding and preventing acl injuries: current biomechanical and epidemiologic considerations-update 2010. North American Journal of Sports Physical Therapy: NAJSPT. 2010;5(4):234.
    2. Pappas E, Shiyko MP, Ford KR, Myer GD, Hewett TE. Biomechanical deficit profiles associated with ACL injury risk in female athletes. Medicine and Science in Sports and Exercise. 2016;48(1):107.
    3. Holden S, Boreham C, Doherty C, Delahunt E. Two‐dimensional knee valgus displacement as a predictor of patellofemoral pain in adolescent females. Scandinavian Journal of Medicine & Science in Sports. 2017;27(2):188-94.
    4. Lee TQ, Yang BY, Sandusky MD, McMahon PJ. The effects of tibial rotation on the patellofemoral joint: assessment of the changes in in situ strain in the peripatellar retinaculum and the patellofemoral contact pressures and areas. Journal of rehabilitation Research and Development. 2014;38(5):463-9.
    5. Nguyen A-D, Shultz SJ, Schmitz RJ, Luecht RM, Perrin DH. A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. Journal of Athletic Training. 2011;46(3):246-56.
    6. Sung PS, Zipple JT, Andraka JM, Danial P. The kinetic and kinematic stability measures in healthy adult subjects with and without flat foot. The Foot. 2017;30:
      21-6.
    7. Söderman K, Alfredson H, Pietilä T, Werner S. Risk factors for leg injuries in female soccer players: a prospective investigation during one out-door season. Knee Surgery, Sports Traumatology, Arthroscopy. 2001;9(5):313-21.
    8. McLean SG, Huang X, Van Den Bogert AJ. Association between lower extremity posture at contact and peak knee valgus moment during sidestepping: implications for ACL injury. Clinical Biomechanics. 2005;20(8):863-70.
    9. Willson JD, Ireland ML, Davis I. Core strength and lower extremity alignment during single leg squats. Medicine & Science in Sports & Exercise. 2006;38(5):945-52.
    10. Hewett TE, Torg JS, Boden BP. Video analysis of trunk and knee motion during non-contact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism. British Journal of Sports Medicine. 2009;43(6):417-22.
    11. Daneshmandi H, Saki F, Shahheidari S, Khoori A. Lower extremity Malalignment and its linear relation with Q angle in female athletes. Procedia-Social and Behavioral Sciences. 2011;15:3349-54.
    12. arabjafari z, fatahi H, Shamsehkohan P. The effect of 8 weeks combined exercises (core stability and theraband) on distance of knee medail condyles, Q angle and endurance of core muscles in adolescent students with genu varum. Journal for Research in Sport Rehabilitation. 2020;8(15):101-13.
    13. Burnham JM, Yonz MC, Robertson KE, McKinley R, Wilson BR, Johnson DL, et al. Relationship of hip and trunk muscle function with single leg step-down performance: implications for return to play screening and rehabilitation. Physical Therapy in Sport. 2016;22:66-73.
    14. Gringmuth RH, Jackson C. Therapeutic exercise for spinal segmental stabilization in low back pain: scientific basis and clinical approach. The Journal of the Canadian Chiropractic Association. 2000;44(2):125.
    15. Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports medicine. 2006;36(3):189-98.
    16. Sato K, Mokha M. Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners? The Journal of Strength & Conditioning Research. 2009;23(1):133-40.
    17. Myer GD, Chu DA, Brent JL, Hewett TE. Trunk and hip control neuromuscular training for the prevention of knee joint injury. Clin Sports Med. 2008;27(3):
      425-48.
    18. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk: prospective biomechanical-epidemiologic study. The American Journal of Sports Medicine. 2007;35(7):1123-30.
    19. Fallah Mohammadi M, Shojaadin s, Amir L, Ebrahimi Takomjani E, Mansour E. Relationship between core stability and strength of some lower extremity muscles, and jump-landing biomechanics using Landing Error Scoring System. Journal of Applied Exercise Physiology. 2018;13(26):125-38.
    20. Araujo S, Cohen D, Hayes L. Six weeks of core stability training improves landing kinetics among female capoeira athletes: a pilot study. Journal of Human Kinetics. 2015;45:27.
    21. Everard E, Lyons M, Harrison AJ. An examination of the relationship between the functional movement screen, landing error scoring system, and 3d kinematic data during a drop jump task. Journal of Strength and Conditioning Research. 2021;35(11):3012-20.
    22. Wilkerson GB, Colston MA. A refined prediction model for core and lower extremity sprains and strains among collegiate football players. Journal of Athletic Training. 2015;50(6):643-50.
    23. de Oliveira Silva D, Briani R, Pazzinatto M, Ferrari D, Aragão F, de Azevedo F. Vertical ground reaction forces are associated with pain and self-reported functional status in recreational athletes with patellofemoral pain. Journal of Applied Biomechanics. 2015;31(6):409-14.
    24. Weiss L, DeForest B, Hammond K, Schilling B, Ferreira L. Reliability of goniometry-based Q-angle. PM&R. 2013;5(9):763-8.
    25. Choi B-R, Kang S-Y. Intra-and inter-examiner reliability of goniometer and inclinometer use in Craig’s test. Journal of Physical Therapy Science. 2015;27(4):1141-4.
    26. Daneshmandi H, Saki F. The Study of Static Lower Extremity Alignment in Female Athletes with ACL Injury. Journal of Exercise Science and Medicine. 2009;1(1):75-165.
    27. Daneshmandi H, Saki F. The study of joint hypermobility and Q angle in female football players. World Journal of Sport Science. 2010;3(4):243-7.
    28. McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Archives of Physical Medicine and Rehabilitation. 1999;80(8):941-4.
    29. Nagano Y, Ida H, Akai M, Fukubayashi T. Biomechanical characteristics of the knee joint in female athletes during tasks associated with anterior cruciate ligament injury. The Knee. 2009;16(2):153-8.
    30. Herrington L, Munro A. Drop jump landing knee valgus angle: normative data in a physically active population. Physical Therapy in Sport. 2010;11(2):56-9.
    31. Hewett TE, Myer GD, Ford KR, Heidt Jr RS, Colosimo AJ, McLean SG, et al. 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. 2005;33(4):492-501.
    32. Hamdan M, Ismail SI, Hassan H, Ismail H, Bukry SA, Raja Azidin R. How reliable is kinovea vs. Templo in knee and hip kinematics assessment during side cutting tasks. Knee. 2017;2(1):1-2.
    33. Dadfar M, Sheikhhoseini R, Jafarian M, Esmaeili A. Lower extremity kinematic coupling during single and double leg landing and gait in female junior athletes with dynamic knee valgus. BMC Sports Science, Medicine and Rehabilitation. 2021;13(1):1-10.
    34. Mohammadi MF, Sobhani V. The Relationship Between Trunk Muscle Endurance and Three-dimensional Knee Kinematics During Jump-Landing Among Military Personnel. Journal of Modern Rehabilitation. 2019;13(3):
      161-70.
    35. De Blaiser C, Roosen P, Willems T, Danneels L, Bossche LV, De Ridder R. Is core stability a risk factor for lower extremity injuries in an athletic population? A systematic review. Physical Therapy in sport. 2018;30:48-56.
    36. Tubbs RS, Oskouian Jr RJ, Iwanaga J, Moisi M. Surgical anatomy of the lateral transpsoas approach to the lumbar spine E-Book. Amsterdam: Elsevier Health Sciences; 2019.
    37. Pool-Goudzwaard A, Vleeming A, Stoeckart R, Snijders C, Mens JM. Insufficient lumbopelvic stability: a clinical, anatomical and biomechanical approach to ‘a-specific’low back pain. Manual Therapy. 1998;3(1):12-20.
    38. Akuthota V, Nadler SF. Core strengthening. Archives of Physical Medicine and Rehabilitation. 2004;85:86-92.
    39. Teng H-L, Powers CM. Sagittal plane trunk posture influences patellofemoral joint stress during running. Journal of Orthopaedic & Sports Physical Therapy. 2014;44(10):785-92.
    40. Hewett TE, Myer GD. The mechanistic connection between the trunk, knee, and anterior cruciate ligament injury. Exercise and Sport Sciences Reviews. 2011;39(4):161.
    41. Willson JD, Dougherty CP, Ireland ML, Davis IM. Core stability and its relationship to lower extremity function and injury. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2005;13(5):316-25.
    42. Nakagawa TH, Maciel CD, Serrão FV. Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain. Manual Therapy. 2015;20(1):189-93.
    43. Mozafaripour E, Seidi F, Minoonejad H, Mousavi SH, Bayattork M. Can lower extremity anatomical measures and core stability predict dynamic knee valgus in young men? Journal of Bodywork and Movement Therapies. 2021;27:358-63.
    44. MacKinnon CD, Winter DA. Control of whole body balance in the frontal plane during human walking. Journal of Biomechanics. 1993;26(6):633-44.
    45. Park S-K, Stefanyshyn DJ. Greater Q angle may not be a risk factor of patellofemoral pain syndrome. Clinical Biomechanics. 2011;26(4):392-6.
    46. Sigward SM, Havens KL, Powers CM. Knee separation distance and lower extremity kinematics during a drop land: implications for clinical screening. National Athletic Trainers' Association, Inc; 2011, pp. 471-5.
    47. Stefanyshyn DJ, Stergiou P, Lun VM, Meeuwisse WH, Worobets JT. Knee angular impulse as a predictor of patellofemoral pain in runners. The American Journal of Sports Medicine. 2006;34(11):1844-51.
    48. Bonci CM. Assessment and evaluation of predisposing factors to anterior cruciate ligament injury. Journal of Athletic Training. 1999;34(2):155.
    49. Bell DR, Oates DC, Clark MA, Padua DA. Two-and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. Journal of Athletic Training. 2013;48(4):442-9.
    50. Zarei M. The relationship between static lower extremity alignment and injuries in adolescent soccer players. Research in Sport Medicine and Technology. 2016;14(12):59-70.
    51. Tiberio D. The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. Journal of Orthopaedic & Sports physical Therapy. 1987;9(4):160-5.

     

Studies in Sport Medicine
Volume 14, Issue 34
February 2023
Pages 49-70

  • Receive Date 08 June 2022
  • Revise Date 21 January 2023
  • Accept Date 31 January 2023

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