A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength

Palmer, Kathryn; Hebron, Clair; Williams, Jonathan M.

doi:10.1186/s12891-015-0563-9

Cited by 37 publications

(41 citation statements)

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“…This approach could be called a top-down approach (Barton, Lack, Malliaras, & Morrissey, 2012, Brindle, Mattacola, & McCrory, 2003Brumitt, 2009;Grelsamer & McConnell, 1998;Fredericson & Moore, 2005;Hollman, Kolbeck, Hitchcick, Koverman, & Krause, 2005;Hollman et al, 2006;Powers, 2010;). However, related experimental studies have shown no general support for the concept that strengthening the hip muscles affects the running mechanics such as range of motion and external moments during dynamic tasks (Herman et al, 2008;Willy & Davis, 2011;Palmer et al, 2015) suggesting that the top-down approach does not produce a change in the mechanics of the knee and ankle joint. Another theory concentrates more on the ankle joint and suggests that an increase of strength, especially of the small muscles crossing the ankle joint, should affect movement and moments at the ankle, knee and hip joints (Feltner et al, 1994;Hollman et al, 2005;Tiberio, 1987;).…”

Section: Introductionmentioning

confidence: 99%

“…However, many of these suggestions are based on personal opinion/experience rather than on scientific facts. One theory suggests that increased muscular strength around the hip and the core should help to reduce lower extremity joint movement and external joint moments at the lower extremities during running, and thus, reduce the frequency of running injuries (Hott, Liavaag, Juel, & Brox, 2015;Palmer, Hebron, & Williams, 2015;Powers, 2010). This approach could be called a top-down approach (Barton, Lack, Malliaras, & Morrissey, 2012, Brindle, Mattacola, & McCrory, 2003Brumitt, 2009;Grelsamer & McConnell, 1998;Fredericson & Moore, 2005;Hollman, Kolbeck, Hitchcick, Koverman, & Krause, 2005;Hollman et al, 2006;Powers, 2010;).…”

Section: Introductionmentioning

confidence: 99%

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Functional relevance of the small muscles crossing the ankle joint – the bottom-up approach

Nigg

Baltich

Federolf

et al. 2017

CISS

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A b s T R Ac TIt has been suggested that increasing muscle strength could help reducing the frequency of running injuries and that a top-down approach using an increase in hip muscle strength will result in a reduced range of movement and reduced external moments at the knee and ankle level. This paper suggests, that a bottom-up approach using an increase of strength of the small muscles crossing the ankle joint, should reduce movement and loading at the ankle, knee and hip. This bottom-up approach is discussed in detail in this paper from a conceptional point of view. The ankle joint has two relatively "large" extrinsic muscles and seven relatively small extrinsic muscles. The large muscles have large levers for plantar-dorsi flexion but small levers for pro-supination. In the absence of strong small muscles the large muscles are loaded substantially when providing balancing with respect to pro-supination. Specifically, the Achilles tendon will be loaded in this situation asymmetrically with high local stresses. Furthermore, a mechanical model with springs shows that (a) the amplitude of the displacement with the strong small springs is smaller and (b) that the loading in the joints of the springs is substantially smaller for the model with the strong small springs. Additionally, strong and active small muscles crossing the ankle joint provide stability for the ankle joint (base). If they are weak, forces in the ankle, knee and hip joint increase substantially due to multiple co-contractions at the joints. Finally, movement transfer between foot and tibia is high for movements induced from the bottom and small for movements induced from the top. Based on these considerations one should speculate that the bottom-up approach may be substantially more effective in preventing running injuries than the top down approach. Various possible strategies to strengthen the small muscles of the ankle joint are presented.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional relevance of the small muscles crossing the ankle joint – the bottom-up approach

Nigg

Baltich

Federolf

et al. 2017

CISS

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“…The vast majority of programs focus on many often complex exercises not only strengthening but also stretching or equivalent [13][14][15]. The problem in implementing the home exercise plan that the participants report is the time they have to spend.…”

Section: Introductionmentioning

confidence: 99%

“…Palmer et al 2015 and Patrek et al 2011 research focusing on valgus 3D assessment determined a 3positive change as clinically significant and representative. The researchers used a one-leg landing test to assess, which due to a similar motion pattern can be compared to a one-leg squat test in the context of valgus assessment[14,30].In addition, Palmer et al 2015, using the hip abduction exercise strengthening the gluteal muscles over a 6 week period in military personnel, showed a high tendency to decrease valgus by 5˚ defined as clinically significant, but not statistically significant. Intervention group performed exercises focused on strengthening hip abductors[14].Video analysis showed mean of knee valgus angle at the pre-training stage for the left leg CON group (18˚±9.7 ˚), INT (16.1˚±10.5 ˚) and for right leg CON (18.5˚±12.0 ˚), INT (1.3 ˚±11.8˚).…”

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confidence: 99%

The impact of exercise of lower limbs on dynamic balance and valgus of the knees among young footballers

Wilczyński

Zorena

2019

Preprint

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Background Participation of children and youth in sporting activities, among others in training and football competitions, is an optimistic manifestation of activation in the current trend of computerization. Unfortunately, this is also often associated with musculoskeletal injuries. An example is the association of dynamic valgus and disturbed dynamic balance with lower limb injuries. The main purpose of the studies is to determine the impact of three strengthening exercises on the parameters of dynamic knee valgus and balance of lower limbs. The secondary objectives are to investigate the dominant influence and the length of lower limb on the valgus values and to determine risk of injury to young football players. Methods 134 young footballers training at the Arka Gdynia SI club were invited to first stage of the research in order to examine anthropometric features and kinematics of the lower limb. Single Leg Squat Test was used, which was recorded. The samples were analyzed video to determine exact knee angle of valgus. During the second stage, to which players with valgus knee were qualified (≥15˚), the Y-Balance Test was additionally used. Intervention group underwent an exercise program to strengthen gluteus medius, popliteal and tibialis posterior muscles for 6 weeks to repeat tests in the third stage. Results Statistical methods used at the assumed level of significance allow to conclude that there are no differences in results of dynamic valgus (≥15˚) and dynamic balance between the intervention group and control group during the 6 week period between stages. In addition, there were results confirming the lack of influence of length and dominant lower limb on valgus. Results of composite direction in the Y-Balance Test test determine the low risk of injury in both intervention and control groups. Conclusions Intervention did not affect the dynamic valgus and knee balance in young football players. Both the length and the dominant limb did not affect the results. The "low risk" occurrence of injuries among the examined participants with valgus knee due to the values of dynamic balance was determined.

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“…Por otro lado, la ganancia de fuerza muscular está relacionada con la mejora del control motor y de la activación neuromuscular en trabajos de un mínimo del 40-60% con respecto a la contracción máxima voluntaria (11,12). La activación muscular isométrica se relaciona con los mecanismos de control motor mejorando la eficacia del acoplamiento de información entre los propioceptores musculares, y con los efectores motores centrales (13,14).…”

Section: Introductionunclassified

Análisis de la activación isométrica del glúteo medio y la musculatura intrínseca de la planta del pie en la prevención de lesiones en jugadores de baloncesto de élite: Estudio Piloto

Polo

Calvo²,

Calvo‐Lobo

et al. 2018

Eur J Pod

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Introducción: El valgo dinámico de rodilla es uno de los principales factores de riesgo de lesión de deportes de impacto como el Baloncesto. Mejorar los sistemas de análisis de identificación de los factores de riesgo y los protocolos de prevención de lesiones se ha convertido en uno de los objetivos principales del fisioterapeuta deportivo, con el objetivo de disminuir el riesgo de lesión del deportista.Material y Métodos: Se analizó la distribución de las presiones plantares y los ángulos de alineación de los segmentos corporales en el plano frontal durante el Single-Leg-Squat Test en 10 sujetos deportistas de élite, con el objetivo de y observar la modificación a corto plazo asociada a la activación isométrica del glúteo medio y la musculatura intrínseca de la planta del pie.Resultados: Variaciones significativas en el aumento de la presión plantar del primer metatarsiano se registraron tras la activación del glúteo medio y de la musculatura intrínseca del pie. No se obtuvieron resultados significativos en la modificación de los ángulos de alineación en el plano frontal.Conclusiones: Un aumento de la presión plantar de la cabeza del primer metatarsiano puede relacionarse con una mayor estabilidad del miembro, mediante la activación del glúteo medio y de la musculatura intrínseca del pie. Son necesarios estudios con muestras más amplias que correlacionen los datos obtenidos en una muestra más homogénea.

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A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength

Cited by 37 publications

References 27 publications

Functional relevance of the small muscles crossing the ankle joint – the bottom-up approach

Functional relevance of the small muscles crossing the ankle joint – the bottom-up approach

The impact of exercise of lower limbs on dynamic balance and valgus of the knees among young footballers

Análisis de la activación isométrica del glúteo medio y la musculatura intrínseca de la planta del pie en la prevención de lesiones en jugadores de baloncesto de élite: Estudio Piloto

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