Altered hip control during a standing knee‐lift test is associated with increased risk of knee injuries

Abstract

A few prospective studies have investigated hip and pelvic control as a risk factor for lower extremity (LE) injuries. The purpose of this study was to investigate whether deficits in hip and lumbopelvic control during standing knee‐lift test are associated with increased risk of acute knee and LE injuries in youth team sports. At baseline, 258 basketball and floorball players (aged 12‐21 years) participated in a standing knee‐lift test using 3‐dimensional motion analysis. Two trials per leg were recorded from each participant. Peak sagittal plane pelvic tilt and frontal plane pelvic drop/hike were measured. Both continuous and categorical variables were analyzed. New non‐contact LE injuries, and match and training exposure, were recorded for 12 months. Seventy acute LE injuries were registered. Of these, 17 were knee injuries (eight ACL ruptures) and 35 ankle injuries. Risk factor analyses showed that increased contralateral pelvic hike was significantly associated with knee injury risk when using categorical variable (HR for high vs low group 4.07; 95% CI 1.32‐12.6). Furthermore, significant association was found between high lateral pelvic hike angles and ACL injury risk in female players (HR for high vs low group 9.10; 95% CI 1.10‐75.2). Poor combined sensitivity and specificity of the test was observed. In conclusion, increased contralateral pelvic hike is associated with non‐contact knee injury risk among young team sport players and non‐contact ACL injuries among female players. More research to determine the role of pelvic control as a risk factor for knee injuries is needed.

Landing instructions focused on pelvic and trunk lateral tilt decrease the knee abduction moment during a single-leg drop vertical jump

“…A video analysis study of ACL injuries during single-leg movements showed that the trunk lateral tilt angles of ACL-injured female athletes were 31 larger than those of control female athletes (Hewett, Torg, & Boden, 2009). There was a significant association between a large pelvic lateral tilt angle and ACL injury risk in female athletes (Leppänen et al, 2020). The present study showed that landing instructions are effective in reducing pelvic and trunk lateral tilt.…”

Risk Factors for Lower Limb Injury in Female Team Field and Court Sports: A Systematic Review, Meta-analysis, and Best Evidence Synthesis

“…metaanalysis, best evidence synthesis). Risk factors reported by a single study are presented in Electronic Supplementary Material Appendix S3 [31][32][33][34][35][36][37][38][39][40][41][42].…”

“…Potential participant heterogeneity was accounted for by limiting studies to team field and court sports with similar physical demands, and performing random effect model meta-analyses. Further, this review focussed on synthesising evidence across studies, however, there were a number of risk factors found by single studies that require further examination [68,40,42,70,56,35,32].…”

Assessing Movement Quality Using the Hip and Lower Limb Movement Screen: Development, Reliability and Potential Applications

“…Altered hip control of increased contralateral pelvic hike (hitch) is associated with increased risk of acute non-contact knee injuries and anterior cruciate ligament (ACL) injuries. 59 . This is a test of specific muscle recruitment/ concentric activation of the hip flexor stabilizers (iliacus/pectineus) 7 , 49 and assesses the ability to actively dissociate and control hip lateral rotation/abduction 26 .…”