How Young Girls Change Their Landing Technique Throughout the Adolescent Growth Spurt

Wild, Catherine; Munro, Bridget J.; Steele, Julie R.

doi:10.1177/0363546516629419

Cited by 24 publications

(17 citation statements)

References 38 publications

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“…Riskier knee biomechanics characteristic of post-pubertal females (reduced flexion; greater peak valgus angles and moments) emerge during puberty, and thus age at menarche may serve in part as a simple proxy for the timing of these neuromuscular developments. [11][12][13][14][15]20,50,51 The observed effect of earlier menarche could therefore be nothing more than an artifact of longer exposure to riskier postpubertal movement patterns: for a given age, athletes who entered the post-pubertal period of higher risk earlier would have naturally accrued greater cumulative years of injury risk.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,10 Divergent pubertal developmental trajectories in males and females likely underlie a suite of high-risk traits that appear widely in post-pubertal females, but less commonly in males. [11][12][13][14][15][16][17][18][19][20] Despite these broad sex-based distinctions, the process of puberty in terms of rates and timing of growth events is highly variable within each sex. Variation in pubertal development may therefore have effects on variability in ACL injury risk factors within females.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Age at Menarche on Anterior Cruciate Ligament Injury Incidence and Anterior Knee Laxity in Collegiate Athletes

Froehle¹,

Cox²,

May³

et al. 2020

JSMAHS

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Female athletes suffer painful, costly, and career-limiting non-contact anterior cruciate ligament (ACL) injuries more often than males. Previous research suggests that pubertal neuromusculoskeletal development contributes to this sex-bias, but the manner in which variation in pubertal development affects injury risk within females is poorly understood. Age at menarche is a variable, significant pubertal developmental event, signaling the onset of estrogen cycling and affecting musculoskeletal development. Earlier menarche may increase injury risk, possibly by increasing anterior knee laxity through prolonged estrogen exposure. The purpose of this case-control study was to test the primary hypothesis that collegiate athletes with previous ACL injuries have earlier age at menarche than their uninjured peers, and to test the secondary hypothesis that earlier menarche is related to greater anterior knee laxity in injured and uninjured athletes. The study sample consisted of female NCAA Division-I varsity athletes (N=14 injured, N=120 uninjured). Outcome measures included: menstrual history and ACL injury details (injury age, activity at time of injury, contact vs. non-contact), assessed by questionnaire; and anterior knee laxity assessed by KT-1000 arthrometer. Correlation, t-tests, and regression analysis were used to test for associations between age at menarche, injury incidence, and knee laxity. Fourteen athletes reported ≥1 non-contact ACL injury, and had significantly earlier menarche than uninjured athletes (12.6±1.3 y vs. 13.4±1.4 y; P=0.05). Earlier menarche also significantly predicted injury status (Wald c2=7.43; Pb=-1.02±0.37; OR=0.36; 95% CI:0.17-0.75), but was not correlated with anterior knee laxity. Within injured athletes, however, laxity in the unaffected knee was significantly related to time since menarche (r2=0.79, Pr2=0.72, P

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Age at Menarche on Anterior Cruciate Ligament Injury Incidence and Anterior Knee Laxity in Collegiate Athletes

Froehle¹,

Cox²,

May³

et al. 2020

JSMAHS

View full text Add to dashboard Cite

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“…Peaks for all moments were derived and exported for analysis. Joint moments were evaluated during the first 25% of stance as ACL injury typically occurs shortly after initial contact [ 4 ]. Anthropometric segment lengths for the thigh and shank were extracted from the kinematic model.…”

Section: Methodsmentioning

confidence: 99%

Effect of high and low‐supportive footwear on female tri‐planar knee moments during single limb landing

Sayer

Hinman

Paterson

et al. 2018

Journal of Foot and Ankle Research

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BackgroundHigher landing-related external knee joint moments at later stages of female pubertal development likely contribute to a higher incidence of non-contact anterior cruciate ligament (ACL) injury. Athletic footwear may provide a potential strategy to alter higher knee moments.MethodsThirty-one late/post-pubertal girls (Tanner stage IV-V, menarche and growth spurt attained) performed a single limb drop lateral jump in three footwear conditions (barefoot, low support shoes and high support shoes), in which peak knee abduction moment (KAbM), flexion moment (KFM) and internal rotation moments (KIRM) were measured. Repeated measures ANOVA and ANCOVA were used to test for a main effect of footwear with and without foot posture index (FPI) as a covariate (p < 0.05) with post-hoc test carried out via Fisher’s Least Significant Difference (LSD).ResultsA main effect of footwear condition was observed for peak KFM (p < 0.05), but not KAbM or KIRM, in both unadjusted and adjusted models. Post-hoc analysis demonstrated that both high- and low-support shoes increased peak KFM compared with barefoot (p < 0.001).ConclusionOur findings indicate commercially available high- and low-supportive footwear increase peak KFM, but do not effect KAbM or KIRM while landing among late/post-pubertal girls. This suggests that these styles of footwear are inadequate at reducing higher knee moments in an at-risk cohort.

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“…19,30 A substantial body of literature has shown that postpubertal females exhibit a tendency toward more valgus knee angles and loading than do males during the DVJ. 10,16,21,23,27,63 Greater valgus angulation and loading among females generate high frontal plane shear stress on the ACL, 26 making "valgus collapse" the most common mode of female injuries. 48 There also appears to be a relationship between the timing of pubertal development and the emergence of biomechanical risk factors in females.…”

mentioning

confidence: 99%

Relationship Between Age at Adult Height and Knee Mechanics During a Drop Vertical Jump in Men

Steffensmeier

Lamont

Metoyer

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Anterior cruciate ligament (ACL) injuries are relatively common among younger athletes, with significant physical, psychological, and financial consequences. Research has largely focused on female athletes by identifying specific risk factors for an ACL injury, including variation in pubertal growth timing. There is less known about risk factors in males, and little is known about the effects of pubertal development on ACL injury risk in men. Purpose/Hypothesis: The purpose of this study was to analyze the relationship between an indicator of pubertal growth timing (age at adult height) and biomechanical risk for ACL injuries in men. We hypothesized that earlier age at adult height is correlated with riskier landing biomechanics during a drop vertical jump (DVJ) in men. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 21 recreationally active male students (age range, 20-33 years) were included. Participants completed a questionnaire on age at adult height and limb dominance, and anthropometric measurements were taken. There were 6 DVJ tests performed, with participants landing on a force plate while digital cameras recorded kinematic data from retroreflective markers placed according to the Helen Hayes marker system. Primary outcomes were sagittal and frontal plane knee kinematics and kinetics during contact. Data were analyzed using Pearson product-moment correlation. Results: In both limbs, age at achieving adult height was significantly negatively correlated with knee flexion/extension angle at toe-off (dominant: r = –0.79, P < .01; nondominant: r = –0.74, P < .01) and with peak flexion (dominant: r = –0.63, P < .01; nondominant: r = –0.70, P < .01) and extension (dominant: r = –0.66, P < .01; nondominant: r = –0.56, P = .01) angles during contact. In the nondominant limb, age at adult height was significantly negatively correlated with varus/valgus angle at initial contact ( r = –0.43; P = .05) and toe-off ( r = –0.44; P = .04) and was positively correlated with peak varus moment during contact ( r = 0.42; P = .06). Age at adult height was also positively correlated with peak vertical ground-reaction force ( r = 0.58; P < .01). Conclusion: Later age at adult height was correlated with riskier landing profiles in this study. This suggests that males with later or longer pubertal growth may have increased mechanical risk for ACL injuries. A better understanding of the effects of pubertal growth on landing biomechanics can improve the early identification of male athletes at greater risk for injuries.

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How Young Girls Change Their Landing Technique Throughout the Adolescent Growth Spurt

Abstract: The outcomes of this research provide a greater understanding of the changes in the landing strategy used by pubescent girls throughout the adolescent growth spurt. This can assist in the development of screening tools designed to determine "at-risk" landing biomechanics during puberty.

Cited by 24 publications

References 38 publications

Effect of Age at Menarche on Anterior Cruciate Ligament Injury Incidence and Anterior Knee Laxity in Collegiate Athletes

Effect of Age at Menarche on Anterior Cruciate Ligament Injury Incidence and Anterior Knee Laxity in Collegiate Athletes

Effect of high and low‐supportive footwear on female tri‐planar knee moments during single limb landing

Relationship Between Age at Adult Height and Knee Mechanics During a Drop Vertical Jump in Men

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