Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training

Tsai, Liang-Ching; Ko, Yi‐An; Hammond, Kyle E.; Xerogeanes, John W.; Warren, Gordon L.; Powers, Christopher M.

doi:10.1080/02640414.2016.1271138

Cited by 29 publications

(19 citation statements)

References 35 publications

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“…In our study, although there were no changes in hip or ankle angles due to match play, there was a 12.8% increase from baseline in knee flexion at T3. Based on existing literature, increased knee flexion during landing is desirable, since it can improve the mechanical advantage of the knee flexors, aiding the ACL in resisting potential anterior tibial shear [39]. However, in the current study, the decrease in KF strength at T3, combined with a recovery of KE strength to baseline levels and the small effect size (0.398) of the knee angle change, make a potential protective effect less likely.…”

Section: Discussionmentioning

confidence: 82%

Effects of Two Competitive Soccer Matches on Landing Biomechanics in Female Division I Soccer Players

Snyder

Hutchison

Mills

et al. 2019

Sports

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Fatigue has been proposed to increase the risk of knee injury. This study tracked countermovement jump, knee isometric strength, and kinetics and kinematics in 8 female soccer players (experimental group) during an anticipated sidestep maneuver before and after two matches played over a 43-h period. Time points were: Before and after match 1 (T0 and T1), 12 h after the first match (T2), and immediately after the second match (T3). A control group participated only in practice sessions. Isometric knee extension strength decreased by 14.8% at T2 (p = 0.003), but knee flexion was not affected until T3, declining by 12.6% (p = 0.018). During the sidestep maneuver, knee joint degrees of flexion at initial contact was increased by 17.1% at T3, but maximum knee and hip angle at initial contact were unchanged. Peak resultant ground reaction force (GRF) increased by 12.6% (p = 0.047) at T3 (3.03 xBW) from 2.69 xBW at T0, while posterior GRF was significantly higher than T0 at all three subsequent time points (T1 = 0.82 ± 0.23 xBW, T2 = 0.87 ± 0.22 xBW, T3 = 0.89 ± 0.22 xBW). Anterior tibial shear force increased significantly (p = 0.020) at T3 (1.24 ± 0.12 xBW) compared to T1 (1.15 ± 0.13 xBW), an 8.8% increase. Lateral tibial shear force was significantly higher at both T1 (0.95 ± 0.20 xBW) and T3 (1.15 ± 0.38 xBW) compared to T0 (0.67 ± 0.25 xBW). These findings suggest that participation in a soccer match has significant effects on both physical performance parameters and kinetics/kinematics during a sidestep cut, but these can be more pronounced after a second match with short rest.

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Section: Discussionmentioning

confidence: 82%

Effects of Two Competitive Soccer Matches on Landing Biomechanics in Female Division I Soccer Players

Snyder

Hutchison

Mills

et al. 2019

Sports

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“…Although Paterno et al focused on limb asymmetry after ACLR for the risk of secondary injury, they recommended for an attempt to decrease residual limb asymmetries that clinicians should consider incorporating similar principles of ACL injury prevention into the late stages of ACLR rehabilitation 20,33 . For reducing VGRF or joint moment, Tsai et al reported increasing range of motion of hip and knee flexion reduced tibiofemoral shear and compressive forces 34 . Moreover, DiStefano et.al.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Biomechanics at 6 Months Are Associated With Cartilage Degeneration at 3 Years After Anterior Cruciate Ligament Reconstruction

Shimizu

Samaan

Tanaka

et al. 2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: The purpose of this study was to investigate the changes in landing biomechanics over a three-year period and its correlation with cartilage degenerative changes in the medial tibiofemoral joint of the knee after anterior cruciate ligament reconstruction (ACLR) using magnetic resonance (MR) T1 ρ mapping. Methods: Thirty-one ACL injured patients underwent magnetic resonance imaging (MRI) of the injured knee prior to ACLR and three years after ACLR as well as biomechanical analysis of a drop-landing task at six months and three years after ACLR. Sixteen healthy individuals were recruited and underwent knee MRI and biomechanical assessment during a drop-landing task. T 1ρ cartilage relaxation times were calculated for the medial femur and tibia. Results: ACLR patients exhibited increased peak vertical ground reaction forces (VGRF), VGRF impulse, peak knee flexion moment (KFM) and KFM impulse from six months to three years (P<0.001, respectively). Although the ACLR knees showed significantly lower peak VGRF and KFM at six months (P<0.001, respectively) when compared to the controls, there were no significant differences at three years. At three years, ACLR patients showed higher T 1ρ values over the medial femur (P<0.001) and tibia (P=0.012) when compared to their preoperative and healthy

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“…This gender difference seems to emerge during maturation, where post-pubertal girls are noted to land with more extended knee joint angles compared to pre-pubertal girls ( DiStefano et al, 2015 ). Use of extended knee joint positions during landing has been associated with elevated anterior shear forces in the knee joint and hence presumably elevated ACL strain in female study participants ( Chappell et al, 2002 ; Shultz et al, 2009 ; Tsai and Powers, 2013 ; Tsai et al, 2017 ). Likewise, computer model analysis of landings have uniformly indicated that landing/cutting at more extended hip and knee joint angles are predictive of elevated anterior tibial shear forces most likely resulting in increased strain in the ACL ( Sell et al, 2007 ; Southard et al, 2012 ; Tsai and Powers, 2013 ; Tsai et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…Use of extended knee joint positions during landing has been associated with elevated anterior shear forces in the knee joint and hence presumably elevated ACL strain in female study participants ( Chappell et al, 2002 ; Shultz et al, 2009 ; Tsai and Powers, 2013 ; Tsai et al, 2017 ). Likewise, computer model analysis of landings have uniformly indicated that landing/cutting at more extended hip and knee joint angles are predictive of elevated anterior tibial shear forces most likely resulting in increased strain in the ACL ( Sell et al, 2007 ; Southard et al, 2012 ; Tsai and Powers, 2013 ; Tsai et al, 2017 ). Conversely, landing or sidecutting with more flexed knee joint angles has been reported to reduce the magnitude of anteriorly directed strain in the ACL, but also to facilitate the hamstrings to act as ACL synergists as demonstrated in cadaveric studies and using computer modeling ( Li et al, 1999 ; Kernozek and Ragan, 2008 ; Southard et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Muscle Activation During ACL Injury Risk Movements in Young Female Athletes: A Narrative Review

2018

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Young, adolescent female athletes are at particular high risk of sustaining a non-contact anterior cruciate ligament (ACL) injury during sport. Through the last decades much attention has been directed toward various anatomical and biomechanical risk factors for non-contact ACL injury, and important information have been retrieved about the influence of external loading factors on ACL injury risk during given sports-specific movements. However, much less attention has been given to the aspect of neuromuscular control during such movements and only sparse knowledge exists on the specific muscle activation patterns involved during specific risk conditions. Therefore, the aim of this narrative review was (1) to describe anatomical aspects, strength aspects and biomechanical aspects relevant for the understanding of ACL non-contact injury mechanisms in young female athletes, and (2) to review the existing literature on lower limb muscle activation in relation to risk of non-contact ACL-injury and prevention of ACL injury in young female athletes. Studies investigating muscle activity patterns associated with sports-specific risk situations were identified, comprising cohort studies, intervention studies and prospective studies. Based on the retrieved studies, clear gender-specific differences in muscle activation and coordination were identified demonstrating elevated quadriceps activity and reduced hamstring activity in young female athletes compared to their male counterparts, and suggesting young female athletes to be at elevated risk of non-contact ACL injury. Only few studies (n = 6) examined the effect of preventive exercise-based intervention protocols on lower limb muscle activation during sports-specific movements. A general trend toward enhanced hamstring activation was observed during selected injury risk situations (e.g., sidecutting and drop landings). Only a single study examined the association between muscle activation deficits and ACL injury risk, reporting that low medial hamstring activation and high vastus lateralis activation prior to landing was associated with an elevated incidence of ACL-injury. A majority of studies were performed in adult female athletes. The striking paucity of studies in adolescent female athletes emphasizes the need for increased research activities to examine of lower limb muscle activity in relation to non-contact ACL injury in this high-risk athlete population.

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Increasing hip and knee flexion during a drop-jump task reduces tibiofemoral shear and compressive forces: implications for ACL injury prevention training

Cited by 29 publications

References 35 publications

Effects of Two Competitive Soccer Matches on Landing Biomechanics in Female Division I Soccer Players

Effects of Two Competitive Soccer Matches on Landing Biomechanics in Female Division I Soccer Players

Abnormal Biomechanics at 6 Months Are Associated With Cartilage Degeneration at 3 Years After Anterior Cruciate Ligament Reconstruction

Muscle Activation During ACL Injury Risk Movements in Young Female Athletes: A Narrative Review

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