Dynamic Valgus Alignment and Functional Strength in Males and Females During Maturation

Abstract

Context: Sex differences in dynamic measures have been established in physically mature populations. Gaining information on maturation's effect on dynamic performance measures implicated in injury risk may enable us to better design injury prevention programs.Objective: To examine sex differences in dynamic valgus alignment and triple-hop distance measures across maturational stages in males and females. A secondary purpose was to determine if a field test of strength and power predicts dynamic valgus alignment.Design: Cross-sectional study. Setting: Laboratory.Patients or Other Participants: 157 young athletes (78 females, 79 males) aged 9 to 18 years.Intervention(s): Subjects performed drop-jump landings and single-leg triple-hop tests as part of a broader injury screening.Main Outcome Measure(s): Maturational status was ascertained from self-report questionnaires and grouped according to Tanner stages 1 and 2 (MatGrp1), 3 and 4 (MatGrp2), and 5 (MatGrp3). Frontal-plane knee valgus displacement, which served as a measure of dynamic valgus alignment, and single-leg triple-hop distance were assessed.Results: Males demonstrated less dynamic valgus alignment during drop jumps in the latter maturational stages (MatGrp1 5 13.16 6 8.76, MatGrp2 5 9.06 6 6.26, MatGrp3 5 9.26 6 9.46), whereas females increased dynamic valgus alignment throughout maturation (MatGrp1 5 11.56 6 6.96, MatGrp2 5 12.86 6 8.86, MatGrp3 5 15.56 6 8.76). Thus, in the more mature groups, males had less dynamic valgus alignment than females. Both males (MatGrp1 5 N Although both males and females improved their performance in the triple-hop test as they matured, males showed greater improvement.393.5 6 63.7 cm, MatGrp2 5 491.8 6 95.1 cm, MatGrp3 5 559.3 6 76.3 cm) and females (MatGrp1 5 360.3 6 37.1 cm, MatGrp2 5 380.1N The triple-hop test did not predict dynamic valgus alignment by sex or level of maturation.M usculoskeletal injury risk is reported to increase with age 1-4 and physical maturation status. 5 In a recent review across sports, adolescents (those older than 13 years) were at a consistently increased risk of injury compared with younger children. 6 This risk appears to coincide with physical maturation, because Michaud et al 5 reported that Tanner stages 4 and 5 were associated with an increased occurrence of sport injuries. With authors 6 of a comprehensive literature review reporting that adolescents are consistently at an increased risk of injury with respect to a younger population, we need to focus on the maturing youth population to better understand potential relevant risk factors for injury. Specifically, functional performance changes that occur in males and females as part of the maturation process should be considered further, because young females have a greater risk of straining or spraining the knee and ankle than young males. 7

Identifying Multiplanar Knee Laxity Profiles and Associated Physical Characteristics

“…10 These factors may also partially explain why females begin to demonstrate poorer hip and knee neuromuscular control than do males about the time that body composition changes begin to emerge during physical maturation. [61][62][63][64] However, further work using a more accurate measure of lean body mass and stratifying analyses within sex (to control for other sex confounding factors) is needed to confirm whether these physical characteristics are the key underlying factors leading to the development of greater VV and IER laxity.…”

Effect of Injury Prevention Training on Knee Mechanics in Female Adolescents During Puberty

“…[12][13][14][15] Injury prevention strategies that minimize these biomechanical changes during puberty are necessary.…”

“…11 Female adolescents increase knee valgus motion following the onset of the pubertal growth spurt. [12][13][14] Female athletes might also land with a reduced knee flexion angle after puberty as age increases. 15 This phenomenon is probably the consequence of rapid physical development.…”

Validation of a Device for Clinical Measurement of Frontal Tibiofemoral Alignment

“…genu varum, normal or genu valgum) is a clinically important entity as frontal tibiofemoral malalignment is a predisposing factor for developing gonarthrosis [1][2][3][4][5]. Varus or valgus weight bearing of a joint can induce wear and tear in a joint causing gonarthrosis [6,7]. Genu varum can cause medial gonosteoarthritis if major adduction movements occur [8,9].…”