Generalized Joint Laxity Associated With Increased Medial Foot Loading in Female Athletes

Abstract

Context:The relationship between generalized joint laxity and plantar pressure distribution of the foot and the potential implications for lower extremity injury have not been studied.Objective: To determine the relationship between generalized joint laxity and dynamic plantar pressure distribution. We hypothesized that individuals with greater generalized joint laxity, or hypermobility, would have greater dynamic medial midfoot pressure and loading during walking than nonhypermobile individuals.Design: Case control. Setting: Institutional biomechanics laboratory.Patients or Other Participants: Participants included 112 female soccer players between 11 and 21 years of age.Main Outcome Measure(s): Each participant was tested for generalized joint laxity using the Beighton and Horan Joint Mobility Index (BHJMI; range, 0-9) and was categorized as having either high (BHJMI score $4) or low (BHJMI score ,4) generalized joint laxity. Peak pressure and maximum force were calculated from a dynamic, barefoot plantar pressure distribution system.Results: Peak pressure and maximum force were greater in the 27 participants categorized as having high generalized joint laxity than in the 85 participants categorized as having low generalized joint laxity. The midfoot region exhibited greater loading in participants with high generalized joint laxity than in the other participants. We found an effect of BHJMI classification in the medial midfoot; peak pressure in the dominant (F 1,109 5 11.262, P 5 .001) and nondominant (F 1,109 5 14.32, P , .001) sides and maximum force in the dominant (F 1,109 5 7.88, P 5 .006) and nondominant (F 1,109 5 9.18, P 5 .003) sides were greater in the high generalized joint laxity group than in the low generalized joint laxity group.Conclusions: Athletes classified as having high generalized joint laxity demonstrated increased midfoot loading. Delineation of risk factors for medial collapse of the foot, which include hypermobility in athletes, may help clinicians evaluate and prevent lower extremity injury with treatments, such as orthoses.

Do Plantar Pressure and Loading Patterns Vary with Joint Hypermobility in Young Females?

“…28 Although pedobarographic analysis in our study measured static plantar pressure, it had a number of similarities with Foss and colleagues' findings, in which dynamic plantar pressure was measured. 17 In the group with high generalized joint laxity peak pressure and maximum force were greater in comparison with low generalized joint laxity group. 17 These results were correlated with our study, where peak pressure on the non-dominant side was greater in the group with high BHJMI scores (p= 0.01).…”

“…17 In the group with high generalized joint laxity peak pressure and maximum force were greater in comparison with low generalized joint laxity group. 17 These results were correlated with our study, where peak pressure on the non-dominant side was greater in the group with high BHJMI scores (p= 0.01).…”

“…evaluated pedobarographic plantar pressure in individuals with JH, it was found that athletes with high BHJMI scores have increased midfoot peak pressure and maximum force. 17 Lack of awareness about the relationship between JH and plantar loading pattern may lead to complaints and injuries such as arthralgia, sprains and impaired proprioception, which can be preventable. [17][18][19] Assessing the differences between individuals with JH can help us to identify the possible risk factors of pain and injury, as well as a guide for physicians and rehabilitation therapists to better understand this issue.…”

“…17 Lack of awareness about the relationship between JH and plantar loading pattern may lead to complaints and injuries such as arthralgia, sprains and impaired proprioception, which can be preventable. [17][18][19] Assessing the differences between individuals with JH can help us to identify the possible risk factors of pain and injury, as well as a guide for physicians and rehabilitation therapists to better understand this issue. Therefore, we planned this study to find whether plantar pressure and loading pattern of young females with and without JH would differ while standing.…”

Generalized Joint Laxity and Ligament Injuries in High School–Aged Female Volleyball Players in Japan

“…Also, it was suggested that injured athletes with generalized joint hypermobility might require more time to rehabilitate before returning to sports to avoid reinjury. 11 Foss et al 16 investigated whether generalized joint laxity was correlated with dynamic plantar pressure in female soccer players and found that athletes with high generalized joint laxity demonstrated increased midfoot loading resulting from medial foot collapse, suggesting that those athletes might be at a greater risk of lower leg injuries. Similarly, a systematic review conducted by Pacey et al 29 indicated that athletes with generalized joint laxity might be at an increased risk of knee injuries during contact activities.…”