Relationships between Knee Valgus, Hip-Muscle Strength, and Hip-Muscle Recruitment during a Single-Limb Step-Down

Hollman, John H.; Ginos, Barbara E.; Kozuchowski, Jakub; Vaughn, Amanda S.; Krause, David A.; Youdas, James W.

doi:10.1123/jsr.18.1.104

Cited by 166 publications

(155 citation statements)

References 26 publications

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“…29 Although the reasons underlying the biomechanical profile exhibited by females are not entirely clear, there is growing evidence to suggest that proximal factors may play a contributory role. As noted above, several studies have reported that reduced hip strength is related to greater knee valgus angles 17,30,32,81 and valgus moments. 35 Pollard et al 57 suggests that higher knee valgus angles and moments observed in female athletes is representative of a movement strategy in which there is insufficient utilization of the hip extensors to decelerate the body center of mass.…”

Section: Tibiofemoral Joint Injury Mechanisms: Proximal Factorsmentioning

confidence: 99%

“…Because the foot is fixed to the ground, the inward movement of the knee joint causes the tibia to abduct and the foot to pronate, the end result being dynamic knee valgus (FIGURE 1). Excessive knee valgus has been shown to be related to diminished hip muscle strength 17,30,32,81 and has been implicated in contributing to numerous knee injuries, including anterior cruciate ligament (ACL) injury 29 and patellofemoral joint dysfunction. 58 It has been reported that hip adduction is the primary contributor to excessive dynamic knee valgus.…”

Section: Tibiofemoral Joint Proximal Contributions To Abnormal Tibiofmentioning

confidence: 99%

“…58 It has been reported that hip adduction is the primary contributor to excessive dynamic knee valgus. 30,80 As such, excessive hip adduction would be expected to strain the soft tissue restraints that limit knee valgus (ie, the medial collateral ligament, medial patellofemoral ligament, and ACL). As a transverse plane motion, hip internal rotation plays less of a role in the observed medial collapse of the lower extremity.…”

Section: Tibiofemoral Joint Proximal Contributions To Abnormal Tibiofmentioning

confidence: 99%

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The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective

Powers¹

2010

Journal of Orthopaedic & Sports Physical Therapy

898

693

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Synopsis During the last decade, there has been a growing body of literature suggesting that proximal factors may play a contributory role with respect to knee injuries. A review of the biomechanical and clinical studies in this area indicates that impaired muscular control of the hip, pelvis, and trunk can affect tibiofemoral and patellofemoral joint kinematics and kinetics in multiple planes. In particular, there is evidence that motion impairments at the hip may underlie injuries such as anterior cruciate ligament tears, iliotibial band syndrome, and patellofemoral joint pain. In addition, the literature suggests that females may be more disposed to proximal influences than males. Based on the evidence presented as part of this clinical commentary, it can be argued that interventions which address proximal impairments may be beneficial for patients who present with various knee conditions. More specifically, a biomechanical argument can be made for the incorporation of pelvis and trunk stability, as well as dynamic hip joint control, into the design of knee rehabilitation programs. Level of Evidence Aetiology/therapy, level 5. J Orthop Sports Phys Ther 2010;40(2):42–51. doi:10.2519/jospt.2010.3337

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Section: Tibiofemoral Joint Injury Mechanisms: Proximal Factorsmentioning

confidence: 99%

Section: Tibiofemoral Joint Proximal Contributions To Abnormal Tibiofmentioning

confidence: 99%

Section: Tibiofemoral Joint Proximal Contributions To Abnormal Tibiofmentioning

confidence: 99%

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The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective

Powers¹

2010

Journal of Orthopaedic & Sports Physical Therapy

898

693

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“…However, PFPS is associated with decreased hip strength, specifically in the abductors and external rotators (1,2,(8)(9)(10)(11)(12)(13)(14)(15)(16). Since the hip abductors can affect knee valgus by controlling the frontal plane position of the femur, increasing hip abduction strength may help these patients (17).…”

Section: Introductionmentioning

confidence: 99%

The effect of hip and knee exercises on pain, function, and strength in patientswith patellofemoral pain syndrome: a randomized controlled trial

Şahin¹,

Ayhan²,

Borman³

et al. 2016

Turk J Med Sci

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IntroductionPatellofemoral pain syndrome (PFPS) is often used as an umbrella term for anterior or retropatellar pain. It is a common source of knee pain, especially in the physically active female population (1-6).Treatment methods, such as vastus medialis oblique retraining, open kinetic chain exercises, and isokinetic muscle strengthening, were the most effective over a short period of time; however, they were not more effective than home-based exercise programs (7). Quadricepsstrengthening exercise therapy is commonly recommended for patients suffering from PFPS (7). However, PFPS is associated with decreased hip strength, specifically in the abductors and external rotators (1,2,(8)(9)(10)(11)(12)(13)(14)(15)(16). Since the hip abductors can affect knee valgus by controlling the frontal plane position of the femur, increasing hip abduction strength may help these patients (17).The importance of hip abductors, external rotator muscles, and extensor-strengthening programs for PFPS has received increased attention in recent years (7).Biomechanically, weakness in the hip musculature could lead to increased femoral adduction and medial rotation during dynamic weight-bearing activities, which would increase the lateral patellofemoral joint vector, leading to patellar facet overload (1,2,5,14).However, there are limited numbers of controlled studies on additional hip-strengthening exercises in PFPS (3,4,(18)(19)(20)(21)(22). Sex bias (18,19) and small sample size (3,4,16,19,21) were common problems in most of these studies. Interestingly, specific causes for differential diagnosis of knee pathologies or coexistence of different knee problems confirmed by knee radiographs or magnetic resonance imaging (MRI) were not investigated in the previous studies. Intraarticular lesions, such as meniscus and ligament injuries, were not evaluated in these studies and only clinical PFPS cases were included in these previous reports.This study aimed to indicate the hip exercises in addition to knee exercises with regard to pain, function, and isokinetic muscle strength in young sedentary women with PFPS.Background/aim: The role of hip muscles in the rehabilitation of patellofemoral pain syndrome has recently received interest. The aim of this study was to compare the efficiencies of hip exercises alongside knee exercises versus only knee exercises on pain, function, and isokinetic muscle strength in patients with this syndrome.Materials and methods: Fifty-five young female patients (mean age: 34.1 ± 6.2 years; mean BMI: 25.9 ± 3.9 kg/m 2 ) with patellofemoral pain syndrome were included. The patients were randomized into groups of hip-and-knee exercises and knee-only exercise programs for 6 weeks with a total of 30 sessions at the clinic. Both groups were evaluated before therapy, after 6 weeks of a supervised exercise program, and after 6 weeks of an at-home exercise program. The outcome measures were muscle strength, pain, and both subjective and objective function. Results:The improvements of the patients in the hip-and-knee exe...

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“…The researcher stabilised the pelvis with one hand and applied medially directed resistance with the dynamometer in the other hand, just proximal to the greater trochanter of the femur. [16] contact, in order to measure club head speed and ball speed, and ball landing distance.…”

Section: Fig 1 Kinesio-taping Of the Gluteus Medius Musclementioning

confidence: 99%

Gluteus medius kinesio-taping: the effect on torso-pelvic separation, ball flight distance and accuracy during the golf swing

Pearce¹

2016

S. Afr. j. sports med.

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Background. The kinesio-taping method, which is becoming increasingly popular, may provide support and stability to joints and muscles without inhibiting range of motion. Objective. The aim of the study was to determine the effect of kinesio-taping of the gluteus medius muscle on x-factor (torsopelvic separation), ball flight distance and accuracy (smash factor ratio). A specific aim was to determine whether a correlation exists between hip abduction strength and x-factor, ball distance and accuracy. Methods. This study is a one group pretest-posttest quasiexperimental design which took place at a golf facility. Twentynine amateur golfers with handicap of scratch ±2, who were between the ages of 18- and 25-years, participated in this study. Biomechanical outcomes were recorded with and without kinesio-tape applied on the gluteus medius muscle of the trail leg. Biomechanical golf swing analysis with the iClub™ Body Motion System determined the x-factor at the top of the backswing. Ball flight distance and accuracy were measured with FlightScope® and dominant hip abduction strength was measured with the MicroFET Hand-held Dynamometer. Results. Kinesio-tape is effective in improving the relative hip abduction strength (p<0.001), although the effect size was small (Cohen’s d=0.24). With regard to the biomechanical outcome measures, namely x-factor (p=0.28), ball flight distance (p=0.53) and accuracy (p=0.1), there was no significant improvement. Conclusion: Even though the relative hip abduction strength was improved, there was no effect on golf swing biomechanics. This can be explained due to the fact that x-factor, ball flight distance and accuracy are dependent on a combination of body movements to produce the golf swing. Keywords. Golf, X-factor, pelvic stability, taping

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Relationships between Knee Valgus, Hip-Muscle Strength, and Hip-Muscle Recruitment during a Single-Limb Step-Down

Abstract: Gluteus maximus recruitment might have greater association with reduced knee valgus in women than does external-rotation strength during step-down tasks. Gluteus medius strength might be associated with increased knee valgus.

Cited by 166 publications

References 26 publications

The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective

The Influence of Abnormal Hip Mechanics on Knee Injury: A Biomechanical Perspective

The effect of hip and knee exercises on pain, function, and strength in patientswith patellofemoral pain syndrome: a randomized controlled trial

Gluteus medius kinesio-taping: the effect on torso-pelvic separation, ball flight distance and accuracy during the golf swing

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