Weak Hip Strength Increases Dynamic Knee Valgus in Single-Leg Tasks of Collegiate Female Athletes

Crowell, Kyndell R; Nokes, Ryan D; Cosby, Nicole L.

doi:10.1123/jsr.2021-0043

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…Several studies on the visual assessment of the LSD have shown that poor performance is associated with reduced ADF [ 31 , 78 , 86 , 87 ], while a study on the FSD [ 14 ] and one on the SLS [ 88 ] do not support this. Furthermore, quantitative studies using 3-dimensional analysis on both healthy subjects and those with a knee condition suggest that poor performance in the SLS, LSD, and FSD is associated with reduced ADF [ 11 , 12 , 89 ]. The reason for the non-significant association in the present study might be related to the relatively good ankle mobility displayed by this sample of female soccer players, as well as the lack of contrast in our data, as the range of data was small, which might have hampered the possibility of finding significant associations with the outcome of the SLS.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the Single Leg Squat test in female soccer players: a cross-sectional study

Ressman,

von Rosen,

Grooten

et al. 2024

BMC Sports Sci Med Rehabil

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Background The Single Leg Squat (SLS) test is widely used in the clinical setting to examine and evaluate rehabilitation goals. It is simple to perform and is proposed to have biomechanical and neuromuscular similarities to athletic movements. The aim of the present study was to investigate whether demographics, previous injuries, and biomechanical and psychosocial factors are associated with the outcome of the SLS, assessed as a total score for all segments and as a separate knee segment in elite and sub-elite female soccer players. Methods We conducted a cross-sectional study involving 254 female soccer players (22 yrs; SD ± 4, height 1.69 m; SD ± 0.1, weight 64 kg; SD ± 6) from divisions 1–3 of the Swedish Soccer League. During the preseason, we assessed the participants using the SLS and tested their hip strength and ankle mobility. Demographics, previous injury, sleep quality, fear of movement, anxiety, and perceived stress were assessed with questionnaires. Logistic regression models were built to analyse the association between the outcome of the SLS and the independent variables for the dominant and non-dominant leg. Results Significantly more participants failed the SLS on the dominant leg compared with the non-dominant leg (p < 0.001). The outcome of the SLS associated with various biopsychosocial factors depending on if the dominant or non-dominant leg was tested. The total score associated with hip strength for the dominant (OR 0.99, 95% CI 0.98–0.99, p = 0.04) and the non-dominant leg (OR 0.99, 95% CI 0.97–0.99, p = 0.03). The knee segment associated with division level for the dominant (div 2; OR 2.34, 95% CI 1.01–5.12, p = 0.033. div 3; OR 3.07, 95% CI 1.61–5.85, p = 0.001) and non-dominant leg (div 2; OR 3.30, 95% CI 1.33-8.00, p = 0.01. div 3; OR 3.05, 95% CI 1.44–6.43, p = 0.003). Conclusions This study identified that leg dominance, division level, hip strength, and psychosocial factors were associated with the outcome of the SLS when assessed as a total score and as a separate knee segment. This indicates that clinicians need to understand that movement control is associated with factors from several domains. Whether these factors and, the results of the SLS are related to injury need to be studied prospectively. Trial registration Clinical Trials Gov, date of registration 2022-03-01. Clinical trials identifier: NCT05289284A.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the Single Leg Squat test in female soccer players: a cross-sectional study

Ressman,

von Rosen,

Grooten

et al. 2024

BMC Sports Sci Med Rehabil

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“…One reason for the higher degree of knee valgus noted in the female players in the present study may be that their relative strength was significantly lower than the male player’s. Previous research has noted that weak hip abductors can lead to increased knee valgus [ 17 , 48 ] and the hip abductors are a muscle group that is largely recruited during a squat [ 49 ]. Thus, one explanation for the women’s inferior relative strength could be that they were weaker than the men in the hip abductors and therefore demonstrated greater knee valgus.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Maximal Squat Strength for Neuromuscular Knee Control in Elite Handball Players: A Cross-Sectional Study

Augustsson,

Gannby

2023

Sports

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Both weak muscle strength and impaired neuromuscular control has previous been suggested as risk factors for future traumatic knee injury. However, data on the relationship between these two factors are scarce. Thus, the aim of this study was to investigate the relationship and influence of the one repetition maximum (1RM) barbell squat strength on dynamic knee valgus in elite female and male handball players. In this cross-sectional study 22 elite handball players (7 females) were included. A unilateral drop jump (VDJ) test was used for the assessment of frontal plane dynamic knee valgus. Players also performed a one repetition maximum (1RM) barbell squat test, expressed relative to bodyweight (r1RM), to assess maximal strength, which were dichotomized to analyze ‘weak’ versus ‘strong’ players according to median. Correlations were noted between r1RM in squat and knee valgus angle for both the non-dominant (r = −0.54; p = 0.009) and dominant leg (r = −0.46, p = 0.03). The odds of knee valgus were eight times higher, for the dominant leg, in the weak group compared to the strong group (p = 0.03) and 27 times higher, for the non-dominant leg (p = 0.002). The outcome of the present study suggests that maximum squat strength plays an important role when it comes to neuromuscular control of the knee, and that weak handball players are at higher risk of knee valgus compared to strong players during jumping activity.

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“…Hip-muscle weakness is associated with knee OA [38]. Decreased hip abductor, extensor, and external rotator strength can lead to dynamic knee valgus [39,40]. Hence, the straight-stem surgical approach is associated with knee arthritis and valgus configuration.…”

Section: Discussionmentioning

confidence: 99%

Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases

Thöne,

Gruber,

Kindermann

et al. 2023

JCM

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Background: Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of knee arthritis is formed by asymmetric loadings. The aim of this study was to evaluate the impact of stem design in THA on knee valgus by comparing a standard implant with an implant with a short stem. Methods: A total of 2953 patients who underwent primary total knee arthroplasty for end-stage osteoarthritis between 2015 and 2021 were included in this retrospective data analysis. Patients were divided into three groups, depending on hip status (straight stem, short stem, and native joint). Leg alignment was distinguished as varus or valgus, and the degree of axial deviation was measured. Descriptive and explorative statistical analyses were performed, with a p value < 0.05 set as significant. Results: Ipsilateral knee valgus occurred significantly more often in patients with straight stems (57.2%) than in those with short stems (29%) and native joints (25.8%) (p < 0.001). Additionally, mean valgus deviation was significantly increased in patients with straight stems (8.9°) compared to those with short stems (6.4°) or native hip joints (6.7°). Both findings were accentuated in women. Conclusions: Previous ipsilateral straight-stem THA is associated with knee valgus deformity, especially in women. Short-stem THA seems to be better suited to restoring physiological biomechanics and preventing the development of valgus osteoarthritis of the ipsilateral knee.

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Weak Hip Strength Increases Dynamic Knee Valgus in Single-Leg Tasks of Collegiate Female Athletes

Cited by 6 publications

References 12 publications

Factors associated with the Single Leg Squat test in female soccer players: a cross-sectional study

Factors associated with the Single Leg Squat test in female soccer players: a cross-sectional study

The Significance of Maximal Squat Strength for Neuromuscular Knee Control in Elite Handball Players: A Cross-Sectional Study

Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases

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