Melissa M Montgomery | California State University, Fullerton (original) (raw)

Papers by Melissa M Montgomery

International Journal of Athletic Therapy and Training

Patient-reported outcomes (PROs) are important for capturing patients’ perspectives on quality of... more Patient-reported outcomes (PROs) are important for capturing patients’ perspectives on quality of life and aiding in provision of whole-person patient care; yet, PROs are not routinely used in athletic training practice. We investigated the athletic trainers’ perceptions of using PROs after they had completed a required PRO implementation program. Athletic trainers had positive perceptions after integrating PROs into clinical practice. Barriers associated with PRO use may be improved with a support structure that requires accountability and provides resources such as reminders and professional development to recognize ways that PROs can be used to improve patient care.

The online version of this article can be found at:

CONTEXT Running-related injuries are common in distance runners. Strength training is used for pe... more CONTEXT Running-related injuries are common in distance runners. Strength training is used for performance enhancement and injury prevention. However, the association between maximal strength and distance-running biomechanics is unclear. OBJECTIVE To determine the relationship between maximal knee- and hip-extensor strength and running biomechanics previously associated with injury risk. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 collegiate distance runners (26 men, 10 women; age = 20.0 ± 1.5 years, height = 1.74 ± 0.09 m, mass = 61.97 ± 8.26 kg). MAIN OUTCOME MEASURE(S) Strength was assessed using the 1-repetition maximum (1RM) back squat and maximal voluntary isometric contractions of the knee extensors and hip extensors. Three-dimensional running biomechanics were assessed overground at a self-selected speed. Running variables were the peak instantaneous vertical loading rate; peak forward trunk-lean angle; knee-flexion...

Journal of athletic training, Jan 12, 2015

Context : Knee laxity increases during exercise. However, no one, to our knowledge, has examined... more Context : Knee laxity increases during exercise. However, no one, to our knowledge, has examined whether these increases contribute to higher-risk landing biomechanics during prolonged, fatiguing exercise. Objectives : To examine associations between changes in fatigue (measured as sprint time [SPTIME]), multiplanar knee laxity (anterior-posterior [APLAX], varus-valgus [VVLAX], and internal-external rotation [IERLAX]), and landing biomechanics during prolonged, intermittent exercise. Design : Descriptive laboratory study. Setting : Laboratory and gymnasium. Patients or Other Participants : A total of 30 male (age = 20.3 ± 2.0 years, height = 1.79 ± 0.05 m, mass = 75.2 ± 7.2 kg) and 29 female (age = 20.5 ± 2.3 years, height = 1.67 ± 0.08 m, mass = 61.8 ± 9.0 kg) competitive athletes. Intervention(s) : A 90-minute intermittent exercise protocol (IEP) designed to simulate the physiologic and biomechanical demands of a soccer match. Main Outcome Measure(s) : We measured SPTIME, A...

Clinical Biomechanics, 2014

Sports Health: A Multidisciplinary Approach, 2013

Background: As injury rates rise in the later stages of sporting activities, a better understandi... more Background: As injury rates rise in the later stages of sporting activities, a better understanding of lower extremity biomechanics in the later phases of gamelike situations may improve training and injury prevention programs. Hypothesis: Lower extremity biomechanics of a drop-jump task (extracted from a principal components analysis) would reveal factors associated with risk of anterior cruciate ligament injury during a 90-minute individualized intermittent exercise protocol (IEP) and for 1 hour following the IEP. Study Design: Controlled laboratory study. Level of Evidence: Level 4. Methods: Fifty-nine athletes (29 women, 30 men) completed 3 sessions. The first session assessed fitness for an IEP designed to simulate the demands of a soccer match. An experimental session assessed drop-jump biomechanics, after a dynamic warm-up, every 15 minutes during the 90-minute IEP, and for 1 hour following the IEP. A control session with no exercise assessed drop-jump performance at the same...

Medicine & Science in Sports & Exercise, 2012

Purpose: Less lean body mass may limit one's ability to produce adequate muscle forces to safely ... more Purpose: Less lean body mass may limit one's ability to produce adequate muscle forces to safely control landing from a jump, thus increasing the risk for injury. The primary objective of this study was to determine the effect of lower extremity lean mass (LELM) and eccentric muscle strength on lower extremity energy absorption (EA) during a drop jump landing. Methods: Seventy athletic subjects (35 men and 35 women) were measured for LELM with dual-energy x-ray absorptiometry, maximal eccentric strength of the quadriceps (QuadECC) and hamstrings (HamECC), and lower extremity joint energetics during the initial landing of a drop jump. A mediation analysis examined the extent to which LELM predicted EA at each lower extremity joint (EAHIP, EAKNEE, and EAANK) and subsequently whether these relationships were mediated by each subject's maximal eccentric strength capabilities. Results: LELM was a significant predictor of EAKNEE (R 2 = 0.22, P < 0.01) in females but not in males (R 2 = 0.03, P = 0.16). In females, QuadECC was a significant mediator of the effect of LELM on EA at the knee (ab = 179.72, 95% confidence interval [CI] = 10.43-423.42) and ankle (ab = 1.71, 95% CI = [0.16, 3.94]), whereas HamECC was a significant mediator of the relationship between LELM and EAHIP (ab = 4.89, 95% CI = 2.05-8.40). No significant relationships were observed in males. Conclusions: LELM was a significant factor in energetic capabilities for females but not males. For females, this relationship was evident secondary to the stronger underlying relationship between maximal strength and EA. Thus, the maximal eccentric strength capabilities may be a more important determinant of energetic behaviors compared with the available quantity of lean mass alone. More work is needed to investigate these relationships and to reveal the underlying sex-specific mechanisms that determine EA capabilities.

Medicine & Science in Sports & Exercise, 2012

Medicine & Science in Sports & Exercise, 2010

Medicine & Science in Sports & Exercise, 2009

Medicine & Science in Sports & Exercise, 2011

Purpose-To better understand how sex differences in anterior knee joint laxity (AKL) impact knee ... more Purpose-To better understand how sex differences in anterior knee joint laxity (AKL) impact knee joint biomechanics, we examined the consequence of greater absolute baseline (males and females) and cyclic increases in AKL during the menstrual cycle (females) on anterior tibial translation (ATT) as the knee transitioned from non-weight bearing (NWB) to weight bearing (WB) conditions, while also controlling for genu recurvatum (GR). Methods-Males and females (71F,48M;18-30 years) were measured for AKL and GR, and underwent measurement of ATT. Females were tested on the days of their cycle when AKL was at its minimum (T1) and maximum (T2); males were matched in time to a female with similar AKL. Linear regressions examined relationships between absolute baseline (AKL T1 , GR T1) and cyclic changes (Δ=T2-T1; AKL Δ , GR Δ)(females only) in knee laxity with ATT as measured at T1 and T2, and Δ (T2-T1) (females only). Results-AKL and GR increased in females, but not males, from T1 to T2. Greater AKL T1 and GR T1 predicted greater ATT T1 and ATT T2 in males (R 2 =21.0, P<.007). The combination of greater AKL T1 , AKL Δ and less GR Δ predicted greater ATT T1 and ATT T2 in females (R2=12.5-13.1, P<.05), with AKL Δ being a stronger predictor (coefficient, P-value) of ATT T2 (0.864, P=.027) compared to ATT T1 (0.333, P=.370). AKL Δ was the sole predictor of ATT Δ (R 2 =.104; 0.740, P=.042). Conclusions-Greater absolute baseline and cyclic increases in AKL were consistently associated with greater ATT produced by transition of the knee from NWB to WB. As the ACL is the primary restraint to ATT, these findings provide insight into possible mechanisms by which greater AKL may be associated with at risk knee biomechanics during the weight acceptance phase of dynamic tasks. Article: INTRODUCTION Serious knee trauma, such as anterior cruciate ligament (ACL) injury, most often occurs when the knee transitions from non-weight bearing (NWB) to weight bearing (WB) during sudden deceleration or change-of-direction with the knee relatively extended (12, 20). Studies have shown that as the knee transitions to WB at low knee flexion angles (e.g. 15-30°), there is anterior translation of the tibia relative to the femur (ATT) (8, 37) that is restrained by the ACL

Medicine & Science in Sports & Exercise, 2011

Journal of Orthopaedic Research, 2012

Journal of Orthopaedic Research, 2010

Journal of Electromyography and Kinesiology, 2012

The American Journal of Sports Medicine, 2012

Sports Health: A Multidisciplinary Approach, 2012

Background: Sex steroid hormone fluctuations during the menstrual cycle are considered a risk fac... more Background: Sex steroid hormone fluctuations during the menstrual cycle are considered a risk factor for noncontact anterior cruciate ligament injuries. Objective: To determine whether self-reported menstrual history data can be used to accurately categorize menstrual cycle events using calendar-based counting methods. Study Design: Descriptive laboratory study. Methods: Seventy-three women completed a menstrual history questionnaire and submitted to blood sampling for the first 6 days of menses and 8 to 10 days after a positive ovulation test over 2 consecutive months. Frequency counts determined whether appropriate criterion hormone (progesterone) levels were achieved at predefined calendar days. Results: For the criterion of progesterone >2 ng/mL, 18% and 59% of women attained it when counting forward 10 to 14 days after the onset of menses and counting back 12 to 14 days from the end of the cycle, respectively. Most women (76%) attained the criterion for ovulation 1 to 3 days...

Journal of Sports Sciences

Medicine & Science in Sports & Exercise

Medicine & Science in Sports & Exercise

International Journal of Athletic Therapy and Training

Patient-reported outcomes (PROs) are important for capturing patients’ perspectives on quality of... more Patient-reported outcomes (PROs) are important for capturing patients’ perspectives on quality of life and aiding in provision of whole-person patient care; yet, PROs are not routinely used in athletic training practice. We investigated the athletic trainers’ perceptions of using PROs after they had completed a required PRO implementation program. Athletic trainers had positive perceptions after integrating PROs into clinical practice. Barriers associated with PRO use may be improved with a support structure that requires accountability and provides resources such as reminders and professional development to recognize ways that PROs can be used to improve patient care.

The online version of this article can be found at:

CONTEXT Running-related injuries are common in distance runners. Strength training is used for pe... more CONTEXT Running-related injuries are common in distance runners. Strength training is used for performance enhancement and injury prevention. However, the association between maximal strength and distance-running biomechanics is unclear. OBJECTIVE To determine the relationship between maximal knee- and hip-extensor strength and running biomechanics previously associated with injury risk. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 collegiate distance runners (26 men, 10 women; age = 20.0 ± 1.5 years, height = 1.74 ± 0.09 m, mass = 61.97 ± 8.26 kg). MAIN OUTCOME MEASURE(S) Strength was assessed using the 1-repetition maximum (1RM) back squat and maximal voluntary isometric contractions of the knee extensors and hip extensors. Three-dimensional running biomechanics were assessed overground at a self-selected speed. Running variables were the peak instantaneous vertical loading rate; peak forward trunk-lean angle; knee-flexion...

Journal of athletic training, Jan 12, 2015

Context : Knee laxity increases during exercise. However, no one, to our knowledge, has examined... more Context : Knee laxity increases during exercise. However, no one, to our knowledge, has examined whether these increases contribute to higher-risk landing biomechanics during prolonged, fatiguing exercise. Objectives : To examine associations between changes in fatigue (measured as sprint time [SPTIME]), multiplanar knee laxity (anterior-posterior [APLAX], varus-valgus [VVLAX], and internal-external rotation [IERLAX]), and landing biomechanics during prolonged, intermittent exercise. Design : Descriptive laboratory study. Setting : Laboratory and gymnasium. Patients or Other Participants : A total of 30 male (age = 20.3 ± 2.0 years, height = 1.79 ± 0.05 m, mass = 75.2 ± 7.2 kg) and 29 female (age = 20.5 ± 2.3 years, height = 1.67 ± 0.08 m, mass = 61.8 ± 9.0 kg) competitive athletes. Intervention(s) : A 90-minute intermittent exercise protocol (IEP) designed to simulate the physiologic and biomechanical demands of a soccer match. Main Outcome Measure(s) : We measured SPTIME, A...

Clinical Biomechanics, 2014

Sports Health: A Multidisciplinary Approach, 2013

Background: As injury rates rise in the later stages of sporting activities, a better understandi... more Background: As injury rates rise in the later stages of sporting activities, a better understanding of lower extremity biomechanics in the later phases of gamelike situations may improve training and injury prevention programs. Hypothesis: Lower extremity biomechanics of a drop-jump task (extracted from a principal components analysis) would reveal factors associated with risk of anterior cruciate ligament injury during a 90-minute individualized intermittent exercise protocol (IEP) and for 1 hour following the IEP. Study Design: Controlled laboratory study. Level of Evidence: Level 4. Methods: Fifty-nine athletes (29 women, 30 men) completed 3 sessions. The first session assessed fitness for an IEP designed to simulate the demands of a soccer match. An experimental session assessed drop-jump biomechanics, after a dynamic warm-up, every 15 minutes during the 90-minute IEP, and for 1 hour following the IEP. A control session with no exercise assessed drop-jump performance at the same...

Medicine & Science in Sports & Exercise, 2012

Purpose: Less lean body mass may limit one's ability to produce adequate muscle forces to safely ... more Purpose: Less lean body mass may limit one's ability to produce adequate muscle forces to safely control landing from a jump, thus increasing the risk for injury. The primary objective of this study was to determine the effect of lower extremity lean mass (LELM) and eccentric muscle strength on lower extremity energy absorption (EA) during a drop jump landing. Methods: Seventy athletic subjects (35 men and 35 women) were measured for LELM with dual-energy x-ray absorptiometry, maximal eccentric strength of the quadriceps (QuadECC) and hamstrings (HamECC), and lower extremity joint energetics during the initial landing of a drop jump. A mediation analysis examined the extent to which LELM predicted EA at each lower extremity joint (EAHIP, EAKNEE, and EAANK) and subsequently whether these relationships were mediated by each subject's maximal eccentric strength capabilities. Results: LELM was a significant predictor of EAKNEE (R 2 = 0.22, P < 0.01) in females but not in males (R 2 = 0.03, P = 0.16). In females, QuadECC was a significant mediator of the effect of LELM on EA at the knee (ab = 179.72, 95% confidence interval [CI] = 10.43-423.42) and ankle (ab = 1.71, 95% CI = [0.16, 3.94]), whereas HamECC was a significant mediator of the relationship between LELM and EAHIP (ab = 4.89, 95% CI = 2.05-8.40). No significant relationships were observed in males. Conclusions: LELM was a significant factor in energetic capabilities for females but not males. For females, this relationship was evident secondary to the stronger underlying relationship between maximal strength and EA. Thus, the maximal eccentric strength capabilities may be a more important determinant of energetic behaviors compared with the available quantity of lean mass alone. More work is needed to investigate these relationships and to reveal the underlying sex-specific mechanisms that determine EA capabilities.

Medicine & Science in Sports & Exercise, 2012

Medicine & Science in Sports & Exercise, 2010

Medicine & Science in Sports & Exercise, 2009

Medicine & Science in Sports & Exercise, 2011

Purpose-To better understand how sex differences in anterior knee joint laxity (AKL) impact knee ... more Purpose-To better understand how sex differences in anterior knee joint laxity (AKL) impact knee joint biomechanics, we examined the consequence of greater absolute baseline (males and females) and cyclic increases in AKL during the menstrual cycle (females) on anterior tibial translation (ATT) as the knee transitioned from non-weight bearing (NWB) to weight bearing (WB) conditions, while also controlling for genu recurvatum (GR). Methods-Males and females (71F,48M;18-30 years) were measured for AKL and GR, and underwent measurement of ATT. Females were tested on the days of their cycle when AKL was at its minimum (T1) and maximum (T2); males were matched in time to a female with similar AKL. Linear regressions examined relationships between absolute baseline (AKL T1 , GR T1) and cyclic changes (Δ=T2-T1; AKL Δ , GR Δ)(females only) in knee laxity with ATT as measured at T1 and T2, and Δ (T2-T1) (females only). Results-AKL and GR increased in females, but not males, from T1 to T2. Greater AKL T1 and GR T1 predicted greater ATT T1 and ATT T2 in males (R 2 =21.0, P<.007). The combination of greater AKL T1 , AKL Δ and less GR Δ predicted greater ATT T1 and ATT T2 in females (R2=12.5-13.1, P<.05), with AKL Δ being a stronger predictor (coefficient, P-value) of ATT T2 (0.864, P=.027) compared to ATT T1 (0.333, P=.370). AKL Δ was the sole predictor of ATT Δ (R 2 =.104; 0.740, P=.042). Conclusions-Greater absolute baseline and cyclic increases in AKL were consistently associated with greater ATT produced by transition of the knee from NWB to WB. As the ACL is the primary restraint to ATT, these findings provide insight into possible mechanisms by which greater AKL may be associated with at risk knee biomechanics during the weight acceptance phase of dynamic tasks. Article: INTRODUCTION Serious knee trauma, such as anterior cruciate ligament (ACL) injury, most often occurs when the knee transitions from non-weight bearing (NWB) to weight bearing (WB) during sudden deceleration or change-of-direction with the knee relatively extended (12, 20). Studies have shown that as the knee transitions to WB at low knee flexion angles (e.g. 15-30°), there is anterior translation of the tibia relative to the femur (ATT) (8, 37) that is restrained by the ACL

Medicine & Science in Sports & Exercise, 2011

Journal of Orthopaedic Research, 2012

Journal of Orthopaedic Research, 2010

Journal of Electromyography and Kinesiology, 2012

The American Journal of Sports Medicine, 2012

Sports Health: A Multidisciplinary Approach, 2012

Background: Sex steroid hormone fluctuations during the menstrual cycle are considered a risk fac... more Background: Sex steroid hormone fluctuations during the menstrual cycle are considered a risk factor for noncontact anterior cruciate ligament injuries. Objective: To determine whether self-reported menstrual history data can be used to accurately categorize menstrual cycle events using calendar-based counting methods. Study Design: Descriptive laboratory study. Methods: Seventy-three women completed a menstrual history questionnaire and submitted to blood sampling for the first 6 days of menses and 8 to 10 days after a positive ovulation test over 2 consecutive months. Frequency counts determined whether appropriate criterion hormone (progesterone) levels were achieved at predefined calendar days. Results: For the criterion of progesterone >2 ng/mL, 18% and 59% of women attained it when counting forward 10 to 14 days after the onset of menses and counting back 12 to 14 days from the end of the cycle, respectively. Most women (76%) attained the criterion for ovulation 1 to 3 days...

Journal of Sports Sciences

Medicine & Science in Sports & Exercise

Medicine & Science in Sports & Exercise