Does Pronated Foot Predispose the Females to Risk of Anterior Cruciate Ligament injury (original) (raw)
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Poor static balance is a risk factor for non-contact anterior cruciate ligament injury
Archives of Orthopaedic and Trauma Surgery, 2018
Background This prospective study aimed to investigate the relationship between static balance and the incidence of noncontact anterior cruciate ligament (ACL) injury in female high school athletes. Methods This study included 276 female high school handball or basketball players. At the time of admission, each subject's static balance was measured with a gravicorder, and the incidence of non-contact ACL injury was investigated in the 3 years until the student graduated. The measured parameters of postural sway were locus length per time (the distance that a center of gravity of the foot pressure moves per second) and environmental area (AR: the area surrounded by the integumentary covering of the trace of the center of gravity). Twenty-seven players (9.8%) experienced an ACL injury during the 3-year observation period. Twenty-four injured players sustained a non-contact injury and three injured players sustained a contact injury. In this study, the three contact injury players were excluded. We compared the differences in the static balance between injured and uninjured players. Results The locus length per time was significantly longer in injured than in uninjured players (p = 0.046). Though there was no statistically significant difference between the two groups in AR (p = 0.190), AR tended to be larger in the ACL injured group. Conclusions This result shows that poor static balance is a risk factor for non-contact ACL injury.
Anterior Cruciate Ligament (ACL) injuries are a prevalent concern in athletic population, particularly among female athletes who are disproportionately affected. The increased incidence of ACL injuries in females is attributed to a combination of anatomical, physiological, and biomechanical factors that influence knee stability. This review comprehensively explores these contributing factors, highlighting genderspecific anatomical differences such as wider pelvis, increased quadriceps (Q) angle, and steeper tibial slopes, all of which predispose females to greater knee valgus during dynamic activities.
2014
ABSTRACT Introduction Ligament reconstruction of the anterior cruciate ligament (ACL) is one of the most frequent arthroscopic procedures. According to the Technical Agency for Information on Hospitalizations (ATIH) 41,122 ligament reconstructions were performed in France in 2012. Treatment of the injury is costly and not always successful at returning patients to their preinjury activity level. Identification of all factors associated with increased risk of ACL injury during sport is important to provide an appropriate level of counseling and programs for prevention. These factors have been categorized as intrinsic (inherent to the individual athlete) or extrinsic (external to the athlete). Risk of ACL injury in female athletes depending on sports Female athletes have been identified at increased risk of injuring their ACL during certain sports, with reported injury rates that are 3.6 times greater for basketball and 5.1 times greater for handball when compared with male athletes who participate in these sports at similar levels of play. Extrinsic risk factors Several extrinsic factors seem increase the risk of ACL injury in both female and male athletes with a slightly increased risk in female: competition, wet and rainy weather, the type and number of cleats, the design of the shoe, the type of grass, artificial grass or floor surface and previous ACL reconstruction. Intrinsic risk factors Several anatomic risk factors have been identified, mainly an increased anterior-posterior knee laxity, a smaller intercondylar notch width with a shorter ACL, and a greater condyle offset ratio. Neuromuscular and biomechanical risk factors are also involved as increased dynamic valgus and muscle and proprioceptive deficit of the non-dominant leg in female. The hormonal theory is based on several reports of elevated ACL tear rates in pre- as compared to postovulatory phase. Other risk factors were evocated: a familial predisposition to noncontact ACL tears, genetic factors and a higher body mass index. Multivariate risk factor analysis Given the multiplicity of risk factors it seems important to develop multivariable models but very few studies have followed this approach. Conclusion Several intrinsic factors may explain the sex-ration in ACL tear but intrinsic and extrinsic risk factors act in combination to increase the risk of ACL injury. The identification of these factors has led to the development of appropriate prevention programs with good but still insufficient results. Optimizing prevention requires the organization of large cohort studies for each sport, involving all participants. A generalization of multivariate statistical analyzes would take into account the possible interactions and to quantify the risk for each factor. Comprehensive prevention programs specific to each sport, incorporating all the factors, could then be developed.
British Journal of Sports Medicine, 2008
The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate highquality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the ''knee over toe position'' when cutting.
ObjectivesThis study was aimed to reveal the differences in knee valgus angle at landing as a static indicator and wobbling movement of the knee during landing as a dynamic indicator between ACL injury and uninjured athletes.MethodsThis study was case-control study. There were 6 female basketball players with ACL injuries and 38 female basketball players without them, whose knee kinematics were measured using 2-dimensional video cameras during single-leg jump landings. The task was performed from 30cm-box. Knee kinematics and wobbling of the knee which was calculated by relative frontal motion to the flexion movement were compared between knees with ACL-injured and uninjured.ResultsSix athletes who had confirmed ACL injuries, did not demonstrate significantly different knee valgus angle at initial contact and maximum knee flexion during landing, compared to 38 uninjured athletes. The knee valgus angles at initial contact for injured and uninjured athletes were 12.3° and 14.8° (p = 0...
The American Journal of Sports Medicine, 2016
Background: Few prospective studies have investigated the biomechanical risk factors of anterior cruciate ligament (ACL) injury. Purpose: To investigate the relationship between biomechanical characteristics of vertical drop jump (VDJ) performance and the risk of ACL injury in young female basketball and floorball players. Study Design: Cohort study; Level of evidence, 3. Methods: At baseline, a total of 171 female basketball and floorball players (age range, 12-21 years) participated in a VDJ test using 3-dimensional motion analysis. The following biomechanical variables were analyzed: (1) knee valgus angle at initial contact (IC), (2) peak knee abduction moment, (3) knee flexion angle at IC, (4) peak knee flexion angle, (5) peak vertical ground-reaction force (vGRF), and (6) medial knee displacement. All new ACL injuries, as well as match and training exposure, were then recorded for 1 to 3 years. Cox regression models were used to calculate hazard ratios (HRs) and 95% CIs. Result...
2021
Anterior cruciate ligament (ACL) injury is one the most common knee injuries in the young and middle age population. Large numbers of studies have examined the anatomy, biomechanics, management and rehabilitation of ACL injuries in the general population and athletes. Contemporary medical technology has facilitated new treatment paradigms and lead to the exponential growth in knowledge in this fundamental area of knee surgery and sports medicine. The objective of this narrative review was to identify studies that examined certain intrinsic and extrinsic factors contributing to ACL injury risk in female athletes. Participation in sports by females is increasing globally and the burden of disease in relation to ACL injuries is expected to increase in association with these increased participation rates. There is a paucity of literature that clearly delineates the intrinsic and extrinsic risk factors for ACL injury among different populations, especially higher-level female athletes. To facilitate the best possible care for knee injured patients, it is essential to understand the key factors that may underpin different injury patterns, especially in the context of dramatically increased participation in high risk sports, including Australian Rules Football, rugby union and rugby league, basketball, netball, soccer and skiing; focusing on those identifiable risk factors that have a female predilection will be the focus of this review and an attempt has been made to broadly review the most pertinent scientific literature.
Gender Differences in Noncontact Anterior Cruciate Ligament Injuries
Clinics in Sports Medicine, 2000
After the passage of Title IX in 1972, women began competing in organized sports in large numbers. There was concern that women would have significantly higher injury rates than men. For the most part, these fears were unfounded. Sports injury rates between men and women are similar and, in general, seem to be sport-specific rather than gender-specifi~.~~, 37, 94, 99 There is, however, an increased predisposition (two to eight times) to anterior cruciate ligament (ACL) rupture in women., There are many theories and much research devoted to explaining why this difference in injury rate exists. Research has focused on intrinsic and extrinsic factors. Intrinsic factors are those that are individual, physical, and psychosocial.6 Intrinsic factors include joint laxity, hormonal influences, limb alignment, notch dimensions, and ligament size. The intrinsic causes tend to be more sex-specific and may not be modifiable. Most research into the cause of ACL injuries has been directed toward intrinsic causes. Extrinsic factors are those related to the type of sport, the environmental conditions, the conditioning of the athlete, and the equipment used.6 Unlike most intrinsic factors, extrinsic factors are potentially controllable or changeable. Extrinsic factors include conditioning, experience, skill, strength, muscle recruitment patterns, and landing techniques. Extrinsic
The American Journal of Sports Medicine, 2008
Background Women who participate in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than men. Purpose To prospectively determine if female athletes with decreased passive knee joint restraint (greater joint laxity) and greater side-to-side differences in knee laxity would be at increased risk of anterior cruciate ligament injury. Study Design Case control study; Level of evidence, 3. Methods From 1558 female soccer and basketball players who were prospectively screened, 19 went on to tear their anterior cruciate ligaments. Four height- and mass-matched control subjects were selected from the uninjured screened athletes for comparison with each of the 19 injured subjects, making a total of 95 subjects (19 injured; 76 uninjured). Generalized joint-laxity tests and anterior-posterior tibiofemoral translation were quantified using the CompuKT knee arthrometer. A multivariable logistic regression model was constructed to determine predictors of an...
Prevention of anterior cruciate ligament injury in the female athlete
British Journal of Sports Medicine, 2007
The relationships of gender, age and training to the incidence of anterior cruciate ligament (ACL) injury are pivotal to developing a comprehensive neuromuscular and proprioceptive training programme to decrease ACL injuries in female athletes. A prophylactic neuromuscular and proprioceptive training programme may have direct benefit in decreasing the number of ACL injuries in female athletes. This research foundation endorses further epidemiological and biomechanical studies to determine the exact mechanism of ACL injury and the most effective intervention for decreasing ACL injuries in this high-risk population. i52 www.bjsportmed.com