Female athletes land from a jump with greater knee valgus and ankle pronation/eversion. Excessive valgus and pronation have been linked to risk of anterior cruciate ligament injury. A medially posted orthosis decreases component motions of knee valgus such as foot pronation/eversion and tibial internal rotation.
Hypothesis
We hypothesized a medial post would decrease knee valgus and ankle pronation/eversion during drop-jump landings in NCAA-I female athletes.
Study Design
Controlled laboratory study.
Methods
Knee and ankle 3-dimensional kinematics were measured using high-speed motion capture in 10 National Collegiate Athletic Association Division I female athletes during a drop-jump landing with and without a medial post. Analysis of variance was used to determine differences in posting condition, t tests were used to determine dominant-nondominant differences, and the Pearson correlation coefficient was used to determine relationships between variables.
Results
Significant differences were found for all measures in the posted condition. A medial post decreased knee valgus at initial contact (1.24°, P< .01) and maximum angle (1.21 °, P< .01). The post also decreased ankle pronation/eversion at initial contact (0.77°, P < .01) and maximum angle (0.95°, P = .039).
Conclusion
The authors have demonstrated a significant decrease in knee valgus and ankle pronation/eversion during a drop jump with a medial post placed in the athletes’ shoes.
Clinical Relevance
A medial post may be a potential means to decrease risk of anterior cruciate ligament injury.
ArendtEAgelJDickR.Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train. 1999;34:86–92.
2.
ArendtEDickR.Knee injury patterns among men and women in collegiate basketball and soccer: NCAA data and review of literature. Am J Sports Med. 1995;23:694–701.
3.
BellchamberTLvan den BogertAJ. Contributions of proximal and distal moments to axial tibial rotation during walking and running. J Biomech. 2000;33:1397–1403.
4.
BonciC.Assessment and evaluation of predisposing factors for anterior cruciate ligament injury. J Athl Train. 1999;34:155–164.
5.
EngJPierrynowskiM.The effect of soft foot orthotics on three-dimensional lower-limb kinematics during walking and running. Phys Ther. 1994;74:836–844.
6.
FagenbaumRDarlingWG. Jump landing strategies in male and female college athletes and the implications of such strategies for anterior cruciate ligament injury. Am J Sports Med. 2003;31:233–240.
7.
FordKRMyerGDHewettTE. Valgus knee motion during landing in high school female and male basketball players. Med Sci Sports Beere. 2003;35:1745–1750.
8.
GouldN.Evaluation of hyperpronation and pes planus in adults. Clin Orthop Relat Res. 1983;181:37–45.
9.
GwinnDEWilckensJHMcDevittERRossGKaoTC. The relative incidence of anterior cruciate ligament injury in men and women at the United States Naval Academy. Am J Sports Med. 2000;28:98–102.
10.
HamillJBatesBTKnutzenKMKirkpatrickGM. Relationship between selected static and dynamic lower extremity measures. Clin Biomech (Bristol, Avon). 1989;4:217–225.
HewettTEFordKRMyerGD. Anterior cruciate ligament injuries in female athletes, part 2: A meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med. 2006;34:490–498.
13.
HewettTEMyerGDFordKR. Anterior cruciate ligament injuries in female athletes, part 1: Mechanisms and risk factors. Am J Sports Med. 2006;34:299–311.
14.
HewettTEMyerGDFordKR. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: A prospective study. Am J Sports Med. 2005;33:492–501.
15.
HurdWJChmielewskiTLAxeMJDavisISnyder-MacklerL.Differences in normal and perturbed walking kinematics between male and female athletes. Clin Biomech (Bristol, Avon). 2004;19:465–472.
16.
HustonLJGreenfieldMLWojtysEM. Anterior cruciate ligament injuries in the female athlete: Potential risk factors. Clin Orthop Relat Res. 2000;372:50–63.
17.
HustonLJVibertBAshton-MillerJAWojtysEM. Gender differences in knee angle when landing from a drop-jump. Am J Knee Surg. 2001;14:215–219, discussion 219–220.
18.
JohansonMADonatelliRWoodenMJAndrewPDCummingGS. Effects of three different posting methods on controlling abnormal subtalar pronation. Phys Ther. 1994;74(2):149–158, discussion 158–161.
19.
KernozekTWTorryMRVan HoofHCowleyHTannerS.Gender differences in frontal and sagittal plane biomechanics during drop landings. Med Sci Sports Exerc. 2005:37(6):1003–1012, discussion 1013.
20.
KrosshaugTNakamaeABodenBP. Mechanisms of anterior cruciate ligament injury in basketball: Video analysis of 39 cases. Am J Sports Med. 2007;35:359–367.
21.
LandorfKBKeenanAM. Efficacy of foot orthoses: What does the literature tell us?J Am Podiatr Med Assoc. 2000;90:149–158.
22.
LoudonJKJenkinsWLoudonKL. The relationship between static posture and ACL injury in female athletes. J Orthop Sports Phys Ther. 1996;24:91–97.
23.
LundbergA.Kinematics of the ankle and foot: In vivo roentgen stereophotogrammetry. Acta Orthop Scand Suppl. 1989;60:1–25.
24.
MacLeanCDavisI McClayHamillJ.Influence of a custom foot orthotic intervention on lower extremity dynamics in healthy runners. Clin Biomech (Bristol, Avon). 2006;21:623–630.
25.
MalinzakRAColbySMKirkendallDTYuBGarrettWE. A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon). 2001;16:438–445.
26.
ManalKMcClayIStanhopeSRichardsJGalinatB.Comparison of surface mounted markers and attachment methods in estimating tibial rotations during walking: An in vivo study. Gait Posture. 2000;11:38–45.
27.
MarksRPentonL.Are foot orthotics efficacious for treating painful medial compartment knee osteoarthritis? A review of the literature. Int J Clin Pract. 2004;58:49–57.
28.
McClayIManalK.A comparison of three-dimensional lower extremity kinematics during running between excessive pronators and normals. Clin Biomech (Bristol, Avon). 1998;13:195–203.
29.
McCullochMUBruntDVander LindenD.The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. J Orthop Sports Phys Ther. 1993;17:2–10.
30.
McLeanSGLipfertSWvan den BogertAJ. Effect of gender and defensive opponent on the biomechanics of sidestep cutting. Med Sci Sports Exerc. 2004;36:1008–1016.
31.
McPoilTGCornwallMW. The effect of foot orthoses on transverse tibial rotation during walking. J Am Podiatr Med Assoc. 2000;90:2–11.
32.
MessinaDFFarneyWCDeLeeJC. The incidence of injury in Texas high school basketball: A prospective study among male and female athletes. Am J Sports Med. 1999;27:294–299.
33.
MundermannANiggBMHumbleRNStefanyshynDJ. Foot orthotics affect lower extremity kinematics and kinetics during running. Clin Biomech (Bristol, Avon). 2003;18:254–262.
34.
NawoczenskiDCookTSalzmanC.The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running. J Orthop Sports Rehabil. 1995;21:317–327.
35.
NovickAKelleyD.Position and movement changes of the foot with orthotic intervention during the loading response of gait. J Orthop Sports Rehabil. 1990;11:301–312.
36.
NoyesFRBarber-WestinSDFleckensteinCWalshCWestJ.The drop-jump screening test: Difference in lower limb control by gender and effect of neuromuscular training in female athletes. Am J Sports Med. 2005;33:197–207.
37.
NylandJCabomDNShapiroRJohnsonDLFangH.Hamstring extensibility and transverse plane knee control relationship in athletic women. Knee Surg Sports Traumatol Arthrosc. 1999;7:257–261.
38.
OlsenOEMyklebustGEngebretsenLBahrR.Injury mechanisms for anterior cruciate ligament injuries in team handball: A systematic video analysis. Am J Sports Med. 2004;32:1002–1012.
39.
RodgersMLeveauB.Effectiveness of foot orthotic devices used to modify pronation in runners. J Orthop Sports Rehabil. 1982;4:86–90.
40.
StevensJP. Applied Multivariate Statistics for the Social Sciences. Vol 3. London, England: Eribaum; 2001.
41.
TiberioD.Pathomechanics of structural foot deformities. Phys Ther. 1988:68:1840–1849.
42.
VinicombeARaspovicAMenzH.Reliability of navicular displacement measurement as a clinical indicator of foot posture. J Am Podiatr Med Assoc. 2001;91:262–268.
43.
Woodford-RogersBCyphertLDenegarC.Risk factors for anterior cruciate ligament injury in highschool and college athletes. J Athl Train. 1994;29(4):343–346.
44.
ZellerBLMcCroryJLKiblerWBUhlTL. Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med. 2003;31:449–456.
