Elsevier

Clinical Biomechanics

Volume 16, Issue 5, June 2001, Pages 438-445
Clinical Biomechanics

A comparison of knee joint motion patterns between men and women in selected athletic tasks

https://doi.org/10.1016/S0268-0033(01)00019-5Get rights and content

Abstract

Background. Women have higher non-contact anterior cruciate ligament injury rate than men do in sport activities. Non-contact anterior cruciate ligament injuries frequently occur in sports requiring cutting tasks. Alternated motor control strategies have identified as a potential risk factor for the non-contact anterior cruciate ligament injuries. The purpose of this study was to compare the patterns of knee kinematics and electromyographic activities in running, side-cutting, and cross-cutting between men and women recreational athletes.

Methods. Three-dimensional kinematic data of the knee and electromyographic data of selected muscles across the knee joint were collected for 11 men and 9 women recreational athletes in running, side-cutting, and cross-cutting. Regression analyses with dummy variables for comparison of knee motion patterns between men and women.

Results. Women tend to have less knee flexion angles, more knee valgus angles, greater quadriceps activation, and lower hamstring activation in comparison to men during the stance phase of each of the three athletic tasks. Literatures suggest these alternated knee motion patterns of women tend to increase the load on the anterior cruciate ligament.

Conclusion. Women on average may have certain motor control strategies that may alter their knee motion patterns. Women's altered knee motion patterns may tend to increase the load on the anterior cruciate ligament in the selected athletic tasks, which may contribute to the increased anterior cruciate ligament injury rate among women.
Relevance

Non-contact anterior cruciate ligament injuries frequently occur in sports. Altered motor control strategies and lower extremity motion patterns are likely to play an important role in non-contact anterior cruciate ligament injuries. Non-contact anterior cruciate ligament injuries may be prevented by correcting altered motor control strategies and associated lower extremity motion patterns through certain training programs.

Introduction

Anterior cruciate ligament (ACL) disruption is a commonly seen knee injury. It was estimated that the incidence of ACL disruption was one in 3000 people in the general population [1] with over 70% of all ACL injuries occurred in sport activities [2], [3], [4]. Paulos [5] reported that nearly 50,000 primary ACL surgeries were performed in 1982 in the United States alone. The majority of ACL injuries are non-contact in nature, that is, there is no direct physical contact to the athlete when an injury occurs [6], [7], [8].

Women have a higher incidence than men for non-contact ACL injuries in sport activities. Recent injury reports from National Collegiate Athletic Association indicate that female collegiate soccer and basketball players were three and four times more likely to have non-contact ACL injuries than their male counterparts [9]. Other studies report the non-contact ACL injury rate for female athletes as high as eight times of that for male athletes [5], [10], [11], [12], [13], [14], [15], [16].

Several intrinsic and extrinsic factors have been proposed as contributors to the increased incidence of non-contact ACL ruptures among female athletes [9]. Among these intrinsic and extrinsic factors, altered neuromuscular control strategies and movement patterns are likely to contribute to the increased incidence of non-contact ACL injuries for female athletes. A recent study [8] showed non-contact ACL injuries frequently occurred with the knee at small flexion angle accompanied by a knee valgus motion during running, cutting, and jumping tasks in soccer and basketball. Studies have shown that the contraction of the quadriceps muscle group applies an anterior shear force on the tibia through the patella tendon [17], [18]. This shear force may lead to an ACL injury when the knee flexion angle is less than 30° and the hamstring muscle group does not apply sufficient posterior shear force [17], [18].

The purpose of this study was to compare three-dimensional (3-D) knee joint motions and electromyographic (EMG) activities of the quadriceps and hamstring muscle groups between male and female recreational athletes in running, cross-cutting, and side-cutting. We hypothesize:

  • 1.

    Female athletes tend to have smaller knee flexion angles than male athletes during the support phases in athletic tasks such as running, side-cutting, and cross-cutting;

  • 2.

    Female and male athletes tend to have different knee valgus–varus angles during the stance phase in these athletic tasks;

  • 3.

    Female athletes tend to have higher quadriceps muscle activation than male athletes during these athletic tasks; and

  • 4.

    Female athletes tend to have lower hamstring muscle activation than male athletes during these athletic tasks.

Section snippets

Subjects

Twenty healthy recreational athletes (11 males and 9 females), with no known history of any knee pathological conditions were randomly recruited from Duke University campus. A recreational athlete was defined as a person who plays basketball, soccer, or volleyball less than or equal to three times per week but does not follow a professionally designed training regimen. The mean age, height, and body mass were 24.5 (SD, 2.5) yr, 1.80 (SD, 0.05) m, and 78.1 (SD, 7.3) kg, respectively, for male

Results

The mean approach run speeds were 5.21 (SD, 0.45) m/s, 5.18 (SD, 0.38) m/s, and 5.15 (SD, 0.46) m/s for male subjects in running, side-cutting, and cross-cutting, respectively, and 5.11 (SD, 0.51) m/s, 5.01 (SD, 0.44) m/s, and 4.96 (SD, 0.41) m/s for female subjects. The mean takeoff speeds were 5.23 (SD, 0.41) m/s, 4.68 (SD, 0.42) m/s, and 4.41 (SD, 0.44) m/s for male subjects in running, side-cutting, and cross-cutting, respectively, and 5.17 (SD, 0.55) m/s, 4.46 (SD, 0.42) m/s, and 4.25 (SD,

Discussion

The results of this study support our hypotheses indicating that female and male athletes on average have different knee motion patterns in selected athletic tasks, specifically, female athletes have decreased knee flexion angle, increased knee valgus angle, increased quadriceps muscle activation, and decreased hamstring muscle activation. These differences in knee motion patterns between female and male subjects may be attributed to differences between female and male athletes in (a) motor

References (31)

  • P. McNair et al.

    Important features associated with acute anterior cruciate ligament injury

    NZ Med. J.

    (1990)
  • B.P. Boden et al.

    Mechanisms of ACL injury

    Med. Sci. Sports Exerc.

    (1996)
  • E. Arendt et al.

    Knee injury patterns among men and women in collegiate basketball and soccer

    Am. J. Sports Med.

    (1995)
  • J. Cox et al.

    Women midshipmen in sports

    Am. J. Sports Med.

    (1984)
  • K. DeHaven et al.

    Athletic Injuries: comparison by age, sport, and gender

    Am. J. Sports Med.

    (1986)
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