Whole body kinematics and knee moments that occur during an overhead catch and landing task in sport
Introduction
The two primary sporting maneuvers observed during non-contact anterior cruciate ligament (ACL) injuries are sidestep cutting and landing following a jump (Cochrane et al., 2007). As such, there has been extensive research attempting to better understand what characteristics of these tasks are associated with non-contact ACL injuries. Even though there are many factors implicated in ACL injury, ultimately, when the ACL loading become higher than its strength, ligament damage occurs. Therefore to best prevent non-contact ACL injuries it is important to understand the mechanism behind high ACL loading. Consequently, much of the previous research has been directed towards understanding the causes of, and support for, external knee moments that results in high ACL loads in sporting tasks (Besier et al., 2001, Besier et al., 2003a, McLean et al., 2007). These moments are studied as it has been shown that high valgus and internal rotation moments at the knee coupled with anterior draw, caused by quadriceps extension, can highly load the ACL in particularly in extended knee postures (Fleming et al., 2001, Markolf et al., 1995). So the question arises; what particular facets of sidestep cutting and landing result in critical high knee loading?
Specific sidestepping and landing techniques have been associated with non-contact ACL injuries. These relationships have been derived from both the visual analysis of videos of actual injuries (Cochrane et al., 2007, Hewett et al., 2009, Olsen et al., 2004), and in laboratory studies that have linked specific sidestep cutting techniques to increased knee load (Dempsey et al., 2007, McLean et al., 2005). Specifically, it appears that body postures that have an extended and internally rotated lower limb, with an abducted hip, are associated with increased peak valgus moments (Dempsey et al., 2007, McLean et al., 2005). This would suggest that these postures have an increased risk of ACL injury. From an upper body perspective, increased torso rotation and lateral flexion away from the stance leg have been linked to higher knee internal rotation and valgus moments respectively (Dempsey et al., 2007). Although there have been numerous studies investigating lower limb kinematics during landing (Decker et al., 2003, Hewett et al., 2005, Lephart et al., 2002, Onate et al., 2003), there is yet to be a study investigating the relationship between full body kinematics and knee moments during landing tasks.
An understanding of how full body kinematics affect knee moments is important, particularly in team sports that involve carrying or catching a ball. Indeed, it has been shown that team sport athletes that suffer a non-contact ACL injury have had some interaction with the ball, often performing a task in rapid response to some game situation (Olsen et al., 2004). This ball interaction probably affects the full body kinematics and knee moments. For example, while performing a sidestep cut the act of carrying a ball on different sides of the body has been shown to modify both technique and knee valgus loading (Chaudhari et al., 2005). Furthermore, Cowling and Steele (2001) found that requiring an athlete to catch a ball during flight altered hip and trunk sagittal plane kinematics during single leg landing. Therefore, a landing task that has anticipatory and ball handling components may better reflect the game scenarios related to ACL injury and high knee loading. Such a task may also provide sufficient kinematic variation to enable the investigation of the relationship between whole body kinematics and knee joint loading.
The first aim of this study was to investigate how knee moments generated during landing were affected by variations in an overhead ball catching and landing tasks that occurs in Australian Football. It was hypothesized that different ball movement directions would result in changed knee joint moments. The second aim was to identify joint postures associated with increased knee valgus and internal rotation moments, as these moments have been associated with high ACL loading. It was anticipated that joint postures associated with increased load would be similar to those observed during actual non-contact ACL injury.
Section snippets
Participants
Twenty five healthy male team sports athletes were recruited to participate in this study (height: mean 181.8 (SD 7.1) cm, mass: mean 78.0 (SD 12.1) kg). All participants were experienced in performing landing tasks through their respective team sport. Participants were excluded if they had a history of major lower limb injury. Ethics approval was obtained from The University of Western Australia (UWA) Human Research Ethics committee and written informed consent was obtained from all
Results
There was no significant difference between any of the four landing tasks for either the peak flexion moment (P = 0.270) or peak internal rotation moment (P = 0.441) of the support limb. However, there was a significant difference between tasks for the peak valgus moment (P = 0.001). The post hoc test showed that the TE condition (0.43 (SD 0.24) Nm·kg− 1·m− 1) had a significantly greater valgus moment than both the AE (0.23 (SD 0.17) Nm·kg− 1·m− 1, P = 0.001) and AL conditions (0.31 (SD 0.16) Nm·kg− 1·m− 1, P
Discussion
This study first aimed to investigate the impact of different ball movement conditions during an overhead ball catch and landing task on knee moments. We found that catching a ball that was dropping and moving toward the participants' preferred landing leg caused larger peak knee valgus moments compared to catching a ball dropping and moving away from the participants' preferred landing leg. No significant between-task differences were observed for any of the other knee moments. In the second
Conclusions
This study showed that when an individual is attempting to catch an overhead pass, movement of the ball towards the support leg before the catch is made affects the subsequent landing posture and increases the knee joint valgus moment during the land. We also identified certain postures at initial foot contact during landing that were associated with increased valgus and internal rotation loads at the knee. Specifically, landing with an externally rotated foot, with the knee also externally
Conflict of Interest
No authors have a conflict of interest.
Acknowledgments
This project was funded in part by a grant from the Australian Football League Research Board, who had no contribution to the design, undertaking, interpretation or decision to publish the work presented in this paper.
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