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Objective Establish normative values for knee valgus angle during drop jump and step landings. Design Observational. Setting University biomechanics laboratory. Participants 100 physically active asymptomatic individuals (50 male, 50 female) aged 18–28 years old. Main outcome measures Knee valgus angle during drop jump and step landings. Results There were no differences between genders during the step landing task (p < 0.12) but there were differences during the drop jump landing task (p < 0.048). Both males and females showed no significant differences between sides for either of the tasks (p > 0.05) or between the valgus angle generated for either of the tasks (p > 0.05). Conclusion It would appear in order to be regarded as an average “normal” performance during a drop jump landing task knee valgus angle should be symmetrical and in the range of 7–13° for females and 3–8° for males. For a unilateral step landing task knee valgus angle should be symmetrical and in the range of 5–12° for females and 1–9° for males.

INTRODUCTION: The prevalence of ACL injuries is increasing in previous years. One of the most common studied kinematic risk factors related to ACL injuries is a resultant weak, leg axis alignment known as the dynamic knee valgus angle presented during a vertical drop jump [8, 14, 15]. Hewett et. al. concluded that a knee valgus angle was a primary predictor of the mechanism that leads to an ACL rupture [8]. By increasing the excessive knee valgus angle during a two-legged DVJ, an athlete is in turn increasing the possibility of a high knee valgus moment, which can increase the anterior tibial translation as well as the load on the ACL several-fold and the chances for an ACL tear [4]. METHODS: In our study, ten collegiate female participants, including ballet and non-ballet athletes performed two-legged DVJs for 6 different flexor and extensor muscles while digital recordings of knee valgus angle were captured at initial contact and push off with simultaneous collection of EMG data. RESULTS: Results displayed statistical significance for the average valgus angle to estimated GRF ratio for the non-dominant leg at push-off between the ballet and non-ballet athletes (0.8 ± 0.43 vs. 1.8 ± 0.33 degrees/N, p < 0.05). In addition, we also found that the hip extensor activity significantly increased for the non-ballet group and that the lateral thigh CCI noticeably increased for the non-dominant leg for the non-ballet group, which could be indicative of the noticeable difference in the biceps femoris muscle activation for the non-ballet group when comparing sports type. In addition, statistically significant interactions between sports type and leg type for vastus medialis and gluteus maximus were produced. Observed results also indicated that there was an increase in overall variability for the dominant leg of the non-ballet athletes amongst all studied muscles and for the non-dominant leg for the ballet group specifically studying the gluteus maximus muscle activity. DISCUSSION: Relatively, the non-ballet group could be at a higher risk for increase in femoral adduction, hip adduction, and tibial external rotation, and overall predict a larger knee valgus moment; therefore, the non-ballet group could potentially be at a higher risk for an ACL injury than the ballet group. In addition, there is potential in continued research of neuromuscular differences between ballet and non-ballet athletes to further investigate the vastus medialis and the gluteus maximus muscle activations as well as to investigate the knee valgus moment values.

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Background. Knee injuries such as anterior cruciate ligament injuries (ACL) are common in young female athletes resulting in great medical and personal costs. Both knee valgus and muscle fatigue has been reported to increase the risk of injury, while strength training has been used to reduce the occurrence of knee valgus and injury. However, few data exist on the impact of muscle strength and fatigue on knee valgus. Aim. The study aimed at investigating whether muscle strength affects the presence of knee valgus and if fatigue affects knee valgus differently depending on the level of muscle strength in young female athletes. Methods. Twenty young female athletes, mean age 18,15 (±0,79) years, participated in this study. A unilateral drop jump, video analysed in 2-dimensional, was used to evaluate knee valgus and a one Repetition Maximum (1RM) in squat was used to determine the level of muscle strength. A fatigue protocol was used to achieve muscle fatigue before another unilateral drop jump was performed. The subjects were dichotomised, by the 1 RM according to the median, to analyse ‘weak’ versus ‘strong’ females. Both the right leg (RL) and the left leg (LL) were measured before and after fatigue. Results. No significant differences, in the degree of knee valgus, were found between strong and weak group before (RL, p=0.6, LL, p=0.11), or after (RL, p=0.97, LL p=0.36) fatigue. There was also no significant difference in how fatigue affected knee valgus between strong and weak group (RL, p=0.5, LL, p=0.38). Conclusion. The present study suggests that there is no difference in knee valgus between strong and weakfemale athletes. In addition, fatigue does not seem to have an impact on knee valgus in neitherstrong nor weak females. This study has limited number of subjects and further studies are needed. / Bakgrund. Knäskador såsom främre korsbandsskada (ACL) är vanliga hos unga idrottande kvinnor och bidrar till höga medicinska kostnader och personligt lidande. Knävalgus och muskelutmattning har var för sig visat sig öka risken för knäskador hos kvinnor, medan styrketräning har rapporterats kunna minska förekomsten av knävalgus och risken för skada. Emellertid finns få studier som undersöker effekterna av muskelstyrka och utmattning på knävalgus. Syfte. Studien syftar till att undersöka huruvida styrka påverkar förekomsten av knävalgus och om muskulär trötthet påverkar knävalgus olika beroende på nivå av muskelstyrka hos unga idrottande kvinnor. Metod. Tjugo unga kvinnliga idrottare deltog i studien, ålder 18,15 (±0,79). Ett enbenshopp, vilket filmades med videokamera, användes för att utvärdera knävalgus och en repetition maximum (1RM) i knäböj för att bestämma maximal muskelstyrka. Ett utmattningsprotokoll användes för att åstadkomma muskeltrötthet. Genom att dela styrkevariabeln, 1 RM testet, vid medianen delades försökspersonerna in i två grupper; starka och svaga. Samtliga försökspersoner testade både höger och vänster ben innan och efter utmattning. Resultat. Resultaten visade ingen signifikant skillnad mellan stark och svag grupp gällande graden av knävalgus, i varken höger (p= 0,6) eller vänster (p= 0,97) ben före utmattning. Inte heller var det någon skillnad mellan stark och svag grupp efter utmattning (höger ben, p= 0,11, vänster ben, p= 0,36). Inte heller kunde någon signifikant skillnad konstateras angående utmattningens effekt på knävalgus beroende på styrka, stark/svag (höger ben, p= 0,5, vänster ben, p= 0,38). Slutsats. Sammanfattningsvis verkar det inte föreligga någon skillnad i förekomst av knävalgus mellan starka och svaga individer. Således verkar det som att muskelstyrka saknar betydelse för knävalgus hos unga kvinnliga idrottare. Vidare verkar inte heller utmattning påverka knävalgus hos varken starka eller svaga unga kvinnliga idrottare. Studien har begränsat antal deltagare och fler studier krävs.

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Context: Two-dimensional (2D) video analysis of frontal-plane dynamic knee valgus during common athletic screening tasks has been purported to identify individuals who may be at high risk of suffering knee injuries such as anterior cruciate ligament tear or patellofemoral pain syndrome. Although the validity of 2D video analysis has been studied, the associated reliability and measurement error have not. To assess the reliability and associated measurement error of a 2D video analysis of lower limb dynamic valgus. Design: Reliability study. Participants: 20 recreationally active university students (10 women age 21.5 ± 2.3 y, height 170.1 ± 6.1 cm, weight 66.2 ± 10.2 kg, and 10 men age 22.6 ± 3.1 y, height 177.9 ± 6.0 cm, weight 75.8 ± 7.9 kg). Main Outcome Measurement: Within-day and between-days reliability and measurement-error values of 2D frontal-plane projection angle (FPPA) during common screening tasks. Interventions: Participants performed single-leg squat and drop jump and single-leg landings from a standard 28-cm step with standard 2D digital video camera assessment. Results: Women demonstrated significantly higher FPPA in all tests except the left single-leg squat. Within-day ICCs showed good reliability and ranged from .59 to .88, and between-days ICCs were good to excellent, ranging from .72 to .91. Standard error of measurement and smallest detectable difference values ranged from 2.72° to 3.01° and 7.54° to 8.93°, respectively. Conclusions: 2D FPPA has previously been shown to be valid and has now also been shown to be a reliable measure of lower extremity dynamic knee valgus. Using the measurement error values presented along with previously published normative data, clinicians can now make informed judgments about individual performance and changes in performance resulting from interventions.

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No / Objective To evaluate landing strategies of female football and basketball athletes with relation to possible injury mechanisms and disparity in injury. Design Descriptive laboratory study. Participants 52 female football players and 41 female basketball players. Main outcome measures Frontal plane projection angle (FPPA) was measured during the single leg land (SLL) and drop jump (DJ) screening tasks. Results 2 × 2 × 2 mixed factorial ANOVA showed significant main effects were observed for sport, whilst significant interaction effects were seen between sport and task. Females in both sports exhibited significantly greater FPPA values during the SLL task than the DJ task (p < 0.001). Basketball players demonstrated significantly greater FPPA values during SLL than football players (p < 0.001), whilst no differences were found between sports in the DJ task (p = 0.328). Conclusion Female basketball players display greater FPPA values during unilateral landing tasks than female football players which may reflect the greater ACL injury occurrence in this population. Injury prevention programs in these athletes should incorporate unilateral deceleration and landing tasks and should consider the specific injury mechanisms in each sport.