Jin Hyun Kim1, Ki-Kwang Lee1, Se Jin Kong2, Keun Ok An3, Jin Hwa Jeong4, Yong Seuk Lee5. 1. School of Sports Science, Kookmin University, Seoul, South Korea. 2. DooRee System, Seongam, South Korea. 3. Department of Kinesiologic Medical Science, Dankook University, Cheonan, South Korea. 4. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Korea. 5. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seongnam-si, Korea smcos1@hanmail.net smcos1@snu.ac.kr.
Abstract
BACKGROUND: Less mature athletes exhibit biomechanical parameters during cutting maneuvers that may place these athletes at greater risk for injury than their more mature counterparts, especially if the maneuvers are unanticipated. However, most studies on risk factors for anterior cruciate ligament (ACL) injury have focused on neuromuscular and knee kinematic differences between the sexes, not on the biomechanical parameters between specific sporting maneuvers. HYPOTHESES: (1) Anticipation will have a greater effect than the type of cutting maneuver (side- vs cross-cutting) in terms of the biomechanical risk factors for ACL injuries, and (2) the biomechanical risk factors will be different between the 2 types of maneuvers. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-seven young, male middle school soccer players participated in this study. Three-dimensional motion analysis featuring ground-reaction force and electromyography of the right leg was used. Kinematics, kinetics, and electromyography data for each athlete were analyzed during anticipated and unanticipated side- and cross-cutting maneuvers. The differences between anticipated and unanticipated states as well as between side- and cross-cutting maneuvers were calculated and compared. RESULTS: After unanticipated side-cutting, the time to peak ground-reaction force was longer and peak values were smaller compared with anticipated side-cutting. Flexion, valgus, and internal rotations in the knee joint were larger, and greater flexion and valgus moments were observed. The vastus lateralis and vastus medialis showed lower activity, and the lateral gastrocnemius showed higher activity after unanticipated side-cutting maneuvers. With unanticipated cross-cutting, the time to peak ground-reaction force was longer and peak values were smaller compared with anticipated cross-cutting, and the lateral gastrocnemius showed higher activity. Differences in the peak values of the mediolateral and vertical forces were smaller in the cross-cutting maneuver than in side-cutting. Changes in flexion and adduction of the hip joint, flexion of the knee joint, and inversion of the ankle joint were larger during side-cutting. CONCLUSION: Although there were some interactions between direction and anticipation, anticipating a cutting maneuver generally had a greater effect than the type of maneuver when there was no significant interaction. CLINICAL RELEVANCE: Increases in the valgus angle and moment of the knee joint and higher lateral gastrocnemius activity during the late period showed an association with ACL injury risk factors during side-cutting, and higher lateral gastrocnemius activity during the early period showed an association with injury risk factors during cross-cutting.
BACKGROUND: Less mature athletes exhibit biomechanical parameters during cutting maneuvers that may place these athletes at greater risk for injury than their more mature counterparts, especially if the maneuvers are unanticipated. However, most studies on risk factors for anterior cruciate ligament (ACL) injury have focused on neuromuscular and knee kinematic differences between the sexes, not on the biomechanical parameters between specific sporting maneuvers. HYPOTHESES: (1) Anticipation will have a greater effect than the type of cutting maneuver (side- vs cross-cutting) in terms of the biomechanical risk factors for ACL injuries, and (2) the biomechanical risk factors will be different between the 2 types of maneuvers. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-seven young, male middle school soccer players participated in this study. Three-dimensional motion analysis featuring ground-reaction force and electromyography of the right leg was used. Kinematics, kinetics, and electromyography data for each athlete were analyzed during anticipated and unanticipated side- and cross-cutting maneuvers. The differences between anticipated and unanticipated states as well as between side- and cross-cutting maneuvers were calculated and compared. RESULTS: After unanticipated side-cutting, the time to peak ground-reaction force was longer and peak values were smaller compared with anticipated side-cutting. Flexion, valgus, and internal rotations in the knee joint were larger, and greater flexion and valgus moments were observed. The vastus lateralis and vastus medialis showed lower activity, and the lateral gastrocnemius showed higher activity after unanticipated side-cutting maneuvers. With unanticipated cross-cutting, the time to peak ground-reaction force was longer and peak values were smaller compared with anticipated cross-cutting, and the lateral gastrocnemius showed higher activity. Differences in the peak values of the mediolateral and vertical forces were smaller in the cross-cutting maneuver than in side-cutting. Changes in flexion and adduction of the hip joint, flexion of the knee joint, and inversion of the ankle joint were larger during side-cutting. CONCLUSION: Although there were some interactions between direction and anticipation, anticipating a cutting maneuver generally had a greater effect than the type of maneuver when there was no significant interaction. CLINICAL RELEVANCE: Increases in the valgus angle and moment of the knee joint and higher lateral gastrocnemius activity during the late period showed an association with ACL injury risk factors during side-cutting, and higher lateral gastrocnemius activity during the early period showed an association with injury risk factors during cross-cutting.