Rasmus S Husted, Jesper Bencke1, Per Hölmich2, Lars L Andersen, Kristian Thorborg, Thomas Bandholm3, Bjørn Gliese4, Hanne B Lauridsen1, Grethe Myklebust5, Per Aagaard6, Mette K Zebis7. 1. Human Movement Analysis Laboratory, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark. 2. Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark. 3. Optimed, Clinical Research Centre, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark. 4. Clinical Orthopaedic Research Hvidovre (CORH), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark. 5. Oslo Sport Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway. 6. Department of Sports Sciences and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC), University of Southern Denmark, Odense M, Denmark. 7. Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark.
Abstract
BACKGROUND: Reduced lower extremity muscle strength as well as reduced lower extremity muscle pre-activity (defined as muscular activity just prior to initial ground contact) during high-risk movements are factors related to increased risk of non-contact ACL injury in adolescent female athletes. A strong relationship exists between muscle strength and muscle activity obtained during an isometric contraction, however, whether these two measures are related when muscle activity is obtained during a movement associated with a high risk of non-contact ACL injury is not known. Absence or presence of such a relationship may have implications for which training modalities to choose in the prevention of ACL injuries. PURPOSE: The purpose of this study was to examine the relationship between maximal muscle strength of the hip extensors, hip abductors and knee flexors and the pre-activity of these muscle groups recorded during a sidecutting maneuver (high-risk movement) in adolescent female soccer and handball athletes. STUDY DESIGN: Cross-sectional study. METHODS: Eighty-five adolescent (age 16.9 ± 1.2 years) female elite handball and soccer athletes were assessed for maximal hip extensor, hip abductor and knee flexor muscle strength; and muscle pre-activity (electromyography recordings over a 10 ms time interval prior to foot ground contact) of the gluteus maximus (Gmax), gluteus medius (Gmed), biceps femoris (BF) and semitendinosus (ST) during a standardized sidecutting maneuver. RESULTS: The results of the correlation analyses demonstrated poor and statistically non-significant correlations. Maximal hip extensor force (N/kg bw) and Gmax pre-activity [rs = 0.012 (95% CI -0.202 - 0.224), p = 0.91], maximal hip abductor force (N/kg bw) and Gmed pre-activity [rs = 0.171 (95% CI -0.044 - 0.371), p = 0.11], maximal knee flexor force (N/kg bw) and BF pre-activity [rs = 0.049 (95% CI -0.166 - 0.259), p = 0.65], and maximal knee flexor force and ST pre-activity [rs = 0.085 (95% CI -0.131 - 0.293), p = 0.44]. CONCLUSION: In the present exploratory study, the results imply that no relationship exists between maximal lower extremity isometric muscle strength and lower extremity muscle pre-activity during sidecutting. This means that athletes with low muscle strength may not necessarily demonstrate high (or low) muscle pre-activity during sidecutting - a well-known risk movement for sustaining non-contact ACL injury. LEVELS OF EVIDENCE: Level 3.
BACKGROUND: Reduced lower extremity muscle strength as well as reduced lower extremity muscle pre-activity (defined as muscular activity just prior to initial ground contact) during high-risk movements are factors related to increased risk of non-contact ACL injury in adolescent female athletes. A strong relationship exists between muscle strength and muscle activity obtained during an isometric contraction, however, whether these two measures are related when muscle activity is obtained during a movement associated with a high risk of non-contact ACL injury is not known. Absence or presence of such a relationship may have implications for which training modalities to choose in the prevention of ACL injuries. PURPOSE: The purpose of this study was to examine the relationship between maximal muscle strength of the hip extensors, hip abductors and knee flexors and the pre-activity of these muscle groups recorded during a sidecutting maneuver (high-risk movement) in adolescent female soccer and handball athletes. STUDY DESIGN: Cross-sectional study. METHODS: Eighty-five adolescent (age 16.9 ± 1.2 years) female elite handball and soccer athletes were assessed for maximal hip extensor, hip abductor and knee flexor muscle strength; and muscle pre-activity (electromyography recordings over a 10 ms time interval prior to foot ground contact) of the gluteus maximus (Gmax), gluteus medius (Gmed), biceps femoris (BF) and semitendinosus (ST) during a standardized sidecutting maneuver. RESULTS: The results of the correlation analyses demonstrated poor and statistically non-significant correlations. Maximal hip extensor force (N/kg bw) and Gmax pre-activity [rs = 0.012 (95% CI -0.202 - 0.224), p = 0.91], maximal hip abductor force (N/kg bw) and Gmed pre-activity [rs = 0.171 (95% CI -0.044 - 0.371), p = 0.11], maximal knee flexor force (N/kg bw) and BF pre-activity [rs = 0.049 (95% CI -0.166 - 0.259), p = 0.65], and maximal knee flexor force and ST pre-activity [rs = 0.085 (95% CI -0.131 - 0.293), p = 0.44]. CONCLUSION: In the present exploratory study, the results imply that no relationship exists between maximal lower extremity isometric muscle strength and lower extremity muscle pre-activity during sidecutting. This means that athletes with low muscle strength may not necessarily demonstrate high (or low) muscle pre-activity during sidecutting - a well-known risk movement for sustaining non-contact ACL injury. LEVELS OF EVIDENCE: Level 3.
Authors: McKenzie L Fauth; Erich J Petushek; Christina R Feldmann; Brittni E Hsu; Luke R Garceau; Brittney N Lutsch; William P Ebben Journal: J Strength Cond Res Date: 2010-04 Impact factor: 3.775
Authors: P Aagaard; J L Andersen; P Dyhre-Poulsen; A M Leffers; A Wagner; S P Magnusson; J Halkjaer-Kristensen; E B Simonsen Journal: J Physiol Date: 2001-07-15 Impact factor: 5.182
Authors: M K Zebis; P Aagaard; L L Andersen; P Hölmich; M B Clausen; M Brandt; R S Husted; H B Lauridsen; D J Curtis; J Bencke Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-05-07 Impact factor: 4.342