The Journal of Bone and Joint Surgery (American) 86:1601-1608 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.
Decrease in Neuromuscular Control About the Knee with Maturation in Female Athletes
Timothy E. Hewett, PhD1,
Gregory D. Myer, MS1 and
Kevin R. Ford, MS1
1 Cincinnati Children's Sports Medicine Biodynamics Center, 3333 Burnet Avenue,
MLC 10001, Cincinnati, OH 45229-3039. E-mail address for T.E. Hewett:
tim.hewett{at}cchmc.org
Investigation performed at Cincinnati Children's Sports Medicine
Biodynamics Center, Cincinnati, Ohio
The authors did not receive grants or outside funding in support of their
research or preparation of this manuscript. They did not receive payments or
other benefits or a commitment or agreement to provide such benefits from a
commercial entity. No commercial entity paid or directed, or agreed to pay or
direct, any benefits to any research fund, foundation, educational
institution, or other charitable or nonprofit organization with which the
authors are affiliated or associated.
Background: Compared with male athletes, female athletes demonstrate
increased dynamic valgus angulation of the knee during landing from a jump,
although prior to maturation male and female athletes have similar forces and
motions about the knee when they land from a jump. Our hypothesis was that
musculoskeletal changes that accompany maturation result in poor neuromuscular
control of the knee joint in female athletes.
Methods: One hundred and eighty-one middle-school and high-school
soccer and basketball players—100 girls and eighty-one
boys—participated in the study. Dynamic control of the knee joint was
measured kinematically by assessing medial knee motion and the lower-extremity
valgus angle and was measured kinetically by assessing knee joint torques; the
values were then compared between female and male athletes according to
maturational stage. Lower-extremity bone length was measured with
three-dimensional kinematic analysis.
Results: Following the onset of maturation, the female athletes
landed with greater total medial motion of the knees and a greater maximum
lower-extremity valgus angle than did the male athletes. The girls also
demonstrated decreased flexor torques compared with the boys as well as a
significant difference between the maximum valgus angles of their dominant and
nondominant lower extremities after maturation.
Conclusions: After girls mature, they land from a jump differently
than do boys, as measured kinematically and kinetically.
Clinical Relevance: Following the onset of the pubertal growth
spurt, female athletes change the way that they land from a jump. This change
may be due to decreased neuromuscular control of the knee and may explain why
the risk of anterior cruciate ligament injury is higher in girls than it is in
boys. The measures of neuromuscular control of the knee used in this report
may be employed to monitor athletes and to direct appropriate new
interventions to athletes at high risk for injury.
 CiteULike  Connotea  Del.icio.us  Facebook  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
K. F. Orishimo, I. J. Kremenic, E. Pappas, M. Hagins, and M. Liederbach
Comparison of Landing Biomechanics Between Male and Female Professional Dancers
Am. J. Sports Med.,
November 1, 2009;
37(11):
2187 - 2193.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C E Quatman and T E Hewett
The anterior cruciate ligament injury controversy: is "valgus collapse" a sex-specific mechanism?
Br. J. Sports Med.,
May 1, 2009;
43(5):
328 - 335.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G D Myer, J L Brent, K R Ford, and T E Hewett
A pilot study to determine the effect of trunk and hip focused neuromuscular training on hip and knee isokinetic strength
Br. J. Sports Med.,
July 1, 2008;
42(7):
614 - 619.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J Parkkari, K Pasanen, V M Mattila, P Kannus, and A Rimpela
The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up
Br. J. Sports Med.,
June 1, 2008;
42(6):
422 - 426.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G Panics, A Tallay, A Pavlik, and I Berkes
Effect of proprioception training on knee joint position sense in female team handball players
Br. J. Sports Med.,
June 1, 2008;
42(6):
472 - 476.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. D. Myer, K. R. Ford, M. V. Paterno, T. G. Nick, and T. E. Hewett
The Effects of Generalized Joint Laxity on Risk of Anterior Cruciate Ligament Injury in Young Female Athletes
Am. J. Sports Med.,
June 1, 2008;
36(6):
1073 - 1080.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. C. Herman, P. S. Weinhold, K. M. Guskiewicz, W. E. Garrett, B. Yu, and D. A. Padua
The Effects of Strength Training on the Lower Extremity Biomechanics of Female Recreational Athletes During a Stop-Jump Task
Am. J. Sports Med.,
April 1, 2008;
36(4):
733 - 740.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Hewett, B. T. Zazulak, and G. D. Myer
Effects of the Menstrual Cycle on Anterior Cruciate Ligament Injury Risk: A Systematic Review
Am. J. Sports Med.,
April 1, 2007;
35(4):
659 - 668.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Hewett, L. Snyder-Mackler, K. P. Spindler, F. R. Noyes, and S. D. Barber-Westin
Letters to the Editor * Authors' Response
Am. J. Sports Med.,
January 1, 2007;
35(1):
145 - 147.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Y. Griffin, M. J. Albohm, E. A. Arendt, R. Bahr, B. D. Beynnon, M. DeMaio, R. W. Dick, L. Engebretsen, W. E. Garrett Jr, J. A. Hannafin, et al.
Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries: A Review of the Hunt Valley II Meeting, January 2005
Am. J. Sports Med.,
September 1, 2006;
34(9):
1512 - 1532.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. E. Quatman, K. R. Ford, G. D. Myer, and T. E. Hewett
Maturation Leads to Gender Differences in Landing Force and Vertical Jump Performance: A Longitudinal Study
Am. J. Sports Med.,
May 1, 2006;
34(5):
806 - 813.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. J. Warden, L. K. Saxon, A. B. Castillo, and C. H. Turner
Knee ligament mechanical properties are not influenced by estrogen or its receptors
Am J Physiol Endocrinol Metab,
May 1, 2006;
290(5):
E1034 - E1040.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. D. Myer, K. R. Ford, S. G. McLean, and T. E. Hewett
The Effects of Plyometric Versus Dynamic Stabilization and Balance Training on Lower Extremity Biomechanics
Am. J. Sports Med.,
March 1, 2006;
34(3):
445 - 455.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. D. Barber-Westin, F. R. Noyes, and M. Galloway
Jump-Land Characteristics and Muscle Strength Development in Young Athletes: A Gender Comparison of 1140 Athletes 9 to 17 Years of Age
Am. J. Sports Med.,
March 1, 2006;
34(3):
375 - 384.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Hewett, G. D. Myer, and K. R. Ford
Anterior Cruciate Ligament Injuries in Female Athletes: Part 1, Mechanisms and Risk Factors
Am. J. Sports Med.,
February 1, 2006;
34(2):
299 - 311.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. D Myer, H. I Brunner, P. G Melson, M. V Paterno, K. R Ford, and T. E Hewett
Specialized Neuromuscular Training to Improve Neuromuscular Function and Biomechanics in a Patient With Quiescent Juvenile Rheumatoid Arthritis
Physical Therapy,
August 1, 2005;
85(8):
791 - 802.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. L. Tosi, B. D. Boyan, and A. L. Boskey
Does Sex Matter in Musculoskeletal Health? The Influence of Sex and Gender on Musculoskeletal Health
J. Bone Joint Surg. Am.,
July 1, 2005;
87(7):
1631 - 1647.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T E Hewett, B T Zazulak, G D Myer, and K R Ford
A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes
Br. J. Sports Med.,
June 1, 2005;
39(6):
347 - 350.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Montgomery and M. D. Miller
What's New in Sports Medicine
J. Bone Joint Surg. Am.,
March 1, 2005;
87(3):
686 - 694.
[Full Text]
[PDF]
|
|
|
|
