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The effect of changing toe direction on knee kinematics during drop vertical jump: a possible risk factor for anterior cruciate ligament injury

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to examine the effect of changing toe direction on knee kinetics and kinematics associated with anterior cruciate ligament injury during drop vertical jumps.

Methods

Fourteen females performed drop vertical jumps under three toe conditions (natural, toe-in, and toe-out). The knee kinetics and kinematics during landing were evaluated using a motion analysis system. Results under three toe conditions were compared using a one-way repeated measures analysis of variance and a post hoc Bonferroni test.

Results

Toe-in landing was associated with a significantly greater knee abduction angle, tibial internal rotation angle, and knee abduction moment than the natural and toe-out conditions. Toe-out landing was associated with significantly greater tibial internal rotational angular velocity.

Conclusions

Changing toe direction significantly affects knee kinetics and kinematics during landing. It is important to avoid changing toe direction excessively inward or outward during landing to prevent the increases in knee abduction and tibial internal rotation which might increase the risk of ACL injury.

Level of evidence

Prognosis, Level IV.

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References

  1. Agel J, Arendt EA, Bershadsky B (2005) Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review. Am J Sports Med 33(4):524–530

    Article  PubMed  Google Scholar 

  2. Arendt E, Dick R (1995) Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 23(6):694–701

    Article  CAS  PubMed  Google Scholar 

  3. Boden BP, Dean GS, Feagin JA, Garrett WE (2000) Mechanisms of anterior cruciate ligament injury. Orthopedics 23(6):573–578

    CAS  PubMed  Google Scholar 

  4. Fleiss JL (1986) The design and analysis of clinical experiments. Wiley, New York

    Google Scholar 

  5. Ford KR, Shapiro R, Myer GD, Van Den Bogert AJ, Hewett TE (2010) Longitudinal sex differences during landing in knee abduction in young athletes. Med Sci Sports Exerc 42(10):1923–1931

    Article  PubMed Central  PubMed  Google Scholar 

  6. Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD, Demaio M et al (2006) Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting. Am J Sports Med 34(9):1512–1532

    Article  PubMed  Google Scholar 

  7. Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105(2):136–144

    Article  CAS  PubMed  Google Scholar 

  8. Hewett T, Lindenfeld T, Riccobene J, Noyes F (1999) The effect of neuromuscular training on the incidence of knee injury in female athletes—a prospective study. Am J Sports Med 27(6):699–706

    CAS  PubMed  Google Scholar 

  9. Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, McLean SG et al (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 33(4):492–501

    Article  PubMed  Google Scholar 

  10. Ishida T, Yamanaka M, Takeda N, Aoki Y (2013) Knee rotation associated with dynamic knee valgus and toe direction. Knee. doi:10.1016/j.knee.2012.12.002

    Google Scholar 

  11. Koga H, Nakamae A, Shima Y, Iwasa J, Myklebust G, Engebretsen L et al (2010) Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball. Am J Sports Med 38(11):2218–2225

    Article  PubMed  Google Scholar 

  12. Mandelbaum BR, Silvers HJ, Watanabe DS, Knarr JF, Thomas SD, Griffin LY et al (2005) Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med 33(7):1003–1010

    Article  PubMed  Google Scholar 

  13. Myer G, Ford K, Hewettt T (2004) Rationale and clinical techniques for anterior cruciate ligament injury prevention among female athletes. J Athl Train 39(4):352–364

    PubMed Central  PubMed  Google Scholar 

  14. Myklebust G, Engebretsen L, Braekken IH, Skjølberg A, Olsen O-E, Bahr R (2007) Prevention of noncontact anterior cruciate ligament injuries in elite and adolescent female team handball athletes. Instr Course Lect 56:407–418

    PubMed  Google Scholar 

  15. Nagano Y, Ida H, Akai M, Fukubayashi T (2007) Gender differences in knee kinematics and muscle activity during single limb drop landing. Knee 14(3):218–223

    Article  PubMed  Google Scholar 

  16. Olsen O-E, Myklebust G, Engebretsen L, Bahr R (2004) Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. Am J Sports Med 32(4):1002–1012

    Article  PubMed  Google Scholar 

  17. Olsen O-E, Myklebust G, Engebretsen L, Holme I, Bahr R (2005) Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. BMJ 330:449–452

    Article  PubMed Central  PubMed  Google Scholar 

  18. Padua DA, Marshall SW, Boling MC, Thigpen CA, Garrett WE Jr, Beutler AI (2009) The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics: the JUMP-ACL study. Am J Sports Med 37(10):1996–2002

    Article  PubMed  Google Scholar 

  19. Pioletti DP, Rakotomanana LR, Leyvraz PF (1999) Strain rate effect on the mechanical behavior of the anterior cruciate ligament-bone complex. Med Eng Phys 21(2):95–100

    Article  CAS  PubMed  Google Scholar 

  20. Renstrom P, Ljungqvist A, Arendt E, Beynnon B, Fukubayashi T, Garrett W et al (2008) Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br J Sports Med 42(6):394–412

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Shimokochi Y, Shultz SJ (2008) Mechanisms of noncontact anterior cruciate ligament injury. J Athl Train 43(4):396–408

    Article  PubMed Central  PubMed  Google Scholar 

  22. Shin CS, Chaudhari AM, Andriacchi TP (2011) Valgus plus internal rotation moments increase anterior cruciate ligament strain more than either alone. Med Sci Sports Exerc 43(8):1484–1491

    Article  PubMed  Google Scholar 

  23. Viskontas DG, Giuffre BM, Duggal N, Graham D, Parker D, Coolican M (2008) Bone bruises associated with ACL rupture: correlation with injury mechanism. Am J Sports Med 36(5):927–933

    Article  PubMed  Google Scholar 

  24. Waldén M, Atroshi I, Magnusson H, Wagner P, Hägglund M (2012) Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ 344:e3042

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors thank Prof. Junko Fukushima for her suggestions in the preparation of this article.

Conflict of interest

All authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan

    Tomoya Ishida, Kentaro Homan & Yuta Koshino

  2. Department of Rehabilitation, Hokushin Orthopedic Hospital, Sapporo, Hokkaido, Japan

    Tomoya Ishida & Hisashi Matsumoto

  3. Division of Health Sciences, Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, West 5, North 12, Kitaku, Sapporo, Hokkaido, 060-0812, Japan

    Masanori Yamanaka & Naoki Takeda

  4. Hokuto Endowed Chair in Prevention of Joint Disease, Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan

    Masanori Yamanaka, Naoki Takeda & Takumi Kobayashi

  5. Rehabilitation Center, NTT East Japan Sapporo Hospital, Sapporo, Hokkaido, Japan

    Yuta Koshino

  6. Department of Orthopedic Surgery, Hokushin Orthopedic Hospital, Sapporo, Hokkaido, Japan

    Yoshimitsu Aoki

Authors
  1. Tomoya Ishida
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  2. Masanori Yamanaka
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  3. Naoki Takeda
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  4. Kentaro Homan
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  5. Yuta Koshino
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  6. Takumi Kobayashi
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  7. Hisashi Matsumoto
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  8. Yoshimitsu Aoki
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Corresponding author

Correspondence to Masanori Yamanaka.

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Ishida, T., Yamanaka, M., Takeda, N. et al. The effect of changing toe direction on knee kinematics during drop vertical jump: a possible risk factor for anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 23, 1004–1009 (2015). https://doi.org/10.1007/s00167-013-2815-2

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  • DOI: https://doi.org/10.1007/s00167-013-2815-2

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