Weak associations between hip adduction angle and hip abductor muscle activity during running
Introduction
A large peak hip adduction angle may be a biomechanical predictor of the two most common overuse running injuries in women: patellofemoral pain syndrome (Noehren et al., 2013) and iliotibial band syndrome (Noehren et al., 2007). Hip abductor muscle strengthening was recommended to reduce hip adduction in runners with patellofemoral pain syndrome (Ireland et al., 2003) and iliotibial band syndrome (Fredericson and Weir, 2006). Yet, there is no association between the peak hip adduction angle during running and isometric hip abductor muscle strength (Baggaley et al., 2015, Heinert et al., 2008).
Beyond muscle strength, muscle activation patterns likely play an important role in controlling joint movement during running. In anticipation of foot-contact, the central nervous system pre-activates the hip abductor musculature to provide body-weight support and limit frontal plane hip motion (Chaudhari and Andriacchi, 2006). The muscle force produced by the hip abductor gluteus medius during the stance phase of running is larger than the other hip abductor muscles (Lenhart et al., 2014). Gluteus medius contributes to supporting body-weight (Pandy and Andriacchi, 2010) and stabilizing the hip joint (Gottschalk et al., 1989) during the stance phase of gait, particularly during weight acceptance. Additionally, tensor fascia lata assists in resisting excessive hip adduction and actively abducts the hip during the stance phase of gait (Gottschalk et al., 1989, Lenhart et al., 2014). Collectively, gluteus medius and tensor fascia lata activity magnitude and activity duration may be more important factors limiting the peak hip adduction angle and controlling the rate of hip adduction during the stance phase of running than maximal isometric hip abductor muscle strength.
No previous study has investigated if associations exist between the peak hip adduction angle and hip abductor muscle activity in healthy female runners. However, greater hip adduction excursion had a fair association with lower gluteus medius activity onset prior to foot contact during running in female runners with patellofemoral pain syndrome (Willson et al., 2011). This suggests at least a fair linkage of gluteus medius activity controlling hip kinematics during running. Additionally, during drop landing, average gluteus medius activity magnitude was higher in participants with low isometric hip abductor muscle strength compared to the high strength group (Homan et al., 2013). Yet, no differences in the peak hip adduction angle and hip adduction excursion were observed between groups during drop landing (Homan et al., 2013). The lack of group differences in hip adduction angles during landing was hypothesized to be due to the greater average gluteus medius activity magnitude to compensate for less strength (Homan et al., 2013). However, associations between hip adduction angle and hip abductor muscle activity during the stance phase of gait remains under-investigated in female runners. No previous study has examined the associations among hip adduction kinematics, hip abductor muscle activity, and isometric hip abductor muscle strength in a healthy sample of female runners. Additionally, it is unknown the individual contributions of hip abductor muscle activity and isometric hip abductor muscle strength to the peak hip adduction angle during running. Furthering our understanding of the central nervous system’s contribution to controlling the peak hip adduction angle during running may provide insight towards improving hip mechanics in those with a history of overuse knee injury.
Therefore, the purpose of this cross-sectional investigation was to determine if associations existed among hip adduction kinematics, hip abductor muscle activity, and isometric hip abductor muscle strength in healthy female runners. Our secondary purpose was to determine the relative contributions of hip abductor muscle activity and isometric hip abductor muscle strength to the total variance of the peak hip adduction angle. We hypothesized that hip adduction angle at foot-contact, peak hip adduction angle, hip adduction excursion, peak hip adduction velocity would each have negative associations with gluteus medius and tensor fascia lata activity. Additionally, we hypothesized that isometric hip abductor muscle strength would not be associated with the peak hip adduction angle, hip adduction excursion, or hip adduction velocity. Isometric hip abductor muscle strength was hypothesized to be inversely associated with gluteus medius and tensor fascia lata activity. Finally, it was hypothesized that gluteus medius activity magnitude would predict the most amount of the variance in the peak hip adduction angle.
Section snippets
Methods
Central Washington University’s Human Subjects Research Council granted approval for all procedures prior to the commencement of this study. Each runner provided her written informed consent to participate. Women were recruited from the Central Washington University campus and Ellensburg, WA community via word of mouth, flyers, and a University approved social media. To participate, all runners were between the ages of 18–45 years, had been injury-free for at least three months prior to data
Results
Female runners’ descriptive statistics (mean ± standard deviation) of hip adduction kinematics, hip abductor muscle activity, and isometric hip abductor muscle strength are provided (Table 2).
Discussion
The purpose of this study was to determine if associations existed among hip adduction kinematics, hip abductor muscle activity, and isometric hip abductor muscle strength in healthy female runners. Contrary to our hypothesis, gluteus medius activity during running was unrelated to the hip adduction angle during running. Additionally, a fair positive relationship between tensor fascia lata activity during running and the peak hip adduction angle was unexpected. In agreement with our hypothesis,
Conclusion
This study found low associations between the peak hip adduction angle and hip adduction excursion with hip abductor muscle activity during running. Furthermore, isometric hip abductor muscle strength was not associated with either the peak hip adduction angle or hip adduction excursion during running. There was a positive fair association between tensor fascia lata activity magnitude and peak hip adduction angles during running. However, the relatively weak relationship between tensor fascia
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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