Gender difference in Patellofemoral Pain biomechanics?

NewsBot · Jul 28, 2012

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Are Mechanics Different between Male and Female Runners with Patellofemoral Pain?
Willy, Richard W.; Manal, Kurt T.; Witvrouw, Erik E.; Davis, Irene
Medicine & Science in Sports & Exercise, 26 July 2012

Introduction: Patellofemoral pain (PFP) has often been attributed to abnormal hip and knee mechanics in females. To date, there have been few investigations of the hip and knee mechanics of males with PFP. The purpose of this study was to compare the lower extremity mechanics and alignment of male runners with PFP with healthy male runners and female runners with PFP. We hypothesized that males with PFP would move with greater varus knee mechanics compared with male controls and compared with females with PFP. Further, it was hypothesized that males with PFP would demonstrate greater varus alignment.

Methods: A gait and single leg squat analysis was conducted on each group (18 runners per group). Measurement of each runner's tibial mechanical axis was also recorded. Motion data were processed using Visual 3D (CMotion, Bethesda, Md., USA). Analyses of Variance were used to analyze the data.

Results: Males with PFP ran and squatted in greater peak knee adduction and demonstrated greater peak knee external adduction moment compared with healthy male controls. In addition, males with PFP ran and squatted with less peak hip adduction and greater peak knee adduction compared with females with PFP. The static measure of mechanical axis of the tibial was not different between groups. However, a post-hoc analysis revealed that males with PFP ran with greater peak tibial segmental adduction.

Conclusion: Males with PFP demonstrated different mechanics during running and during a single leg squat compared with females with PFP and with healthy males. Based upon the results of this study, therapies for PFP may need to be sex-specific.
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Admin2 · Jul 28, 2012

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NewsBot · Jul 27, 2013

Knee and Hip Joint Biomechanics are Gender-specific in Runners with High Running Mileage
D. Gehring, G. Mornieux, J. Fleischmann, A. Gollhofer
Int J Sports Med DOI: 10.1055/s-0033-1343406

Female runners are reported to be more prone to develop specific knee joint injuries than males. It has been suggested that increased frontal plane joint loading might be related to the incidence of these knee injuries in running. The purpose of this study was to evaluate if frontal plane knee and hip joint kinematics and kinetics are gender-specific in runners with high mileage. 3D-kinematics and kinetics were recorded from 16 female and 16 male runners at a speed of 3 m/s, 4 m/s, and 5 m/s. Frontal plane joint angles and joint moments were ascertained and compared between genders among speed conditions. Across all speed conditions, females showed increased hip adduction and reduced knee adduction angles compared to males (p<0.003). The initial peak in the hip adduction moment was enhanced in females (p=0.003). Additionally, the hip adduction impulse showed a trend towards an increase in females at slow running speed (p=0.07). Hip and knee frontal plane joint kinematics are gender-specific. In addition, there are indications that frontal plane joint loading is increased in female runners. Future research should focus on the relationship of these observations regarding overuse running injuries.
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NewsBot · Aug 30, 2016

Sex differences in lower extremity kinematics and patellofemoral kinetics during running
Thomas G. Almonroeder & Lauren C. Benson
Journal of Sports Sciences

The incidence of patellofemoral pain (PFP) is 2 times greater in females compared with males of similar activity levels; however, the exact reason for this discrepancy remains unclear. Abnormal mechanics of the hip and knee in the sagittal, frontal, and transverse planes have been associated with an increased risk of PFP. The purpose of this study was to compare the mechanics of the lower extremity in males and females during running in order to better understand the reason(s) behind the sex discrepancy in PFP. Three-dimensional kinematic and kinetic data were collected as male and female participants completed overground running trials at a speed of 4.0 m ? s−1 (?5%). Patellofemoral joint stress (PFJS) was estimated using a sagittal plane knee model. The kinematics of the hip and knee in the frontal and transverse planes were also analysed. Male participants demonstrated significantly greater sagittal plane peak PFJS in comparison with the female participants (P < .001, ES = 1.9). However, the female participants demonstrated 3.5? greater peak hip adduction and 3.4? greater peak hip internal rotation (IR). As a result, it appears that the sex discrepancy in PFP is more likely to be related to differences in the kinematics of the hip in the frontal and transverse planes than differences in sagittal plane PFJS.
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NewsBot · Dec 16, 2018

Females with patellofemoral pain have impaired impact absorption during a single-legged drop vertical jump
Guilherme S.Nunes et al
Gait & Posture 10 December 2018

Highlights
•Females with PFP had impaired ability to absorb impact during jump landings.
•Females with PFP had reduced lower limb movement during jump landings.
•Impact was correlated with lower limb movement for asymptomatic females.
•Strategies to reduce impact during landings may be important for PFP rehabilitation.
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Background
Females with patellofemoral pain (PFP) have been reported to land with altered biomechanics in some, but not all studies. Kinematic alterations previously reported may indicate, and relate to potential impairments in absorbing impact.

Research question
To compare vertical ground reaction force (vGRF) and lower limb kinematics during single-legged drop vertical jumps in females with and without PFP; and establish the relationship between vGRF and kinematics during this task.

Methods
Fifty-two physically active females (26 with PFP and 26 controls) participated in the present cross-sectional study. Peak of vGRF was evaluated during landing; and lower limb kinematics in the sagittal and frontal planes during deceleration (landing) and acceleration (take-off) phases were evaluated.

Results
The PFP group had 11% greater vGRF (p < 0.01); and 13-24% lower hip, knee and ankle excursion in the sagittal plane during acceleration and deceleration phases (p ≤ 0.02) compared to the control group. No significant between group differences (p > 0.05) for hip, knee and ankle excursion in the frontal plane were identified. Greater impact was significantly correlated with reduced knee (r =–0.56), hip (r =–0.50) and ankle (r =–0.41) excursion in the sagittal plane during the acceleration phase in the control group, but not in the PFP group. No significant correlations were found between vGRF and kinematics variables during the deceleration phase in either group.

Significance
Impaired ability to absorb load and reduced lower limb movement in the sagittal plane during landing in females with PFP may provide separate treatment targets during rehabilitation.
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NewsBot · Aug 15, 2019

Electromyographic activity of knee vastii muscles during toe rise and heel rock tasks in women with patellofemoral pain syndrome in two phases of the menstrual cycle.
Samani M et al
PM R. 2019 Aug 13

BACKGROUND:
Changes in hormonal levels during the menstrual cycle are known to affect muscle electromyographic (EMG) activity, but no studies have investigated the effect of hormonal changes on the EMG activity of muscles around the knee in patients with patellofemoral pain syndrome (PFPS). The aim of this study was to evaluate the EMG activity of the vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles during toe rise and heel rock tasks in different phases of the menstrual cycle in women with PFPS.

METHOD:
Ten women with PFPS between 18 and 40 yr old participated in this study. The VL/VMO amplitude ratio and differences between onset (onset VL - onset VMO) of vastii muscle activity were measured in the affected limb during rise and rock tasks in the follicular and ovulatory phases of the menstrual cycle. The signals were analyzed with MATLAB software.

RESULTS:
During both tasks, there were no significant changes in onset differences in vastii muscles between the ovulatory and follicular phases. However, the amplitude ratio (VL/VMO) was significantly lower in the ovulatory phase compared to the follicular phase (P = 0.035 for rise tasks and 0.010 for rock tasks).

CONCLUSION:
The menstrual cycle may affect some EMG parameters.
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NewsBot · Sep 12, 2019

Gender differences in the spatial–temporal variability between walking and running
Mahta SardroodianMahdi Hosseinzadeh
Sport Sciences for Health: 04 September 2019

Purpose
The pattern of gender differences in gait variability has not yet been well examined. The aim of the present study was therefore to investigate gender differences in the spatial–temporal variability between walking and running.

Methods
Twenty healthy recreational active individuals (ten males/ten females) were instructed to walk for 5 min at a constant speed of 4.0 km/h and then run for 5 min at 8.4 km/h on a treadmill. Walking and running kinematic data were collected during the 5 min.

Results
CV of duration [F (1,18) = 7.61, p < 0.01], CV of rate [F (1,18) = 7.56, p < 0.01], and CV of stance [F (1,18) = 33.49, p < 0.001] were significantly greater during running comparing to walking in both genders. Furthermore, CV of swing was significantly greater through running compared to walking only in women p < 0.05.

Conclusion
This study elucidates greater variability during running in females than males. The greater variability through running in females comparing to males might make them more prone to lower limb injury. These results may be useful in understanding the underlying mechanism contributing to differences in injury risk in males and females.
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NewsBot · Feb 13, 2020

Patellofemoral Joint Stress during Running with Added Load in Females.
Kujawa M et al
Int J Sports Med. 2020 Feb 11

Patellofemoral joint (PFJ) pain syndrome is a commonly reported form of pain in female runners and military personnel. Increased PFJ stress may be a contributing factor. Few studies have examined PFJ stress running with added load. Our purpose was to analyze PFJ stress, PFJ reaction force, quadriceps force, knee flexion angle, and other kinematic and temporospatial variables running with and without a 9 kg load. Nineteen females ran across a force platform with no added load and 9.0 kg weight vest. Kinematic data were collected using 3D motion capture and kinetic data with a force platform. Muscle forces were estimated using a musculoskeletal model, and peak PFJ loading variables were calculated during stance. Multivariate analyses were run on PFJ loading variables and on cadence, step length and foot strike index. Differences were shown in PFJ stress, PFJ reaction force, peak knee flexion angle and quadriceps force. Joint specific kinetic variables increased between 5-16% with added load. PFJ loading variables increased with 9 kg of added load without changes in cadence, step length, or foot strike index compared to no load. Added load appears to increase the PFJ loading variables associated with PFJ pain in running.
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NewsBot · Oct 13, 2021

Effect of lumbopelvic control on landing mechanics and lower extremity muscles’ activities in female professional athletes: implications for injury prevention
Paria Fadaei Dehcheshmeh, Farzaneh Gandomi & Nicola Maffulli
BMC Sports Science, Medicine and Rehabilitation volume 13, Article number: 101 (2021)

Background
Lumbopelvic control (LPC) has recently been associated with function, kinesiology, and load distribution on the limb. However, poor LPC has not been studied as a risk factor for lower limb injury in sports requiring frequent jump landings. The present study investigated the effects of LPC on landing mechanics and lower limb muscle activity in professional athletes engaged in sport requiring frequent landing.

Methods
This study was conducted on 34 professional female athletes aged 18.29 ± 3.29 years with the height and body mass of 173.5 ± 7.23 cm and 66.79 ± 13.37 kg, respectively. The landing error scoring system (LESS) and ImageJ software were used to assess landing mechanics. Wireless electromyography was also used to record the activity of the gluteus medius (GMed), rectus femoris, and semitendinosus. Lumbopelvic control was evaluated using the knee lift abdominal test, bent knee fall-out, active straight leg raising, and the PRONE test using a pressure biofeedback unit. Based on the LPC tests results, the participants were divided into two groups of proper LPC (n = 17) and poor LPC (n = 17).

Results
There were significant differences between the groups with proper and poor LPC in terms of the LESS test scores (P = 0.0001), lateral trunk flexion (P = 0.0001), knee abduction (P = 0.0001), knee flexion (P = 0.001), trunk flexion (P = 0.01), and GMed muscle activity (P = 0.03). There were no significant differences in the activity of the rectus femoris and semitendinosus muscles, and ankle dorsiflexion (P > 0.05).

Conclusions
Poor lumbopelvic control affects the kinematics and activity of the lower limb muscles, and may be a risk factor for lower limb injuries, especially of the knee.
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