Hip Abductor Weakness and Lower Extremity Kinematics During Running

NewsBot · Jul 18, 2008

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Hip Abductor Weakness and Lower Extremity Kinematics During Running
Becky Heinert, Thomas W. Kernozek, John Greany, Dennis C.W. Fater
JSR, 17(3), August 2008,

Objective: To determine if females with hip abductor weakness are more likely to demonstrate greater knee abduction during the stance phase of running than a strong hip abductor group.

Study Design: Observational prospective study design.

Setting: University biomechanics laboratory. Participants: 15 females with weak hip abductors and 15 females with strong hip abductors.

Main Outcome Measures: Group differences in lower extremity kinematics were analyzed using repeated measures ANOVA with one between factor of group and one within factor of position with a significance value of P < .05.

Results: The subjects with weak hip abductors demonstrated greater knee abduction during the stance phase of treadmill running than the strong group (P < .05). No other significant differences were found in the sagittal or frontal plane measurements of the hip, knee, or pelvis.

Conclusions: Hip abductor weakness may influence knee abduction during the stance phase of running.
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ericajones80 · Jul 18, 2008

so its better for your knees to have weak hips? Am i reading that right?

Admin2 · Jul 19, 2008

Related threads:
Hip musculature and position and its effect on foot pronation
Gait re-training in runners
Patellofemoral pain and asymmetrical hip rotation

Stanley · Jul 19, 2008

ericajones80 said: ↑

so its better for your knees to have weak hips? Am i reading that right?
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Erica,

The point that we don't understand is the definition of knee abduction.:confused: I take it to mean that the distal part of the knee is abducted (genu valgum). This is a position with a greater Q angle, and hence more prone to patella femoral dysfunction.
What do you think?

Regards,

Stanley

NewsBot · Jul 19, 2008

Here are a couple of recent papers on this:
Hip strength in collegiate female athletes with patellofemoral pain.
Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE.
Med Sci Sports Exerc. 2007 Aug;39(8):1227-32.

PURPOSE: Decreased hip strength has been theorized to contribute to the development of patellofemoral pain. The purpose of this study was to test for strength differences of six hip muscle groups in collegiate female athletes diagnosed with unilateral patellofemoral pain compared with the unaffected leg and noninjured sport-matched controls.

METHODS: At four Division III schools, all collegiate female athletes experiencing unilateral patellofemoral pain were recruited during the 2004-2005 academic school year. The athletes were diagnosed with patellofemoral pain by sports medicine-trained family physicians or orthopedic surgeons. Hip strength of six different muscle groups was tested using a handheld dynamometer. The highest value of two trials was used, and strength values were normalized to body weight. The measurements from the injured leg were compared with the uninvolved leg and also with uninjured control subjects matched for sport.

RESULTS: Thirteen athletes were diagnosed with unilateral patellofemoral pain. The injured-side hip abductor (P = 0.003) and external rotator muscle groups (P = 0.049) were significantly weaker than the noninjured sides. There were no significant differences in the other hip muscles tested. In addition, the injured legs were significantly weaker in five of the six hip muscle groups compared with the control group.

CONCLUSIONS: The results of this study show that hip abductors and external rotators were significantly weaker between the injured and unaffected legs of the injured athletes. In addition, injured collegiate female athletes exhibited global hip weakness compared with age- and sport-matched asymptomatic controls. Screening for hip muscle weakness and adding strengthening exercises to the affected hip muscles may be important factors in managing female athletes with patellofemoral pain.
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Hip Muscle Weakness and Overuse Injuries in Recreational Runners.
Niemuth, Paul E.; Johnson, Robert J.; Myers, Marcella J; Thieman, Thomas J
Clinical Journal of Sport Medicine. 15(1):14-21, January 2005.

Objective: To test for differences in strength of 6 muscle groups of the hip on the involved leg in recreational runners with injuries compared with the uninvolved leg and a control group of noninjured runners.

Design: Descriptive analysis.

Setting: Three outpatient physical therapy clinics in the Minneapolis/St. Paul metropolitan area.

Participants: Thirty recreational runners (17 female, 13 male) experiencing a single leg overuse injury that presented for treatment between June and September 2002. Thirty noninjured runners (16 female, 14 male) randomly selected from a pool of 46 volunteers from a distance running club served as controls.

Main Outcome Measures: Self-report demographic information on running habits, leg dominance demonstrated by preferred kicking leg, and injury information. Muscle strength of the 6 major muscle groups of the hip was recorded using a hand-held dynamometer. The highest value of 2 trials was used, and strength values were normalized to body mass2/3.

Results: Results comparing the injured and noninjured groups showed that leg dominance did not influence the leg of injury ([chi]2(1) = 0.134; P = 0.71). Correlations for internal reliability of muscle measurements between trials 1 and 2 with the hand-held dynamometer ranged from 0.80 to 0.90 for the 6 muscle groups measured, and all P values were less than 0.0001. No significant side-to-side differences in hip group muscle strength were found in the noninjured runners (P = 0.62-0.93). Among the injured runners, the injured side hip abductor (P = 0.0003) and flexor muscle groups (P = 0.026) were significantly weaker than the noninjured side. In addition, the injured side hip adductor muscle group was significantly stronger (P = 0.010) than the noninjured side. Duration of symptoms was not a contributing factor to the extent of injury as measured by muscle strength imbalance between injured and uninjured sides.

Conclusions: Although no cause-and-effect relationship has been established, this is the first study to show an association between hip abductor, adductor, and flexor muscle group strength imbalance and lower extremity overuse injuries in runners. Because most running injuries are multifaceted in nature, areas secondary to the site of pain, such as hip muscle groups exhibiting strength imbalances, must also be considered to gain favorable outcomes for injured runners. The addition of strengthening exercises to specifically identified weak hip muscles may offer better treatment results in patients with running injuries.
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Stanley · Jul 21, 2008

NewsBot said: ↑

Here are a couple of recent papers on this:
Hip strength in collegiate female athletes with patellofemoral pain.
Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE.
Med Sci Sports Exerc. 2007 Aug;39(8):1227-32.

Hip Muscle Weakness and Overuse Injuries in Recreational Runners.
Niemuth, Paul E.; Johnson, Robert J.; Myers, Marcella J; Thieman, Thomas J
Clinical Journal of Sport Medicine. 15(1):14-21, January 2005.
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30 years ago, the MD's said Quadricep weakness (especially the Vastus Medialis Obliquus) was the cause of Patella Femoral pain. The PT's said it was the ratio of Quadricep strength to Hamstring strength.

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