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Clinical Mechanics and Kinesiology
by Janice K. Loudon, Robert C. Manske and Michael P. Reiman
456 Pages
Clinical Mechanics and Kinesiology provides a solid foundation so that students of physical therapy, occupational therapy, and athletic training can understand biomechanics and functional anatomy as they relate to both normal and abnormal movement. Written by active clinicians with more than 40 combined years of clinical and teaching experience, this text is also a practical reference for rehabilitation professionals working with a range of populations and pathologies.
Taking a clinical approach not found in other texts, Clinical Mechanics and Kinesiology follows a logical progression that maximizes learning. It first presents biomechanical principles that students must understand in order to examine and treat clients and patients undergoing rehabilitation. Next, it explores muscle and nerve physiology and function of the muscle and joint systems. Then the focus shifts to applying those concepts to specific joints. Divided into 10 regions, each joint is evaluated by the bones that make up the joints; the joint articulation, anatomy, and function; and the muscles that act on the joints. In the final section of the text, students gain insight into full-body movement patterns of particular concern to rehabilitation specialists. They will examine not only the usual topics of posture and walking gait but also running gait and the mechanics of jumping and cutting—some of the most common sources of injury.
Clinical Mechanics and Kinesiology is enhanced with over 360 pieces of full-color art. Unique combination figures integrate detailed bone illustrations and photos. Medical art displays locations of bones, muscles, and ligaments. Arthrokinematic motions are clearly shown with the appropriate skeletal locations, making it easy for students to see how a particular motion relates to the rest of the body. Several other features also aid in students’ learning and retention:
• Clinical Correlations included in each chapter help students increase their understanding of biomechanics and kinesiology and apply the theoretical content to clinical practice.
• Problem Sets and Practice It sidebars with activities in chapters 1 and 2 assist students in applying and mastering biomechanical concepts.
• Pedagogical aids such as chapter objectives and conclusions, key points, glossary terms, and review questions highlight important information so students can quickly grasp and review the main points.
In addition, instructors will have online access to an instructor guide, image bank, and test package. The instructor guide further encourages students’ learning by offering class assignments and lab activities not featured in the book. The class assignments, at least three per chapter, are quick activities that can be completed in class. The lab activities are longer assignments intended to be completed outside the classroom by pairs of students. Each lab contains an overview, a statement of purpose, a list of equipment needed, and instruction on data collection and analysis.
Written for students and practitioners of rehabilitation programs, Clinical Mechanics and Kinesiology provides a foundation in kinesiology reinforced by numerous clinically applicable examples. Students will gain a strong understanding of mechanical principles governing human motion, with particular knowledge of both normal and abnormal functional motions, and be able to apply their knowledge directly to rehabilitation protocols.
Part I: Basic Biomechanics
Chapter 1. Kinematics
Movement Mechanics
Joint Motion
Kinematic Analyses
Conclusion
Review Questions
Chapter 2. Kinetics
Basic Kinetic Terms
Forces
Levers
Moments
Vector Analysis
Force Diagrams
Clinical Application of Kinetics
Conclusion
Review Questions
Part II: Basic Muscle and Joint Physiology and Function
Chapter 3. Muscle and Nerve Physiology
Muscle Structure
Motor Unit
Muscle Fiber Types
Muscle Contraction
Nervous System
Neuromuscular Control
Conclusion
Review Questions
Chapter 4. Muscle Performance and Function
Skeletal Muscle Properties
Muscle Contractions
Muscle Functions
Muscle Flexibility and Range of Motion
Muscle Performance
Factors Affecting Muscle Performance
Clinical Measures of Muscle Performance
Effects of Injury, Immobilization, and Aging on Muscle Performance
Conclusion
Review Questions
Chapter 5. Human Joint Structure and Function
Joints
Periarticular Tissues
Joint Positions and Movements
Conclusion
Review Questions
Part III: Regional Anatomy and Kinesiology
Chapter 6. Cervical Spine
Vertebral Column
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 7. Craniomandibular Complex
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 8. Thoracic Spine
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 9. Lumbar Spine and Pelvic Girdle
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 10. Shoulder
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 11. Elbow and Forearm
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 12. Wrist and Hand
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 13. Hip
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 14. Knee
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Chapter 15. Foot and Ankle
Osteology
Joint Articulations
Joint Anatomy
Joint Function
Muscles
Conclusion
Review Questions
Part IV: Basic Movements and Clinical Applications
Chapter 16. Posture
Body Types
Standing Posture
Sitting and Lying Postures
Postural Faults
Conclusion
Review Questions
Chapter 17. Walking Gait
Determinants of Gait
Gait Sequence
Gait Kinematics
Muscle Activity During Gait
Gait Kinetics
Gait Parameters
Abnormal Gait
Conclusion
Review Questions
Chapter 18. Running Gait
Running Compared With Walking
Running Sequence
Running Kinematics
Muscle Activity During Running
Running Kinetics
Running Injuries
Conclusion
Review Questions
Chapter 19. Cutting and Jumping
Cutting
Jumping
Conclusion
Review Questions
Janice K. Loudon, PT, PhD, ATC, is an associate professor in the doctor of physical therapy division in the department of community and family medicine at Duke University in Durham, North Carolina. She has more than 25 years of experience in clinical sports medicine and has worked as a physical therapy instructor for over 20 years. Previously, she was an associate professor and director of the doctorate of physical therapy (DPT) program at the University of Kansas Medical Center in Kansas City. In 2007, Loudon was named an Outstanding Physical Therapy Faculty by the department of physical therapy education at the University of Kansas Medical Center.
Loudon has published more than 25 articles in referred journals, written 4 book chapters, and coauthored two editions of The Clinical Orthopedic Assessment Guide (Human Kinetics, 1998, 2008). She is a frequent invited presenter at national, state, and local conferences and is a member of the American Physical Therapy Association. She resides in Durham, North Carolina. In her spare time she enjoys tennis, cycling, and gardening.
Robert C. Manske, PT, DPT, MEd, SCS, ATC, CSCS, is an associate professor of physical therapy at Wichita State University. He earned a doctoral degree in physical therapy in 2006 from the MGH Institute of Health Professions. Manske was also a sport physical therapy fellow training under the guidance of George J. Davies in one of the first sport physical therapy residency programs. As a practicing physical therapist, Manske has over 18 years of clinical experience in orthopedic rehabilitation and actively researches knee and shoulder rehabilitation and sport performance enhancement.
Manske has published more than 30 articles in peer-reviewed journals, edited 3 home study courses, coauthored 12 home study course chapters, coauthored 30 book chapters, and authored or coauthored 5 books, all related to orthopedic or sport rehabilitation. He is a board-certified sport physical therapist, certified athletic trainer, and certified strength and conditioning specialist. He is also a member of the National Athletic Trainers' Association and the American Physical Therapy Association, where he serves as vice president of the Sports Section. Manske presents multiple weekend courses on various topics concerning the shoulder and knee and remains active in clinical practice.
He also serves as an associate editor for the International Journal of Sports Physical Therapy. He is a reviewer for several journals, including American Journal of Sports Medicine, Journal of Sport Rehabilitation, Journal of Orthopaedic and Sports Physical Therapy, Physical Therapy in Sports, Sports Health, Athletic Training and Sports Health Care, and Physiotherapy Theory and Practice.
In 2007, Manske received the Sports Section Excellence in Education Award from the American Physical Therapy Association. He also received the Kansas Physical Therapy Educator award from the Kansas Physical Therapy Association (2003) and the Rodenberg Teaching Award from the College of Health Professions at Wichita State University (2004).
Manske and his wife, Julie, live in Wichita. He enjoys spending time with his family, exercising, and watching collegiate and professional sports.
Michael P. Reiman, PT, DPT, MEd, OCS, SCS, ATC, FAAOMPT, CSCS, is an associate professor in the division of doctorate of physiccal therapy in the department of community and family practice at Duke University Medical Center in Durham, North Carolina. He also serves as an adjunct assistant professor in the department of physical therapy at Wichita State University and clinical faculty in the Duke University Medical Center manual therapy fellowship program.Reiman has published more than 30 articles in peer-reviewed journals as well as 9 book chapters and 3 home study courses. He coauthored one text, Functional Testing in Human Performance (Human Kinetics, April 2009), with Robert C. Manske. He has given numerous presentations at national, regional, and local conferences.
Reiman is a member of the American Physical Therapy Association, American Academy of Orthopedic and Manual Physical Therapy, Kansas Physical Therapy Association, National Athletic Trainers’ Association, National Strength and Conditioning Association, and Alpha Eta Society. He serves as an associate editor for the Journal of Physical Therapy and is a member of the editorial boards for the International Journal of Sports Physical Therapy and the Journal of Sport Rehabilitation. He is a reviewer for several journals, including British Journal of Sports Medicine, Journal of Sport Science and Medicine, Physiotherapy Theory and Practice, Journal of Sport Rehabilitation, Journal of Manual and Manipulative Therapy, Journal of Orthopaedic and Sports Physical Therapy, Clinical Anatomy, and Journal of Athletic Training.
Reiman is a level 1 track and field coach and a level 1 Olympic weightlifting club coach. He also works as a strength and conditioning specialist for women’s volleyball at Friends University in Wichita, Kansas, and for the men’s and women’s volleyball teams at Newman University in Wichita.
Reiman resides in Hillsborough, North Carolina, where he enjoys spending time with his family, hiking in the surrounding hills, and wakeboarding with his children.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
Learn more about Clinical Mechanics and Kinesiology.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
Learn more about Clinical Mechanics and Kinesiology.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
Learn more about Clinical Mechanics and Kinesiology.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
Learn more about Clinical Mechanics and Kinesiology.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
Learn more about Clinical Mechanics and Kinesiology.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
Learn more about Clinical Mechanics and Kinesiology.
Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
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Understand the impact of cutting on athletic performance
The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side.
Cutting
Many have heard of the plant-and-cut maneuver, or “faking out” an opponent, during athletic events. The player acts as if she is going to the right but quickly and aggressively plants the right foot and immediately reverses her motion and accelerates to the opposite left side. This occurs in soccer, football, and basketball to get by or away from a defender. Unfortunately, a quick direction change such as this is cited as an injury mechanism for noncontact ACL ruptures (Boden et al. 2000; McNair et al. 1990). Movements such as cutting, rotating, and pivoting occur as often as 70% of the time during the active portion of basketball games (Stacoff et al. 1996). It is during these types of motions that anatomically the leg (knee) can fall into a valgus collapse. The closed-chain theory suggests that excessive knee valgus occurs when the leg (thigh) falls into adduction and internal rotation, while the knee (tibia) moves into a position of abduction as the ankle and foot move into eversion during weight-bearing motions.
It is very possible and highly probable that this position is brought about by faulty neuromuscular function, aberrant postural adjustments, or reflex responses (Ford et al. 2005). Neuromuscular control of the lower extremity affects not only the knee but also the entire kinematic chain (the foot, ankle, knee, hip, and trunk). This makes females especially vulnerable because they display patterns of ligament dominance. Ligament dominance theory is a concept initially developed by Andrews and Axe (1985) to describe their analysis of knee ligament instability. Hewett (Hewett et al. 2002) has expanded its use to describe how during sporting activities, an athlete will allow the knee ligaments, rather than the lower extremity musculature, to absorb a significant portion of the ground reaction forces. Muscular dominance theory provides a better option for most athletes because ground reaction forces are absorbed by eccentric control from the lower extremity muscles. The ligament-dominant motor control pattern is seen during cutting or landing when a female athlete allows the ground reaction force to control the direction of motion of the lower extremity. As the ligament accepts an unusually high load of force, the athlete collapses into the position of excessive dynamic valgus, or valgus collapse described earlier.
This collapse has been seen by Malinzak and colleagues (2001) as greater knee valgus angles not only during running but also during sidestep cuts and crossover cuts in female athletes. Females have also been found to have less knee flexion during the stance phase of a sidestep maneuver when compared with males (Malinzak et al. 2001). McLean et al. (1999) found no difference in knee valgus during running but did in regard to increased maximum knee valgus angles during sidestep cuts when compared with male counterparts. Ford and colleagues (2005) assessed unanticipated cutting patterns and found that female athletes had significantly greater knee abduction angles when readying themselves to execute a cutting maneuver when compared with males. This faulty motor pattern could result in injury, as described in Clinical Correlation 19.1. Ford reports that these gender differences in knee abduction angle during dynamic cutting movements, and even when adapting the ready position, suggest that women employ an altered muscular control of the lower extremity in contraction patterns (motor control) of the knee and hip abductors and adductors (Ford et al. 2005). In the ready position the trunk, knees, and hips are slightly flexed so that the stance is widened and the base of support is lowered.
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