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The majority of anterior cruciate ligament (ACL) injuries in team sports are non-contact injuries, with cutting maneuvers identified as high-risk tasks. Young female handball players have been shown to be at greater risk for ACL injuries than males. One risk factor for ACL injuries is the magnitude of the knee abduction moment (KAM). Cutting technique variables on foot placement, overall approach and knee kinematics have been shown to influence the KAM. Since injury risk is believed to increase with increasing task complexity, the purpose of the study was to test the effect of task complexity on technique variables that influence the KAM in female handball players during fake-and-cut tasks.
Landing heel first has been associated with elevated external knee abduction moments (KAM), thereby potentially increasing the risk of sustaining a non-contact ACL injury. Apart from the foot strike angle, knee valgus angle (VAL) and vertical center of mass velocity at initial ground contact (IC) have been associated with increased KAM in females across different sidestep cuts. While real-time biofeedback training has been proven effective for gait retraining [4], the highly dynamic, non-cyclical nature of cutting maneuvers makes real-time feedback unsuitable and alternative approaches necessary. This study aimed at assessing the efficacy of immediate software-aided feedback on cutting technique in reducing KAM during handball-specific cutting maneuvers.
The purpose of this study was to 1) compare knee joint kinematics and kinetics of fake-and-cut tasks of varying complexity in 51 female handball players and 2) present a case study of one athlete who ruptured her ACL three weeks post data collection. External knee joint moments and knee joint angles in all planes at the instance of the peak external knee abduction moment (KAM) as well as moment and angle time curves were analyzed. Peak KAMs and knee internal rotation moments were substantially higher than published values obtained during simple change-of-direction tasks and, along with flexion angles, differed significantly between the tasks. Introducing a ball reception and a static defender increased joint loads while they partially decreased again when anticipation was lacking. Our results suggest to use game-specific assessments of injury risk while complexity levels do not directly increase knee loading. Extreme values of several risk factors for a post-test injured athlete highlight the need and usefulness of appropriate screenings.
This study aimed to compare a simplified calculation of the knee abduction moment with the traditional inverse dynamics calculation when athletes perform fake-cut maneuvers with different complexities. In the simplified calculation, we multiply the force vector with its lever arm to the knee, projected onto the local coordinate system of the proximal thigh, hence neglecting the inertial contributions from distal segments. We found very strong ranking consistency using Spearman’s rank correlation coefficient when using the simplified method compared to the traditional calculation. Independent of the tasks, the simplified method resulted in higher moments than the inverse dynamics. This was caused by ignoring the moment caused by segment linear acceleration generating a counteracting moment by about 7%. An alternative to the complex calculations of inverse dynamics can be used to investigate the contributions of the GRF magnitude and its lever arm to the knee.
Injury prevention is essential in running due to the risk of overuse injury development. Tailoring running shoes to individual needs may be a promising strategy to reduce this risk. Novel manufacturing processes allow the production of individualised running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualise footwear to reduce injury risk are poorly understood. Therefore, this scoping review provides an overview of (1) footwear design features that have the potential for individualisation; and (2) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing the risk of overuse injuries. We included studies in the English language on adults that analysed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, sex) for running-related biomechanical risk factors or injury incidences; (2) footwear comfort perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analysed male runners. Female runners may be more susceptible to footwear-induced changes and overuse injury development; future research should target more heterogonous sampling. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualisation. However, the literature addressing individualised footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualisation.
Running shoes were categorized either as motion control, cushioned, or minimal footwear in the past. Today, these categories blur and are not as clearly defined. Moreover, with the advances in manufacturing processes, it is possible to create individualized running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualize footwear to reduce individual injury risk are poorly understood. Therefore, the purpose of this scoping review was to provide an overview of (1) footwear design features that have the potential for individualization; (2) human biomechanical variability as a theoretical foundation for individualization; (3) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing running-related risk factors for overuse injuries. We included studies in the English language on adults that analyzed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, gender) for running-related biomechanical risk factors or injury incidences; (2) footwear perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analyzed male runners. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualization. However, the overall body of literature addressing individualized footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualization.
Running footwear is continuously being modified and improved; however, running-related overuse injury rates remain high. Nevertheless, novel manufacturing processes enable the production of individualized running shoes that can fit the individual needs of runners, with the potential to reduce injury risk. For this reason, it is essential to investigate functional groups of runners, a collective of runners who respond similarly to a footwear intervention. Therefore, the objective of this study was to develop a framework to identify functional groups based on their individual footwear response regarding injury-specific running-related risk factors for Achilles tendinopathy, Tibial stress fractures, Medial tibial stress syndrome, and Patellofemoral pain syndrome. In this work, we quantified the footwear response patterns of 73 female and male participants when running in three different footwear conditions using unsupervised learning (k-means clustering). For each functional group, we identified the footwear conditions minimizing the injury-specific risk factors. We described differences in the functional groups regarding their running style, anthropometric, footwear perception, and demographics. The results implied that most functional groups showed a tendency for a single footwear condition to reduce most biomechanical risk factors for a specific overuse injury. Functional groups often differed in their hip and pelvis kinematics as well as their subjective rating of the footwear conditions. The footwear intervention only partially affected biomechanical risk factors attributed to more proximal joints. Due to its adaptive nature, the framework could be applied to other footwear interventions or performance-related biomechanical variables.