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Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk

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A special issue of Sports (ISSN 2075-4663).

Deadline for manuscript submissions: 31 July 2024 | Viewed by 16068

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Dr. Jesper Augustsson

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Department of Sport Science, Linnaeus University, 39182 Kalmar, Sweden
Interests: sports medicine; strength training; hamstring injury; ACL injury

Special Issue Information

Dear Colleagues,

Lower extremity biomechanics and injury risk in athletes have been an important topic of research in sports science for many years. Recent advances in technology have allowed for a more detailed understanding of lower extremity movement patterns during sports activities, which has led to a better understanding of injury mechanisms and the development of injury prevention strategies.

One of the most important advances in this field has been the use of motion capture systems to analyze lower extremity biomechanics during dynamic movements such as running, jumping, and cutting. These systems allow researchers to collect detailed information on joint angles, forces, and movements, which can be used to identify movement patterns that are associated with increased injury risk.

Overall, the range of motion capture systems available for lower extremity biomechanics research is quite diverse, with options ranging from simple mobile phone 2D scans, which are easy to perform in any setting, to sophisticated and expensive multi-camera setups for laboratory settings. The choice of system will depend on a variety of factors, including the research question, available resources, and the level of detail and accuracy required for the analysis.

Strength training research focused on lower extremity biomechanics during, for example, the deadlift, barbell squat and the Nordic hamstring exercise has also contributed to our understanding of injury risk and injury prevention in athletes. These exercises are commonly used in strength and conditioning programs to improve lower extremity strength and power and can be an effective way to reduce injury risk when performed correctly.

Despite these advances, however, there are still gaps in our knowledge on how to effectively prevent lower extremity injuries in athletes.

Therefore, in this Special Issue, we welcome papers ranging from studies on practical applications to advanced biomechanical analyses that may lead to a better understanding of injury mechanisms and the development of injury prevention strategies.

Dr. Jesper Augustsson
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Sports is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

lower extremity biomechanics
injury risk
motion capture
strength training
neuromuscular training
injury prevention

Published Papers (6 papers)

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Research

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22 pages, 2308 KiB

Open AccessEditor’s ChoiceArticle

Short-Term Effects of Lower-Extremity Heavy Resistance versus High-Impact Plyometric Training on Neuromuscular Functional Performance of Professional Soccer Players

by Michał Boraczyński, José Magalhães, Jacek J. Nowakowski and James J. Laskin

Sports 2023, 11(10), 193; https://doi.org/10.3390/sports11100193 - 04 Oct 2023

Cited by 1 | Viewed by 2470

Abstract

Background: To compare the effects of short-term 8 week heavy-resistance or plyometric training protocols (HRT or PLY) incorporated into regular soccer practice on measures of neuromuscular functional performance in professional soccer players, a single-blind randomized controlled trial was conducted. Methods: Forty-seven participants aged 22.3 ± 3.52 years were assigned to three groups: HRT (n = 15), PLY (n = 15), and control (CON; n = 17). The HRT group performed 3 sets and 10 repetitions twice a week using 80% of their baseline 1-RM (weeks 1–3), followed by 8 repetitions at 85% 1-RM (weeks 4–6), and 6 repetitions at 90% 1-RM (weeks 7–8) of 6 lower-body strength exercises with a 1 min rest period between sets. The PLY protocol involved a preparatory phase (weeks 1–2), followed by two 3-week progressive periods (weeks 3–5 and weeks 6–8). The plyometric sessions consisted of four jump exercises/drills with progressively increasing number of sets and total number of foot contacts. The rest intervals between repetitions and sets were 15 and 90 s, respectively. Outcome measures included tests assessing 10 and 30 m speed (t10m and t30m), one-repetition maximum half-back squat (1-RM squat), isokinetic peak torques for the quadriceps and hamstring muscles (Qcon and Hcon), countermovement jump (CMJ), and squat jump (SJ). Results: Two-way ANOVA detected main effects of time and group×time interactions for all examined variables, except t30m, 1-RM, and relative 1-RM. Post hoc analyses revealed significant increases in the HRT group (t10m: 6.3%, t30m: 7.1%; absolute 1-RM: 29.6%; relative 1-RM: 30.3%, Qcon: 24.5%; Hcon: 14.4%; CMJ: 5.9%; SJ: 7.2%, all p < 0.001) and the PLY group (t10m: 3.1%; t30m: 4.1%; absolute 1-RM:19.1%; relative 1-RM: 20.3%; Qcon: 12.6%; Hcon: 8.7%; CMJ: 3.3%; SJ: 3.5%, all p < 0.001). HRT was superior compared to PLY in relative 1-RM, Qcon and Hcon (all p < 0.001). In addition, we found knee muscular strength imbalance in 70.5% of participants from the total sample (H/Q ratio < 60%). The HRT and PLY protocols resulted in improved neuromuscular functional performance compared to the regular soccer regime. Conclusions: This study showed that during the pre-competitive season, additional HRT and PLY drills/exercises as a substitute for standard soccer training as part of a regular 90 min practice twice a week for 8 weeks, can produce acute physical performance-enhancing effects in professional soccer players. Full article

(This article belongs to the Special Issue Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk)

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12 pages, 533 KiB

Open AccessArticle

Neuromuscular Response during Different Side-Cutting Maneuvers and Its Influence on the Risk of Knee Injuries

by Adrián Feria-Madueño, Timothy E. Hewett, Alejandro Sánchez-Arteaga and Borja Sañudo

Sports 2023, 11(10), 190; https://doi.org/10.3390/sports11100190 - 03 Oct 2023

Viewed by 1696

Abstract

Background: The objective of this study was to investigate the impact of a customized exercise program on electromyographic (EMG) variables during side-cutting maneuvers. Methods: Fifty-seven physically active volunteers were recruited and randomized into two groups: a control group (CG) and an experimental group (EG). The CG maintained their regular physical activity, while the EG followed an individualized, integrated exercise regimen that included strength, neuromuscular, proprioceptive, eccentric training, and whole-body vibration (WBV) exercises, lasting for 12 weeks. EMG-Root Means Square (RMS) values for the quadriceps (Q) and hamstrings (H) were measured immediately following initial foot contact at 50, 100, 150, and 200 milliseconds. Changes in EMG activity were evaluated before and after a twelve-week intervention, and the effect size (ES, 90% confidence limit [90%CL]) was calculated. Results: The results showed that the EG participants exhibited enhanced co-contraction as measured by the hamstring/quadriceps ratio (H/Q ratio) during both open and cross-cutting side maneuvers after the twelve-week intervention. Conclusion: Furthermore, the customized, integrated exercise program that combined strength, neuromuscular, proprioceptive, eccentric training, and WBV exercises were could potentially serve as a beneficial neuromuscular and biomechanical strategy for addressing knee injury risk in non-professional, physically active populations at high risk for such injuries. Full article

(This article belongs to the Special Issue Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk)

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24 pages, 2404 KiB

Open AccessArticle

Development of a Cutting Technique Modification Training Program and Evaluation of its Effects on Movement Quality and Cutting Performance in Male Adolescent American Football Players

by Lutz Thieschäfer, Julius Klütz, Julian Weig, Thomas Dos’Santos and Dirk Büsch

Sports 2023, 11(9), 184; https://doi.org/10.3390/sports11090184 - 17 Sep 2023

Cited by 1 | Viewed by 2395

Abstract

This study developed a cutting technique modification training program and investigated its effects on cutting performance and movement quality in adolescent American football players. For six weeks, an intervention group (IG) of 11 players participated in 25 min cutting technique modification training sessions integrated into team training twice a week, while a control group (CG) of 11 players continued their usual team training. Movement quality was assessed by evaluating 2D high-speed videos, obtained during preplanned 45° and 90° cutting tests, using the Cutting Movement Assessment Score (CMAS) qualitative screening tool. Cutting performance was assessed based on change of direction deficit (CODD). Significant interaction effects of time × group were found for CMAS in 45° and 90° cuttings (p < 0.001, η_p² = 0.76, p < 0.001, η_p² = 0.64, respectively), with large improvements in the IG (p < 0.001, g = −2.16, p < 0.001, g = −1.78, respectively) and deteriorations in the CG for 45° cuttings (p = 0.002, g = 1.15). However, no statistically significant differences in CODD were observed pre-to-post intervention. The cutting technique modification training was effective at improving movement quality without impairing cutting performance, and it can be used by practitioners working with adolescent athletes. Full article

(This article belongs to the Special Issue Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk)

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10 pages, 924 KiB

Open AccessArticle

Cryo plus Ultrasound Therapy, a Novel Rehabilitative Approach for Football Players with Acute Lateral Ankle Injury Sprain: A Pilot Randomized Controlled Trial

by Antonio Ammendolia, Alessandro de Sire, Lorenzo Lippi, Valerio Ammendolia, Riccardo Spanò, Andrea Reggiani, Marco Invernizzi and Nicola Marotta

Sports 2023, 11(9), 180; https://doi.org/10.3390/sports11090180 - 09 Sep 2023

Cited by 1 | Viewed by 2890

Abstract

Background: Acute lateral ankle sprains are common injuries among athletes, but the optimal treatment strategies in elite athletes are still debated. This proof-of-concept study aimed to assess the impact of cryo-ultrasound therapy on the short-term recovery of football players with acute lateral ankle sprains. Methods: Semi-professional football players with grade I or II lateral ankle sprains were randomly assigned to the experimental group (receiving cryo-ultrasound therapy combined with conventional physical therapy) or control group (sham cryo-ultrasound therapy combined with conventional physical therapy). Pain intensity and physical functioning were assessed by the Numeric Rating Scale (NRS) and Foot and Ankle Disability Index (FADI) at baseline (T0) at the end of treatment (T1), after one month (T2), and two months after treatment (T3). Results: After the study intervention, significant between groups differences were reported in terms of pain relief (NRS: 4.08 ± 1.29 vs. 5.87 ± 1.19; p = 0.003) and physical function (FADI: 50.9 ± 10.3 vs. 38.3 ± 11.5; p = 0.021). However, no significant between group differences were reported at T2 and T3. No adverse effects were reported. Conclusions: Cryo-ultrasound therapy combined with conventional physical therapy can accelerate recovery and early return to sport in elite football players with acute lateral ankle sprains. While this study contributes valuable insights into the potential benefits of cryo-ultrasound therapy, further investigations with a longer follow-up are needed to validate and optimize the application of physical agent modalities in the management of ankle injuries. Full article

(This article belongs to the Special Issue Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk)

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12 pages, 2150 KiB

Open AccessArticle

Speed Matters in Nordic Hamstring Exercise: Higher Peak Knee Flexor Force during Fast Stretch-Shortening Variant Compared to Standard Slow Eccentric Execution in Elite Athletes

by Jesper Augustsson, Tobias Alt and Håkan Andersson

Sports 2023, 11(7), 130; https://doi.org/10.3390/sports11070130 - 07 Jul 2023

Cited by 1 | Viewed by 4134

Abstract

Hamstring strain injuries are prevalent in many sports. Research has demonstrated that the Nordic hamstring exercise (NHE), a knee-dominant exercise addressing the posterior chain muscles, can aid in reducing the risk of hamstring injuries in athletes. However, most research on hamstring injury prevention has focused on performing the eccentric version of the NHE (NHE_ECC). In contrast, in sports, it is quite frequent for athletes to use an eccentric–concentric version of the NHE. Additionally, eccentric NHE is typically performed using a slow, controlled tempo. The effect of a fast stretch-shortening cycle NHE (NHE_SSC) compared to standard slow NHE_ECC on peak knee flexor force has not been investigated. The aim of the study was therefore to investigate fast NHE_SSC vs. standard slow NHE_ECC. Our hypothesis posited that peak knee flexor force would be greater for fast NHE_SSC compared with standard slow NHE_ECC. The study involved 22 elite athletes (actively competing in both national and international events) consisting of female (n = 10) and male (n = 7) track and field athletes and male football players (n = 5), aged 17–31 years. The participants performed maximum trials of slow NHE_ECC and fast NHE_SSC repetitions in which measurement of bilateral peak knee flexor force was conducted at the ankle with the use of a load cell. During the NHEs, a linear encoder was used to measure both the position where the peak knee flexor force was recorded and the average eccentric velocity. SSC contributed to an enhanced NHE performance, where bilateral absolute peak knee flexor force was 13% higher for fast NHE_SSC vs. standard slow NHE_ECC (822 vs. 726 N, p < 0.01, ES = 0.54). Participants achieved a 32% greater forward distance at the breakpoint stage during NHE_ECC compared to the coupling phase for NHE_SSC (54 vs. 41 cm, p < 0.001, ES = 1.37). Eccentric average velocity was more than three times higher for NHE_SSC compared with NHE_ECC (0.38 vs. 0.12 m/s, p < 0.001, ES = 3.25). The key findings of this study were that SSC contributed to an enhanced NHE performance, where absolute peak knee flexor force was 13% greater for fast NHE_SSC compared to standard slow NHE_ECC. The fast NHE_SSC could therefore be an interesting alternative to the standard slow NHE_ECC execution, as it may offer potential advantages for sprint performance, as well as hamstring injury prevention and rehabilitation. Full article

(This article belongs to the Special Issue Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk)

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11 pages, 754 KiB

Open AccessReview

Predicting Risk Factors of Lower Extremity Injuries in Elite Women’s Football: Systematic Review and Meta-Analysis

by Feim Gashi, Tine Kovacic, Arbnore Ibrahimaj Gashi, Arben Boshnjaku and Ismet Shalaj

Sports 2023, 11(9), 187; https://doi.org/10.3390/sports11090187 - 20 Sep 2023

Viewed by 1887

Abstract

This study identified and analyzed the risk factors of lower extremity injuries (LEI) in elite women football players to improve career and health outcomes. To address this aim, a systematic review and meta-analysis methodology was used. In total, four relevant research articles were identified through database searching and screening using the PRISMA flow diagram. From these articles, eight predictors were identified that influence the risk of LEI among elite women football players: higher body mass index (OR 1.51, 95% CI); previous knee injury (OR 3.57, 95% CI); low normalized knee separation (≤10th percentile) (RR 1.92, 95% CI); all previous injury (previous ACL tear: OR 5.24, 95% CI; ankle sprain: 1.39, 95% CI; knee sprain: 1.50, 95% CI); and previous injury in the lower body (OR 2.97, 95% CI). Meanwhile, lower knee valgus angle in a drop-jump landing (OR 0.64, 95% CI) was found to decrease the risk of LEI among elite women football players. Full article

(This article belongs to the Special Issue Advances in Lower Extremity Biomechanics and Lower Extremity Injury Risk)

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