Relationship Between Fatigue, Gender And Knee Injuries In Athletes

Armen Hareyan's picture
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Fatigued lower limb muscles can inhibit the ability to control dynamic sports landing movements, increasing the risk of non-contact injury to the knee's anterior cruciate ligament (ACL), particularly among females. These are the key findings of a recent study of 10 female and 10 male NCAA athletes completed at Cleveland Clinic.

The study published in the March issue of Medicine and Science in Sports and Exercise, found that female athletes have a tendency to land with a more flexed ankle, the foot rolling outward with an elevated arch, more knee abduction and knee internal rotation compared to male athletes. The study also showed that fatigue caused significant increases in these same biomechanical measures. Importantly, the impact of fatigue on knee movements and loads was observed to be more pronounced in women, possibly explaining their greater risk of ACL injury during landing compared to men.

"Fatigue affects individuals differently. As we begin to pinpoint how fatigue relates to joint motion during sports movements, we hope to gain a better understanding of how ACL injuries occur and how to prevent them." said Susan Joy, M.D., Director, Woman's Sports Health at Cleveland Clinic and Co-author of the study.

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Athletes who took part in the study were observed drop-jumping in the Cleveland Clinic Lerner Research Center's Biomechanics lab. The athletes had their movement recorded using state-of-the-art 3D high-speed motion analysis techniques to examine lower-limb-joint kinematics and kinetics during 10 drop jumps, both before and after fatigue.

Gary Calabrese, Director, Cleveland Clinic Sports Health Rehabilitation and the study's Co-author said the findings open the door for further research and clinical application.

"Understanding when and why athletes suffer debilitating knee injuries helps us develop more successful and personalized treatment and prevention programs for at-risk individuals," Mr. Calabrese said.

The study's lead researcher, Scott McLean, Ph. D., was previously at Cleveland Clinic. He is currently an Assistant Professor with the Division of Kinesiology at the University of Michigan.

According to the NCAA, female athletes are at least twice as likely to suffer an ACL injury as male athletes and in some cases up to eight times more likely. Research shows that one in 10 female athletes will experience an ACL injury at some point in their career.

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