Abstract
For golf swing, the soft tissue structure resisting joint compression and internal rotation of the knee at low flexion angle may be susceptible for a lead knee injury. Therefore, anterior cruciate ligament (ACL) rupture is one of the potential injuries that may occur from repeated stress during golf. The current study was purposed to investigate the biomechanical factors that lead to high ACL load in the lead knee during golf swing. The joint kinematic data of the lead leg and trunk, joint kinetic data of the lead knee, ground reaction force, and the external knee moments were compared between the low and high ACL loading groups. The results demonstrated an increased amount of frontal plane moment arm and external knee adduction (varus) moment just after ball impact for the high ACL loading group. These observations were associated with a characteristic difference in the upper body motion and were the main contributors to the elevated ACL force of the lead knee. The mechanism that generates a high amount of ACL loading during golf swing, which involves the application of external knee adduction moment just after ball impact, may differ from conventional non-contact ACL injury mechanisms that associated with dynamic valgus loading during injury circumstance.
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Farrally, M. R., Cochran, A. J., Crews, D. J., Hurdzan, M. J., Price, R. J., Snow, J. T., et al. (2003). Golf science research at the beginning of the twenty-first century. Journal of Sports Sciences,21(9), 753–765.
Parziale, J. R., & Mallon, W. J. (2006). Golf injuries and rehabilitation. Physical Medicine and Rehabilitation Clinics of North America,17(3), 589–607.
Lee, C., & Park, S. (2018). Estimation of unmeasured golf swing of arm based on the swing dynamics. International Journal of Precision Engineering and Manufacturing,19(5), 745–751.
Cabri, J., Sousa, J. P., Kots, M., & Barreiros, J. (2009). Golf-related injuries: A systematic review. European Journal of Sport Science,9(6), 353–366.
Lindsay, D. M., Horton, J. F., & Vandervoort, A. A. (2000). A review of injury characteristics, aging factors and prevention programmes for the older golfer. Sports Medicine (Auckland, New Zealand),30(2), 89–103.
McHardy, A., Pollard, H., & Luo, K. (2006). Golf injuries. Sports Medicine (Auckland, New Zealand),36(2), 171–187.
Gosheger, G., Liem, D., Ludwig, K., Greshake, O., & Winkelmann, W. (2003). Injuries and overuse syndromes in golf. American Journal of Sports Medicine,31(3), 438–443.
Batt, M. E. (1992). A survey of golf injuries in amateur golfers. British Journal of Sports Medicine,26(1), 63–65.
Marshall, R. N., & McNair, P. J. (2013). Biomechanical risk factors and mechanisms of knee injury in golfers. Sports Biomechanics,12(3), 221–230.
Gatt, C. J., Pavol, M. J., Parker, R. D., & Grabiner, M. D. (1998). Three-dimensional knee joint kinetics during a golf swing. American Journal of Sports Medicine,26(2), 285–294.
Lynn, S. K., & Noffal, G. J. (2010). Frontal plane knee moments in golf: Effect of target side foot position at address. Journal of Sports Science and Medicine,9(2), 275–281.
D’Lima, D. D., Steklov, N., Patil, S., & Colwell, C. W. (2008). The Mark Coventry award: In vivo knee forces during recreation and exercise after knee arthroplasty. Clinical Orthopaedics and Related Research,466(11), 2605–2611.
Baker, M. L., Epari, D. R., Lorenzetti, S., Sayers, M., Boutellier, U., & Taylor, W. R. (2017). Risk factors for knee injury in golf: A systematic review. Sports Medicine (Auckland, New Zealand),47(12), 2621–2639.
Purevsuren, T., Kwon, M. S., Park, W. M., Kim, K., Jang, S. H., Lim, Y. T., et al. (2017). Fatigue injury risk in anterior cruciate ligament of target side knee during golf swing. Journal of Biomechanics,53, 9–14.
Weiss, J. M., Noble, P. C., Conditt, M. A., Kohl, H. W., Roberts, S., Cook, K. F., et al. (2002). What functional activities are important to patients with knee replacements? Clinical Orthopaedics and Related Research,404, 172–188.
Choi, A., Sim, T., & Mun, J. H. (2015). Quasi-stiffness of the knee joint in flexion and extension during the golf swing. Journal of Sports Sciences,33(16), 1682–1691.
Chu, Y., Sell, T. C., & Lephart, S. M. (2010). The relationship between biomechanical variables and driving performance during the golf swing. Journal of Sports Sciences,28(11), 1251–1259.
Khuyagbaatar, B., Purevsuren, T., & Kim, Y. H. (2019). Kinematic determinants of performance parameters during golf swing. Proceedings of the Institution of Mechanical Engineers, Part H,233(5), 554–561.
Egret, C. I., Vincent, O., Weber, J., Dujardin, F. H., & Chollet, D. (2003). Analysis of 3D kinematics concerning three different clubs in golf swing. International Journal of Sports Medicine,24(6), 465–470.
Egret, C., Dujardin, F., Weber, J., & Chollet, D. (2004). 3-D kinematic analysis of the golf swings of expert and experienced golfers. Journal of Human Movement Studies,47(3), 193–204.
Egret, C. I., Nicolle, B., Dujardin, F. H., Weber, J., & Chollet, D. (2006). Kinematic analysis of the golf swing in men and women experienced golfers. International Journal of Sports Medicine,27(6), 463–467.
Hamai, S., Miura, H., Higaki, H., Shimoto, T., Matsuda, S., Okazaki, K., et al. (2008). Three-dimensional knee joint kinematics during golf swing and stationary cycling after total knee arthroplasty. Journal of Orthopaedic Research,26(12), 1556–1561.
Healy, A., Moran, K. A., Dickson, J., Hurley, C., Smeaton, A. F., O’Connor, N. E., et al. (2011). Analysis of the 5 iron golf swing when hitting for maximum distance. Journal of Sports Sciences,29(10), 1079–1088.
Pfeiffer, J. L., Zhang, S., & Milner, C. E. (2014). Knee biomechanics during popular recreational and daily activities in older men. Knee,21(3), 683–687.
Somjarod, M., & Tanawat, V. (2011). The analysis of knee joint movement during golf swing in professional and amateur golfers. International Journal of Social, Behavioral, Educational, Economic, Business and Industrial Engineering,5(5), 545–548.
Sinclair, J., Currigan, G., Fewtrell, D. J., & Taylor, P. J. (2014). Three-dimensional kinematics observed between different clubs during the full golf swing. Journal of Athletic Enhancement,3(3), 1–5.
Murakami, K., Hamai, S., Okazaki, K., Ikebe, S., Shimoto, T., Hara, D., et al. (2016). In vivo kinematics of healthy male knees during squat and golf swing using image-matching techniques. Knee,23(2), 221–226.
Mundermann, A., Dyrby, C. O., D’Lima, D. D., Colwell, C. W., Jr., & Andriacchi, T. P. (2008). In vivo knee loading characteristics during activities of daily living as measured by an instrumented total knee replacement. Journal of Orthopaedic Research,26(9), 1167–1172.
Carlsöö, S. (1967). A kinetic analysis of the golf swing. The Journal of Sports Medicine and Physical Fitness,7(2), 76–82.
Bechler, J. R., Jobe, F. W., Pink, M., Perry, J., & Ruwe, P. A. (1995). Electromyographic analysis of the hip and knee during the golf swing. Clinical Journal of Sport Medicine,5, 162–166.
Marta, S., Silva, L., Vaz, J. R., Castro, M. A., Reinaldo, G., & Pezarat-Correia, P. (2016). Electromyographic analysis of the lower limb muscles in low-and high-handicap golfers. Research Quarterly for Exercise and Sport,87(3), 318–324.
Purevsuren, T., Dorj, A., Kim, K., & Kim, Y. H. (2016). Prediction of medial and lateral contact force of the knee joint during normal and turning gait after total knee replacement. Proceedings of the Institution of Mechanical Engineers, Part H,230(4), 288–290.
Nha, K. W., Dorj, A., Feng, J., Shin, J. H., Kim, J. I., Kwon, J. H., Kim, K., & Kim, Y. H. (2013) Application of computational lower extremity model to investigate different muscle activities and joint force patterns in knee osteoarthritis patients during walking. Computational and Mathematical Methods in Medicine, 314280.
Purevsuren, T., Khuyagbaatar, B., Kim, K., & Kim, Y. H. (2018). Investigation of knee joint forces and moments during short-track speed skating using wearable motion analysis system. International Journal of Precision Engineering and Manufacturing,19(7), 1055–1060.
Purevsuren, T., Kim, K., Nha, K. W., & Kim, Y. H. (2016). Evaluation of compressive and shear joint forces on medial and lateral compartments in knee joint during walking before and after medial open-wedge high tibial osteotomy. International Journal of Precision Engineering and Manufacturing,17(10), 1365–1370.
Purevsuren, T., Elias, J. J., Kim, K., & Kim, Y. H. (2015). Dynamic simulation of tibial tuberosity realignment: Model evaluation. Computer Methods in Biomechanics and Biomedical Engineering,18(14), 1606–1610.
Guess, T. M., Liu, H., Bhashyam, S., & Thiagarajan, G. (2013). A multibody knee model with discrete cartilage prediction of tibio-femoral contact mechanics. Computer Methods in Biomechanics and Biomedical Engineering,16(3), 256–270.
Kim, Y. H., Khuyagbaatar, B., & Purevsuren, T. (2018). Relationship between joint angles and x-factor in golf swing. ISBS Proceedings Archive,36(1), 502.
Lipps, D. B., Wojtys, E. M., & Ashton-Miller, J. A. (2013). Anterior cruciate ligament fatigue failures in knees subjected to repeated simulated pivot landings. American Journal of Sports Medicine,41(5), 1058–1066.
Beaulieu, M. L., Wojtys, E. M., & Ashton-Miller, J. A. (2015). Risk of anterior cruciate ligament fatigue failure is increased by limited internal femoral rotation during in vitro repeated pivot landings. American Journal of Sports Medicine,43(9), 2233–2241.
Horan, S. A., Evans, K., & Kavanagh, J. J. (2011). Movement variability in the golf swing of male and female skilled golfers. Medicine & Science in Sports & Exercise,43(8), 1474–1483.
Hume, P. A., Keogh, J., & Reid, D. (2005). The role of biomechanics in maximising distance and accuracy of golf shots. Sports Medicine (Auckland, New Zealand),35(5), 429–449.
Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms. Sports Medicine (Auckland, New Zealand),40(9), 729–746.
Shimokochi, Y., & Shultz, S. J. (2008). Mechanisms of noncontact anterior cruciate ligament injury. Journal of Athletic Training,43(4), 396–408.
Oh, Y. K., Kreinbrink, J. L., Wojtys, E. M., & Ashton-Miller, J. A. (2012). Effect of axial tibial torque direction on ACL relative strain and strain rate in an in vitro simulated pivot landing. Journal of Orthopaedic Research,30(4), 528–534.
Markolf, K. L., Burchfield, D. M., Shapiro, M. M., Shepard, M. F., Finerman, G. A., & Slauterbeck, J. L. (1995). Combined knee loading states that generate high anterior cruciate ligament forces. Journal of Orthopaedic Research,13(6), 930–935.
Wascher, D. C., Markolf, K. L., Shapiro, M. S., & Finerman, G. A. (1993). The effect of multiplane loading in the intact knee. JBJS,75(3), 377–386.
Miyasaka, T., Matsumoto, H., Suda, Y., Otani, T., & Toyama, Y. (2002). Coordination of the anterior and posterior cruciate ligaments in constraining the varus–valgus and internal–external rotatory instability of the knee. Journal of Orthopaedic Science,7(3), 348–353.
Inoue, M., McGurk-Burleson, E., Hollis, J. M., & Woo, S. L. (1987). Treatment of the medial collateral ligament injury: I: The importance of anterior cruciate ligament on the varus–valgus knee laxity. American Journal of Sports Medicine,15(1), 15–21.
Acknowledgements
This work was supported by the National Research Foundation of Korea (NRF) Grant Funded by the Korea Government (MSIP) (No. 2017R1E1A1A03070418).
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Purevsuren, T., Khuyagbaatar, B., Lee, S. et al. Biomechanical Factors Leading to High Loading in the Anterior Cruciate Ligament of the Lead Knee During Golf Swing. Int. J. Precis. Eng. Manuf. 21, 309–318 (2020). https://doi.org/10.1007/s12541-019-00266-y
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DOI: https://doi.org/10.1007/s12541-019-00266-y