Gender Differences in Core Strength and Lower Extremity Function During the Single-Leg Squat Test

  • Mary Lloyd Ireland
  • Thomas Durbin
  • Lori A. Bolgla
Chapter

Abstract

This chapter discusses the principles of core stability in terms of its importance on lower extremity function. The use of the single-leg squat test to measure core stability is described, which is a practical tool that can easily be used in the clinical setting. The test protocol and methods for interpretation of the results are provided. Reliability and validity data are cited. Associations between core strength, neuromuscular activity, and lower extremity function during the test are described. Differences in core strength, lower limb position, and posture between male and female subjects depicted by the single-leg squat are summarized.

Keywords

Anterior Cruciate Ligament Anterior Cruciate Ligament Injury Female Athlete Knee Valgus Core Stability 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Ageberg E, Bennell KL, Hunt MA et al (2010) Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat. BMC Musculoskelet Disord 11:265PubMedCrossRefGoogle Scholar
  2. 2.
    Alentorn-Geli E, Myer GD, Silvers HJ (2009) Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc 17(7):705–729PubMedCrossRefGoogle Scholar
  3. 3.
    Baldon Rde M, Lobato DF, Carvalho LP et al (2011) Relationship between eccentric hip torque and lower-limb kinematics: gender differences. J Appl Biomech 27(3):223–232PubMedGoogle Scholar
  4. 4.
    Berns GS, Hull ML, Patterson HA (1992) Strain in the anteromedial bundle of the anterior cruciate ligament under combination loading. J Orthop Res 10(2):167–176PubMedCrossRefGoogle Scholar
  5. 5.
    Bolgla LA, Malone TR, Umberger BR et al (2011) Comparison of hip and knee strength and neuromuscular activity in subjects with and without patellofemoral pain syndrome. Int J Sports Phys Ther 6(4):285–296PubMedGoogle Scholar
  6. 6.
    Cholewicki J, VanVliet JJ (2002) Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertions. Clin Biomech (Bristol, Avon) 17(2):99–105CrossRefGoogle Scholar
  7. 7.
    Claiborne TL, Armstrong CW, Gandhi V et al (2006) Relationship between hip and knee strength and knee valgus during a single leg squat. J Appl Biomech 22(1):41–50PubMedGoogle Scholar
  8. 8.
    Cowley HR, Ford KR, Myer GD et al (2006) Differences in neuromuscular strategies between landing and cutting tasks in female basketball and soccer athletes. J Athl Train 41(1):67–73PubMedGoogle Scholar
  9. 9.
    Crossley KM, Zhang WJ, Schache AG et al (2011) Performance on the single-Leg squat task indicates Hip abductor muscle function. Am J Sports Med 39(4):866–873PubMedCrossRefGoogle Scholar
  10. 10.
    Dierks TA, Manal KT, Hamill J et al (2008) Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run. J Orthop Sports Phys Ther 38(8):448–456PubMedGoogle Scholar
  11. 11.
    Earl JE, Monteiro SK, Snyder KR (2007) Differences in lower extremity kinematics between a bilateral drop-vertical jump and a single-leg step-down. J Orthop Sports Phys Ther 37(5):245–252PubMedGoogle Scholar
  12. 12.
    Ferber R, Davis IM 3rd, Williams DS (2003) Gender differences in lower extremity mechanics during running. Clin Biomech (Bristol, Avon) 18(4):350–357CrossRefGoogle Scholar
  13. 13.
    Ford KR, Myer GD, Toms HE et al (2005) Gender differences in the kinematics of unanticipated cutting in young athletes. Med Sci Sports Exerc 37(1):124–129PubMedCrossRefGoogle Scholar
  14. 14.
    Ford KR, Myer GD, Smith RL (2006) A comparison of dynamic coronal plane excursion between matched male and female athletes when performing single leg landings. Clin Biomech (Bristol, Avon) 21(1):33–40CrossRefGoogle Scholar
  15. 15.
    Fung DT, Zhang LQ (2003) Modeling of ACL impingement against the intercondylar notch. Clin Biomech (Bristol, Avon) 18(10):933–941CrossRefGoogle Scholar
  16. 16.
    Geiser CF, O’Connor KM, Earl JE (2010) Effects of isolated hip abductor fatigue on frontal plane knee mechanics. Med Sci Sports Exerc 42(3):535–545PubMedCrossRefGoogle Scholar
  17. 17.
    Gilchrist J, Mandelbaum BR, Melancon H et al (2008) A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Am J Sports Med 36(8):1476–1483PubMedCrossRefGoogle Scholar
  18. 18.
    Hewett TE, Myer GD, Ford KR et al (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 33(4):492–501PubMedCrossRefGoogle Scholar
  19. 19.
    Hodges PW, Richardson CA (132) Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther 77(2):132–142; discussion 142–134Google Scholar
  20. 20.
    Ireland ML (2002) The female ACL: why is it more prone to injury? Orthop Clin North Am 33(4):637–651PubMedCrossRefGoogle Scholar
  21. 21.
    Jacobs CA, Uhl TL, Mattacola CG et al (2007) Hip abductor function and lower extremity landing kinematics: sex differences. J Athl Train 42(1):76–83PubMedGoogle Scholar
  22. 22.
    Kernozek TW, Torry MR, Iwasaki M (2008) Gender differences in lower extremity landing mechanics caused by neuromuscular fatigue. Am J Sports Med 36(3):554–565PubMedCrossRefGoogle Scholar
  23. 23.
    Krosshaug T, Nakamae A, Boden BP et al (2007) Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases. Am J Sports Med 35(3):359–367PubMedCrossRefGoogle Scholar
  24. 24.
    Lawrence RK 3rd, Kernozek TW, Miller EJ et al (2008) Influences of hip external rotation strength on knee mechanics during single-leg drop landings in females. Clin Biomech (Bristol, Avon) 23(6):806–813CrossRefGoogle Scholar
  25. 25.
    Leetun DT, Ireland ML, Willson JD et al (2004) Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc 36(6):926–934PubMedCrossRefGoogle Scholar
  26. 26.
    Lephart SM, Ferris CM, Riemann BL et al (2002) Gender differences in strength and lower extremity kinematics during landing. Clin Orthop 401:162–169PubMedCrossRefGoogle Scholar
  27. 27.
    Li RT, Lorenz S, Xu Y et al (2011) Predictors of radiographic knee osteoarthritis after anterior cruciate ligament reconstruction. Am J Sports Med 39(12):2595–2603PubMedCrossRefGoogle Scholar
  28. 28.
    Lubowitz JH, Appleby D (2011) Cost-effectiveness analysis of the most common orthopaedic surgery procedures: knee arthroscopy and knee anterior cruciate ligament reconstruction. Arthroscopy 27(10):1317–1322PubMedCrossRefGoogle Scholar
  29. 29.
    Malinzak RA, Colby SM, Kirkendall DT (2001) A comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol, Avon) 16(5):438–445CrossRefGoogle Scholar
  30. 30.
    Mandelbaum BR, Silvers HJ, Watanabe DS et al (2005) Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. Am J Sports Med 33(7):1003–1010PubMedCrossRefGoogle Scholar
  31. 31.
    Markolf KL, Burchfield DM, Shapiro MM et al (1995) Combined knee loading states that generate high anterior cruciate ligament forces. J Orthop Res 13(6):930–935PubMedCrossRefGoogle Scholar
  32. 32.
    McLean SG, Walker K, Ford KR et al (2005) Evaluation of a two dimensional analysis method as a screening and evaluation tool for anterior cruciate ligament injury. Br J Sports Med 39(6):355–362PubMedCrossRefGoogle Scholar
  33. 33.
    Munro A, Herrington L, Carolan M (2012) Reliability of 2-dimensional video assessment of frontal-plane dynamic knee valgus during common athletic screening tasks. J Sport Rehabil 21(1):7–11PubMedGoogle Scholar
  34. 34.
    Myer GD, Chu DA, Brent JL et al (2008) Trunk and hip control neuromuscular training for the prevention of knee joint injury. Clin Sports Med 27(3):425–448; ixPubMedCrossRefGoogle Scholar
  35. 35.
    Nagano Y, Ida H, Akai M et al (2007) Gender differences in knee kinematics and muscle activity during single limb drop landing. Knee 14(3):218–223PubMedCrossRefGoogle Scholar
  36. 36.
    Neumann DA (2010) Kinesiology of the musculoskeletal system, 2nd edn. Mosby, St. LouisGoogle Scholar
  37. 37.
    Nguyen AD, Shultz SJ, Schmitz RJ et al (2011) A preliminary multifactorial approach describing the relationships among lower extremity alignment, hip muscle activation, and lower extremity joint excursion. J Athl Train 46(3):246–256PubMedGoogle Scholar
  38. 38.
    Panjabi MM (1992) The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 5(4):383–389; discussion 397PubMedCrossRefGoogle Scholar
  39. 39.
    Patrek MF, Kernozek TW, Willson JD et al (2011) Hip-abductor fatigue and single-leg landing mechanics in women athletes. J Athl Train 46(1):31–42PubMedCrossRefGoogle Scholar
  40. 40.
    Pollard CD, Sigward SM, Ota S et al (2006) The influence of in-season injury prevention training on lower-extremity kinematics during landing in female soccer players. Clin J Sport Med 16(3):223–227PubMedCrossRefGoogle Scholar
  41. 41.
    Pope MH, Panjabi M (1985) Biomechanical definitions of spinal instability. Spine (Phila Pa 1976) 10(3):255–256CrossRefGoogle Scholar
  42. 42.
    Portney LG, Watkins MP (2009) Foundations of clinical research. Applications to practice, 3rd edn. Prentice Hall Health, Upper Saddle RiverGoogle Scholar
  43. 43.
    Powers CM (2010) The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther 40(2):42–51PubMedGoogle Scholar
  44. 44.
    Prodromos CC, Han Y, Rogowski J et al (2007) A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy 23(12):1320–1325, e1326PubMedCrossRefGoogle Scholar
  45. 45.
    Sahrmann S (2002) Diagnosis and treatment of movement impairment syndromes. Mosby, PhiladelphiaGoogle Scholar
  46. 46.
    Shirey M, Hurlbutt M, Johansen N et al (2012) The influence of core musculature engagement on hip and knee kinematics in women during a single leg squat. Int J Sports Phys Ther 7(1):1–12PubMedGoogle Scholar
  47. 47.
    Shultz SJ, Schmitz RJ, Nguyen AD et al (2010) ACL research retreat V: an update on ACL injury risk and prevention, March 25–27, 2010, Greensboro, NC. J Athl Train 45(5):499–508PubMedCrossRefGoogle Scholar
  48. 48.
    Silvers HJ, Mandelbaum BR (2007) Prevention of anterior cruciate ligament injury in the female athlete. Br J Sports Med 41(Suppl 1):i52–i59PubMedCrossRefGoogle Scholar
  49. 49.
    Souza RB, Powers CM (2009) Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther 39(1):12–19PubMedGoogle Scholar
  50. 50.
    Souza RB, Powers CM (2009) Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain. Am J Sports Med 37(3):579–587PubMedCrossRefGoogle Scholar
  51. 51.
    van der Hart CP, van den Bekerom MP, Patt TW (2008) The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament. J Orthop Surg Res 3:24PubMedCrossRefGoogle Scholar
  52. 52.
    Willson JD, Dougherty CP, Ireland ML et al (2005) Core stability and its relationship to lower extremity function and injury. J Am Acad Orthop Surg 13(5):316–325PubMedGoogle Scholar
  53. 53.
    Willson JD, Ireland ML, Davis I (2006) Core strength and lower extremity alignment during single leg squats. Med Sci Sports Exerc 38(5):945–952PubMedCrossRefGoogle Scholar
  54. 54.
    Willson JD, Davis IS (2008) Utility of the frontal plane projection angle in females with patellofemoral pain. J Orthop Sports Phys Ther 38(10):606–615PubMedGoogle Scholar
  55. 55.
    Willy RW, Davis IS (2011) The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. J Orthop Sports Phys Ther 41(9):625–632PubMedGoogle Scholar
  56. 56.
    Zazulak BT, Hewett TE, Reeves NP et al (2007) Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med 35(7):1123–1130PubMedCrossRefGoogle Scholar
  57. 57.
    Zeller BL, McCrory JL, Kibler WB et al (2003) Differences in kinematics and electromyographic activity between men and women during the single-legged squat. Am J Sports Med 31(3):449–456PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Mary Lloyd Ireland
    • 1
  • Thomas Durbin
    • 1
  • Lori A. Bolgla
    • 2
  1. 1.Department of Orthopaedic Surgery & Sports MedicineUniversity of Kentucky, KY Sports Medicine PerimeterLexingtonUSA
  2. 2.Department Physical TherapyCollege Allied Health Sciences, Georgia Health Sciences UniversityAugustaUSA

Personalised recommendations