78.
KINETIC ANALYSIS OF KNEE AND HIP JOINT LOADING
DURING SIDECUTTING IN HANDBALL – IMPLICATIONS FOR
PREVENTION AND REHABILITATION AFTER ACL-INJURIES
Jesper Bencke, Jesper Curtis, Hanne Bloch Lauridsen, Thomas Bandholm,
Mette Kreutzfeld Zebis
Gait analysis lab, dept. of Orthopaedic Surgery Hvidovre Hospital; Gait
analysis lab, dept. of Orthopaedic Surgery, Hvidovre Hospital; Gait analysis
lab, dept. of Orthopaedic Surgery, Hvidovre Hospital; Clinical Research
Center, Hvidovre Hospital; Gait analysis lab, dept. of Orthopaedic Surgery,
Hvidovre Hospital
Background:
Injuries to the anterior cruciate ligament (ACL) are frequent
among young female athletes in handball and football, especially during the
sidecutting manoeuvre. The biomechanics of this movement may thus yield
information useful for prevention and rehabilitation, and potentially also
surgery procedure in this group of patients.
Purpose / Aim of Study:
The aim was to determine which muscle groups
would potentially be the most important for prevention and rehabilitation,
using the 3D measurements on the biomechanics of the hip and knee joint
during sidecutting.
Materials and Methods:
Twenty-four young female handball players (age 15-
18
yrs) agreed, with their parent’s consent, to participate. Five repetitions of
each player’s individual sidecut manoeuvre were investigated using 3D
movement analysis. Net moments in three planes around the knee and hip
joints were calculated, and the net moments during the first 30% of the contact
phase was selected as outcome measures.
Findings / Results:
The results showed a peak external knee valgus moment,
coinciding with a peak external outward rotating and a peak internal knee
extensor moment at 10-20% of the contact phase. Internal extensor moments,
adductor moments, and outward rotator moments were dominant around the
hip joint in this time period.
Conclusions:
The present results show a dependency on the medial hamstrings
to counteract the external valgus and outward rotating moments occurring
around the knee joint during the sidecut manoeuvre, and that hip outward
rotators, and hip adductors are the most loaded muscle groups during this
crucial early part of the sidecut. Attention to these muscle groups may be
important in prevention programs and rehabilitation regimes involving female
handball players. Furthermore, the results may yield further information to the
graft selection decision before ACL – surgery.
