Hip, Knee, and Ankle Velocities May Predict Injury Risk in Female Distance Runners

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Dynamic mal-alignment is often associated with injury risk in runners. Joint angle peaks and excursions are typically used to distinguish between injured and non-injured movement patterns. However, joint velocities may be useful for characterizing movement patterns during specific phases of gait, such as during the impact phase. PURPOSE: To compare joint velocities during impact to joint peaks and excursions for predicting injury risk. Elevated hip adduction (HADD), hip internal rotation (HINT), and rearfoot eversion (REV) peaks, excursions, and velocities were expected on the injured side. Elevated knee abduction (KABD) peaks and excursions, and decreased (less negative) knee adduction (KADD) velocities were also expected. METHODS: The injured and uninjured sides of 11 female runners with a history of retrospective and prospective, unilateral injury were compared. HADD, HINT, KABD, and REV data were collected using motion analysis. Synchronized force plate data were used to identify the stance phase and vertical impact peak for each trial; five for each leg. The peak joint angle, angle excursion from heel strike to peak, and average joint velocity from heel strike to vertical impact peak were extracted from each trial and averaged within each side. Paired t-tests were used to compare between sides, using each method (α = 0.05). The percent difference between sides, as identified by each method, was also calculated. RESULTS: Although most of the variables showed the expected results, only KADD velocity was significantly different between limbs (94.3% decreased on the injured side). Of the peaks and excursions, only HADD excursion was more than 15% greater on the injured side. However, as for KADD, REV and HADD velocities were more than 20% and 60% greater on the injured side, respectively. CONCLUSIONS: Joint velocities during the impact phase of stance may distinguish between the injured and uninjured sides of runners better than peaks and excursions. These early stance joint velocities may provide insight into injury mechanisms which have not been previously explored.Table