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Original article
Association between frontal plane knee control and lower extremity injuries: a prospective study on young team sport athletes
  1. Anu M Räisänen1,
  2. Kati Pasanen2,3,
  3. Tron Krosshaug4,
  4. Tommi Vasankari3,
  5. Pekka Kannus3,
  6. Ari Heinonen5,
  7. Urho M Kujala5,
  8. Janne Avela5,
  9. Jarmo Perttunen6,
  10. Jari Parkkari1
  1. 1 Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
  2. 2 Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  3. 3 UKK Institute for Health Promotion Research, Tampere, Finland
  4. 4 Norwegian School of Sports Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  5. 5 Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
  6. 6 Tampere University of Applied Sciences, Tampere, Finland
  1. Correspondence to Anu M Räisänen; anu.raisanen{at}uta.fi

Abstract

Background/aim Poor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk.

Methods A total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimensional video analysis.

Results Athletes displaying a high FPKPA were 2.7 times more likely to sustain a lower extremity injury (adjusted OR 2.67, 95% CI 1.23 to 5.83) and 2.4 times more likely to sustain an ankle injury (OR 2.37, 95% CI 1.13 to 4.98). There was no statistically significant association between FPKPA and knee injury (OR 1.49, 95% CI 0.56 to 3.98). The receiver operating characteristic curve analyses indicated poor combined sensitivity and specificity when FPKPA was used as a screening test for lower extremity injuries (area under the curve of 0.59) and ankle injuries (area under the curve of 0.58).

Conclusions Athletes displaying a large FPKPA in the SLS test had an elevated risk of acute lower extremity and ankle injuries. However, the SLS test is not sensitive and specific enough to be used as a screening tool for future injury risk.

  • risk factor
  • knee injuries
  • sporting injuries
  • ankle

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjsem-2017-000311

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    Footnotes

    • Contributors All authors were involved in conceiving the study. All authors contributed to study concept and design. KP and AMR were responsible for conducting the data acquisition. AMR was responsible for the video analysis, data analysis and interpretation. AMR was the significant manuscript writer. KP, TK, TV, PK, AH, UMK, JA, JPe and JPa were significant manuscript revisers. All authors have approved the submitted version of the manuscript. AMR is the guarantor.

    • Funding This study was financially supported by the Finnish Ministry of Education and Culture, the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Grants 9N053, 9S047, 9T046), and the Foundation of Sports Institute (Urheiluopistosäätiö).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study was approved by the Ethics Committee of Pirkanmaa Hospital District (ETL code R10169).

    • Provenance and peer review Not commissioned; externally peer reviewed.