Comparative Analysis of Neuromuscular Activation Patterns Associated with Force between Semi-Professional Female Soccer Players with Previous Anterior Cruciate Ligament Surgery and Healthy Players in Thigh Musculature Related to Valgus Collapse

Abstract

This study investigates electromyography activation and force development differences in key lower limb muscles between female football players with previous anterior cruciate ligament injuries compared with healthy players. Twenty-two semi-professional players were divided into ACL-injured (n = 11) and non-injured groups (n = 11). Participants underwent maximal voluntary isometric contractions while electromyography activation, peak and average, and peak torque of force were measured. Results indicated significant differences in electromyography activation patterns between anterior cruciate ligament players and non-injured players, particularly in biceps femoris and gluteus maximus muscles. These differences were also evident when comparing between limbs within anterior cruciate ligament players. Interestingly, both groups exhibited similar peak torque of force during maximal contractions, suggesting a compensatory neuromuscular strategy that supports a return to sport based on kinetic and kinematic factors. However, these findings underscore persistent muscle integration imbalances potentially contributing to the high rate of anterior cruciate ligament reinjury. In conclusion, this study highlights the importance of evaluating electromyography activation alongside force development in understanding neuromuscular adaptations post anterior cruciate ligament injury. These insights emphasize the need for comprehensive rehabilitation strategies that address muscle imbalance to mitigate the risk of recurrent anterior cruciate ligament injuries in female football players.