Clinical Determinants of Knee Joint Loads While Sidestepping: An Exploratory Study With Male Rugby Union Athletes

Abstract

Background: While several clinical factors have independently been linked to anterior cruciate ligament (ACL) injury risk factors, their collective impact on knee loading during the sidestep maneuver is unknown. To better understand these factors, we assessed the relationship between strength, balance, and sprint kinetics and external knee abduction moments during sidestepping on each leg. Methods: Sixteen male academy-level rugby union athletes (age, 20 ± 3 years; body-height, 186 ± 9 cm; body-mass, 99 ± 14 kg) were bilaterally assessed in single-leg: isokinetic concentric and eccentric knee and concentric hip strength, balance at 2 difficulty levels, vertical and horizontal force production during maximal sprinting, and 3-dimensional motion capture while sidestepping on the preferred and non-preferred leg. A hierarchical multiple regression analysis based on this theoretical approach of the mechanics of ACL injury risk was performed. Results: When sidestepping on the preferred leg, larger abduction moments were explained by less concentric hip extension strength and vertical force production during maximal sprinting ( R2 = 41%; ES = 0.64); when sidestepping on the non-preferred leg, larger abduction moments were explained by more concentric hip flexion strength ( R2 = 8%; ES = 0.29). Larger symmetry scores between the legs (representing greater abduction moments) were explained by more horizontal force production during maximal sprinting and less eccentric knee flexion strength ( R2 = 32%; ES = 0.56). Conclusions: Independently, the preferred and non-preferred legs contribute to increased knee abduction moments via unique distributions of strength and/or sprint kinetics. The allocations of strength and sprint kinetics appear interrelated through weaker posterior muscular strength and may be modifiable through a targeted strength training approach.