Association Between the Medial-Lateral Quadriceps and Hamstring Muscle Thickness and the Knee Kinematics and Kinetics During Single-Leg Landing

Abstract

Background: Muscle thickness can influence the joint kinematics and/or kinetics during dynamic activities. The relationship between the muscle thickness of individual quadriceps and hamstrings or medial-to-lateral thigh muscle thickness ratio and the knee kinematics/kinetics with respect to anterior cruciate ligament (ACL) injury risk remains unclear. Hypothesis: Higher medial-to-lateral thigh muscle thickness ratio would be associated with lower knee valgus angle/moment and lower tibial internal rotation angle/moment during single-leg landing. Study Design: Cross-sectional. Level of Evidence: Level 4. Methods: Muscle thickness of the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and semitendinosus (ST) of 30 healthy participants (16 males and 14 females) were measured using ultrasound. Knee joint kinematics and kinetics during single-leg landing were obtained. Stepwise multiple regression analysis, a follow-up Fisher’s r to z test to examine the sex as a moderator, and independent t tests to evaluate sex difference were performed. Results: Both knee valgus moment ( R2 = 0.466, P < 0.001) and tibial external rotation moment ( R2 = 0.330, P < 0.001) at peak anterior tibial shear force during single-leg landing were negatively correlated with medial-to-lateral (ie, (VM+ST):(VL+BF)) thickness ratio regardless of sex, whereas medial-to-lateral thigh muscle thickness ratio was not correlated with knee valgus and tibial external rotation angles. Male participants exhibited higher (VM+ST):(VL+BF) thickness ratio than female participants ( P = 0.005), and lower knee valgus moment ( P = 0.04) and tibial external rotation moment ( P = 0.05), as well. Conclusion: The knee joint moments in frontal and transverse planes during single-leg landing were associated with the medial-to-lateral thigh muscle thickness ratio; thus, the medial-lateral thigh muscle thickness could be a potential contributor to frontal and transverse plane knee joint loading during dynamic movement. Clinical Relevance: Strength training that aims to selectively strengthen the medial/lateral thigh muscles might be considered in a new ACL injury prevention training program to alter the biomechanical parameters associated with ACL injuries.