Hip muscles and cruciate ligament injury

Hip muscles and cruciate ligament injury - what are the risk factors ?

The increasing frequency of injuries to the anterior cruciate ligament, especially in adolescent female football players and in football sports as a whole, has become increasingly important in recent years. The probability of an injury to the anterior cruciate ligament is highest in football, next to skiing.

Risk factor muscle imbalance

One of the reasons for this increased susceptibility in football is, among others, the imbalances (imbalance) of the leg and hip-surrounding muscle groups acquired through the sport-specific load. Particularly in the case of female football players, a dysbalance often develops due to stereotypical one-sided force development and strain in favour of shortened adductors (hip flexors) → VIEW VIDEO. This is caused, for example, by the high strain of passing with the inside of the foot, resulting in a weakening of the muscles of the opposing players, the hip abductors (hip abductors) → VIEW VIDEO.

Risk factor anatomy

Different anatomy of the female and male pelvic skeleton

Insbesondere bei weiblichen Sportlern kann diese gestörte Balance durch ihre anlagebedingte, der weiblichen Anatomie geschuldete und genetisch determinierte Becken- und Kniegelenkveränderungen, eine Stressbelastung auf das Vordere Kreuzband auslösen. Bei schnellen Drehbewegungen, nicht korrekt durchgeführten Landemanövern aus der Luft bei zusätzlich teilweise abweichender Stellungen der Beinachse  ( z.b. X-Beine, Valgusmoment !) kommt dieses Phänomen besonders zu tragen. Eine aktuelle Veröffentlichung von Malloy,Philip ( Hip External Rotator Strength Is Associated With  Better Dynamic Control of the Lower Extremity During Landing Tasks) erschienen im Journal of Strength & Conditioning Research vom Januar 2016, bestätigt die Ergebnisse unserer Untersuchungsreihe im Rahmen unseres Präventivscreenings und unserer personifizierter Rehabilitation – returntomove- back to sports.

Risk factor lack of muscular pelvic stability

In our follow-up examinations (www.returntomove.com) after anterior cruciate ligament surgery on more than 80 operated cruciate ligament patients (age 16-60, m:.50,w: 30), we were able to determine a lack of stability of the hip-surrounding muscle groups in almost 90%, especially the muscles for abduction and external rotation of the hip. It was striking that not only the hip joint on the operated side was deficient, but in the majority of cases the supposedly healthy opposite side of the hip also showed no stabilising functions. In our series of examinations, besides sensorimotor tests, landing techniques,plyometric skills, the maximum isometric hip abduction and the strength of the external rotators were measured with the dynamometer.

Important in rehabilitation and prevention:

The examination of the joints above and below the knee joint, the muscle functions of the muscle groups surrounding the hip and the functional status of the lumbar spine is mandatory.

Risk selection makes sense or prevention programme for everyone

Die schon heute insbesondere für Fussballerinnen empfohlenen Präventionsprogramme ( z.b.FIFA 11+) zur Verbesserung der Becken- und Rumpfstabilität sind deshalb empfehlenswert und sollten fester Bestandteil jeglichen wettkampforientierten Trainings sein, auch bei den männlichen Kollegen, vornehmlich in den Amateur-Leistungsklassen besteht hier erheblicher Handlungsbedarf. Auch gilt, schon in der unmittelbar postoperativen Reha nach einer Vorderen Kreuzbandplastik, frühzeitig derartige Schwächen zu erkennen, um so eine Risikoselektion von gefährdeten Sportlern und Sportlerinnen zu ermöglichen. Für den Operateur könnten o.g . Aspekte in der Operationsvorbereitung und Planung Bedeutung erlangen. Die personifizierte Kreuzbandplastik  würde unter Berücksichtigung oben angeführter Hypothesen die Frage der Sehnenentnahme mit der auf der Innenseite befindlichen Semitendinosussehne gerade bei o.g. Klientel in Frage stellen.

This is how it should be:
The treatment and the surgical procedure are geared to the patient and not vice versa!

The Tuck Jump Test

The Tuck Jump Test provides us with essential information about possible deficits and weaknesses of the athlete, especially in the area of his pelvic and trunk muscles, leg position during landing, e.g. after several jumps, and control of the leg axis. This test is an essential component of our examination series: returntomove-back to sports, as part of our prevention screening - Preventco - and post-operative aftercare, e.g. after anterior cruciate ligament surgery.

Excerpt from our series of exercises to improve pelvic and trunk stability