Excessive Q-Angle and its association with sports injury risk: A literature review

Abstract

Background: The quadriceps angle (Q-angle) is an anatomical parameter reflecting lower extremity alignment and knee biomechanics. Abnormal or excessive Q-angle has been proposed as an intrinsic risk factor for sports-related injuries, particularly involving the knee joint. Objective: This review aimed to summarize current evidence regarding the association between Q-angle and the risk of sports-related injuries in athletes and physically active individuals. Methods: A narrative literature review was conducted using PubMed and Google Scholar databases. Articles published between 2020 and 2025 were identified using relevant keywords related to Q-angle, injury risk, and sport. Original research and review articles involving human participants were included and analyzed descriptively. Results: Most studies reported that increased and abnormal Q-angle values are associated with altered lower extremity alignment, increased patellofemoral stress, impaired patellar tracking, and a greater tendency toward dynamic knee valgus. These biomechanical alterations were linked to a higher risk of patellofemoral pain syndrome, iliotibial band syndrome, patellar instability, and knee ligament injuries. Higher and asymmetric Q-angle values were more frequently observed in female athletes and in sports involving repetitive and high-impact movements. Conclusion: Excessive Q-angle appears to be an important anatomical factor associated with increased lower extremity injury risk.&nbsp