Is Hip Abduction Strength Asymmetry Present in Female Runners in the Early Stages of Patellofemoral Pain Syndrome?

BACKGROUND: The current literature indicates that hip abduction weakness in female patients is associated with ipsilateral patellofemoral pain syndrome (PFPS) as part of the weaker hip abductor complex. Thus, it has been suggested that clinicians should consider screening female athletes for hip strength asymmetry to identify those at risk of developing PFPS to prevent the condition. However, no study to date has demonstrated that hip strength asymmetry exists in the early stages of PFPS. PURPOSE: To determine whether hip abduction strength asymmetry exists in female runners with early unilateral PFPS, defined as symptoms of PFPS not significant enough to cause patients to seek medical attention or prevent them from running at least 10 miles per week. STUDY DESIGN: Controlled laboratory study. METHODS: This study consisted of 21 female runners (mean age, 30.5 years; range, 18-45 years) with early unilateral PFPS, who had not yet sought medical care and who were able to run at least 10 miles per week, and 36 healthy controls comparably balanced for age, height, weight, and weekly running mileage (mean, 18.5 mi/wk). Study volunteers were recruited using flyers and from various local running events in the metropolitan area. Bilateral hip abduction strength in both a neutral and extended hip position was measured using a handheld dynamometer in each participant by an examiner blinded to group assignment. RESULTS: Patients with early unilateral PFPS demonstrated no significant side-to-side difference in hip abduction strength, according to the Hip Strength Asymmetry Index, in both a neutral (mean, 83.5 ± 10.2; P = .2272) and extended hip position (mean, 96.3 ± 21.9; P = .6671) compared with controls (mean, 87.0 ± 8.3 [P = .2272] and 96.6 ± 16.2 [P = .6671], respectively). Hip abduction strength of the affected limb in patients with early unilateral PFPS (mean, 9.9 ± 2.2; P = .0305) was significantly stronger than that of the weaker limb of control participants (mean, 8.9 ± 1.4; P = .0305) when testing strength in a neutral hip position; however, no significant difference was found when testing the hip in an extended position (mean, 7.0 ± 1.4 [P = .1406] and 6.6 ± 1.5 [P =.1406], respectively). CONCLUSION: The study data show that early stages of unilateral PFPS in female runners is not associated with hip abduction strength asymmetry and that hip abduction strength tested in neutral is significantly greater in the affected limb in the early stages of PFPS compared with the unaffected limb. However, when tested in extension, no difference exists. Further studies investigating the early stages of PFPS are warranted. CLINICAL RELEVANCE: Unlike patients with PFPS seeking medical care, early PFPS does not appear to be significantly associated with hip abduction strength asymmetry

Hip Abduction Strength and Its Relationship with Sequential Movement and Ball Velocity in Softball Players

This study examined the relationship between hip abduction strength, segmental sequentiality of the upper extremity and ball velocity of throwing in softball positional players. Hip abduction strength, ball velocity, and related kinematics were collected on sixteen (167.7 + 6.7 cm; 68.9 + 10.4 kg; 19.2 + 1.1 yrs) National Collegiate Athletic Association Division I softball players. The participant had to catch a simulated hit ball and perform her positional throw. A position player was on second base and only those throws that she was able to catch without stepping off the base were recorded. There was no significance in the relationship between hip, trunk, upper arm, or lower arm speed with hip strength or ball velocity though segmental sequentiality was exhibited for each participant

The Effects of Ankle Mobilizations on Hip Abduction Strength

2013 Online Presentations RCA

Effect of Dynamic Platform Lateral Step-Up versus Stable Platform Lateral Step-Up Weight Bearing Exercise in Hip Abductor Strengthening on Healthy Male Volunteers - Randomized Clinical Trial

Objective & Background: To determine the effect of the dynamic platform lateral step-up and stable platform lateral step-up weight bearing standing exercise in strengthening of hip abductor. Many researchers have reported that strengthening of hip muscles as important component especially hip abductors in lower extremity rehabilitation program. Study Design: Single blinded randomized comparative clinical trial. Methodology: Sixty five healthy college going male subjects (Age group of 18 – 24 years) volunteered for this study. They were randomly assigned to one of the 2 groups. One group received the dynamic platform lateral step-up and the other received stable platform lateral step-up weight bearing standing exercise. The strength measurements were recorded using hand held dynamometer. Results: The results indicate that both groups had a positive effect on the outcome measures. The strength of hip abductors in dynamic platform group improved from a mean value (SD) of 19.47(3.59) to 26.93(3.19) and in stable platform group from 19.07(2.32) to 22.67(2.46). Significant difference is also observed between the two groups at p value .05. Conclusion: The study shows that dynamic platform lateral step-up exercise is more beneficial than stable platform lateral step-up weight bearing standing exercise in improving hip abductor muscle strength

Gluteus medius kinesio-taping: the effect on torso-pelvic separation, ball flight distance and accuracy during the golf swing

Background. The kinesio-taping method, which is becoming increasingly popular, may provide support and stability to joints and muscles without inhibiting range of motion. Objective. The aim of the study was to determine the effect of kinesio-taping of the gluteus medius muscle on x-factor (torsopelvic separation), ball flight distance and accuracy (smash factor ratio). A specific aim was to determine whether a correlation exists between hip abduction strength and x-factor, ball distance and accuracy. Methods. This study is a one group pretest-posttest quasiexperimental design which took place at a golf facility. Twentynine amateur golfers with handicap of scratch ±2, who were between the ages of 18- and 25-years, participated in this study. Biomechanical outcomes were recorded with and without kinesio-tape applied on the gluteus medius muscle of the trail leg. Biomechanical golf swing analysis with the iClub™ Body Motion System determined the x-factor at the top of the backswing. Ball flight distance and accuracy were measured with FlightScope® and dominant hip abduction strength was measured with the MicroFET Hand-held Dynamometer. Results. Kinesio-tape is effective in improving the relative hip abduction strength (p<0.001), although the effect size was small (Cohen’s d=0.24). With regard to the biomechanical outcome measures, namely x-factor (p=0.28), ball flight distance (p=0.53) and accuracy (p=0.1), there was no significant improvement. Conclusion: Even though the relative hip abduction strength was improved, there was no effect on golf swing biomechanics. This can be explained due to the fact that x-factor, ball flight distance and accuracy are dependent on a combination of body movements to produce the golf swing. Keywords. Golf, X-factor, pelvic stability, tapin

Inter-limb strength asymmetry in adolescent distance runners: test-retest reliability and relationships with performance and running economy

The purpose of this investigation was, firstly, to quantify the test-retest reliability of strength measures in adolescent distance runners; and secondly, to explore the relationships between inter-limb strength asymmetry and performance and running economy (RE) in a similar cohort of young runners. For the reliability study, twelve (n=6 female) post-pubertal adolescent distance runners performed an isometric quarter-squat on a dual force plate and unilateral isometric hip extension and hip abduction tests on two occasions. For the correlation study, participants (n=31) performed the strength tests plus a submaximal incremental running assessment and a maximal running test. Running economy was expressed as the average energy cost of running for all speeds below lactate turnpoint and was scaled for body mass using a previously calculated power exponent. Allometrically scaled peak force during the quarter-squat and peak torque in the hip strength tasks showed acceptable levels of reproducibility (typical error ≤6.3%). Relationships between strength asymmetry and performance and RE were low or negligible (r0.05), except for hip abduction strength asymmetry and RE in the female participants (r=0.85, p<0.001, n=16). Practitioners should consider inter-limb hip abduction strength asymmetry on an individual level, and attempting to reduce this asymmetry in females may positively impact RE

An investigation into the role of gluteal muscle strength and EMG activity in controlling hip and knee motion during landing tasks

Objectives: To examine the relationship between gluteal muscle activity and strength and knee and hip biomechanics during single leg loading tasks Design: Correlation study Setting: University Biomechanics laboratory Participants: 34 physically active, healthy participants, (17 males and 17 females). Main outcome measures: gluteal muscle EMG activity; hip abduction and extension muscle strength; knee and hip angles and moments Results: In females knee abduction moments and angles were strongly correlated to hip abduction strength across all tasks, whereas in males the relationships were less clear across tasks with both hip abduction strength and gluteus medius EMG activity showing the strongest relationships in specific tasks. Conclusion: Hip and knee kinetic and kinematic variables related to the development of dynamic knee valgus would appear to be influenced by gluteal muscle strength and EMG activity. The level of influence varies across single leg squatting and landing tasks and varies between genders