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Sport-Dependent Variations in Arm Position During Single-Limb Landing Influence Knee Loading

Implications for Anterior Cruciate Ligament Injury

Ajit M. Chaudhari, PhD^*,, Brenna K. Hearn, MS and Thomas P. Andriacchi, PhD^,

From the Stanford Biomotion Laboratory, Department of Mechanical Engineering, Stanford University, Stanford, California, and the VA Palo Alto Rehabilitation Research & Development Center, Veteran’s Administration, Palo Alto Health Care System, Palo Alto, California

^* Address correspondence to Ajit M. Chaudhari, PhD, Stanford University, Durand Building, Room 201, Stanford, CA 94305-4038 (e-mail: ajit.chaudhari{at}stanford.edu).

Background: Increased valgus loading at the knee has been previously identified as a possible risk factor for noncontact anterior cruciate ligament injuries, which are common in sports. Arm position variation may affect risk of injury by altering valgus knee loading.

Hypothesis: Sport-dependent variations in arm position increase valgus loading of the knee during run-to-cut maneuvers.

Study Design: Controlled laboratory study.

Methods: Eleven subjects performed a sidestep cutting maneuver, first with no arm constraints and then with 3 sports-related arm positions in random order (holding a lacrosse stick, holding a football on the plant side, and holding a football on the cut side). The analysis focused on the knee valgus moment relative to the arm positions during the landing phase of the activity.

Results: Arm position significantly influenced the valgus moment with an increase in the lacrosse trials and in the plant-side football trials but not in the cut-side football trials ( = .05).

Conclusions: Constraining the plant-side arm results in increased valgus loading at the knee during run-to-cut maneuvers, which suggests the possibility of greater risk of anterior cruciate ligament injury during these conditions.

Clinical Relevance: These results suggest that training methods that consider arm position as a risk factor could help reduce the risk of anterior cruciate ligament noncontact injury.

Key Words: anterior cruciate ligament (ACL) injury • injury mechanisms • football • lacrosse • knee biomechanics • noncontact injury

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