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ORIGINAL ARTICLE
Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 6-14

An analysis of musculoskeletal variables, comparative to team norms, leading to an anterior cruciate ligament rupture in a female soccer player


1 University of Pittsburgh, Neuromuscular Research Laboratory, Pittsburgh, PA, USA
2 Michael W. Krzyzewski Human Performance Laboratory, Duke University, Durham, NC, USA
3 Department of Physical Therapy, Augusta University, Augusta, GA, USA
4 Department of Athletics, University of Pittsburgh, Petersen Events Center, Pittsburgh, PA, USA

Correspondence Address:
Dr. Caleb D Johnson
Harvard Medical School, Spaulding National Running Center, 1575 Cambridge St., Cambridge, MA 02138
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/DORJ.DORJ_2_19

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Aim: The identification of sport- and gender-specific, prospective, and modifiable risk factors contributing to noncontact anterior cruciate ligament (ACL) injury is limited. This lack of information leaves clinicians at a loss in practicing evidence-based injury prevention. The purpose of this study is to describe the methods by which a female soccer player suffering from a noncontact ACL injury was compared to the rest of her team to identify modifiable strength and flexibility deficits possibly contributing to the injury. Materials and Methods: Twenty-two individuals were recruited from a Division I, female soccer team (age = 19.3 ± 1.2 years). All testing was completed 2 months before competitive play. Strength was assessed for ankle inversion/eversion and dorsiflexion (AIS/AES, ADS), knee flexion/extension (KFS/KES), hip abduction/adduction (HABS/HADS), and hip internal/external rotation (HIS/HES). Agonist/antagonist ratios were also calculated. Flexibility was assessed for active ankle dorsiflexion (DF), weight-bearing ankle DF mobility, hamstring flexibility with passive hip flexion (PHF), and active knee extension. The ACL case's strength and flexibility variables were compared to team averages for the dominant leg (affected side) using one-sample t-tests and Wilcoxon signed-rank tests. Results: The ACL case's injury was the result of a planting and cutting motion. The ACL case displayed significantly lower ADS (−7.84% of body weight), AIS (−7.41%), AES (−6.58%), KFS (−5.39%), HABS (−3.14%), HES (−2.84%), and a significantly lower HABS-to-HADS ratio (−0.12) compared to team averages. The ACL case also displayed significantly lower PHF (−16.89°) and higher DF (+1.85°). Conclusions: Several plausible strength and flexibility deficits were identified that could have played a role in the ACL case's injury. Clinical Significance: The methods and instrumentation used to identify deficits in the ACL case were inexpensive and clinic-friendly.


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