Transsynaptic activation of human lumbar spinal motoneurons by transvertebral magnetic stimulation.

Noninvasive spinal stimulation has been increasingly used in research on motor control and neurorehabilitation. Despite advances in percutaneous electrical stimulation techniques, magnetic stimulation is not as commonly used as electrical stimulation. Therefore, it is still under discussion what neuronal elements are activated by magnetic stimulation of the human spinal cord. In this study, we demonstrated that transvertebral magnetic stimulation (TVMS) induced transsynaptic activation of spinal motoneuron pools in the lumbar cord. In healthy humans, paired-pulse TVMS was given over an intervertebral space between the L1-L2 vertebrae with an interpulse interval of 100 ms, and the stimulus-evoked electromyographic (EMG) responses were recorded in the lower limb muscles. The results show that the evoked EMG responses after the 2nd pulse were clearly suppressed compared with the widespread responses evoked after the 1st pulse in the muscles of the lower extremity, indicating that the transsynaptic activation of spinal motoneurons by the 2nd pulse was suppressed by the effects produced by the 1st pulse. The inconsistent modulation of response suppression to stimulus intensity across individuals suggests that the TVMS-evoked EMG responses are composed of the compound potentials mediated by the direct activation of motor axons and the transsynaptic activation of motoneuron pools through sensory afferents and that the recruitment order of those fibers by TVMS may be nonhomogeneous across individuals.

A novel method intersecting three-dimensional motion capture and medial elbow strength dynamometry to assess elbow injury risk in baseball pitchers.

In baseball pitching, resultant elbow varus torque reaches the peak value of 50-120 N m, exceeding the joint failure limit that risks damage to the ulnar collateral ligament (UCL). In-vivo methodology is lacking to assess whether pitchers have sufficient muscular strength to shield UCL and how strongly the elbow musculature must contract to minimize valgus loading on UCL. This study introduces a method to assess relative percentages of muscular varus strength required to unload the UCL. The maximum voluntary isometric varus strength (MVIVS) produced by the medial elbow musculature and the maximum resultant varus torques at elbow in pitching fastballs and other types were measured for two professional pitchers. Simulation was conducted to determine the relative percentages of MVIVS required to unload the UCL to varying degrees and the impact of athletes' previous UCL reconstruction on the relative percentages was examined. The maximum resultant varus torque in pitching was found to range 72-97%MVIVS depending on the type of pitch. The elbow musculature had to produce 21-49%MVIVS to avoid acute failure of intact UCL whereas the corresponding requirements were 39-63%MVIVS for UCL reconstructed joint. The method offers new insight into baseball pitcher's training/rehabilitation and physical assessment to reduce the risk of UCL injury.

Proximal to distal sequencing impacts on maximum shoulder joint angles and the risk of impingement in baseball pitching involving a scapular independent thoracohumeral model.

BACKGROUND: Hyperangulation of the scapulohumeral joint due to poor coordination of the scapula during throwing motion is claimed to be a major cause of internal impingement in baseball pitchers. However, evidence of injurious scapular kinematics is lacking, particularly regarding how hyperangularion actually occurs in full-effort pitching. The purpose of this study was to describe sequential scapular motions involved in attaining maximum joint angles during pitching and the implications for internal impingement in elite baseball pitchers. METHODS: An electromagnetic goniometer system computed kinematics for pelvis, thorax, scapulae, arms, and forearms during baseball pitching in 72 pitchers. Internal impingement risk was assessed based on kinematic characteristics of internal impingement quantified in a cadaveric study. RESULTS: The pelvis, thorax, and scapula rotated in the proximal-to-distal sequence. Large forearm layback observed near the end of the cocking phase (182 ± 27°) was achieved with a submaximal scapulohumeral external rotation (98 ± 14°). In the next 0.027 ± 0.007 s, forward thoracic rotation and then scapular rotation caused increased scapulohumeral external rotation to a maximum of 113 ± 14°. Here, humeral horizontal adduction and scapula protraction occurred simultaneously preventing the humerus from lagging further behind the scapula. Only one participant reached critical hyperangulation beyond which internal impingement was reported to occur. CONCLUSION: Most elite pitchers safely attained the fully cocked position, yet off-timed recoiling of scapular protraction caused hyperangulation in full-effort pitching. Therefore, proximal-distal sequencing between the scapula and humerus should be evaluated to lessen the risk of internal impingement in baseball pitchers.

A method for measuring muscle strength in restraining valgus joint angulation: Elbow varus muscle strength against valgus loading.

Skeletal muscle works as a dynamic joint stabilizer, assisting the underlying ligaments in restricting joint angulation by actively resisting external loads. Despite its clinical importance, little is known about the muscle strength required to produce torque to help ligaments restrict joint angulation within the physiological range permitted by the joint structure. In this study, we introduce a method for measuring the strength of the elbow musculature in restraining valgus angulation and present the values obtained in 20 healthy young men. Each participant was fastened to a Biodex dynamometer, with the elbow joint flexed to 90° and the varus-valgus axis aligned to the dynamometer's rotation axis. Maximal voluntary isometric ramp contraction of shoulder internal rotators was performed while the humeroulnar joint gap was monitored with an ultrasound apparatus. The largest torque recorded while the humeroulnar joint gap did not exceed a predetermined individualized threshold was considered to be the elbow varus strength of the participant. The elbow varus strength of the dynamic stabilizer was found to be 41 ± 12 Nm, which agreed with the value estimated by our musculoskeletal model. The inter-operator reliability test indicated excellent reliability (ICC (2,1) = 0.91). These findings suggest that the present method is valid for measuring the strength of the elbow musculature in restraining the valgus angulation. Measurements of this aspect of strength are expected to provide insights for understanding and preventing elbow injuries.

Activation of human spinal locomotor circuitry using transvertebral magnetic stimulation.

Transvertebral magnetic stimulation (TVMS) of the human lumbar spinal cord can evoke bilateral rhythmic leg movements, as in walking, supposedly through the activation of spinal locomotor neural circuitry. However, an appropriate stimulus intensity that can effectively drive the human spinal locomotor circuitry to evoke walking-like movements has not been determined. To address this issue, TVMS was delivered over an intervertebral space of the lumbar cord (L1-L3) at different stimulus intensities (10-70% of maximum stimulator output) in healthy human adults. In a stimulus intensity-dependent manner, TVMS evoked two major patterns of rhythmic leg movements in which the left-right movement cycles were coordinated with different phase relationships: hopping-like movements, in which both legs moved in the same direction in phase, and walking-like movements, in which both legs moved alternatively in anti-phase; uncategorized movements were also observed which could not be categorized as either movement type. Even at the same stimulation site, the stimulus-evoked rhythmic movements changed from hopping-like movements to walking-like movements as stimulus intensity was increased. Different leg muscle activation patterns were engaged in the induction of the hopping- and walking-like movements. The magnitude of the evoked hopping- and walking-like movements was positively correlated with stimulus intensity. The human spinal neural circuitry required a higher intensity of magnetic stimulation to produce walking-like leg movements than to produce hopping-like movements. These results suggest that TVMS activates distinct neural modules in the human spinal cord to generate hopping- and walking-like movements.

Critical scapula motions for preventing subacromial impingement in fully-tethered front-crawl swimming.

The aims were to quantitatively describe the coordinated motions of the scapula and humerus during fully tethered front-crawl strokes and to test the hypothesis that scapular motion functions to reduce the risk of subacromial compression. An electromagnetic tracking device was used to record the kinematics of the thorax, humerus, and scapula on the dominant side in 17 collegiate swimmers. Because evidence suggests that compressive force develops under the coracoacromial arch when the arm elevated above 90º of arm elevation is maximally internally rotated, such shoulder configurations were measured for each participant. A series of scapulohumeral angles measured with this procedure were compared with the corresponding angles exhibited during fully tethered front-crawl swimming to identify the scapulohumeral angles indicative of subacromial compression. Additional comparison was performed without taking the scapular motion into account. Scapulohumeral angles indicative of subacromial compression were observed in 15 participants, accounting for 7.7 ± 7.1% of stroke cycle time. This duration was significantly less than the corresponding duration identified without having taken the scapular motion into account (22.6 ± 13.8% of stroke cycle time). The difference was due primarily to the unique movements of the scapular to accommodate demands imposed by stroke motions, and this supported the hypothesis.

Accuracy and reliability of a method for measuring three-dimensional articular motions of the shoulder complex during swimming.

This technical report introduces a method for measuring the three-dimensional articular motions of the shoulder complex during swimming. Eleven collegiate swimmers performed front-crawl strokes at maximal effort and their shoulder motions were measured with an electromagnetic tracking device. Sensors were attached to the sternum, acromia and humeri to determine their relative positions and orientations. A cart carrying the components of the device was pushed back-and-forth along the poolside, so that the sensors attached to the swimmer could be detected within the electromagnetic field. The stroke-to-stroke reliability of the measured articular motions was determined for each swimmer. The accuracy of the device was tested by measuring the relative positions and orientations of multiple sensors fixed on a wooden stick moving above and below the water surface. The measured values were compared with pre-determined fixed values. The coefficient of variance for the joint angles between stroke cycles was <10% of the total range of movement. Within a range of 1282 mm from the transmitter, the root-mean-square error of measurement was 0.7° for orientation and 4 mm for position, both of which were superior to optical measurements. This method is accurate and reliable for measuring the kinematics of the shoulder complex during swimming.

Difference in racket head trajectory and muscle activity between the standard volley and the drop volley in tennis.

Among tennis coaches and players, the standard volley and drop volley are considered basically similar, but muscles need to be relaxed (deactivation) just at the moment of impact when hitting the drop volley. However, this is not evidence-based. The aim of this study was to clarify racket head trajectory and muscle activity during the drop volley and to compare them with those of the standard volley. We hypothesized that 1) the racket head would move less forward for the drop volley than for the standard volley and 2) the wrist and elbow muscles be relaxed for the drop volley at the time of ball impact. Eleven male college students with sufficient tennis experience volunteered to participate in this study. Wireless EMG sensors recorded activation of the four arm muscles. Each subject performed the standard volley or the drop volley with both a forehand and a backhand from a position near the net. Four high speed video cameras (300 Hz) were set up on the court to measure ball speed and racket head trajectory. Returned ball speed of the drop volley was significantly lower than that of the standard volley (p < 0.05). The racket head moved less forward than in the standard volley, supporting the first hypothesis. Muscle activity of the drop volley, just before and after ball impact for both the forehand and backhand, was lower than that of the standard volley. However, the activity was in the form of a gradual increase as impact time approached, rather than a sudden deactivation (relaxation), which did not support the second hypothesis. For the drop volley, lower muscle activity in the forearm enabled a softer grip and thus allowed a "flip" movement of the racket to diminish the speed of the returned ball.

Analysis of Injuries and Pitching Performance Between Major League Baseball and Nippon Professional Baseball: A 2-Team Comparison Between 2015 to 2019.

BACKGROUND: There has been minimal research investigating injury and pitching performance differences between Major League Baseball (MLB) and other professional leagues. PURPOSE/HYPOTHESIS: This 2-team comparison between MLB and Japan's Nippon Professional Baseball (NPB) involved affiliated players over 5 years. We hypothesized that teams would differ in the injury incidence, mechanism of injury, pitch velocity, and pitch type usage. STUDY DESIGN: Descriptive epidemiology study. METHODS: Between 2015 and 2019, pitching data as well as injury statistics for the highest level and minor league affiliates of the Los Angeles Angels (MLB) and the Hiroshima Toyo Carp (NPB) were reviewed for significant differences in the injury prevalence, injury type, mechanism of injury, and days missed. In total, 3781 MLB and 371 NPB injuries were studied. RESULTS: MLB-affiliated players were significantly younger, taller, and heavier (P < .001) than were NPB-affiliated players. MLB-affiliated pitchers threw faster than did their NPB counterparts (P = .026). MLB minor league pitchers threw more curveballs than did NPB minor league pitchers (P = .004), and MLB minor league relief pitchers threw more sliders than did NPB minor league relief pitchers (P = .02). The MLB team had a 3.7-fold higher incidence of injuries versus the NPB team (0.030 vs 0.008 injuries per player-game, respectively) as well as more repeat injuries, with fewer days missed per injury (15.8 ± 54.7 vs 36.2 ± 55.1 days, respectively; P < .001). The MLB team also had a higher percentage of injuries that were throwing related (P < .001), were contact related (P < .001), and occurred outside of competition (P < .001) compared with the NPB team. CONCLUSION: This is the first empirical study examining injury trends and pitching characteristics between MLB and NPB athletes. MLB-affiliated pitchers threw faster and relied more on breaking pitches in comparison with NPB-affiliated pitchers. From injury data, MLB players were younger, taller, and heavier with a higher percentage of throwing-related injuries, contact injuries, and injuries sustained outside of competition. Overall, the MLB team indicated a 3.7-fold higher rate of reported injuries with fewer days missed per injury than did the NPB team. Competitive conditions are distinctly different between MLB and NPB, and thus, more extensive research collaborations in the future can identify best practices to advance health and performance for both leagues.

Forwards-backwards hand velocity induced by the upper trunk rotation in front crawl strokes and its association with the stroke frequency.

The aim of this study was to determine the contribution of the upper trunk rotation consisting of roll-pitch-yaw to hand velocity in the forwards-backwards direction during front crawl strokes and to investigate the association of forwards-backwards hand velocity induced by the upper trunk rotation with stroke frequencies. Fifteen skilled swimmers with retro-reflective markers performed front crawl strokes in a swimming pool where a motion capture system was set. Forwards-backwards hand velocity solely induced by the upper trunk rotation was determined during the performance. In the pull and push phases, 28% and 19% of the backward hand velocity was induced by the upper trunk rotation, respectively, while 19% of the forward hand velocity resulted from the upper trunk rotation in the recovery phase. The upper trunk rotation contributed to the forwards-backwards velocity as much as the elbow joint and was the second primary source of backward hand velocity in the pull phase. The forwards-backwards hand velocity created by the upper trunk rotation was associated with the stroke frequencies (r = 0.56, p < 0.05). The forwards-backwards hand velocity induced by the upper trunk would influence hand propulsion and stroke frequency so that a swimmer and coach should consider this performance-enhancing variable.

Contribution of upper trunk rotation to hand forward-backward movement and propulsion in front crawl strokes.

The study aims to test three hypotheses: (a) the rotation of the upper trunk consists of roll, pitch and yaw of frequencies harmonic to the stroke frequency of the front crawl stroke, (b) the rotation of the upper trunk generates back-and-forth movements of the shoulders, which enhances the movements of the stroking arms, and (c) the angular velocities of roll, pitch and yaw are associated with hand propulsion (HP). Front crawl strokes performed by twenty male swimmers were measured with a motion capture system. The roll, pitch and yaw angles about the three orthogonal axes embedded in the upper trunk were determined as three sequential Cardan angles and their angular velocities were determined as the three respective components of the angular velocity. HP and the drag and lift components of HP (HPD and HPL) were estimated by the hand positions and the data from twelve pressure sensors attached on hands. The roll, pitch, and yaw angles were altered in frequencies harmonic to the stroke frequency during the front crawl stroke. Shoulders alternately moved back and forth due to the upper trunk rotation. In the pull phase the angular velocity of roll was correlated with HPL (r = -0.62, p = 0.004). Based on the back-and-forth movements of the shoulders and roll motion relative to a hand movement, the arm-stroke technique of the front crawl swimming was discussed in terms of increasing the hand velocity and HP.

How does buoyancy affect performance during a 200m maximum front crawl swim?

We investigated the rotational effect of buoyant force around the body's transverse axis, termed buoyant torque, during a 200m front crawl maximal swim. Eleven male swimmers of national or international level participated. One stroke cycle (SC) for each 50m was recorded with two above and four below water cameras. The following variables were analysed: swimming velocity; absolute and normalised buoyant force; minimum, average and maximum buoyant torque; SC and arm recovery times. The average value of buoyant torque was higher in the first 50m (14.2 ± 4.5Nm) than in the following 150m (9.3 ± 4.1Nm~10.9 ± 4.5Nm) and was directed to raise the legs and lower the head throughout the race. The change in its magnitude seemed to be linked to the shorter time spent proportionally in arm recovery (first 50m: 27.6% of SC time; next 150m: 23.3-24.4% of SC time). Most swimmers had periods of the SC where buoyant torque was directed to sink the legs, which accounted to 10% of SC time in the first 50m and about twice this duration in the next 150m. These periods were observed exclusively at some instances when the recovering arm had entered the water while the opposite arm was still underwater.

A cross-sectional study on the mechanical properties of the Achilles tendon with growth.

PURPOSE: This study aimed to elucidate growth pattern of mechanical properties of the Achilles tendon and to examine if imbalance between growth of bone and muscle-tendon unit occurs during adolescence. METHODS: Fourteen elementary school boys, 30 junior high school boys, 20 high school boys and 15 male adults participated in this study. Based on estimated age at peak height velocity (PHV), junior high school boys were separated into two groups (before or after PHV). An ultrasonography technique was used to determine the length, cross-sectional area, stiffness and Young's modulus of Achilles tendon. In addition, the maximum strain in "toe region" (strainTP) was determined to describe the balance between growth of bone and muscle-tendon unit. RESULTS: No group difference was observed in length, cross-sectional area and strainTP among the groups. However, stiffness and Young's modulus in after PHV groups were significantly higher than those of elementary school boys and before PHV groups (p ≤ 0.05). CONCLUSIONS: These results indicate that mechanical properties of Achilles tendon change dramatically at and/or around PHV to increased stiffness. The widely believed assumption that muscle-tendon unit is passively stretched due to rapid bone growth in adolescence is not supported.

Reliability and Validity of Kinetic and Kinematic Parameters Determined With Force Plates Embedded Under a Soil-Filled Baseball Mound.

We developed a force measurement system in a soil-filled mound for measuring ground reaction forces (GRFs) acting on baseball pitchers and examined the reliability and validity of kinetic and kinematic parameters determined from the GRFs. Three soil-filled trays of dimensions that satisfied the official baseball rules were fixed onto 3 force platforms. Eight collegiate pitchers wearing baseball shoes with metal cleats were asked to throw 5 fastballs with maximum effort from the mound toward a catcher. The reliability of each parameter was determined for each subject as the coefficient of variation across the 5 pitches. The validity of the measurements was tested by comparing the outcomes either with the true values or the corresponding values computed from a motion capture system. The coefficients of variation in the repeated measurements of the peak forces ranged from 0.00 to 0.17, and were smaller for the pivot foot than the stride foot. The mean absolute errors in the impulses determined over the entire duration of pitching motion were 5.3 N˙s, 1.9 N˙s, and 8.2 N˙s for the X-, Y-, and Z-directions, respectively. These results suggest that the present method is reliable and valid for determining selected kinetic and kinematic parameters for analyzing pitching performance.

Relation Between Lift Force and Ball Spin for Different Baseball Pitches.

Although the lift force (F(L)) on a spinning baseball has been analyzed in previous studies, no study has analyzed such forces over a wide variety of spins. The purpose of this study was to describe the relationship between F(L) and spin for different types of pitches thrown by collegiate pitchers. Four high-speed video cameras were used to record flight trajectory and spin for 7 types of pitches. A total of 75 pitches were analyzed. The linear kinematics of the ball was determined at 0.008-s intervals during the flight, and the resultant fluid force acting on the ball was calculated with an inverse dynamics approach. The initial angular velocity of the ball was determined using a custom-made apparatus. Equations were derived to estimate the F(L) using the effective spin parameter (ESp), which is a spin parameter calculated using a component of angular velocity of the ball with the exception of the gyro-component. The results indicate that F(L) could be accurately explained from ESp and also that seam orientation (4-seam or 2-seam) did not produce a uniform effect on estimating F(L) from ESp.

Three-Dimensional Torso Motion in Tethered Front Crawl Stroke and its Implications on Low Back Pain.

Low back pain is a common problem among competitive swimmers, and repeated torso hyperextension is claimed to be an etiological factor. The purpose of this study was to describe the three-dimensional torso configurations in the front crawl stroke and to test the hypothesis that swimmers experience torso hyperextension consistently across the stroke cycles. Nineteen collegiate swimmers underwent 2 measurements: a measurement of the active range of motion in 3 dimensions and a measurement of tethered front crawl stroke at their maximal effort. Torso extension beyond the active range of torso motion was defined as torso hyperextension. The largest torso extension angle exhibited during the stroke cycles was 9 ± 11° and it was recorded at or around 0.02 ± 0.08 s, the instant at which the torso attained the largest twist angle. No participant hyperextended the torso consistently across the stroke cycles and subjects exhibited torso extension angles during tethered front crawl swimming that were much less than their active range of motion. Therefore, our hypothesis was rejected, and the data suggest that repeated torso hyperextension during front crawl strokes should not be claimed to be the major cause of the high incidence of low back pain in swimmers.

Abdominal breathing manoeuvre reduces passive drag acting on gliding swimmers.

The purpose of this study was to test the hypothesis that the passive drag acting on a gliding swimmer is reduced if the swimmer adopts an abdominal breathing manoeuvre (expanding the abdominal wall) rather than chest breathing manoeuvre (expanding the rib cage). Eleven male participants participated in this study. A specialised towing machine was used to tow each participant with tension set at various magnitudes and to record time series data of towing velocity. Participants were asked to inhale air by expanding the abdominal wall or the rib cage and to maintain the same body configuration throughout gliding. The steady-state velocity was measured and the coefficient of drag was calculated for each towing trial to compare between the breathing manoeuvres. The results showed that the towing velocity was increased by 0.02 m/s with a towing force of 34.3 N and by 0.06 m/s with a towing force of 98.1 N. The coefficient of drag was reduced by 5% with the abdominal breathing manoeuvre, which was found to be statistically significant (p < 0.05). These results indicate that adopting the abdominal breathing manoeuvre during gliding reduces the passive drag and the hypothesis was supported.

Configuration of the Shoulder Complex During the Arm-Cocking Phase in Baseball Pitching.

BACKGROUND: The role of the scapula during high-velocity baseball pitching has been described without 3-dimensional kinematic data. It has been speculated that the scapula functions to align the humerus with the spine of the scapula on both the transverse and scapular planes at the end of the arm-cocking phase. HYPOTHESIS: Two hypotheses were formulated: (1) the scapulothoracic protraction angle correlates with the humerothoracic horizontal adduction angle among participants, and (2) the scapulohumeral rhythm of the humerothoracic elevation is not the same as the normal ratio (2:1) observed widely in controlled abductions. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 20 Japanese professional baseball pitchers were asked to pitch 3 fastballs as they would normally during pitching practice. The 3-dimensional kinematic data of the thorax, scapulae, humeri, and pelvis were recorded using an electromagnetic tracking device operating at 240 Hz. Humerothoracic, scapulothoracic, and glenohumeral joint configurations were determined at the instant of stride-foot contact (SFC) and the end of the arm-cocking phase (MER). RESULTS: The mean (±SD) glenohumeral horizontal adduction (-6° ± 7°) and elevation (85° ± 10°) angles at the MER indicated that the humerus was positioned almost parallel to the spine of the scapula. The mean scapulothoracic protraction angle (15° ± 10°) was significantly correlated with the humerothoracic horizontal adduction angle (10° ± 11°) at the MER (r = 0.76, P < .001) but not at the SFC (r = 0.13, P = .58). The scapulohumeral rhythm (4.2 [±1.9]:1) expressed as the ratio of the glenohumeral elevation angle to the scapulothoracic upward rotation angle at the MER was significantly greater than the normal ratio (2:1) (P < .01). CONCLUSION: The results supported the hypotheses, providing evidence to corroborate the widely accepted concept that the scapula functions to align the humerus with the spine of the scapula so as to limit the glenohumeral joint configuration within the "safe zone" at the MER. CLINICAL RELEVANCE: Disruption of coordination, such as abnormal patterns including "SICK" scapula (scapular malposition, inferior medial border prominence, coracoid pain, and dyskinesis) and scapular dyskinesis, may result in an abnormal configuration of the glenohumeral joint at the MER.

Hip rotation angle is associated with frontal plane knee joint mechanics during running.

Inability to control lower extremity segments in the frontal and transverse planes resulting in large knee abduction angle and increased internal knee abduction impulse has been associated with patellofemoral pain (PFP). However, the influence of hip rotation angles on frontal plane knee joint kinematics and kinetics remains unclear. The purpose of this study was to explore how hip rotation angles are related to frontal plane knee joint kinematics and kinetics during running. Seventy runners participated in this study. Three-dimensional marker positions and ground reaction forces were recorded with an 8-camera motion analysis system and a force plate while subjects ran along a 25-m runway at a speed of 4m/s. Knee abduction, hip rotation and toe-out angles, frontal plane lever arm at the knee, internal knee abduction moment and impulse, ground reaction forces and the medio-lateral distance from the ankle joint center to the center of pressure (AJC-CoP) were quantified. The findings of this study indicate that greater hip external rotation angles were associated with greater toe-out angles, longer AJC-CoP distances, smaller internal knee abduction impulses with shorter frontal plane lever arms and greater knee abduction angles. Thus, there appears to exist a conflict between kinematic and kinetic risk factors of PFP, and hip external rotation angle may be a key factor to control frontal plane knee joint kinematics and kinetics. These results may help provide an appropriate manipulation and/or intervention on running style to reduce the risk of PFP.

The contraction-induced increase in Achilles tendon moment arm: a three-dimensional study.

The present study aimed to re-examine the influence of the isometric plantarflexors contraction on the Achilles tendon moment arm (ATMA) and the factors influencing the ATMA in three-dimensions. A series of coronal magnetic resonance images of the right ankle were recorded at foot positions of 10° of dorsiflexion, neutral position, and 10° of plantarflexion for the rest condition and the plantarflexors contraction condition at 30% maximal voluntary effort. The shortest distance between the talocrural joint axis and the line of action of the Achilles tendon force projected to the orthogonal plane of the talocrural joint axis was determined as the ATMA. The ATMA determined in the contraction condition was significantly greater by 8mm than that determined in the rest condition. The talocrural joint axis was displaced anteriorly by 3mm and distally by 2mm due to the muscle contraction. As the same time, the line of action of the Achilles tendon force was displaced posteriorly by 5mm and medially by 2mm. These linear displacements of the talocrural joint axis and the line of action of the Achilles tendon force accounted for the difference in the ATMAs between the two conditions by 35.9 and 62.4%, respectively. These angular displacements accounted for the total of 0.4% increase in the ATMA. These results confirm the previous findings reported in two-dimensional studies and found that the linear displacement of the line of action of the Achilles tendon force is the primary source of the contraction-induced increase in the ATMA.