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Knee Valgus During Drop Jumps in National Collegiate Athletic Association Division I Female Athletes

The Effect of a Medial Post

Michael Joseph, MS, PT^,*, David Tiberio, PhD, PT, Jennifer L. Baird, MS, PT, Thomas H. Trojian, MD^||, Jeffrey M. Anderson, MD^,||, William J. Kraemer, PhD and Carl M. Maresh, PhD

From the Department of Kinesiology, University of Connecticut, Storrs, Connecticut, Department of Physical Therapy, University of Connecticut, Storrs, Connecticut, Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts, and ^|| Department of Sports Medicine, University of Connecticut, Storrs, Connecticut

^* Address correspondence to Michael Joseph, MS, PT, Department of Kinesiology, 2095 Hillside Road U-110, Storrs, CT 06269 (e-mail: mickpt{at}sbcglobal.net).

Background: Female athletes land from a jump with greater knee valgus and ankle pronation/eversion. Excessive valgus and pronation have been linked to risk of anterior cruciate ligament injury. A medially posted orthosis decreases component motions of knee valgus such as foot pronation/eversion and tibial internal rotation.

Hypothesis: We hypothesized a medial post would decrease knee valgus and ankle pronation/eversion during drop-jump landings in NCAA-I female athletes.

Study Design: Controlled laboratory study.

Methods: Knee and ankle 3-dimensional kinematics were measured using high-speed motion capture in 10 National Collegiate Athletic Association Division I female athletes during a drop-jump landing with and without a medial post. Analysis of variance was used to determine differences in posting condition, t tests were used to determine dominant-nondominant differences, and the Pearson correlation coefficient was used to determine relationships between variables.

Results: Significant differences were found for all measures in the posted condition. A medial post decreased knee valgus at initial contact (1.24°, P < .01) and maximum angle (1.21°, P < .01). The post also decreased ankle pronation/eversion at initial contact (0.77°, P < .01) and maximum angle (0.95°, P = .039).

Conclusion: The authors have demonstrated a significant decrease in knee valgus and ankle pronation/eversion during a drop jump with a medial post placed in the athletes’ shoes.

Clinical Relevance: A medial post may be a potential means to decrease risk of anterior cruciate ligament injury.

Key Words: knee valgus • anterior cruciate ligament (ACL) injury • foot orthoses • pronation • kinematics