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Cited by 289Knee injuries and reconstruction techniquesLower Extremity Biomechanics and PathologiesSports injuries and prevention

The Mechanistic Connection Between the Trunk, Hip, Knee, and Anterior Cruciate Ligament Injury

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Hewett, Timothy E., Myer, Gregory D.·2011·Exercise and Sport Sciences Reviews
DOI 10.1097/jes.0b013e3182297439PMC PMC4168968
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Abstract

In Brief Neuromuscular control of the trunk and knee predicts anterior cruciate ligament injury risk with high sensitivity and specificity. These predictors are linked, as lateral trunk positioning creates high knee abduction torque (load). The hypotheses explored are that lateral trunk motion increases load and that neuromuscular training that enhance trunk control will decrease load. Mechanistic linkages between trunk control and ACL injury provide a rationale for the development of "core-based" interventions to reduce ACL injury.

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Crossref · 10.1097/jes.0b013e3182297439

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57 of 57 references verified0 citation errors · 0 not checkable

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  • The greater hip adduction and knee medio-lateral displacement in poor SLSs compared to good SLSs suggests that hip abductor weakness may be responsible for the sub-optimal performance.

    “The fact that hip adduction and knee medio-lateral displacement was greater in poor SLSs than in good SLSs suggests that hip abductor weakness may be responsible for the sub-optimal performance. 1,23,24”

    From Lower-Limb Kinematics of Single-Leg Squat Performance in Young Adults (2014) · cites this paper as [24]

    In ‘The Underlying Mechanisms’ (page unavailable), the paper links increased hip adduction and reduced hip-abductor strength or recruitment to greater knee load. It does not compare good and poor single-leg squats or establish that hip-abductor weakness explains the cited difference in squat performance. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The position of the trunk should not be discounted as a contributor to increased knee medio-lateral displacement, as the trunk's large relative mass has the potential to influence the body's centre of mass in the frontal plane and thus affect hip and knee loading during SLS.

    “The position of the trunk, however, should not be discounted as a contributor to increased knee medio-lateral displacement, as the large relative mass of the trunk has the potential to influence the position of the body's centre of mass in the frontal plane and thus to affect hip and knee loading during activities such as the SLS. 24”

    From Lower-Limb Kinematics of Single-Leg Squat Performance in Young Adults (2014) · cites this paper as [24]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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1 of the 58 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [14]Hewett TE Biro FM McLean SG Van den Bogert AJ Identifying female athletes at high risk for ACL injury Book Identifying Female Athletes at High Risk for ACL Injury 2003 National Institutes of Health
  2. [22]Hewett TE Myer GD Ford KR Powers S Neuromuscular intervention targeted to mechanisms of ACL load in female athletes Book Neuromuscular Intervention Targeted to Mechanisms of ACL Load in Female Athletes 2008 National Institutes of Health
  3. [27]Hewett TE Torg JS Boden BP Video analysis of trunk and knee motion during non-contact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism Br. J. Sports Med 2009 43 417 422 19372088 PMC4062295
  4. [33]Krosshaug T Nakamae A Boden BP Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases Am. J. Sports Med 2007 35 359 367 17092928

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Authors
Hewett, T. E., & Myer, G. D.
Affiliations
Cincinnati Children's Hospital Medical Center (US)
Corresponding author
Hewett, Timothy E.
ORCID
Venue
Exercise and Sport Sciences Reviews
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-10
Volume
39
Issue
4
Pages
161-166
ISSN
0091-6331 (ISSN-L)
DOI
10.1097/jes.0b013e3182297439
PMC
PMC4168968
OpenAlex
W3972418
Cited by
289
References
58
Citations by year
2026: 13 · 2025: 18 · 2024: 22 · 2023: 18 · 2022: 25 · 2021: 32 · 2020: 23 · 2019: 22 · 2018: 16 · 2017: 19 · 2016: 16 · 2015: 20 · 2014: 26 · 2013: 9 · 2012: 10
FWCI
14.71
Type
journal article
Language
en
Open access
Locations
  • Exercise and Sport Sciences Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR05563, R01AR049735, R01AR055563, R01AR056259)
Topics
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
Keywords
anterior cruciate ligament injury, knee abduction moment, trunk control, neuromuscular control, hip position, knee injury risk, neuromuscular training, injury prevention
MeSH terms
Anterior Cruciate Ligament Injuries, Biomechanical Phenomena, Female, Humans, Knee Injuries, Knee Joint, Male, Sex Characteristics, Anterior Cruciate Ligament, Torso

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