November 20, 2018
2 min read

Hip, knee mechanics may contribute to patellofemoral pain in young female athletes

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Gregory D. Myer

Maladaptive hip mechanics before puberty may contribute to patellofemoral pain in young female athletes, while aberrant knee mechanics may contribute to patellofemoral pain development throughout the maturational process, according to published results.

Gregory D. Myer, PhD, FACSM, CSCS*D, and colleagues had 506 high school female athletes who completed the anterior knee pain scale and a knee examination for the diagnosis of patellofemoral pain perform a drop vertical jump task instrumented with force plates at sport-specific preseason appointments during the course of 2 years. Researchers also documented pubertal status, landing profile and patellofemoral pain development. Participants were classified into high- or low-risk knee and hip landing profiles for the development of patellofemoral pain using biomechanical measures generated from standard 3-D biomechanical analyses. Researchers used sagittal-plane knee range of motion, peak knee abduction angle, peak knee abduction moment and peak-to-peak transverse-plane knee moment in the knee landing profile, and sagittal-plane hip range of motion, peak hip extensor moment, peak abductor moment and peak hip rotator moment in the hip landing profile.

Results showed increased hip flexion and decreased abductor, rotator and extensor moments among female athletes with high-risk hip landing profiles and showed decreased knee flexion and increased knee abduction, external abductor and external rotator moments among female athletes with high-risk knee landing profiles. Researchers noted higher odds of moving to a low-risk hip landing profile among participants with a high-risk hip landing profile who transitioned to post-pubertal status at follow-up vs. participants who had not reached post-pubertal status at follow-up. According to results, no association was found between pubertal maturation and change in the high-risk knee landing profile at follow-up.

“The results from this study indicate that before puberty in young girls, maladaptive hip mechanics may contribute to [patellofemoral pain] PFP, while aberrant knee mechanics may continue to contribute to PFP development during maturational stages in young female athletes,” Myer told “In young girls, pubertal maturation status may have a protective effect on high-risk hip landing mechanics, while high-risk knee landing mechanics tend to endure during maturational process. Female athletes may benefit from hip targeted exercises prior to puberty and more global (hip and knee focused) neuromuscular training following pubertal maturation to reduce their risk to develop PFP.” – by Casey Tingle


Disclosure: Funding support was received from the National Institute of Arthritis and Musculoskeletal and Skin Diseases/NIH.