Isolated hip and ankle fatigue are unlikely risk factors for anterior cruciate ligament injury

Abstract

Lower extremity neuromuscular fatigue purportedly increases anterior cruciate ligament (ACL) injury risk through promotion of extreme landing mechanics. However, the impact of fatigue on muscle groups critical to the landing strategy remains unclear. This study examined the effects of isolated hip rotator and triceps surae fatigue on lower extremity landing biomechanics. Sixteen healthy females (18–22 years) reported for testing on two occasions, with one muscle group fatigued per session. Subjects performed three single-leg landings onto a force platform pre- and post-fatigue, defined as an 80% decrease in peak torque in the targeted muscle group. Hip rotator fatigue was induced via alternating concentric contractions and triceps surae fatigue through concentric plantar flexion contractions on an isokinetic dynamometer. Initial contact (IC) kinematics and peak stance (PS) kinetics and kinematics were analyzed pre- and post-fatigue. Hip rotator fatigue increased IC ( P =0.05) and PS ( P =0.04) hip internal rotation angles. Triceps surae fatigue decreased IC knee flexion ( P =0.01) angle. Isolated hip rotator and triceps surae fatigue each produced modifications in lower limb kinematic parameters viewed as risk factors for ACL injury. These modifications, however, do not appear of sufficient magnitude to compromise ligament integrity, suggesting injury via an integrative lower extremity fatigue mechanism is more likely.