Article

Male and female gluteal muscle activity and lower extremity kinematics during running

East Carolina University, Department of Physical Therapy, Greenville, NC 27858, USA
Clinical biomechanics (Bristol, Avon) (Impact Factor: 1.97). 09/2012; 27(10). DOI: 10.1016/j.clinbiomech.2012.08.008
Source: PubMed

ABSTRACT

Background:
Patellofemoral pain is one of the most common lower extremity overuse injuries in runners and is significantly more common in females. This study evaluated differences in the timing and magnitude of gluteal muscle activity as well as hip and knee joint frontal and transverse plane kinematics between male and female runners in the context of this gender bias.

Methods:
Twenty healthy male and 20 healthy female runners were participants. Three-dimensional lower extremity kinematics, and gluteus medius and gluteus maximus muscle activation were recorded using motion analysis and electromyography as subjects ran at 3.7 m/s (+/-5%). Comparisons of hip and knee joint kinematic and gluteus muscle activation data were made using independent t-tests (α=0.05).

Findings:
Females ran with 40% greater peak gluteus maximus activation level (P=0.028, effect size=0.79) and 53% greater average activation level (P=0.013, effect size=0.93) than males. Female runners also displayed greater hip adduction (P=.001, effect size=1.20) and knee abduction (P=0.011, effect size=0.87) angles at initial contact, greater hip adduction at peak vertical ground reaction force (P<0.001, effect size=1.31), and less knee internal rotation excursion than males (P=0.035, effect size=0.71).

Interpretation:
Greater gluteus maximus activation levels during running may predispose females to earlier gluteus maximus fatigue, promoting altered lower extremity running kinematics thought to be associated with the etiology of patellofemoral pain. Gender differences in transverse and frontal plane hip and knee kinematics observed in this study may also contribute to the gender bias for patellofemoral pain among females.

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    • "We suggest the pattern of transverse plane pelvic motion during running is a secondary consequence of gluteus maximus activity. This muscle is active for most of stance phase (Gazendam & Hof, 2007; Willson et al., 2012) and functions primarily to extend the hip. However, gluteus maximus will also act to externally rotate the hip (Delp, Hess, Hungerford, & Jones, 1999) or, equivalently, rotate the pelvis away from the stance limb. "
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    • "Furthermore, the recurrence rates for PFP are as high as 90%, leaving some authors to conclude that PFP is an enigma for clinicians (Dye, 2001). While there are a plethora of reported symptoms between individuals with PFP, females often present with similar trends in their functional limitations, such as hip weakness and altered movement patterns during functional activities (Aminaka et al., 2011;Bolgla et al., 2008;Willson and Davis, 2008;Willson et al., 2012). Females with PFP often present with an increased hip adduction, hip internal rotation , and knee abduction, which have all been theorized to increase patellofemoral joint (PFJ) stress (Aminaka et al., 2011;Nakagawa et al., 2012). "
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    • "Muscle contractions were detected when signals rose above 5 standard deviations from the resting mean for a minimum of 25 msec [18]. Regarding kinematics, a ZXY cardan rotation sequence (sagittal, frontal, transverse) was used for data processing [14] [24]. Kinematic variables of interest were HADD, HIR as well as CPD angles during the stance phase. "
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    ABSTRACT: Recreational runners with patellofemoral pain syndrome (PFPS) have been shown to present altered movement kinematics, muscle activations, and ground reaction forces (GRF) during running as well as decreased lower limb strength. However, these variables have never been concurrently evaluated in a specific cohort. Therefore, the aim of this study was to compare lower limb control variables during running in recreational runners with and without PFPS. Lower limb control during treadmill running under typical training conditions (usual shoes, foot strike pattern, and speed) was compared between runners with (n=21) and without (n=20) PFPS using lower limb kinematics, electromyographic (EMG) recordings from representative muscles (gluteus medius/maximus, quadriceps and soleus), and vertical GRF. Isometric muscle strength was also evaluated. When comparing all runners from both groups, no between-group differences were found in variables commonly associated with PFPS such as peak hip adduction, hip internal rotation, contralateral pelvic drop, EMG of gluteal and quadriceps muscles, vertical loading rate, or lower limb strength. However, runners with PFPS showed significantly higher hip adduction at toe-off, lower excursion in hip adduction during late-stance, and longer duration of soleus activation. Sub-analyses were performed for females and for rearfoot strikers (RFS), and revealed that these subgroups accounted for most of between-group differences in hip adduction kinematics. Specifically for RFS with PFPS, lower activation of gluteus medius as well as lower GRF were observed. Our results suggest that deficits reported in runners with PFPS may vary depending on gender and on foot strike pattern. Copyright © 2015 Elsevier B.V. All rights reserved.
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