Sex-Specific Relationships Between Hip Strength and Hip, Pelvis, and Trunk Kinematics in Healthy Runners

in Journal of Applied Biomechanics
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Weak hip muscle strength and excessive hip motion during running have been suggested as potential risk factors for developing patellofemoral pain syndrome (PFPS) in females, but not males. There is conflicting evidence on the relationship between hip strength and hip kinematics, which may be partly due to sex differences in the relationship between these parameters. Hip, pelvis, and trunk kinematics were collected while 60 healthy, habitual runners (23 females, 37 males) ran overground, and isometric hip abduction and external rotation strengths were measured bilaterally. Pearson correlation coefficients quantified sex-specific correlations between hip strength and kinematics, and unpaired t tests assessed sex differences in hip strength and kinematics. Hip abduction strength was moderately and inversely correlated to hip adduction excursion in females, and pelvic internal rotation excursion in males. Hip external rotation strength was moderately and inversely correlated to trunk flexion excursion in females. Finally, females displayed less hip external rotation strength and greater excursion at the hip and trunk during running compared to males. Despite the significant correlations, the relatively low r2 values suggest that additional factors outside of strength contribute to a substantial portion of the variance in trunk, pelvis, and hip kinematics.

Hannigan, Osternig, and Chou are with the Department of Human Physiology, University of Oregon, Eugene, OR.

Address author correspondence to Li-Shan Chou at chou@uoregon.edu.
  • 1.

    Bolgla LA, Malone TR, Umberger BR, Uhl TL. Hip strength and hip and knee kinematics during stair descent in females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008;38(1):12–18. PubMed doi:10.2519/jospt.2008.2462

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther. 2003;33(11):671–676. PubMed doi:10.2519/jospt.2003.33.11.671

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Robinson RL, Nee RJ. Analysis of hip strength in females seeking physical therapy treatment for unilateral patellofemoral pain syndrome. J Orthop Sport Phys Ther. 2007;37(5):232–238. doi:10.2519/jospt.2007.2439

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE. Hip strength in collegiate female athletes with patellofemoral pain. Med Sci Sports Exerc. 2007;39(8):1227–1232. PubMed doi:10.1249/mss.0b013e3180601109

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Souza RB, Powers CM. Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain. Am J Sports Med. 2009;37(3):579–587. PubMed doi:10.1177/0363546508326711

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Nakagawa TH, Moriya ÉTU, MacIel CD, Serrão FV. Frontal plane biomechanics in males and females with and without patellofemoral pain. Med Sci Sports Exerc. 2012;44(9):1747–1755. PubMed doi:10.1249/MSS.0b013e318256903a

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Fredericson M, Cookingham C, Chaudhari A, Dowdell B, Oestreicher N, Sahrmann S. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000;10(3):169–175. PubMed

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Willson JD, Davis IS. Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands. Clin Biomech. 2008;23(2):203–211. doi:10.1016/j.clinbiomech.2007.08.025

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain. J Orthop Sports Phys Ther. 2009;39(1):12–19. PubMed doi:10.2519/jospt.2009.2885

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Noehren B, Pohl MB, Sanchez Z, Cunningham T, Lattermann C. Proximal and distal kinematics in female runners with patellofemoral pain. Clin Biomech. 2012;27(4):366–371. doi:10.1016/j.clinbiomech.2011.10.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40(2):42–51. PubMed doi:10.2519/jospt.2010.3337

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Earl JE, Hoch AZ. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med. 2011;39(1):154–163. PubMed doi:10.1177/0363546510379967

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Ferber R, Kendall KD, Farr L. Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome. J Athl Train. 2011;46(2):142–149. PubMed doi:10.4085/1062-6050-46.2.142

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Khayambashi K, Mohammadkhani Z, Ghaznavi K, Lyle MA, Powers CM. The effects of isolated hip abductor and external rotator muscle strengthening on pain, health status, and hip strength in females with patellofemoral pain: a randomized controlled trial. J Orthop Sport Phys Ther. 2012;42(1):22–29. doi:10.2519/jospt.2012.3704

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Alaca R, Yilmaz B, Goktepe AS, Mohur H, Kalyon TA. Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome. Am J Phys Med Rehabil. 2002;81(11):807–813. PubMed doi:10.1097/00002060-200211000-00002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Snyder KR, Earl JE, O’Connor KM, Ebersole KT. Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clin Biomech. 2009;24(1):26–34. doi:10.1016/j.clinbiomech.2008.09.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Willy RW, Davis IS. The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. J Orthop Sports Phys Ther. 2011;41(9):625–632. PubMed doi:10.2519/jospt.2011.3470

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Wouters I, Almonroeder T, Dejarlais B, Laack A, Willson JD, Kernozek TW. Effects of a movement training program on hip and knee joint frontal plane running mechanics. Int J Sports Phys Ther. 2012;7(6):637–646. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Ford KR, Taylor-Haas JA, Genthe K, Hugentobler J. Relationship between hip strength and trunk motion in college cross-country runners. Med Sci Sports Exerc. 2013;45(6):1125–1130. PubMed doi:10.1249/MSS.0b013e3182825aca

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Baggaley M, Noehren B, Clasey JL, Shapiro R, Pohl MB. Frontal plane kinematics of the hip during running: are they related to hip anatomy and strength? Gait Posture. 2015;42(4):505–510. PubMed doi:10.1016/j.gaitpost.2015.07.064

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Taylor-Haas JA, Hugentobler JA, DiCesare CA, et al. Reduced hip strength is associated with increased hip motion during running in young adult and adolescent male long-distance runners. Int J Sports Phys Ther. 2014;9(4):456–467. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Brund RBK, Rasmussen S, Nielsen RO, Kersting UG, Laessoe U, Voigt M. The association between eccentric hip abduction strength and hip and knee angular movements in recreational male runners: an explorative study. Scand J Med Sci Sports. In press. PubMed doi:10.1111/sms.12923

    • Search Google Scholar
    • Export Citation
  • 23.

    Jacobs CA, Uhl TL, Mattacola CG, Shapiro R, Rayens WS. Hip abductor function and lower extremity landing kinematics: sex differences. J Athl Train. 2007;42(1):76–83. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sport Exerc. 2004;36(6):926–934. doi:10.1249/01.MSS.0000128145.75199.C3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Ferber R, Davis IM, Williams DS. Gender differences in lower extremity mechanics during running. Clin Biomech. 2003;18(4):350–357. doi:10.1016/S0268-0033(03)00025-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Schache A, Blanch P, Rath D, Wrigley T, Bennel K. Differences between the sexes in the three-dimensional angular rotations of the lumbo-pelvic-hip complex during treadmill running. J Sports Sci. 2003;21(2):105–118. PubMed doi:10.1080/0264041031000070859

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Taunton J, Ryan M, Clement D, McKenzie D, Lloyd-Smith D, Zumbo B. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95–101. PubMed doi:10.1136/bjsm.36.2.95

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Willy RW, Manal KT, Witvrouw EE, Davis IS. Are mechanics different between male and female runners with patellofemoral pain? Med Sci Sports Exerc. 2012;44(11):2165–2171. PubMed doi:10.1249/MSS.0b013e3182629215

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Becker J, Pisciotta E, James S, Osternig LR, Chou LS. Center of pressure trajectory differences between shod and barefoot running. Gait Posture. 2014;40(4):504–509. PubMed doi:10.1016/j.gaitpost.2014.06.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Kadaba MP, Ramakrishnan HK, Wootten ME. Measurement of lower extremity kinematics during level walking. J Orthop Res. 1990;8(3):383–392. PubMed doi:10.1002/jor.1100080310

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Vaughan CL, Davis BL, O’Connor JC. Dynamics of Human Gait. 2nd ed. Western Cape, South Africa: Kiboho Publishers; 1992.

  • 32.

    Cavanagh PR, Lafortune MA. Ground reaction forces in distance running. J Biomech. 1980;13(5):397–406. PubMed doi:10.1016/0021-9290(80)90033-0

  • 33.

    Willson JD, Kernozek TW, Arndt RL, Reznichek DA, Straker JS. Gluteal muscle activation during running in females with and without patellofemoral pain syndrome. Clin Biomech. 2011;26(7):735–740. doi:10.1016/j.clinbiomech.2011.02.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Ferber R, McClay Davis I, Williams DS, Laughton C. A comparison of within- and between-day reliability of discrete 3D lower extremity variables in runners. J Orthop Res. 2002;20(6):1139–1145. PubMed doi:10.1016/S0736-0266(02)00077-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Lenhart R, Thelen D, Heiderscheit B. Hip muscle loads during running at various step rates. J Orthop Sport Phys Ther. 2014;44(10):766–774, A1–A4. PubMed doi:10.2519/jospt.2014.5575

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat. 1989;166:179–189. PubMed doi:10.1016/j.clinbiomech.2007.07.001

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Bartlett JL, Sumner B, Ellis RG, Kram R. Activity and functions of the human gluteal muscles in walking, running, sprinting, and climbing. Am J Phys Anthropol. 2014;153(1):124–131. PubMed doi:10.1002/ajpa.22419

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Teng H-L, Powers CM. Hip-extensor strength, trunk posture, and use of the knee-extensor muscles during running. J Athl Train. 2016;51(7):519–524. PubMed doi:10.4085/1062-6050-51.8.05

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Lieberman DE, Raichlen DA, Pontzer H, Bramble DM, Cutright-Smith E. The human gluteus maximus and its role in running. J Exp Biol. 2006;209(pt 11):2143–2155. doi:10.1242/jeb.02255

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Butler RJ, Hamill J, Davis I. Effect of footwear on high and low arched runners’ mechanics during a prolonged run. Gait Posture. 2007;26(2):219–225. PubMed doi:10.1016/j.gaitpost.2006.09.015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Hall JPL, Barton C, Jones PR, Morrissey D. The biomechanical differences between barefoot and shod distance running: a systematic review and preliminary meta-analysis. Sport Med. 2013;43(12):1335–1353. doi:10.1007/s40279-013-0084-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Kadaba MP, Ramakrishnan HK, Wootten ME, Gainey J, Gorton G, Cochran GV. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. J Orthop Res. 1989;7(6):849–860. PubMed doi:10.1002/jor.1100070611

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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