Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain

in Journal of Sport Rehabilitation
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Context: The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. Objective: To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Design: Cross-sectional Setting: Academic medical center. Patients: A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated. Intervention: None. Main Outcome Measures: Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Results: Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Conclusions: Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.

Foster is with the Program in Physical Therapy, Washington University School of Medicine in St. Louis, MO, USA. Harris is with the Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, MO, USA; and with the Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, MO, USA. Hastings and Harris-Hayes are with the Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, MO, USA. Mueller is with the Program in Physical Therapy and Department of Radiology, Washington University School of Medicine in St. Louis, MO, USA. Salsich is with the Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA.

Harris-Hayes (harrisma@wustl.edu) is corresponding author.
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