Is lower limb muscle synchrony during landing affected by gender? Implications for variations in ACL injury rates

This study examined whether lower limb muscle synchrony during abrupt landings was affected by gender, thereby predisposing females to a higher incidence of non-contact anterior cruciate ligament (ACL) injuries than males. Seven males and 11 females landed in single-limb stance on a force platform after receiving a chest-height netball pass and decelerating abruptly. Ground reaction force and electromyographic data for rectus femoris, vastus lateralis, vastus medialis, semimembranosus (SM), biceps femoris, and gastrocnemius were sampled (1000 Hz) during landing. Subjects' sagittal plane motion was also filmed (200 Hz). Knee joint reaction forces and sagittal planar net moments of force were estimated using Newtonian equations of motion and inverse dynamics. Tibiofemoral shear forces (F(s)) were obtained and muscle bursts temporally analysed with respect to initial foot-ground contact (IC) and peak F(s) times. Males displayed significantly delayed SM onset relative to IC (113+/-46 ms) compared to females (173+/-54 ms; p=0.03), and significantly delayed SM peak activity relative to peak F(s) (54+/-27 ms) compared to females (77+/-15 ms; p=0.03). Delayed SM activity during landing was suggested to allow peak muscle activity to better coincide with high anterior F(s), thereby acting as an ACL synergist via increased joint compression and posterior tibial drawer. It was concluded that females displayed muscle synchrony less protective of the ACL than males, possibly increasing their susceptibility to non-contact ACL injuries.