Gender differences in lower extremity mechanics during running

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Abstract

Objective. To compare differences in hip and knee kinematics and kinetics in male and female recreational runners.

Design. Gait analysis of 20 men and 20 women recreational runners.

Background. Female runners are reported to be more likely to sustain certain lower extremity injuries compared to their male counterparts. This has been attributed, in part, to differences in their structure and it has been postulated that these structural differences may lead to differences in running mechanics. It was hypothesized that females would exhibit greater peak hip adduction, hip internal rotation, knee abduction and decreased knee internal rotation compared to their male counterparts. It was also hypothesized that females would exhibit greater hip and knee negative work in the frontal and transverse planes compared to males.

Methods. Comparisons of hip and knee three-dimentional joint angles and negative work during the stance phase of running gait were made between genders.

Results. Female recreational runners demonstrated a significantly greater peak hip adduction, hip internal rotation and knee abduction angle compared to men. Female recreational runners also demonstrated significantly greater hip frontal and transverse plane negative work compared to male recreational runners.

Conclusion. Female recreational runners exhibit significantly different lower extremity mechanics in the frontal and transverse planes at the hip and knee during running compared to male recreational runners.

Relevance Understanding the differences in running mechanics between male and female runners may lend insight into the etiology of different injury patterns seen between genders. In addition, these results suggest that care should be taken to account for gender when studying groups of male and female recreational runners.

Introduction

Women runners are reported to be twice as likely to sustain certain running injuries such as patellofemoral pain syndrome, iliotibial band friction syndrome, and tibial stress fractures as compared to their male counterparts (Taunton et al., 2002). It has been postulated that known differences in structure may predispose females to differences in running mechanics which, over many repetitions, may lead to specific injuries. While gender differences in lower extremity structure have been studied, little attention has been devoted to differences in running patterns between men and women.

In terms of structure, Horton and Hall (1989) refute the notion that women have a wider pelvis than men. They do, however, report that women have a larger hip width to femoral length ratio which leads to greater hip adduction. This increased angulation of the femur contributes to the greater static genu valgus that Benas (1984) has reported in women. Women have also been shown to exhibit greater active hip internal rotation than men (Simoneau et al., 1998). The structural combination of increased hip adduction, hip internal rotation, and genu valgus may explain, in part, the larger Q-angle that is well-documented in women (Aglietti et al., 1983; Horton and Hall, 1989; Hsu et al., 1990; Livingston, 1998; Woodland and Francis, 1992). An increased Q-angle (the angle subtended by the line connecting the anterior superior iliac spine and the midpoint of the patella and one connecting the midpoint of the patella and the tibial tubercle) has been shown to be associated with an increase in lateral patellar contact forces (Mizuno et al., 2001). Therefore, an increased Q-angle is thought to play a partial role in the greater incidence of patellofemoral disorders that women experience (Almeida et al., 1999; DeHaven and Lintner, 1986; Messier et al., 1991).

The structural differences females exhibit at the hip and knee may predispose them to differences in their movement patterns as well. A few studies have examined gender-related differences in lower extremity mechanics during walking. While Keller et al. (1996) reported no gender-related differences in ground reaction forces (GRF) variables, Li et al. (2001) and Chao et al. (1983) found that women exhibited greater vertical GRF and free vertical moments compared to men. However, the specific joints or planes of motion where the increased torques were expected were not described. In a study of sagittal plane joint mechanics during walking, Kerrigan et al. (1998) reported that women exhibited a significantly greater peak hip flexion angle and negative work compared to men.

Only one study, to date, has addressed differences in lower extremity joint mechanics between genders during running. Malinzak et al. (2001) studied the frontal and sagittal plane motion of the knee in 11 male and 9 female runners. They reported that, while the frontal plane excursion was similar between genders, females exhibited 11° more valgus throughout the stance phase. In addition, women were found to exhibit less peak knee flexion and less knee flexion excursion compared to men. However, these authors did not examine hip kinematics or hip and knee kinetic differences in these subjects.

In summary, little information exists on gender-related differences in the secondary planes of movement for lower extremity running mechanics between genders. Therefore, the purpose of this study was to compare differences in kinematic and kinetic patterns of the hip and knee between male and female runners. The variables of interest were those that may be different between males and females based on documented differences in structure. Therefore, it was hypothesized that females would exhibit greater peak hip adduction, hip internal rotation and knee abduction, but lower peak knee internal rotation (due to the greater femoral internal rotation). It was also hypothesized that females would exhibit greater hip and knee negative work in the frontal and transverse planes compared to their male counterparts.

Section snippets

Subjects

Based on a priori power analyses (β=0.20; P=0.05), 40 recreational runners (20 males and 20 females) between the ages of 18 and 45 years old volunteered for this study. The mean body mass and body height of the male subjects were 82.26 kg (SD 11.79 kg) and 1.81 m (SD 0.06 m), respectively and the female subjects were 59.97 kg (SD 9.25 kg) and 1.67 m (SD 0.07 m), respectively. All subjects were rearfoot strikers free of any obvious lower extremity malalignments or injuries at the time of data

Results

There were no differences (P=0.39) in stance duration between the male (0.27, SD 0.01 ms) and female (0.26, SD 0.02 ms) recreational runners. Fig. 2, Fig. 3, Fig. 4, Fig. 5, Fig. 6, Fig. 7 present the 3-D angular motions, joint moments, and power patterns of the hip and knee for male and female recreational runners during the stance phase of gait. In the sagittal plane, women runners tended to be in slightly greater hip flexion and produce a great hip extensor moment throughout most of stance

Discussion

The purpose of this study was to compare differences in kinematic and kinetic patterns of the hip and knee in male and female recreational runners. No differences in sagittal plane hip and knee kinematics or kinetics were observed between male and female recreational runners in the present investigation (Fig. 2, Fig. 3). While Kerrigan et al. (1998) reported that women exhibited significantly greater peak hip flexion and negative work during walking, these differences were not evident during

Acknowledgments

We would like to thank Tracy A. Dierks, Robert J. Butler, and Carrie Laughton for their assistance in data collection and processing. Running shoes were provided by Nike Inc.

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