Contributions of lower extremity joints to energy dissipation during landings

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APPLIED SCIENCES Biodynamics Contributions of lower 'extremity joints to energy dissipation during landings SONG-NING ZHANG, BARRY T. BATES. and JANET S. DUFEK Exercise Science Unit, Biornechanics/Sports Medicine Laboratory, The Universily of Tennessee, Knoxville, Knoxville, TN 37996; and Universiry of Oregon, Eugene, OR ABSTRACT ZHANG, S-N.. B. T. BATES, and I. S. DUFEK. Contributions of lower extremity joints to energy dissipation during landings. Med. Sci. Sports Exerc., Vol. 32, No. 4, pp. 812-5 19,2000. Purpose: The purpose of the study was to investigate changes in lower extremity joint energy absorption for different landing heights and landing techniques. Methods: Nine healthy, active male subjects volunteered to perform step-off landings from three different heights (0.32 m, 2.5 m-'; 0.62 m, 3.5 m^: and 1.03 m, 4.5 m") using three different landing techniques (soft. SFL; normal. NML, and stiff landing, STL). Each subject initially performed five NML trials at 0.62 m to serve as a baseline condition and subsequently executed five trials in each of the nine test conditions (3 heights X 3 techniques). Results: The results demonstrated general increases in peak ground reaction forces, peak joint moments, and powers with increases in landing height and stiffness. The mean eccentric work was 0.52. 0.74, and 0.87 J-kg-' by the ankle muscles, and 0.94, 1.31, and 2.15 J-kg-' by the hip extensors, at 0.32,0.62, and 1.03 m, respectively. The nvernge eccentric work performed by the knee extensors was 1.21, 1.63. and 2.26 ].kg-' for the same three heights. Conclusions: The knee joint extensors were consistent contributors to energy dissipation. The ankle plantarflexors contributed more in the STL landings. whereas the hip extensors were greater contributors during the SFL landings. Also a shift from ankle to hip strategy was observed as landing height increased. Key Words: STRATEGIES, MECHANICAL DEMAND. MUSCULAR WORK uring foot contact with ground in vigorous locomo- tion, the body experiences tremendous impact forces. Maximum vertical ground reaction force values as high as 14.4 times body weight (BW) have been reported (20) for single-leg landings from a double 'back somersault. Stacoff et al. (25) showed that the first peak (Fl) of the vertical component of ground reaction force (GRF) ranged from 1000 to 2000 Newtons (N), whereas the second peak (F2) values ranged from 1000 to 6500 N in landings after a volleyball block jump. McNitt-Gray (17) demon- strated that the maximum vertical ground reaction forces for trained gymnasts were 3.9, 6.3. and 11.0 times BW for landing from heights of 32. 72, and 128 cm, respectively. Accumulation of high impact forces may pose a threat to the integrity of the lower extremity and related overuse injuries are often direct consequences of these impacts (22,23). Many of these injuries are often associated with the knee- joint structure and reported as common in running (16), 0 195-9131/00/3204-0sl a0 MEDICINE & SCIENCE LN SPORTS & EXERCISEo Copyright t3 2000 by the American College of Sports Medicine Submitted for publication February 1998. Accepted for publication September 1998. basketball (19), tennis (24), football (15). volleyball (l2), skiing (10). and the triathlon (3). Fifty-eight percent of all injured female basketball players were engaged in landing from a jump at their time of injury (13) and 40% of high- level volleyball players experienced knee problems during their playing careers (1 1). James et al. (16) reported knee pain as the most common problem for runners. The studies on biomechanical behaviors of the lower extremity in landing have been focused on prediction of impact forces (9). comparisons of landing techniques (4), effects of landing velocities (18). and manipulations of landing distances, heights, and techniques (8). Dufek and Bates (8) demonstrated greater peak moments of the prox- imal extensors (i.e., hip extensors) compared with the distal extensors (i.e., plantarflexors). Few studies, however, inves- tigated the contributions of various lower extremity muscle groups to the total energy dissipation. DeVita and Skelly (4) suggested that the ankle joint plantar flexors absorbed more energy in a stiff landing, whereas the hip and knee extensors absorbed more energy in the soft landing. McNitt-Gray (18) demonstrated that elite gymnasts dissipated more energy .r with ankle and hip extensors at the higher height compared with their recreational counterparts, whereas the latter group adjusted their strategy by increasing hip flexion and by 8 12

Transcript of Contributions of lower extremity joints to energy dissipation during landings

APPLIED SCIENCES Biodynamics

Contributions of lower 'extremity joints to energy dissipation during landings

SONG-NING ZHANG, BARRY T. BATES. and JANET S. DUFEK

Exercise Science Unit, Biornechanics/Sports Medicine Laboratory, The Universily of Tennessee, Knoxville, Knoxville, TN 37996; and Universiry of Oregon, Eugene, OR

ABSTRACT

ZHANG, S-N.. B. T. BATES, and I. S. DUFEK. Contributions of lower extremity joints to energy dissipation during landings. Med. Sci. Sports Exerc., Vol. 32, No. 4, pp. 812-5 19,2000. Purpose: The purpose of the study was to investigate changes in lower extremity joint energy absorption for different landing heights and landing techniques. Methods: Nine healthy, active male subjects volunteered to perform step-off landings from three different heights (0.32 m, 2.5 m-'; 0.62 m, 3.5 m̂ : and 1.03 m, 4.5 m") using three different landing techniques (soft. SFL; normal. NML, and stiff landing, STL). Each subject initially performed five NML trials at 0.62 m to serve as a baseline condition and subsequently executed five trials in each of the nine test conditions (3 heights X 3 techniques). Results: The results demonstrated general increases in peak ground reaction forces, peak joint moments, and powers with increases in landing height and stiffness. The mean eccentric work was 0.52. 0.74, and 0.87 J-kg-' by the ankle muscles, and 0.94, 1.31, and 2.15 J-kg-' by the hip extensors, at 0.32,0.62, and 1.03 m, respectively. The nvernge eccentric work performed by the knee extensors was 1.21, 1.63. and 2.26 ].kg-' for the same three heights. Conclusions: The knee joint extensors were consistent contributors to energy dissipation. The ankle plantarflexors contributed more in the STL landings. whereas the hip extensors were greater contributors during the SFL landings. Also a shift from ankle to hip strategy was observed as landing height increased. Key Words: STRATEGIES, MECHANICAL DEMAND. MUSCULAR WORK

uring foot contact with ground in vigorous locomo- tion, the body experiences tremendous impact forces. Maximum vertical ground reaction force

values as high as 14.4 times body weight (BW) have been reported (20) for single-leg landings from a double 'back somersault. Stacoff et al. (25) showed that the first peak (Fl) of the vertical component of ground reaction force (GRF) ranged from 1000 to 2000 Newtons (N), whereas the second peak (F2) values ranged from 1000 to 6500 N in landings after a volleyball block jump. McNitt-Gray (17) demon- strated that the maximum vertical ground reaction forces for trained gymnasts were 3.9, 6.3. and 11.0 times BW for landing from heights of 32. 72, and 128 cm, respectively. Accumulation of high impact forces may pose a threat to the integrity of the lower extremity and related overuse injuries are often direct consequences of these impacts (22,23). Many of these injuries are often associated with the knee- joint structure and reported as common in running (16),

0 195-9 13 1/00/3204-0s l a 0 MEDICINE & SCIENCE LN SPORTS & EXERCISEo Copyright t3 2000 by the American College of Sports Medicine

Submitted for publication February 1998. Accepted for publication September 1998.

basketball (19), tennis (24), football (15). volleyball (l2), skiing (10). and the triathlon (3). Fifty-eight percent of all injured female basketball players were engaged in landing from a jump at their time of injury (13) and 40% of high- level volleyball players experienced knee problems during their playing careers (1 1). James et al. (16) reported knee pain as the most common problem for runners.

The studies on biomechanical behaviors of the lower extremity in landing have been focused on prediction of impact forces (9). comparisons of landing techniques (4), effects of landing velocities (18). and manipulations of landing distances, heights, and techniques (8). Dufek and Bates (8) demonstrated greater peak moments of the prox- imal extensors (i.e., hip extensors) compared with the distal extensors (i.e., plantarflexors). Few studies, however, inves- tigated the contributions of various lower extremity muscle groups to the total energy dissipation. DeVita and Skelly (4) suggested that the ankle joint plantar flexors absorbed more energy in a stiff landing, whereas the hip and knee extensors absorbed more energy in the soft landing. McNitt-Gray (18) demonstrated that elite gymnasts dissipated more energy

.r with ankle and hip extensors at the higher height compared with their recreational counterparts, whereas the latter group adjusted their strategy by increasing hip flexion and by

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C

, ,. .)nging the landing phase. Different views still exist in literaturc regarding the various contributions made by

tllc. lower extrcrnity muscle groups to the reduction of im- pact and energy. The femur and tibia are among the longest bones in human body and significantly greater loading at the b e e joint are expected. High mechanical output by the knee musculature should be experienced consequently. Research in this area, however. still fails to agree on the issue. There- fore. the purpose of the study was to investigate changes in ?..?r_ry absorption of lower extremity joints for different I:. ding heights and landing techniques.

METHODS

Nine active men (ages: 25 + 5 yr, mass: 74.4 2 6.3 kg) volunteered to participate as subjects in the study. Each subject signed an Informed Consent Form approved by the Institutional Review Board at the University of Oregon, :,hich was consistent with the human subject policy of the .merican College of Sports Medicine before the experi-

. mental sessions. All subjects were actively involved in recreational sports on a regular basis (at least 2-3 times per week) and had participated in sporting activities requiring jumpingllanding skills. They were free of injury or other physical impairment in the lower extremity at the time of testing.

The subjects participated in two test sessions. The first lest session was used to familiarize the subjects with the :xperimental protocol and to obtain mean maximum knee flexion angles for the nine test conditions that were combi- nations of soft (SFL), normal (NML), and stiff (STL) land- ing techniques (stiffness) and three landing heights (0.32 m, 0.62111, and 1.03 m). The subjects were asked to perform five landing trials in each of the 10 conditions and the right knee flexion angles were monitored using an electrogoniometer (Penny and Gile,,1000 Hz). The mean maximum knee flexion angles obtained were used to determine the range of maximum knee flexion angle for each of the nine test conditions for each subject with following equation:

%npc = ffmax 2 90

where a,,,, = range of maximum knee flexion angle and a,, = mean maximum knee flexion angle. The 9' criterion was derived from the data of maximum knee flexion of normal landings from a 60-cm height and two standard deviations were applied to ensure proper range of variation (5). The a,,, values thus obtained for each subject at each height X technique combination (condition) were used to monitor landing technique during the second test session. Any trial with a maximum knee flexion angle beyond %,,, was discarded and an additional landing was performed.

The second session began with an anthropometric mea- surement portion and was followed by the activity testing protocol. All subjects were encouraged to actively warm up before the testing. Subjects performed five step-off landing trials from a raised platform in each of the 10 conditions for a total of 50 trials. The landings were initiated with right foot leading forward, the left foot remaining in contact with

the platform, and thc ccnter ot' grnvity as stcady as possible before the step-off. The subjects were instructed to keep both hands on their buttock so that their upper limbs were parallel to the sagittal plane and clear from obstructing their hip reflective markers during landing. Among the 10 con- ditions, the first was a base-line condition performed at the beginning with normal landing from the median height (i.e., 0.63 m). Subsequently, the subjects were asked to perform landings in nine test conditions which were a combination of SFL, NML, and STL landing trials from the three landing heights of 0.32,0.63, and 1.03 m representing three contact velocities (i.e., 2.5,3.5, and 4.5 mas-'). The order of heights was from the lowest to the highest to minimize potential risk of injury. The landing techniques were randomized in such a way that the soft and stiff landing occurred randomly either before or after normal landing at each height.

The right sagittal view was recorded using two high- speed video cameras (200 Hz, Motion Analysis Corpora- tion, Santa Rosa. CA) with one camera focusing on the' performance of lower extremity and the other camera on the total body. The lower extremity view was mapped on to the total body view to obtain more accurate measurement of lower extremity kinematics. Retro-reflective markers were placed on the right side of the ear canal, acromion, lateral humeral epicondyle, radial styloid process, greater trochani ter, lateral femoral epicondyle, lateral malleolus, heel, and head of the fifth metatarsal. Two force platforms (AMTI) were used to collect data of ground reaction forces (GRF) and moments of force for left and right limbs. Only the right side signals were used for further analyses. The electrogo'- niometer was placed on the right knee joint to monitor the maximum knee flexion angles and landing stiffness (tech- nique-defined as maximum knee flexion angle) during the test sessions. The force platform and electrogoniometer signals were sampled at 1000 Hz using a biomechanical system (Ariel Dynamics Inc., Trabuco Canyon, CA). The synchronization between the video, force platform, and electrogoniometer systems was accomplished through a light-emitting-diode which was present in the video views, triggered by the force platform and fed as an analog channel to the Ariel system. The video images were digitized to obtain coordinates of the joints using the commercial soft- ware (Motion Analysis). The data of the kinematic coordi- nates, ground reaction forces, and moments were imported into customized software to compute typical joint kinemat- ics, segmental inertia properties (14), and joint kinetics via an inverse dynamics model (26).

The variables evaluated included the range of motion (ROM) of the three lower extremity joints, peak GRF, peak joint moments and powers, and total eccentric work per- formed by the different lower extremity muscle groups. Critical values were assessed with statistical procedures, and the time-history of the kinematic and kinetic variables was examined qualitatively. The ground reaction forces and joint kinetic values were normalized to the body mass for each individual subject while the representative moment and power curves were normalized to landing phase; the latter was defined as the time from foot contact to the minimal

LANDING BIOMECHANICS Medicine & Science In Sports & Exercise@ 8 13

.ABLE 1. Collapsed group means and SD of maximum GRF and selected ROM across techniques or heights.

F1 F9 Condition (N.kgI1) ( N . k t l ) Ankle ROM (.) Knee ROM (4) Hip ROM (.)

32 8.27' 25.14' 30.24' 52.02' 40.22" (2.58) (8.52) (p) (21.02) (26.75)

62 17.30' 32.17b 3 .99 56.74" 49.86' (4.55) (8.27) (6.82) (19.11) (26.94)

103 30.60e 46.50' 34.42' 63.61 ' 65.35' (6.07) (10.24) (7.74) (1 7.42) (24.25)

SFL 16.48d 29.17" 34.38 77.Md 79.26"

NML (10.48) (1 1.99) (6.72)

STL 21 .Oaf 41.45' 28.69' (10.34) 11 1.661 (6.751

Values in parenthesis are standard deviation (SD); Significant difference level: p < 0.05; see text for full description ot the variables. a Significantly different between 32 and 62 cm. ' Significantly different between 62 and 103 cm. CSignificantly different between 103 and 32 cm. dSignificantly different between SFL and NML. *Significantly different between NML and STL. 'Significantly different between STL and SFL.

vertical center of gravity (COG) position during landing. By convention, both the positive and negative values for joint moment would represent extensor and flexor moment, and the positive and negative power values would indicate en- ergy generation and absorption. A three-factor 3 X 3 X3 (height X technique X joint) univariate analysis of variance (ANOVA) was computed for the total work performed by lower extremity muscle goups. Two-factor 3 X 3 ANOVAs (height X technique) were performed on the peak GRF, ROM, and moment and power variables. Because the peak moments and powers do not occur at the same time and do not fully reflect the total effort involved in the energy reduction, only the height and technique were adopted as the factors without consideration of the joint in the analyses. Unless mentioned otherwise, the significant level for differ- ence was set at P < 0.05.

RESULTS

Ground reaction force magnitudes. The typical time-history curve of the vertical ground reaction force demonstrated two distinctive maximums with first peak (Fl) related to toe contact and second peak (F2) associated with heel contact (6,7). A summary of the selected critical events collapsed by height across techniques and by technique across heights is provided in Table 1. The 3 X 3 ANOVA (height X technique) results for F1 and F2 demonstrated significant omnibus F (P < 0.0001). significant main effects for height and technique (P < 0.0001), and insignificant height X technique interactions (P > 0.05). Due to the lack of interactions, the data were collapsed across three tech- niques for each height and across three heights for each technique (Table 1). Similar combinations were also made and presented for the ROM, peak moment, and power vari- ables. The peak GRF values (F1 and F2) increased signifi- cantly (P C 0.05) from the lower to higher heights. When comparing these values under.the increased landing stiffness conditions, the significantly augmented peaks were ob- served as well (Table 1). These results demonstrated a trend

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of the increased loading to the body with increases in either landing height or landing stiffness.

Joint ROM. A change of landing technique (stiffneps) is practically defined as a change of lower extremity joint angles during landings. More specifically stiffness was de- fined as a change of maximal knee joint flexion angle during the landing phase in this study. The 3 X 3 ANOVA (height X technique) results indicated highly significant omnibus F (P < 0.0001), and significant main effects for height and technique (P < 0.0001) for the hip, knee, and ankle ROM. The hip and ankle ROM demonstrated insig- nificant interactions between height and technique, whereas the interaction for the knee ROM was significant (P < 0.01). The collapsed mean ROM values for the lower ex- tremity joints generally increased with enhancements in landing height except the changes in the ankle ROM from 62 to 103 cm (Table 1). Meanwhile the decreases in the ROM with increases in landing stiffness (technique) were seen across all three joints except the changes in the ankle joint ROM from SFL to NML. The ankle joint ROM main- tained small changes from SFL to STL and the most drops in ROM at all three heights were accounted for mainly by the hip and knee joint.

Kinetics. Mean representative curves of hip, knee, and ankle joint moment and power normalized to landing phase for NML at 0.62 m are provided in Figure 1 and 2. Two distinctive peaks of first (AM 1 and Khl 1) and second (AM2 and KM2) maximum moment were present in both ankle and knee joint moment curves (Fig. 1). Only one significant peak was observed in hip joint moment (HM) during the impact phase of landing. Similarly. two minimums were observed for the power curves for the ankle (APl and AP2), and knee (KP1 and KP2) joint, whereas only one minimum was observed from the hip (HP) joint (Fig. 2). The maxi- mum and minimum values in the moment and power curves

1 occurred approximately at TI and T2, indicating their close associations with the first and second impact forces.

Peak extensor moments and powers represent maximum efforts by certain muscle groups in energy absorption. The

-2.0 .

0 20 40 60 80 100

(a) Percent 40 60

Percent

. , Figure 1-Representative average joint moment curves of (a) hip joint moment, (b) knee joint moment, and (c) ankle joint moment, for Figure %Representative average joint power curve of (a) hip joint normal landing from 0.63 m. First and second vertical lines corre- power, (b) knee joint power, and (c) ankle joint power, for normal sponding to TI and T2 of GRF. See text for full description of the landing from 0.63 m. First and second vertical lines corresponding to labels. T1 and T2 of GRF. See text for full description of the labels.

3 X 3 ANOVAs (height X technique) were performed for these variables. Significant effects were noticed for the omnibus F (P < 0.0001), the main effects (P < 0.0001), and insignificant interactions between height and technique (ex- cept KM2),The values of AM1 and AP1 were significantly lower than the values of AM2 and AP2 for all conditions, indicating minimum effect of ankle plantarflexors in the impact absorption at TI (Tables 2 and 3). However, the knee extensors became increasingly involved in the absorption of

the first impact force at the two higher heights. The peak hip moment and power that occurred later than AM1 and KM1 demonstrated significantly greater values than that of peak ankle and knee extensor moments and power (Table 2 and 3). The timings for those peaks were consistent and arranged in 'h sequential manner (Figs. 1 and 2).

The mean absolute and relative eccentric work is pro- vided in Table 4. A 3 X 3 X 3 ANOVA (height X tech- nique X joint) was conducted on the eccentric work

LANDING BIOMECHANICS Medicine & Science in Sports & Exercise* 8 15

, TABLE 2. Collapsed group means and SD of maximum joint moments across techniques or heights.

Condition AM1 AM2 KM1 KM2 . H M

32 0.57. 1.54' 1.73d 2.04' 4.1ga - 6 (0.17) (0.38) (0.55) (0.38) (1.33) 6;

62 1.07O 2.06b , 3.91b 2.64b 5 . 8 ~ ~ 4 ...

103

SFL (0.55) (0.55) (2.1 5) (0.64) (2.49)

NML 1.106 1.96' 4.10' 2.75' 6.216 (0.61) (0.61) (2.34) (0.74) (2.70)

STL 1.33' 2.40' 4.42' 2.94' 6.80' (0.65) (0.69) (2.29) (0.84) (2.70)

Peak moment unit is in N.m.kg-,; values in parenthesis are standard deviation (SD); significant difference level: p < 0.05; see text for full description of the variables. a Significantly different between 32 and 62 cm. bSignificantly different between 62 and 103 cm. CSignificantly different between 103 and 32 cm. "Significantly different between SFL and NML. 'Significantly different between NML and STL. 'Significantly different between STL and SFL.

performed by the lower extremity. The result demonstrated significant omnibus F, significant main effects for height, technique and joint, and significant two-way interactions for joint X height and joint X technique (P < 0.01). The interaction between height and technique was not significant (P > 0.05) and no significant three-way interactions were found. Two 3 X 3 ANOVAs (joint X height and joint X technique) were conducted as follow-up analyses. The in- teractions between joint and height as well as joint and technique are shown in Figure 3. The absolute mean values of eccentric work during the landing phase displayed the trends of change that are slightly different from the relative (percent) eccentric work (Table 4). For absolute work, the

sors showed decreased contributions (45.3% to 20.9%) to the total energy dissipation as the landing stiffness in- creased. The increases in landing heights did not influence the relative contributions of each of the three lower extrem- ity muscle groups consistently (Table 4). Clear anticipation by the subjects was demonstrated by the joint positions at contact; these data suggested that the initial ankle joint positions remained constant while the initial knee and hip joint angles demonstrated overall decreases as the landings became stiffer. t

ankle muscle group predominantly demonstrated increased work with the increases in landing heights and slight im- provement of eccentric work from SFL to STL. The hip and knee joint extensor groups showed general decreased ec- centric efforts with increased stiffness and improved work values with increased landing heights (Table 4, Fig. 3). For the relative eccentric work, however, the knee joint main- tained consistent and high mechanical outputs in all landing conditions. Meanwhile, the ankle muscles demonstrated in- creased contributions (12.5% to 38.1%) and the hip exten-

The purpose of the study was to examirie changes in lower extremity joint energy absorption for different landing heights and landing techniques. The changes in the landing heights and the landing techniques are closely related to the changes in mechanical demands placed on human body

' during the landing activities. The effects of mechanical demands placed on the lower extremity and the correspond- ing mechanical responses of lower extremity musculature during landing can be examined by evaluating changes in landing techniques in relation to landing heights and the

TABLE 3. Collapsed group means and SD of minimum joint powers across techniques or heights.

Condition AP1 AP2 KP1 KP2 HP

103

SFL

NML

STL (3.45) (3.47) (16.22) (7.85) (19.63)

Peak power unit is in W.kgml; ~ l u e s in parenthesis are standard deviation (SD); significant difference level: P < 0.05; See text for full description of the variables. 'Significantly different between 32 and 62 cm. bSignificantly different between 62 and 103 cm. I

cSi~nificantly different between 103 and 32 cm. dSlgnificantly different between SFL and NML. a Significantly different between NML and STL. 'Significantly different between STL and SFL.

8 16 Official Journal of the American College of Sports Medicine

5~; ..;lean absolute and relal'~e eccentric work at individual lower extremity joints. --

Work Percent Work condition Ankle Knee Hlo

-7%~ 82 NML 32 STL 62 SFL 62 NML 62 STL 103 SFL 103 NML 103 STL

Total Ankle Knee Hip

3.7SJ." 12.9 46.3 40.9 2.78b,d 21.0 47.1 32.0

/

Ecce !;lc work unit is in Jakg-': values in parenthesis are standard deviation (SD); significant difference level: p < 0.05; see text for full description of the variables. rgifiereflt from NML at the same height. bgifferent from STL at the same height. ~Qifferent from SFL at the same height. dDiffereflt from 62 cm height with the same technique. #Different from 103 cm height with the same technique. 'Different from 32 crn height with the same technique.

interaction of these two factors. The results suggest that several investigators that biarticular muscles are used for th e are general increases in biomechanical responses with power transportation during locomotion (2,21). Prilutsky th.; increased landing heights. However, the two peak and Zatsiorsky (21) demonstrated that the direction of ground reaction forces responded differently with such changes. The average and relative increases with respect to the lowest height (0.32 m) were 136% for F1 and 44% for

7

F2 with all three landing techniques, indicating a more Newtonirtn~mechanical response from the subjects for F l than for F2 without much neuromuscular intervention. The average times from the contact to F1 and F2 were 9.6 and 2 L.2 ms. The F2 responses occurred much later after the first t

impact and therefore were considered more neuromuscular, allowing more time for the lower extremity muscles to absorb the impact. DeVita and Skelly (4) observed a pre- contact muscular activity during landing, which suggests a preset central neuromuscular program. This anticipation may enhance the tension of the musculotendinous structures in the foot and ankle, and other lower extremity regions before the occurrence of landing contact so that greater energy SFL NML STL

lissipation may happen immediately after the impact. (a)

As mentioned previously, the mechanical demands in-, creased with an increase in landing heights. All three lower extremity extensor groups responded with an increase in peak and total mechanical output for the same technique (Tables 2-4). However, these changes were not undertaken in similar fashion among the different lower extremity mus- cle groups. Although the eccentric work performed by the ankle plantarflexors was increased slightly, the increases in the work done by the knee and hip extensors was more apparent as the height changed from 0.32 to 1.03 m (Table 4). The absolute work data from this study suggested that the ankle muscle group was less capable of energy absorp- tion compared with hip and knee muscle groups, especially at the two higher heights. The proximal muscles of the lower 32 62 103

(b) extremity tend to be larger in volume than the distal mus- cles; this is mainly due t~ greater cross-sectional areas (271, Figure &Interactions of R0R.I between (a) technique and joint* and

(h) height and joint. H, nnkle joint; *, knee joint; A. hip joint. For (a), longer muscle fibers, and relatively shorter tendons ( I ) . This no significant differences were found among techniques for ankle joint; mangement reduces the moment of inertia relative to the the differences between knee and hip using SFL was not signflcant;

hip joint and allows the leg to move more efficiently while q e differences between hip and ankle using STL was not signifiant; all other comparisons were significant. For (b), significant differences

it also limits the capacity of energy absorption and genera- found between different combinations of joint and height (P < tion in more distal muscle groups. It has been suggested by 0.05).

L A N D I N G BIOMECHANICS Medic ine & Science in Sports & E x e r c i s e 8 17

power transfcr during landing was from distal to proximal segments: it is therefore logical to assume that the energy generated before landing contact can be transported from the distal end to the more proximal and massive muscle group for further dissipation during impact. An indirect evidence from this study indicated that the peak powers reached at different times with the second peak knee power and the peak hip power occurring at an later time than the second peak ankle power (Fig. 2).

The subjects displayed distinct strategies at the different landing heights. In other words. each joint and muscle group played significantly different roles of energy reduction in the various mechanical loading situations (Fig. 2). It was noted that the ankle maintained a stable mechanical output. whereas the eccentric work by the knee and hip joint ex- tensors was reduced with changes of technique from the soft to stiffer landings at each height. As a result of these changes, the total work was decreased significantly due to the reduced time for energy reduction in normal and stiff landing. The knee and hip extensors were equally important in the landings with more lower extremity flexion (Table 4). As the landing became stiffer, their ability in energy reduc- tion decreased in different fashions. The hip extensors were less effective than the knee muscles in the STL condition at the low height. The same muscle group became more in- volved in the energy reduction at 0.62 m and 1.03 m due to the increases in their mechanical advantages in STL with greater hip joint flexion.

The present study presented a different energy dissipation pattern than has been previously reported in the literature. The eccentric work by knee and ankle muscles was greater for the soft landings compared with the stiff landings in a study reported by DeVita and Skelly (4). In the current experiment, significant increases in knee and hip work and decreases in ankle work were observed in the soft landing condition. McNitt-Gray (18) reported high hip and knee . work. and small ankle work for landings from medium and high heights (0.72 and 1.28 m) for recreational athletes using a normal landing technique. Although we observed similar changes in the knee and hip work, we saw an increase in the ankle eccentric work as the landing height increased. It is logical to a g u e that with the increased lower extremity flexion and longer landing phase at higher heights. the ankle musculature should perform more work. One possible explanation for the discrepancies may lay in the different activities involved in the present and previous studies. DeVita and Skelly investigated soft and stiff Iand- ings from a 0.59 m height, whereas McNitt-Gray studied the self-selected landings from three different heights. It is possible that minor changes in techniques may influence the biomechanical responses. It should be also noted that the subjects involved in this study were regular and active university students. whereas in McNitt-Gray's study, elite and recreational gymnasts were used as the subjects. It was, demonstrated that the strategies were different between the two different subject groups ( 18). In the present research the three self-selected landing strategies were systetnatically manipulated at three different heights. This is the tirst time

5 18 Official Journal of the American College of Sports Medicine

that all three possible techniques from three heights were systematically studied and both joint kinematic and kinetic measurements were presented. In our study. it was clearly demonstrated that the shift of energy absorption was fro[,, distal to proximal muscle groups with increased mechanical demand (i.e. increases in Ianding height). At the lower height. ankle and knee muscle groups were more effective in energy dissipation in the stiff Ianding, whereas the knee and hip extensors were more involved in the soft landing. As the height and mechanical loading increased. the lower extrem- ity posture became more tlexed. and the hip extensors be- came increasinsly involved in energy dissipation. A Second possible explanation may come from the differences in the control of techniques in the studies. In the present study, the three Ianding techniques were self-selected and predefined in a pretest session using an electrogoniometer for-each subject in each test condition. The range of maximum knee flexion using the formula shown earlier was used to monitor a subject's Ianding technique during the subsequent test session. Because the joint range of motion for each tech- nique was different for each subject, this control process preserved the natural techniques of each subject under the various test conditions. Even though there is no documented evidence that a change in natural technique will lead to changes in joint kinetics during landing, it is logical to assume that such changes may occur. More research is warranted_ for this aspect of landing biomechanics.

Main finding in this study was revealed by examining the relative contribution of each muscle group to the total en- ergy reduction. Although the absolute eccentric work data for the knee and hip joints suggested the increases in the energy absorption with the decreased landing stiffness at the all three different heights (Table 4), the relative work values indicated the high and consistent outputs from the knee extensors. The ankle work was increasingly important in the stiff landing at the lower heights; however, these percent- ages decreased with an increase in landing heights and mechanical demands. This is comprehensible due to the fact that the ankle plantarflexors exhibit lesser capacity for en- ergy absorption (I) . The hip extensors were.involved min- imally in STL at the low height and they became more involved as the mechanical demand increased and the hip joint posture became more tlexed. due to the massive po- tential of energy reduction for the muscle group. These observations were supported by the facts that the relative contribution of each joint Rob1 to the total change of ROM demonstrated rather similar fashions (Table I).

Landings involved in many sport activities are repetitive and violent in nature. This type of stress has long been associated with overuse injuries (22.23). With increased mechanical demands, loading to lower extremity joints es- calates accordingly. It was demonstrated in this study that the knee joint consistently experienced enormous mechan- ical demands and high mechanical output in the different landing conditions. At the greater mechanical demands, most of energy is absorbed by the massive knee and hip extensors. Therefore. the eccentric strength and proper

, .~nuscular control of these muscle groups are critical to integrity of the lower extremity. Finally, it was observed

bllt the interactions of height and technique were significant for the knee ROM and second peak moment. These inter- ,,[ions may be due to differences in individual landing

and strategy, and further study is warranted.

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LANDING BIOMECHANICS Medicine & Science in Sports & exercise^ 8 19