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The Effect of Foot Landing Position on Biomechanical Risk Factors Associated with Anterior Cruciate Ligament Injury

by MASS4D® Prescription Orthotics September 25, 2016


The purpose of this study was to investigate the effects of three foot landing positions: “toe-in”, “toe-out” and “neutral”, on biomechanical risk factors for ACL injury in males and females.

Each subject performed an initial static standing calibration trial. After which, subjects completed 3 trials each of 3 jump-landing tasks from a 30-cm box, landing on one of three different foot position templates marked with tape on the floor-mounted force plates.

Neutral foot position was defined as zero degrees rotation from a line directed anteriorly along the sagittal plane of the body.

Toe-in and toe-out landing positions were defined as 30° internal and external rotation, respectively, relative to the neutral position and using the back of the heel as the pivot reference.

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The jump sequence was randomised using a random number generator and subjects were instructed to land on either the neutral, toe-in or toe-out foot position template.

Differences in kinematic and kinetic variables between the three foot landing positions were detected using a mixed-effects ANOVA and pairwise Tukey post-hoc comparison.

Landing in a toe-in position was found to increase knee abduction angle, hip adduction angle and moment as well as tibial internal rotation angle and moment.

Toe-out landing position was found to be associated with decreased knee abduction angles and increased tibial external rotation angles.

Relative to their neutral foot position, females displayed greater increases in risky movement patterns with toe-in landing compared to males, suggesting that changes in foot landing position may have greater effects on lower extremity biomechanics in females.

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  1. Andrew A. Tran, Corey Gatewood, Alex H. S. Harris, Julie A. Thompson, Jason L. Dragoo (2016) The effect of foot landing position on biomechanical risk factors associated with anterior cruciate ligament injury. Journal of Experimental Orthopaedics: 18 June, 2016, Vol. 3, No. 13

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