Contraction of knee flexors and extensors in skiing related to the backward fall mechanism of injury to the anterior cruciate ligament

Abstract

The purpose of this study was to examine the motion pattern and muscle activity during jumping and landing in downhill skiing to estimate the muscular involvement during the jump-landing-backward fall-anterior cruciate ligament (ACL) injury. A digitized 2-D video motion analysis and a synchronous 8-channel electromyography registration was performed over a jump on a downhill slope during 3 runs by 2 skiers and during 6 control jumps in the laboratory. The knee flexors (lateral gastrocnemius and biceps femoris) were recruited before touchdown and mean 60 ms earlier than the extensors (vastus lateralis and rectus femoris). Extensors and flexors reached peak activity simultaneously at the instant of landing. The knee flexion angle at the instant of landing was mean 36 degrees. As the landing was stabilized, the extensor activity persisted during eccentric work at increasing knee flexion as a corresponding flexor relaxation took place. The control jump in the laboratory showed a similar order of recruitment and timing of muscle contraction. The gastrocnemius was recruited mean 96 ms earlier and the biceps femoris mean 63 ms earlier than the extensors. This recruitment pattern during the landing movement suggest a learned motor program engaging the kinetic chain of the lower extremity to intercept the landing energy. The results also indicate that the knee flexor activity may protect the ACL at the instant of landing but that it is minimal shortly thereafter and probably not able to protect the ACL when a backward fall occurs. The knee was flexed substantially as the extensors became the dominating muscles. Thus, their ability to apply any anterior drawer force able to rupture the ACL is questioned.