Hip-Extensor Strength, Trunk Posture, and Use of the Knee-Extensor Muscles During Running

Context: Diminished hip-muscle performance has been proposed to contribute to various knee injuries. Objective: To determine the association between hip-extensor muscle strength and sagittal-plane trunk posture and the relationships among hip-extensor muscle strength and hip and knee-extensor work during running. Design: Descriptive laboratory study. Setting: Musculoskeletal biomechanical laboratory. Patients or Other Participants: A total of 40 asymptomatic recreational runners, 20 men (age = 27.1 +/- 7.0 years, height = 1.74 +/- 0.69 m, mass = 71.1 +/- 8.2 kg) and 20 women (age = 26.2 +/- 5.8 years, height = 1.65 +/- 0.74 m, mass = 60.6 +/- 6.6 kg), participated. Main Outcome Measure(s): Maximum isometric strength of the hip extensors was assessed using a dynamometer. Sagittal-plane trunk posture (calculated relative to the global vertical axis) and hip-and knee-extensor work (sum of energy absorption and generation) during the stance phase of running were quantified while participants ran over ground at a controlled speed of 3.4 m/s. We used Pearson product moment correlations to examine the relationships among hip-extensor strength, mean sagittal-plane trunk-flexion angle, hip-extensor work, and knee-extensor work. Results: Hip-extensor strength was correlated positively with trunk-flexion angle (r = 0.55, P < .001) and hip-extensor work (r = 0.46, P = .003). It was correlated inversely with kneeextensor work (r = -0.39, P = .01). All the correlations remained after adjusting for sex. Conclusions: Our findings suggest that runners with hip-extensor weakness used a more upright trunk posture. This strategy led to an overreliance on the knee extensors and may contribute to overuse running injuries at the knee.