The effect of technique change on knee loads during sidestep cutting

Purpose: To identify the effect of modifying sidestep cutting technique on knee loads and predict what impact such change would have on the risk of noncontact anterior cruciate ligament injury. Methods: A force platform and motion-analysis system were used to record ground-reaction forces and track the trajectories of markers on 15 healthy males performing sidestep cuffing tasks using their normal technique and nine different imposed techniques. A kinematic and inverse dynamic model was used to calculate the three-dimensional knee postures and moments. Results: The imposed techniques of foot wide and torso leaning in the opposite direction to the cut resulted in increased peak valgus moments experienced in weight acceptance. Higher peak internal rotation moments were found for the foot wide and torso rotation in the opposite direction to the cut techniques. The foot rotated in technique resulted in lower mean flexion/extension moments, whereas the foot wide condition resulted in higher mean flexion/extension moments. The flexed knee, torso rotated in the opposite direction to the cut and torso leaning in the same direction as the cut techniques had significantly more knee flexion at heel strike. Conclusion: Sidestep cutting technique had a significant effect on loads experienced at the knee. The techniques that produced higher valgus and internal rotation moments at the knee, such as foot wide, torso leaning in the opposite direction to the cut and torso rotating in the opposite direction to the cut, may place an athlete at higher risk of injury because these knee loads have been shown to increase the strain on the anterior cruciate ligament. Training athletes to avoid such body positions may result in a reduced risk of noncontact anterior cruciate ligament injures.