Abstract
Purpose
CrossFit® (CF) is a high-intensity training method with a large number of practitioners, having an injury prevalence similar to other sports. Although excessive dynamic knee valgus is related to several injuries and associated with the trunk muscles’ endurance and dorsiflexion range of motion (DF-ROM), no study has evaluated these parameters in CF practitioners. The aim of the study was to investigate the association between lower limb alignment during the step-down test, DF-ROM and lateral trunk muscle endurance in CrossFit® (CF) practitioners.
Methods
Forty-two CF practitioners performed the following tests on both limbs: (i) DF-ROM with the weight-bearing lunge test; (ii) knee frontal plane projection angle (FPPA) and hip adduction (hip ADD) ankle during the forward step-down test; (iii) trunk lateral flexors’ endurance with the side plank test.
Results
No significant associations were found between knee FPPA and DF-ROM in both limbs (preferred: r = 0.192; p = 0.230; non-preferred: r = 0.089; p = 0.581) or side plank time (preferred: r = 0.086; p = 0.594; non-preferred: r = 0.248; p = 0.117). Moreover, no significant associations were found between hip ADD and DF-ROM in both limbs (preferred: r = 0.005; p = 0.975; non-preferred: r = 0.175; p = 0.275) or side plank time (preferred: r = – 0.134; p = 0.403; non-preferred: r = 0. 171; p = 0.284).
Conclusion
Lateral trunk flexors’ endurance and ankle dorsiflexion range of motion are not associated with hip and knee kinematics during the forward step-down test in CrossFit®.
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References
Glassman G. Understanding crossfit. CrossFit Journal. 2007;56
Lichtenstein MB, Jensen TT (2016) Exercise addiction in crossfit: prevalence and psychometric properties of the exercise addiction inventory. Addict Behav Rep 3:33–37
Bernstorff MA, Schumann N, Maai N, Schildhauer TA, Königshausen M (2021) An analysis of sport-specific pain symptoms through inter-individual training differences in crossfit. Sports (Basel, Switzerland) 9(5):68
Tibana RA, De Sousa NMF (2018) Are extreme conditioning programmes effective and safe? A narrative review of high-intensity functional training methods research paradigms and findings. BMJ Open Sport Exerc Med 4(1):e000435
Hollman JH, Galardi CM, Lin IH, Voth BC, Whitmarsh CL (2014) Frontal and transverse plane hip kinematics and gluteus maximus recruitment correlate with frontal plane knee kinematics during single-leg squat tests in women. Clin Biomech (Bristol, Avon) 29:468–474
Nakagawa TH, Moriya ET, Maciel CD, Serrao FV (2012) Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther 42:491–501
Sorenson B, Kernozek TW, Willson JD, Ragan R, Hove J (2015) Two- and three-dimensional relationships between knee and hip kinematic motion analysis: single-leg drop-jump landings. J Sport Rehabil 24:363–372
Hewett TE, Myer GD, Ford KR, Heidt RS Jr, Colosimo AJ, McLean SG et al (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med 33:492–501
Zipser MC, Plummer HA, Kindstrand N, Sum JC, Li B, Michener LA (2021) Hip abduction strength: relationship to trunk and lower extremity motion during a single-leg step-down task in professional baseball players. Int J Sports Phys Ther 16:342–349
Paz GA, de Freitas MM, Santana HG, Miranda H, Lima V, Willson JD (2019) Knee frontal plane projection angle: a comparison study between drop vertical jump and step-down tests with young volleyball athletes. J Sport Rehabil 28:153–158
Silva FMD, Canêz DB, Madeira AR, Ferreira GD (2021) Dynamic knee alignment and pelvic balance: comparison regarding gender in young soccer athletes. Rev Bras Ortop 56:175–180
Lima YL, Ferreira V, de Paula Lima PO, Bezerra MA, de Oliveira RR, Almeida GPL (2018) The association of ankle dorsiflexion and dynamic knee valgus: a systematic review and meta-analysis. Phys Ther Sport 29:61–69
Nakagawa TH, Petersen RS (2018) Relationship of hip and ankle range of motion, trunk muscle endurance with knee valgus and dynamic balance in males. Phys Ther Sport 34:174–179
Neumann DA. Kinesiology of the musculoskeletal system-e-book: foundations for rehabilitation: Elsevier Health Sciences; 2013.
Macrum E, Bell DR, Boling M, Lewek M, Padua D (2012) Effect of limiting ankle-dorsiflexion range of motion on lower extremity kinematics and muscle-activation patterns during a squat. J Sport Rehabil 21:144–150
Fitarelli L, Ramos G, Scudiero F, Rabello R, Rodrigues R (2020) Core muscles thickness is not associated with knee frontal plane projection angle during single-leg squat in healthy people. Gait Posture 80:292–297
Rabin A, Portnoy S, Kozol Z (2016) The association of ankle dorsiflexion range of motion with hip and knee kinematics during the lateral step-down test. J Orthop Sports Phys Ther 46:1002–1009
Burnham JM, Yonz MC, Robertson KE, McKinley R, Wilson BR, Johnson DL et al (2016) Relationship of hip and trunk muscle function with single leg step-down performance: implications for return to play screening and rehabilitation. Phys Ther Sport 22:66–73
Rabello R, Bertozzi F, Brunetti C, Silva Zandonato L, Bonotti A, Rodrigues R et al (2022) The influence of task type and movement speed on lower limb kinematics during single-leg tasks. Gait Posture 96:109–116
Stickler L, Finley M, Gulgin H (2015) Relationship between hip and core strength and frontal plane alignment during a single leg squat. Phys Ther Sport 16:66–71
de Baldon RM, Piva SR, Scattone Silva R, Serrão FV (2015) Evaluating eccentric hip torque and trunk endurance as mediators of changes in lower limb and trunk kinematics in response to functional stabilization training in women with patellofemoral pain. Am J Sports Med 43:1485–1493
Cronström A, Creaby MW, Nae J, Ageberg E (2016) Gender differences in knee abduction during weight-bearing activities: a systematic review and meta-analysis. Gait Posture 49:315–328
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale (NJ)1988.
Powers CM, Witvrouw E, Davis IS, Crossley KM (2017) Evidence-based framework for a pathomechanical model of patellofemoral pain: 2017 patellofemoral pain consensus statement from the 4th International patellofemoral pain research retreat, Manchester, UK: part 3. Br J Sports Med 51:1713–1723
de Oliveira SD, Magalhaes FH, Pazzinatto MF, Briani RV, Ferreira AS, Aragao FA et al (2016) Contribution of altered hip, knee and foot kinematics to dynamic postural impairments in females with patellofemoral pain during stair ascent. Knee 23:376–381
Malloy P, Morgan A, Meinerz C, Geiser C, Kipp K (2015) The association of dorsiflexion flexibility on knee kinematics and kinetics during a drop vertical jump in healthy female athletes. Knee Surg Sports Traumatol Arthrosc 23:3550–3555
Schmitz A, Russo K, Edwards L, Noehren B (2014) Do novice runners have weak hips and bad running form? Gait Posture 40:82–86
Cronstrom A, Creaby MW, Nae J, Ageberg E (2016) Modifiable factors associated with knee abduction during weight-bearing activities: a systematic review and meta-analysis. Sports Med 46:1647–1662
Nester CJ, Jarvis HL, Jones RK, Bowden PD, Liu A (2014) Movement of the human foot in 100 pain free individuals aged 18–45: implications for understanding normal foot function. J Foot Ankle Res 7:51
Lewis CL, Foch E, Luko MM, Loverro KL, Khuu A (2015) Differences in lower extremity and trunk kinematics between single leg squat and step down tasks. PLoS ONE 10:e0126258
Bell-Jenje T, Olivier B, Wood W, Rogers S, Green A, McKinon W (2016) The association between loss of ankle dorsiflexion range of movement, and hip adduction and internal rotation during a step down test. Man Ther 21:256–261
Wyndow N, De Jong A, Rial K, Tucker K, Collins N, Vicenzino B et al (2016) The relationship of foot and ankle mobility to the frontal plane projection angle in asymptomatic adults. J Foot Ankle Res 9:3
Willson JD, Ireland ML, Davis I (2006) Core strength and lower extremity alignment during single leg squats. Med Sci Sports Exerc 38:945–952
Nakagawa TH, Maciel CD, Serrao FV (2015) Trunk biomechanics and its association with hip and knee kinematics in patients with and without patellofemoral pain. Man Ther 20:189–193
De Blaiser C, De Ridder R, Willems T, Vanden Bossche L, Danneels L, Roosen P (2019) Impaired core stability as a risk factor for the development of lower extremity overuse injuries: a prospective cohort study. Am J Sports Med 47:1713–1721
Sasaki S, Tsuda E, Yamamoto Y, Maeda S, Kimura Y, Fujita Y et al (2019) Core-muscle training and neuromuscular control of the lower limb and trunk. J Athl Train 54:959–969
Maté-Muñoz JL, Lougedo JH, Barba M, Cañuelo-Márquez AM, Guodemar-Pérez J, García-Fernández P et al (2018) Cardiometabolic and muscular fatigue responses to different crossfit® workouts. J Sports Sci Med 17:668–679
Roth R, Donath L, Faude O, Cresswell AG (2020) Trunk muscle activity during different types of low weighted squat exercises in normal and forefoot standing conditions. J Sports Sci 38:2774–2781
Greene PF, Durall CJ, Kernozek TW (2012) Intersession reliability and concurrent validity of isometric endurance tests for the lateral trunk muscles. J Rehabil 21:161–166
Weiss K, Whatman C (2015) Biomechanics Associated with patellofemoral pain and ACL injuries in sports. Sports Med 45:1325–1337
Jiménez-Del-Barrio S, Mingo-Gómez MT, Estébanez-de-Miguel E, Saiz-Cantero E, Del-Salvador-Miguélez AI, Ceballos-Laita L (2020) Adaptations in pelvis, hip and knee kinematics during gait and muscle extensibility in low back pain patients: a cross-sectional study. J Back and Musculoskelet Rehabil 33:49–56
Rodríguez M, García-Calleja P, Terrados N, Crespo I, Del Valle M, Olmedillas H (2022) Injury in crossfit®: a systematic review of epidemiology and risk factors. Phys Sportsmed. Feb;50(1):3–10
Nakagawa TH, Dos Santos AF, Lessi GC, Petersen RS, Scattone SR (2020) Y-balance test asymmetry and frontal plane knee projection angle during single-leg squat as predictors of patellofemoral pain in male military recruits. Phys Ther Sport 44:121–127
Herrington L, Alenezi F, Alzhrani M, Alrayani H, Jones R (2017) The reliability and criterion validity of 2D video assessment of single leg squat and hop landing. J Electromyogr Kinesiol 34:80–85
Acknowledgements
The authors would like to thank CrossFit Red Java, Caxias do Sul, RS, Brazil
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TVS: the conception, acquisition of data, analysis and interpretation of data, draft of the article revising it critically for important intellectual content, final approval of the version to be submitted; ESR: draft of the article revising it critically for important intellectual content, final approval of the version to be submitted; RR: draft of the article revising it critically for important intellectual content, final approval of the version to be submitted; RR: the conception and design of the study, study orientation and supervision and critical revision of the article, final approval of the version to be submitted. All authors contributed equally to the manuscript and read and approved the final version of the manuscript.
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de Souza, T.V., Rabello, R., da Rocha, E.S. et al. Ankle dorsiflexion range of motion and trunk muscle endurance are not associated with hip and knee kinematics during the forward step-down test in CrossFit® practitioners. Sport Sci Health 19, 519–526 (2023). https://doi.org/10.1007/s11332-022-01039-3
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DOI: https://doi.org/10.1007/s11332-022-01039-3