Stronger subjects select a movement pattern that may reduce ACL loading during cutting

Davies, WT, Ryu, JH, Graham-Smith, P, Goodwin, JE, and Cleather, DJ. Stronger subjects select a movement pattern that may reduce anterior cruciate ligament loading during cutting. J Strength Cond Res 36(7): 1853–1859, 2022—Increased strength has been suggested to reduce the incidence of anterior cruciate ligament (ACL) injury as part of wider neuromuscular training programs; however, the mechanism of this is not clear. Cutting is a high-risk maneuver for ACL injury, but limited research exists as to how strength affects sagittal plane biomechanics during this movement. Sixteen subjects were split into a stronger and weaker group based on their relative peak isometric strength in a unilateral squat (stronger: 29.0 ± 3.4 N·kg−1 and weaker: 18.3 ± 4.1 N·kg−1). Subjects performed 45° cuts with maximal intent 3 times, at 3 different approach velocities (2, 4, and 6 m·s−1). Kinematics and ground reaction forces were collected using optical motion capture and a force platform. The stronger group had lower knee extensor moments, larger hip extensor moments, and a greater peak knee flexion angle than the weaker group (p < 0.05). There was a trend for greater knee flexion at initial contact in the stronger group. There were no differences in resultant ground reaction forces between groups. The stronger group relied more on the hip than the knee during cutting and reached greater knee flexion angles. This could decrease ACL loading by reducing the extensor moment required at the knee during weight acceptance. Similarly, the greater knee flexion angle during weight acceptance is likely to be protective of the ACL.