Advertisement

Male and female gluteal muscle activity and lower extremity kinematics during running

      Abstract

      Background

      Patellofemoral pain is one of the most common lower extremity overuse injuries in runners and is significantly more common in females. This study evaluated differences in the timing and magnitude of gluteal muscle activity as well as hip and knee joint frontal and transverse plane kinematics between male and female runners in the context of this gender bias.

      Methods

      Twenty healthy male and 20 healthy female runners were participants. Three-dimensional lower extremity kinematics, and gluteus medius and gluteus maximus muscle activation were recorded using motion analysis and electromyography as subjects ran at 3.7 m/s (+/−5%). Comparisons of hip and knee joint kinematic and gluteus muscle activation data were made using independent t-tests (α=0.05).

      Findings

      Females ran with 40% greater peak gluteus maximus activation level (P=0.028, effect size=0.79) and 53% greater average activation level (P=0.013, effect size=0.93) than males. Female runners also displayed greater hip adduction (P=.001, effect size=1.20) and knee abduction (P=0.011, effect size=0.87) angles at initial contact, greater hip adduction at peak vertical ground reaction force (P<0.001, effect size=1.31), and less knee internal rotation excursion than males (P=0.035, effect size=0.71).

      Interpretation

      Greater gluteus maximus activation levels during running may predispose females to earlier gluteus maximus fatigue, promoting altered lower extremity running kinematics thought to be associated with the etiology of patellofemoral pain. Gender differences in transverse and frontal plane hip and knee kinematics observed in this study may also contribute to the gender bias for patellofemoral pain among females.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Biomechanics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aminaka N.
        • Pietrosimoe B.G.
        • Armstrong C.W.
        • Meszaros A.
        • Gribble P.A.
        Patellofemoral pain syndrome alters neuromuscular control and kinetics during stair ambulation.
        J. Electromyogr. Kinesiol. 2011; 21: 645-651
        • Besier T.F.
        • Lloyd D.G.
        • Ackland T.R.
        Muscle activation strategies at the knee during running and cutting maneuvers.
        Med. Sci. Sports Exerc. 2003; 35: 119-127
        • Bolgla L.A.
        • Uhl T.I.
        Reliability of electromyographic normalization methods for evaluating the hip musculature.
        J. Electromyogr. Kinesiol. 2007; 17: 102-111
        • Bolgla L.A.
        • Malone T.R.
        • Umberger B.R.
        • Uhl T.I.
        Reliability of electromyographic methods used for assessing hip and knee neuromuscular activity in females diagnosed with patellofemoral pain syndrome.
        J. Electromyogr. Kinesiol. 2010; 20: 142-147
        • Boling M.
        • Padua D.
        • Marshall S.
        • Guskiewicz K.
        • Pyne S.
        • Beutler A.
        Gender differences in the incidence and prevalence of patellofemoral pain syndrome.
        Scand. J. Med. Sci. Sports. 2010; 20: 725-730
        • Brindle T.J.
        • Mattacola C.
        • McCrory J.
        Electromyography changes in the gluteus medius during stair ascent and descent in subjects with anterior knee pain.
        Knee Surg. Sports Traumatol. Arthrosc. 2003; 11: 244-251
        • Chumanov E.S.
        • Wall-Scheffler C.
        • Heiderscheit B.C.
        Gender differences in walking and running on level and inclined surfaces.
        Clin. Biomech. 2008; 23: 1260-1268
        • Cowan S.M.
        • Bennell K.L.
        • Hodges P.W.
        • Crossley K.M.
        • McConnell J.
        Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome.
        Arch. Phys. Med. Rehabil. 2001; 82: 183-189
        • Cowan S.M.
        • Crossley K.M.
        • Bennell K.I.
        Altered hip and trunk muscle function in individuals with patellofemoral pain.
        Br. J. Sports Med. 2009; 43: 584-588
        • Cram S.M.
        • Kasman G.S.
        • Holtz J.
        Introduction to Surface Electromyography.
        Aspen Publishers, Gaithersburg, MD1998
        • Dierks T.A.
        • Manal K.T.
        • Hamil J.
        • Davis I.S.
        Proximal and distal influences on hip and knee kinematics in runner with patellofemoral pain during a prolonged run.
        J. Orthop. Sports Phys. Ther. 2008; 38: 448-456
        • Dierks T.A.
        • Davis I.S.
        • Hamill J.
        The effects of running in an exerted state on lower extremity kinematics and joint timing.
        J. Biomech. 2010; 16: 2993-2998
        • Dolak K.L.
        • Silkman C.
        • McKeon J.M.
        • Hosey R.G.
        • Latterman C.
        • Uhi T.L.
        Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial.
        J. Orthop. Sports Phys. Ther. 2011; 41: 560-570
        • Earl J.E.
        • Hoch A.Z.
        A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome.
        Am. J. Sports Med. 2011; 39: 154-163
        • Ferber R.
        • Kendall K.D.
        • Farr L.
        Changes in knee biomechanics after a hip-abductor strengthening protocol for runners with patellofemoral pain syndrome.
        J. Athl. Train. 2011; 46: 142-149
        • Ferber R.
        • Davis I.M.
        • Williams III, D.S.
        Gender differences in lower extremity mechanics during running.
        Clin. Biomech. 2003; 18: 350-357
        • Finoff J.T.
        • Hall M.M.
        • Kyle K.
        • Krause D.A.
        • Lai J.
        • Smith J.
        Hip strength and knee pain in high school runners: a prospective study.
        Am. Acad. Phys. Med. Rehabil. 2011; 3: 792-801
        • Hicks J.I.
        • Richards J.G.
        Clinical applicability of using spherical fitting to find hip joint centers.
        Gait Posture. 2005; 22: 138-145
        • Hodges P.W.
        • Bui B.H.
        A comparison of computer-based methods for the determination of onset of muscle contraction using electromyography.
        Electroencephalogr. Clin. Neurophysiol. 1996; 101: 511-519
        • Huberti H.H.
        • Hayes W.C.
        Patellofemoral contact pressure. The influence of q-angle and tendofemoral contact.
        J. Bone Joint Surg. Am. 1984; 66: 715-724
        • Ireland M.L.
        • Willson J.D.
        • Ballantyne B.T.
        • Davis I.M.
        Hip strength in females with and without patellofemoral pain.
        J. Orthop. Sports Phys. Ther. 2003; 33: 671-676
        • Myer G.D.
        • Ford K.R.
        • Barber Foss K.D.
        • Goodman A.
        • Ceasar A.
        • Rauh M.J.
        • et al.
        The incidence and potential pathomechanics of patellofemoral pain in female athletes.
        Clin. Biomech. 2010; 25: 700-707
        • Pantano K.J.
        • White S.C.
        • Gilchrist L.A.
        • Leddy J.
        Differences in peak knee valgus angles between individuals with high and low Q-angles during a single limb squat.
        Clin. Biomech. 2005; 20: 966-972
        • Powers C.M.
        The influence of abnormal hip mechanics on knee injury: a biomechanical perspective.
        J. Orthop. Sports Phys. Ther. 2010; 40: 42-51
        • Smoliga J.M.
        • Myers J.B.
        • Redfern M.S.
        • Lephart S.M.
        Reliability and precision of EMG in leg, torso, and arm muscles during running.
        J. Electromyogr. Kinesiol. 2010; 20: e1-e9
        • Souza R.B.
        • Powers C.M.
        Differences in hip kinematics, muscle strength, and muscle activation between subjects with and without patellofemoral pain.
        J. Orthop. Sports Phys. Ther. 2009; 39: 12-19
        • Souza R.B.
        • Powers C.M.
        Predictors of hip internal rotation during running: an evaluation of hip strength and femoral structure in women with and without patellofemoral pain.
        Am. J. Sports Med. 2009; 37: 579-587
        • Stefanyshyn D.J.
        • Stergiou P.
        • Lun V.M.
        • Meeuwisse W.H.
        • Worobets J.T.
        Knee angular impulse as a predictor of patellofemoral pain in runners.
        Am. J. Sports Med. 2006; 34: 1844-1851
        • Taunton J.
        • Ryan M.
        • Clement D.
        • McKenzie D.
        • Lloyd-Smith D.
        • Zumbro B.
        A retrospective case–control analysis of 2002 running injuries.
        Br. J. Sports Med. 2002; 36: 95-101
        • Tegner Y.
        • Lysholm J.
        Rating systems in the evaluation of knee ligament injuries.
        Clin. Orthop. 1985; : 43-49
        • Thijs Y.
        • Pattyn E.
        • Van Tiggelen D.
        • Rombaut L.
        • Witvrouw E.
        Is hip muscle weakness a predisposing factor for patellofemoral pain in female novice runners? A prospective study.
        Am. J. Sports Med. 2011; 39: 1877-1882
        • Willson J.D.
        • Davis I.S.
        Lower extremity mechanics of females with and without patellofemoral pain across activities with progressively greater task demands.
        Clin. Biomech. 2008; 23: 203-211
        • Willson J.D.
        • Davis I.S.
        Lower extremity strength and mechanics during jumping in women with a patellofemoral pain.
        J. Sport Rehabil. 2009; 18: 76-90
        • Willson J.D.
        • Kernozek T.W.
        • Arndt R.L.
        • Reznichek D.A.
        • Straker J.S.
        Gluteal muscle activation during running in females with and without patellofemoral pain syndrome.
        Clin. Biomech. 2011; 26: 735-740
        • Willy R.W.
        • Davis I.S.
        The effect of a hip strengthening program on mechanics during running and during a single-leg squat.
        J. Orthop. Sports Phys. Ther. 2011; 41: 625-632
        • Wirtz A.D.
        • Willson J.D.
        • Kernozek T.W.
        • Hong D.-A.
        Patellofemoral joint stress during running in females with and without patellofemoral pain.
        Knee. 2012; 19: 703-708