Biomechanical evaluation of the side-cutting manoeuvre associated with ACL injury in young female handball players

PURPOSE: The purpose of the study was to investigate the biomechanics of the knee and hip joint during handball-specific side-cutting on the dominant and non-dominant leg. Understanding the sports-specific biomechanics may improve prevention measures and post-injury treatment. METHODS: Twenty-four young female elite handball players performed 5 handball side-cutting manoeuvres on the dominant and non-dominant legs. The local maxima of the joint moments in each plane, during the initial 100 ms following foot contact, were collected. RESULTS: External knee moments of flexion, outward rotation and valgus-along with external hip moments of extension, abduction and internal rotation-were observed, coincidentally 30-40 ms after foot contact. No side-to-side asymmetries were found. The external moments observed support the injury mechanisms previously described in case studies of handball injuries. CONCLUSION: The results underline the importance of implementing preventive exercises that increase activity of medial hamstrings, to match the external outward rotating knee moments and knee valgus moments, and increase activity of hip external rotators to match the external hip inward-rotating moment. Furthermore, the results may yield further information to the graft selection decision before ACL surgery. LEVEL OF EVIDENCE: Diagnostic studies, Level II.