gms | German Medical Science

Objective: Anterior cruciate ligament (ACL) tear is a common injury in handball with a risk 3–5 times higher among women [1]. Despite surgery, the consequences of this injury are severe and the return-to-sport activity unsecured [2]. To progress in understanding the rupture mechanism and prevention, biomechanical studies must now analyse more realistic sports movements which are at risk of ACL tear [3]. The sidestep maneuver is a specific technique movement in handball with a change of direction. It is also the main circumstance of ACL injury in this sport [4]. The purpose of this study was to describe and compare, across gender, knee kinematics and angular displacement of the whole body during this specific handball technique maneuver. The null hypothesis was no difference across gender in the axial rotations of the pivot knee during the stance phase.

Material/Methods: Fifteen females and fourteen males, all good level handball players, executed the same specifique sidestep maneuver. All athletes performed their technique gesture as they used to do in game or practice situation. All were trained to practice this maneuver in their federal handball structure. Spatio-temporal data and kinematics of the pivot knee, ipsilateral foot and hip, pelvis and trunk were calculated using a 3D motion analysis system Vicon. A Mann-Witney test was used to compare data.

Results: The analysed gesture was highly reproducible despite the absence of constraint. At initial contact, men had a higher instantaneous speed. The duration of the stance phase was similar. No gender significant difference was found in the axial rotation of the knee during the pivoting stance phase. At initial contact, women exhibited less knee flexion and more knee valgus. The pelvis rotation was also different with men more turned to the change of direction trajectory. Gender differences were also found during the first part of the stance phase in knee frontal plane and in the hip transverse plane.

Conclusion: kinematic analysis of a technical gesture is possible and reproducible when it is made without constraints. During this specific handball sidestep manoeuver, the observed knee postures suggest an increased ACL injury risk at initial contact in women. A prevention work could be proposed to decrease the risk. Relationships between knee and hip seem important.