Core Stability Measures as Risk Factors for Lower Extremity Injury in Athletes


Medicine & Science in Sports & Exercise: June 2004 - Volume 36 - Issue 6 - pp 926-934
CLINICAL SCIENCES: Clinical Investigations

LEETUN, D. T., M. L. IRELAND, J. D. WILLSON, B. T. BALLANTYNE, and I. M. DAVIS. Core Stability Measures as Risk Factors for Lower Extremity Injury in Athletes. Med. Sci. Sports Exerc., Vol. 36, No. 6, pp. 926–934, 2004.

Introduction/Purpose: Decreased lumbo-pelvic (or core) stability has been suggested to contribute to the etiology of lower extremity injuries, particularly in females. This prospective study compares core stability measures between genders and between athletes who reported an injury during their season versus those who did not. Finally, we looked for one or a combination of these strength measures that could be used to identify athletes at risk for lower extremity injury.

Methods: Before their season, 80 female (mean age = 19.1 ± 1.37 yr, mean weight 65.1 ± 10.0 kg) and 60 male (mean age = 19.0 ± 0.90 yr, mean weight 78.8 ± 13.3 kg) intercollegiate basketball and track athletes were studied. Hip abduction and external rotation strength, abdominal muscle function, and back extensor and quadratus lumborum endurance was tested for each athlete.

Results: Males produced greater hip abduction (males = 32.6 ± 7.3%BW, females = 29.2 ± 6.1%BW), hip external rotation (males = 21.6 ± 4.3%BW, females = 18.4 ± 4.1%BW), and quadratus lumborum measures (males = 84.3 ± 32.5 s, females = 58.9 ± 26.0 s). Athletes who did not sustain an injury were significantly stronger in hip abduction (males = 31.6 ± 7.1%BW, females = 28.6 ± 5.5%BW) and external rotation (males = 20.6 ± 4.2%BW, females = 17.9 ± 4.4%BW). Logistic regression analysis revealed that hip external rotation strength was the only useful predictor of injury status (OR = 0.86, 95% CI = 0.77, 0.097).

Conclusion: Core stability has an important role in injury prevention. Future study may reveal that differences in postural stability partially explain the gender bias among female athletes.

1Kentucky Sports Medicine Clinic, Lexington, KY; 2Joyner Sportsmedicine Institute, Lexington, KY; and 3University of Delaware, Department of Physical Therapy, Newark, DE

Address for correspondence: John D. Willson, MSPT, University of Delaware, Department of Physical Therapy, 305 McKinly Lab, Newark, DE 19716; E-mail:

Submitted for publication November 2003.

Accepted for publication January 2004.

©2004The American College of Sports Medicine