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Cruciate Ligament Forces between Short-Step and Long-Step Forward Lunge

ESCAMILLA, RAFAEL F.1; ZHENG, NAIQUAN2; MACLEOD, TORAN D.3; IMAMURA, RODNEY4; EDWARDS, W. BRENT5; HRELJAC, ALAN4; FLEISIG, GLENN S.6; WILK, KEVIN E.7; MOORMAN, CLAUDE T. III8; PAULOS, LONNIE1; ANDREWS, JAMES R.1,6

Medicine & Science in Sports & Exercise: October 2010 - Volume 42 - Issue 10 - p 1932-1942
doi: 10.1249/MSS.0b013e3181d966d4
Applied Sciences

Purpose: The purpose of this study was to compare cruciate ligament forces between the forward lunge with a short step (forward lunge short) and the forward lunge with a long step (forward lunge long).

Methods: Eighteen subjects used their 12-repetition maximum weight while performing the forward lunge short and long with and without a stride. EMG, force, and kinematic variables were input into a biomechanical model using optimization, and cruciate ligament forces were calculated as a function of knee angle. A two-factor repeated-measure ANOVA was used with a Bonferroni adjustment (P < 0.0025) to assess differences in cruciate forces between lunging techniques.

Results: Mean posterior cruciate ligament (PCL) forces (69-765 N range) were significantly greater (P < 0.001) in the forward lunge long compared with the forward lunge short between 0° and 80° knee flexion angles. Mean PCL forces (86-691 N range) were significantly greater (P < 0.001) without a stride compared with those with a stride between 0° and 20° knee flexion angles. Mean anterior cruciate ligament (ACL) forces were generated (0-50 N range between 0° and 10° knee flexion angles) only in the forward lunge short with stride.

Conclusions: All lunge variations appear appropriate and safe during ACL rehabilitation because of minimal ACL loading. ACL loading occurred only in the forward lunge short with stride. Clinicians should be cautious in prescribing forward lunge exercises during early phases of PCL rehabilitation, especially at higher knee flexion angles and during the forward lunge long, which generated the highest PCL forces. Understanding how varying lunging techniques affect cruciate ligament loading may help clinicians prescribe lunging exercises in a safe manner during ACL and PCL rehabilitation.

1Andrews-Paulos Research and Education Institute, Gulf Breeze, FL; 2Department of Mechanical Engineering and Engineering Science, The Center for Biomedical Engineering, University of North Carolina at Charlotte, NC; 3Department of Physical Therapy, Center for Biomedical Engineering Research, University of Delaware, Newark, DE; 4Kinesiology and Health Science Department, California State University, Sacramento, CA; 5Department of Kinesiology and Nutrition, University of Illinois at Chicago, IL; 6American Sports Medicine Institute, Birmingham, AL; 7Champion Sports Medicine, Birmingham, AL; 8Duke University Medical Center; Durham, NC

Address for correspondence: Rafael F. Escamilla, Ph.D., P.T., CSCS, FACSM, Director of Research, Andrews-Paulos Research and Education Institute, 1020 Gulf Breeze Parkway, Gulf Breeze, FL 32561; E-mail: rescamil@csus.edu.

Submitted for publication November 2008.

Accepted for publication December 2009.

©2010The American College of Sports Medicine