Biomechanics in injury prevention
By Agrima Kapoor (M.B.B.S Student)
Biomechanics stands out as a field, unlike other fields in its unification of diverse and complex fields such as physics, biology, Anatomy, physiology and kinesiology each of which has individual characteristics and complexities. A sublet of this field is preventive biomechanics, which deals with the analysis of complex dynamic motion under standardized in vitro conditions so as to extrapolate risk factors for injury even before occurrence. The most common injuries statistically involve the lower limb the predominant of those involve the tibiofemoral joint and ankle joint. Various studies co- related postural deformation as a plausible risk factor,Such as in cricket pace bowlers with lateral flexion and shoulder counter-rotation have a higher incidence of injury. Thoracic kyphosis also has been demonstrated to be a significant risk factor for lower limb injury. The variation in ankle joint positions at rest and in movement also is found to be a risk factor in case of ankle joint injury. The most dreaded of all injuries, ACL tear which can often prove as career-ending has been extensively studied under preventive biomechanics, through which four risk factors have been determined:
Muscle dominance, Leg dominance, Ligament dominance, Trunk dominance
Muscle dominance means the dominant recruitment of quadriceps in the landing during the jump is found to be a major risk factor for ACL tear as the quadriceps acts as the movement antagonist of ACL tear and promotes anterior tibiofemoral translation which puts strain on the ACL ligament. Ligament dominance refers to the greater transmission of load on the ligament providing stability to the joint which predominantly should be on the muscles. Leg dominance is defined as an imbalance in neuromuscular recruitment in contralateral limbs. Trunk dominance is the excess movement of the upper body leading to improper chain of load transmission.
Each of these requires assessment of an individual athlete using kinesiology equipment and EMG evaluation, both of which are only possible in elite sports athletes with substantial funds. This is the only limiting factor for the utilization of preventive biomechanics, but the cost-to-benefit ratio clearly justifies its utilization as the cost of treatment, rehabilitation and the subsequent monetary loss seems trivial to the cost of operation of preventive biomechanics. In the case of ACL tears secondary tears are common in 23% of athletes which have a poor prognosis. Data suggest that 70% of injuries are non-contact injuries which primarily occur during highly complex movements which are having incorrect biomechanics, contact injuries are however more dependent on the area of contact, the velocity of impact and the static posture at the moment of contact, this non- contact injuries don’t fall under the purview of preventive biomechanics. Here it is crucial to express that prevention biomechanics is not purely limited to sports for its utility, nonathlete individuals can also alleviate pain and achieve peak mobility in daily activities. The prime example of this is lower back pain which is the most common ailment restricting the productivity of a common individual, for which preventive biomechanics can be used as a treatment modality. However, the field is one of the most uncharted ones in India and requires attention and propagation for substantial utilization.
Citation
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- Forrest MRL, Scott BR, Hebert JJ, Dempsey AR. Injury Prevention Strategies for Adolescent Cricket Pace Bowlers. Sports Med. 2018 Nov;48(11):2449-2461. Doi: 10.1007/s40279-018-0981-6. PMID: 30178303.
- Snodgrass SJ, Ryan KE, Miller A, James D, Callister R. Relationship between Posture and Non-Contact Lower Limb Injury in Young Male Amateur Football Players: A Prospective Cohort Study. Int J Environ Res Public Health. 2021 Jun 14;18(12):6424. Doi: 10.3390/ijerph18126424. PMID: 34198516; PMCID: PMC8296252.