Hip Kinematics During Single-Leg Tasks in People With and Without Hip-Related Groin Pain and the Association Among Kinematics, Hip Muscle Strength, and Bony Morphology

J Orthop Sports Phys Ther. 2020 May;50(5):243-251. doi: 10.2519/jospt.2020.9150. Epub 2020 Jan 6.

Abstract

Objective: To compare 3-D hip kinematics during the single-leg squat and step-down in patients with hip-related groin pain to those in asymptomatic participants, and to assess relationships among hip kinematics, muscle strength, and bony morphology.

Design: Controlled laboratory cross-sectional study.

Methods: Forty patients with hip-related groin pain and 40 matched, asymptomatic participants between 18 and 40 years of age participated. A handheld dynamometer was used to assess hip abductor and external rotator strength. An 8-camera motion-analysis system was used to quantify 3-D kinematics during the single-leg squat and step-down. Magnetic resonance imaging was used to quantify bony morphology. The independent t test and Mann-Whitney U test were used to assess between-group differences. Pearson coefficient correlations were used to assess relationships.

Results: Patients with hip-related groin pain had smaller peak hip flexion angles, smaller knee flexion angles, and lesser squat depth compared to asymptomatic participants during the single-leg squat. Among patients with hip-related groin pain, smaller hip flexion angles during the single-leg squat were associated with hip abductor weakness (r = 0.47, P≤.01). Among asymptomatic participants, smaller peak hip flexion angles during the single-leg squat were associated with less acetabular coverage (r = 0.33, P = .04) and shallow squat depth (r = 0.48, P≤.01); a smaller hip internal rotation angle during the step-down was associated with larger femoral neck shaft angle (r = -0.43, P<.01).

Conclusion: Compared to asymptomatic participants, patients with hip-related groin pain had smaller hip and knee flexion angles and shallower squat depth during the single-leg squat. Smaller hip flexion angles were associated with hip abductor weakness among those with hip-related groin pain. J Orthop Sports Phys Ther 2020;50(5):243-251. Epub 6 Jan 2020. doi:10.2519/jospt.2020.9150.

Keywords: dysplasia; femoroacetabular impingement; movement.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Biomechanical Phenomena
  • Cross-Sectional Studies
  • Exercise / physiology
  • Female
  • Groin / injuries*
  • Hip / anatomy & histology*
  • Hip / diagnostic imaging
  • Hip / physiology*
  • Hip / physiopathology
  • Humans
  • Imaging, Three-Dimensional
  • Leg / physiology
  • Magnetic Resonance Imaging
  • Male
  • Matched-Pair Analysis
  • Muscle Strength / physiology*
  • Pain / physiopathology*
  • Rotation
  • Time and Motion Studies
  • Young Adult