The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study

Am J Sports Med. 2007 Mar;35(3):368-73. doi: 10.1177/0363546506297909. Epub 2007 Jan 31.


Background: In sports involving pivoting and landing, female athletes suffer knee injury at a greater rate than male athletes.

Hypotheses: Proprioceptive deficits in control of the body's core may affect dynamic stability of the knee. Female, but not male, athletes who suffered a knee injury during a 3-year follow-up period would demonstrate decreased core proprioception at baseline testing as compared with uninjured athletes.

Study design: Cohort study (prognosis); Level of evidence, 2.

Methods: Study subjects were 277 collegiate athletes (140 female, 137 male) who were prospectively tested for core proprioception by active and passive proprioceptive repositioning. Athletes were monitored for injury for 3 years. An ANOVA and multivariate logistic regression were used to test whether core proprioception was related to knee injuries in athletes.

Results: Twenty-five athletes sustained knee injuries (11 women, 14 men). Deficits in active proprioceptive repositioning were observed in women with knee injuries (2.2 degrees ) and ligament/meniscal injuries (2.4 degrees ) compared with uninjured women (1.5 degrees , P <or= .05). There were no differences in average active proprioceptive repositioning error between injured men and uninjured men (P >or= .05). Uninjured women demonstrated significantly less average error in active proprioceptive repositioning than uninjured men (1.5 degrees vs 1.7 degrees , P <or= .05). For each degree increase in average active proprioceptive repositioning error, a 2.9-fold increase in the odds ratio of knee injury was observed, and a 3.3-fold increase in odds ratio of ligament/meniscal injury was observed (P <or= .01). Active proprioceptive repositioning predicted knee injury status with 90% sensitivity and 56% specificity in female athletes.

Conclusions: Impaired core proprioception, measured by active proprioceptive repositioning of the trunk, predicted knee injury risk in female, but not male, athletes.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Injuries
  • Biomechanical Phenomena
  • Cohort Studies
  • Connecticut
  • Female
  • Humans
  • Knee Injuries / epidemiology*
  • Knee Injuries / etiology
  • Male
  • Proprioception / physiology*
  • Prospective Studies