Sex differences in kinematics and muscle activity during the impact phase of a single-leg landing task after a backhand side overhead stroke in badminton
Abstract
Background: Female badminton players have a higher risk of anterior cruciate ligament (ACL) injury in landing maneuvers compared to males. Gender differences in neuromuscular control may be a potential risk factor for the increased incidence of ACL injury in female badminton players. Study design: Controlled laboratory study. Methods: Sixteen badminton players (8 male, 8 female) participated in a badminton single-leg landing task in which lower limb kinematics, ground reaction forces, and lower limb muscle activity were measured using a marker-based motion capture system, force plates, and electromyography (EMG). An analysis of variance (ANOVA) was used to analyze gender differences in leg kinematic data, mean normalized leg muscle activation (MVC%), and muscle co-contraction during the impact phase after landing. Results: During the impact phase of the badminton landing task (100 ms after initial contact), the knee valgus angle at the moment of initial contact (IC) and posterior peak ground reaction force (GRF) was greater in females than in males (6.27 ± 2.54 vs 1.84 ± 3.28) and (6.16 ± 2.83 vs 0.88 ± 2.59). Knee flexion angle and ankle plantarflexion angle were less in females than in males at the moment of peak posterior GRF (16.71 ± 4.20 vs 23.90 ± 5.04) and (−28.34 ± 5.60 vs −37.05 ± 7.17). During the post-landing impact phase, compared to male badminton players, females exhibited greater rectus femoris (51.85 ± 15.68 vs 19.73 ± 6.63) medial hamstring (44.88 ± 19.07 vs 20.54 ± 10.16), medial gastrocnemius (66.23 ± 21.42 vs 38.21 ± 15.16) lateral gastrocnemius (79.43 ± 22.54 vs 46.53 ± 13.17) muscle activity. In addition, males exhibited a higher co-contraction ratio of the medial and lateral gastrocnemius compared to female athletes (1.44 ± 0.46 vs 0.99 ± 0.24). Conclusion: There were significant gender differences in neuromuscular control (muscle activity patterns, movement patterns) between badminton players during the impact phase of the badminton single-leg landing task. These findings highlight the need for gender-specific training programs to address neuromuscular differences and reduce ACL injury risk in badminton players.
References
1. Cabello-Manrique D, Lorente JA, Padial-Ruz R, et al. Play Badminton Forever: A Systematic Review of Health Benefits. International Journal of Environmental Research and Public Health. 2022; 19(15): 9077. doi: 10.3390/ijerph19159077
2. Kimura Y, Ishibashi Y, Tsuda E, et al. Mechanisms for anterior cruciate ligament injuries in badminton. British Journal of Sports Medicine. 2010; 44(15): 1124-1127. doi: 10.1136/bjsm.2010.074153
3. Ryan J, Magnussen RA, Cox CL, et al. ACL Reconstruction: Do Outcomes Differ by Sex? Journal of Bone and Joint Surgery. 2014; 96(6): 507-512. doi: 10.2106/jbjs.m.00299
4. Sutton KM, Bullock JM. Anterior Cruciate Ligament Rupture: Differences Between Males and Females. Journal of the American Academy of Orthopaedic Surgeons. 2012; 21(1): 41-50. doi: 10.5435/jaaos-21-01-41
5. Takahashi S, Okuwaki T. Epidemiological survey of anterior cruciate ligament injury in Japanese junior high school and high school athletes: cross-sectional study. Research in Sports Medicine. 2017; 25(3): 266-276. doi: 10.1080/15438627.2017.1314290
6. Renstrom P, Ljungqvist A, Arendt E, et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. British Journal of Sports Medicine. 2008; 42(6): 394-412. doi: 10.1136/bjsm.2008.048934
7. Wilczyński B, Zorena K, Ślęzak D. Dynamic Knee Valgus in Single-Leg Movement Tasks. Potentially Modifiable Factors and Exercise Training Options. A Literature Review. International Journal of Environmental Research and Public Health. 2020; 17(21): 8208. doi: 10.3390/ijerph17218208
8. Ellenberger L, Casutt S, Fröhlich S, et al. Thigh muscle activation patterns and dynamic knee valgus at peak ground reaction force during drop jump landings: Reliability, youth competitive alpine skiing-specific reference values and relation to knee overuse complaints. Journal of Science and Medicine in Sport. 2021; 24(12): 1230-1234. doi: 10.1016/j.jsams.2021.06.006
9. Marquez G, Alegre LM, Jaén D, et al. Sex differences in kinetic and neuromuscular control during jumping and landing. Journal of Musculoskeletal & Neuronal Interactions. 2017; 17(1): 409-416.
10. Fedie R, Carlstedt K, Willson JD, et al. Effect of attending to a ball during a side-cut maneuver on lower extremity biomechanics in male and female athletes. Sports Biomechanics. 2010; 9(3): 165-177. doi: 10.1080/14763141.2010.502241
11. Ebben WP, Fauth ML, Petushek EJ, et al. Gender-Based Analysis of Hamstring and Quadriceps Muscle Activation During Jump Landings and Cutting. Journal of Strength and Conditioning Research. 2010; 24(2): 408-415. doi: 10.1519/jsc.0b013e3181c509f4
12. de Britto MA, Carpes FP, Koutras G, et al. Quadriceps and hamstrings prelanding myoelectric activity during landing from different heights among male and female athletes. Journal of Electromyography and Kinesiology. 2014; 24(4): 508-512. doi: 10.1016/j.jelekin.2014.04.009
13. Markolf KL, O’Neill G, Jackson SR, et al. Effects of Applied Quadriceps and Hamstrings Muscle Loads on Forces in the Anterior and Posterior Cruciate Ligaments. The American Journal of Sports Medicine. 2004; 32(5): 1144-1149. doi: 10.1177/0363546503262198
14. Beaulieu ML, Lamontagne M, Xu L. Lower limb muscle activity and kinematics of an unanticipated cutting manoeuvre: a gender comparison. Knee Surgery, Sports Traumatology, Arthroscopy. 2009; 17(8): 968-976. doi: 10.1007/s00167-009-0821-1
15. Landry SC, McKean KA, Hubley-Kozey CL, et al. Neuromuscular and Lower Limb Biomechanical Differences Exist between Male and Female Elite Adolescent Soccer Players during an Unanticipated Side-cut Maneuver. The American Journal of Sports Medicine. 2007; 35(11): 1888-1900. doi: 10.1177/0363546507300823
16. Otsuki R, Del Bel MJ, Benoit DL. Sex differences in muscle activation patterns associated with anterior cruciate ligament injury during landing and cutting tasks: A systematic review. Journal of Electromyography and Kinesiology. 2021; 60: 102583. doi: 10.1016/j.jelekin.2021.102583
17. Waldén M, Hägglund M, Werner J, et al. The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective. Knee Surgery, Sports Traumatology, Arthroscopy. 2010; 19(1): 3-10. doi: 10.1007/s00167-010-1172-7
18. Färber S, Heinrich D, Werner I, et al. Is it possible to voluntarily increase hamstring muscle activation during landing from a snow jump in alpine skiing? - a pilot study. Journal of Sports Sciences. 2018; 37(2): 180-187. doi: 10.1080/02640414.2018.1488423
19. Xu D, Lu J, Baker JS, et al. Temporal kinematic and kinetics differences throughout different landing ways following volleyball spike shots. Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology. 2021; 236(3): 200-208. doi: 10.1177/17543371211009485
20. Hu Z, Zhang Y, Dong T, et al. Gender Differences in Neuromuscular Control during the Preparation Phase of Single-Leg Landing Task in Badminton. Journal of Clinical Medicine. 2023; 12(9): 3296. doi: 10.3390/jcm12093296
21. Zazulak BT, Ponce PL, Straub SJ, et al. Gender Comparison of Hip Muscle Activity During Single-Leg Landing. Journal of Orthopaedic & Sports Physical Therapy. 2005; 35(5): 292-299. doi: 10.2519/jospt.2005.35.5.292
22. Hu Z, Kim Y, Dong T, et al. Correlation between gluteus muscle activity and dynamic control of the knee joint in a single-leg landing task in badminton. International Journal of Performance Analysis in Sport. 2023; 23(6): 429-440. doi: 10.1080/24748668.2023.2249760
23. Hu Z, Kim Y, Zhang Y, et al. Correlation of Lower Limb Muscle Activity with Knee Joint Kinematics and Kinetics during Badminton Landing Tasks. International Journal of Environmental Research and Public Health. 2022; 19(24): 16587. doi: 10.3390/ijerph192416587
24. Hodges PW, van den Hoorn W, Wrigley TV, et al. Increased duration of co-contraction of medial knee muscles is associated with greater progression of knee osteoarthritis. Manual Therapy. 2016; 21: 151-158. doi: 10.1016/j.math.2015.07.004
25. Bencke J, Zebis MK. The influence of gender on neuromuscular pre-activity during side-cutting. Journal of Electromyography and Kinesiology. 2011; 21(2): 371-375. doi: 10.1016/j.jelekin.2010.10.008
26. Nagano Y, Ida H, Akai M, et al. Gender differences in knee kinematics and muscle activity during single limb drop landing. The Knee. 2007; 14(3): 218-223. doi: 10.1016/j.knee.2006.11.008
27. Larwa J, Stoy C, Chafetz RS, et al. Stiff Landings, Core Stability, and Dynamic Knee Valgus: A Systematic Review on Documented Anterior Cruciate Ligament Ruptures in Male and Female Athletes. International Journal of Environmental Research and Public Health. 2021; 18(7): 3826. doi: 10.3390/ijerph18073826
28. Montgomery C, Blackburn J, Withers D, et al. Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases. British Journal of Sports Medicine. 2016; 52(15): 994-1001. doi: 10.1136/bjsports-2016-096425
29. Yu B, Garrett WE. Mechanisms of non-contact ACL injuries. British Journal of Sports Medicine. 2007; 41(suppl 1): i47-i51. doi: 10.1136/bjsm.2007.037192
30. Podraza JT, White SC. Effect of knee flexion angle on ground reaction forces, knee moments and muscle co-contraction during an impact-like deceleration landing: Implications for the non-contact mechanism of ACL injury. The Knee. 2010; 17(4): 291-295. doi: 10.1016/j.knee.2010.02.013
31. Englander ZA, Lau BC, Wittstein JR, et al. Patellar Tendon Orientation and Strain Are Predictors of ACL Strain In Vivo During a Single-Leg Jump. Orthopaedic Journal of Sports Medicine. 2021; 9(3). doi: 10.1177/2325967121991054
32. Tseng HJ, Lo HL, Lin YC, et al. Analyze the Differential Rates of Anterior Cruciate Ligament Injuries Between Men and Women by Biomechanical Study of Single-Leg Landing in Badminton. Indian Journal of Orthopaedics. 2021; 55(S2): 409-417. doi: 10.1007/s43465-021-00421-6
33. Koga H, Nakamae A, Shima Y, et al. Mechanisms for Noncontact Anterior Cruciate Ligament Injuries. The American Journal of Sports Medicine. 2010; 38(11): 2218-2225. doi: 10.1177/0363546510373570
34. Zhao X, Gu Y. Single leg landing movement differences between male and female badminton players after overhead stroke in the backhand-side court. Human Movement Science. 2019; 66: 142-148. doi: 10.1016/j.humov.2019.04.007
35. Hung CL Hung MH, Chang CY, et al. Influences of Lateral Jump Smash Actions in Different Situations on the Lower Extremity Load of Badminton Players. J Sports Sci Med. 2020; 19(2): 264-270.
36. Cejudo A. Lower Extremity Flexibility Profile in Basketball Players: Gender Differences and Injury Risk Identification. International Journal of Environmental Research and Public Health. 2021; 18(22): 11956. doi: 10.3390/ijerph182211956
37. Hughes G, Dally N. Gender difference in lower limb muscle activity during landing and rapid change of direction. Science & Sports. 2015; 30(3): 163-168. doi: 10.1016/j.scispo.2015.02.009
38. Dwyer MK, Boudreau SN, Mattacola CG, et al. Comparison of Lower Extremity Kinematics and Hip Muscle Activation During Rehabilitation Tasks Between Sexes. Journal of Athletic Training. 2010; 45(2): 181-190. doi: 10.4085/1062-6050-45.2.181
39. Navacchia A, Ueno R, Ford KR, et al. EMG-Informed Musculoskeletal Modeling to Estimate Realistic Knee Anterior Shear Force During Drop Vertical Jump in Female Athletes. Annals of Biomedical Engineering. 2019; 47(12): 2416-2430. doi: 10.1007/s10439-019-02318-w
40. Teng PSP, Leong KF, Yi Xian Phua P, et al. An exploratory study of the use of ultrasound in the measurement of anterior tibial translation under gastrocnemius muscle stimulation. Research in Sports Medicine. 2020; 29(2): 103-115. doi: 10.1080/15438627.2020.1840378
41. Ali N, Andersen MS, Rasmussen J, et al. The application of musculoskeletal modeling to investigate gender bias in non-contact ACL injury rate during single-leg landings. Computer Methods in Biomechanics and Biomedical Engineering. 2013; 17(14): 1602-1616. doi: 10.1080/10255842.2012.758718
42. Besier TF, Lloyd DG, Ackland TR. Muscle Activation Strategies at the Knee during Running and Cutting Maneuvers. Medicine & Science in Sports & Exercise. 2003; 35(1): 119-127. doi: 10.1097/00005768-200301000-00019
43. Ramezani F, Saki F, Tahayori B. Neuromuscular training improves muscle co‐activation and knee kinematics in female athletes with high risk of anterior cruciate ligament injury. European Journal of Sport Science. 2024; 24(1): 56-65. doi: 10.1002/ejsc.12046
44. Zhao W, Wang C, Bi Y, et al. Effect of Integrative Neuromuscular Training for Injury Prevention and Sports Performance of Female Badminton Players. Hsieh TH, ed. BioMed Research International. 2021; 2021(1). doi: 10.1155/2021/5555853
45. Kollmitzer J, Ebenbichler GR, Kopf A. Reliability of surface electromyographic measurements. Clinical Neurophysiology. 1999; 110(4): 725-734.
Copyright (c) 2025 Yanan Zhang, Ting Wang, Youngsuk Kim, Sukwon Kim, Zhe Hu
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright on all articles published in this journal is retained by the author(s), while the author(s) grant the publisher as the original publisher to publish the article.
Articles published in this journal are licensed under a Creative Commons Attribution 4.0 International, which means they can be shared, adapted and distributed provided that the original published version is cited.
Submit a Paper
