Sports Injuries

Q/Quadriceps Angle Knee Injuries In Women Athletes

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The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?

Quadriceps Q – Angle Injuries

The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:

  • One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
  • The other is from the patella to the tibial tubercle.
  • On average the angle is three degrees higher in women than men.
  • Average 17 degrees for women and 14 degrees for men. (Ramada R Khasawneh, et al., 2019)
  • Sports medicine experts have linked a wider pelvis to a larger Q-angle. (Ramada R Khasawneh, et al., 2019)

Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.

Injuries

Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.

Patellofemoral Pain Syndrome

  • An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
  • With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
  • Foot orthotics and arch supports could be recommended.
  • Some researchers have found a link, while others have not found the same association. (Wolf Petersen, et al., 2014)

Chondromalacia of the Knee

  • This is the wearing down of the cartilage on the underside of the kneecap.
  • This leads to degeneration of the articular surfaces of the knee. (Enrico Vaienti, et al., 2017)
  • The common symptom is pain under and around the kneecap.

ACL Injuries

  • Women have higher rates of ACL injuries than men. (Yasuhiro Mitani. 2017)
  • An increased Q angle can be a factor that increases stress and causes the knee to lose its stability.
  • However, this remains controversial, as some studies have found no association between the Q angle and knee injuries.

Chiropractic Treatment

Strengthening Exercises

  • ACL injury prevention programs designed for women have resulted in reduced injuries. (Trent Nessler, et al., 2017)
  • The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
  • Strengthening the muscle can increase the stability of the knee joint.
  • Strengthening may require a specific focus on muscle contraction timing.
  • Closed-chain exercises like wall squats are recommended.
  • Glute strengthening will improve stability.

Stretching Exercises

  • Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
  • Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.

Foot Orthotics

  • Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
  • A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
  • Motion-control shoes can also help correct overpronation.

Knee Rehabilitation


References

Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. doi.org/10.1371/journal.pone.0218387

Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. doi.org/10.1007/s00167-013-2759-6

Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. doi.org/10.23750/abm.v88i2-S.6507

Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. doi.org/10.1589/jpts.29.12

Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. doi.org/10.1007/s12178-017-9416-5

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Specialties: Stopping the PAIN! We Specialize in Treating Severe Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sports Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal Mobility, Posture Control, Deep Health Instruction, Integrative & Functional Medicine, Functional Fitness, Chronic Degenerative Disorder Treatment Protocols, and Structural Conditioning. We also integrate Wellness Nutrition, Wellness Detoxification Protocols and Functional Medicine for chronic musculoskeletal disorders. We use effective "Patient Focused Diet Plans", Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols, and the Premier "PUSH Functional Fitness System" to treat patients suffering from various injuries and health problems. Ultimately, I am here to serve my patients and community as a Chiropractor passionately restoring functional life and facilitating living through increased mobility. Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training, functional medicine, and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional & Integrative Nutrition, Agility & Mobility Fitness Training and Cross-Fit Rehabilitation Systems for all ages. As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises and advanced agility treatment options. We have teamed up with the cities' premier doctors, therapist and trainers in order to provide high-level competitive athletes the options to push themselves to their highest abilities within our facilities. We've been blessed to use our methods with thousands of El Pasoans over the last 3 decades allowing us to restore our patients' health and fitness while implementing researched non-surgical methods and functional wellness programs. Our programs are natural and use the body's ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, un-wanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living. With a bit of work, we can achieve optimal health together, no matter the age, ability or disability.

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