Philip Malloy

Guidelines and pitfalls for the rehabilitation following hip arthroscopy

Rehabilitation guidelines following hip arthroscopy have been presented in the literature with common themes consisting of initial protection, restoration of lumbo-pelvic stability, neuromuscular re-education, and return to sport training. The purpose of this review is to present hip arthroscopy guidelines in 4 phases and to address common pitfalls that may delay the rehabilitative process. The goal of phase 1 should be to protect healing tissues through activity modifications. Phase 2 intends to return the patient to pain-free community ambulation without compensation or irritation. A review of hip muscular actions during gait is presented to guide exercise progressions during this phase. Phase 3 should reestablish neuromuscular control through strength and endurance training to provide the foundation for return to functional activities or sports training progressions. The last phase of rehabilitation is dedicated to reestablishing power, speed, agility, and skill for advanced sports and advanced functions.

Hip External Rotator Strength Is Associated With Better Dynamic Control of the Lower Extremity During Landing Tasks

Abstract Malloy, PJ, Morgan, AM, Meinerz, CM, Geiser, CF, and Kipp, K. Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res 30(1): 282–291, 2016—The purpose of this study was to determine the association between hip strength and lower extremity kinematics and kinetics during unanticipated single-leg landing and cutting tasks in collegiate female soccer players. Twenty-three National Collegiate Athletic Association division I female soccer players were recruited for strength testing and biomechanical analysis. Maximal isometric hip abduction and external rotation strength were measured using a hand-held dynamometer and expressed as muscle torque (force × femoral length) and normalized to body weight. Three-dimensional lower extremity kinematics and kinetics were assessed with motion analysis and force plates, and an inverse dynamics approach was used to calculate net internal joint moments that were normalized to body weight. Greater hip external rotator strength was significantly associated with greater peak hip external rotation moments (r = 0.47; p = 0.021), greater peak knee internal rotation moments (r = 0.41; p = 0.048), greater hip frontal plane excursion (r = 0.49; p = 0.017), and less knee transverse plane excursion (r = −0.56; p = 0.004) during unanticipated single-leg landing and cutting tasks. In addition, a statistical trend was detected between hip external rotator strength and peak hip frontal plane moments (r = 0.39; p = 0.06). The results suggest that females with greater hip external rotator strength demonstrate better dynamic control of the lower extremity during unanticipated single-leg landing and cutting tasks and provide further support for the link between hip strength and lower extremity landing mechanics.

Anticipatory Effects on Lower Extremity Neuromechanics During a Cutting Task

CONTEXT Continued research into the mechanism of noncontact anterior cruciate ligament injury helps to improve clinical interventions and injury-prevention strategies. A better understanding of the effects of anticipation on landing neuromechanics may benefit training interventions. OBJECTIVE To determine the effects of anticipation on lower extremity neuromechanics during a single-legged land-and-cut task. DESIGN Controlled laboratory study. SETTING University biomechanics laboratory. PARTICIPANTS Eighteen female National Collegiate Athletic Association Division I collegiate soccer players (age = 19.7 ± 0.8 years, height = 167.3 ± 6.0 cm, mass = 66.1 ± 2.1 kg). INTERVENTION(S) Participants performed a single-legged land-and-cut task under anticipated and unanticipated conditions. MAIN OUTCOME MEASURE(S) Three-dimensional initial contact angles, peak joint angles, and peak internal joint moments and peak vertical ground reaction forces and sagittal-plane energy absorption of the 3 lower extremity joints; muscle activation of selected hip- and knee-joint muscles. RESULTS Unanticipated cuts resulted in less knee flexion at initial contact and greater ankle toe-in displacement. Unanticipated cuts were also characterized by greater internal hip-abductor and external-rotator moments and smaller internal knee-extensor and external-rotator moments. Muscle-activation profiles during unanticipated cuts were associated with greater activation of the gluteus maximus during the precontact and landing phases. CONCLUSIONS Performing a cutting task under unanticipated conditions changed lower extremity neuromechanics compared with anticipated conditions. Most of the observed changes in lower extremity neuromechanics indicated the adoption of a hip-focused strategy during the unanticipated condition.

Mechanical Demands of the Hang Power Clean and Jump Shrug: A Joint-level Perspective

Abstract Kipp, K, Malloy, PJ, Smith, J, Giordanelli, MD, Kiely, MT, Geiser, CF, and Suchomel, TJ. Mechanical demands of the hang power clean and jump shrug: a joint-level perspective. J Strength Cond Res 32(2): 466–474, 2018—The purpose of this study was to investigate the joint- and load-dependent changes in the mechanical demands of the lower extremity joints during the hang power clean (HPC) and the jump shrug (JS). Fifteen male lacrosse players were recruited from a National Collegiate Athletic Association DI team, and completed 3 sets of the HPC and JS at 30, 50, and 70% of their HPC 1 repetition maximum (1RM HPC) in a counterbalanced and randomized order. Motion analysis and force plate technology were used to calculate the positive work, propulsive phase duration, and peak concentric power at the hip, knee, and ankle joints. Separate 3-way analysis of variances were used to determine the interaction and main effects of joint, load, and lift type on the 3 dependent variables. The results indicated that the mechanics during the HPC and JS exhibit joint-, load-, and lift-dependent behavior. When averaged across joints, the positive work during both lifts increased progressively with external load, but was greater during the JS at 30 and 50% of 1RM HPC than during the HPC. The JS was also characterized by greater hip and knee work when averaged across loads. The joint-averaged propulsive phase duration was lower at 30% than at 50 and 70% of 1RM HPC for both lifts. Furthermore, the load-averaged propulsive phase duration was greater for the hip than the knee and ankle joint. The joint-averaged peak concentric power was the greatest at 70% of 1RM for the HPC and at 30%–50% of 1RM for the JS. In addition, the joint-averaged peak concentric power of the JS was greater than that of the HPC. Furthermore, the load-averaged peak knee and ankle concentric joint powers were greater during the execution of the JS than the HPC. However, the load-averaged power of all joints differed only during the HPC, but was similar between the hip and knee joints for the JS. Collectively, these results indicate that compared with the HPC the JS is characterized by greater hip and knee positive joint work, and greater knee and ankle peak concentric joint power, especially if performed at 30 and 50% of 1RM HPC. This study provides important novel information about the mechanical demands of 2 commonly used exercises and should be considered in the design of resistance training programs that aim to improve the explosiveness of the lower extremity joints.