Volume 27, Issue 3 (Autumn-In Press 2026)
jrehab 2026, 27(3): 0-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
nemat zade N, Fatahi A. Association Between Dynamic Knee Valgus and Non-Contact Anterior Cruciate Ligament Injury Risk During Landing in Athletes: A Systematic Review of Prospective Evidence. jrehab 2026; 27 (3)
URL: http://rehabilitationj.uswr.ac.ir/article-1-3738-en.html
URL: http://rehabilitationj.uswr.ac.ir/article-1-3738-en.html
1- Department of Physical Education and Sport Sciences, CT.C., Islamic Azad University, Tehran, Iran. , alifatahi@iau.ac.ir
Abstract: (14 Views)
Background and Objective: Non-contact anterior cruciate ligament (ACL) injury remains a major concern in sport because it can produce long-term functional impairment and delayed return to play. Dynamic knee valgus is frequently considered a modifiable biomechanical contributor to ACL loading. This systematic review evaluated evidence on whether valgus movement or loading during landing tasks is associated with non-contact ACL injury risk in healthy athletes.
Methods: The review was planned and reported according to PRISMA 2020. MEDLINE through PubMed, Web of Science, Scopus, ScienceDirect, SpringerLink, Google Scholar, and the Cochrane Library were searched from database inception to December 2025, and reference lists were screened manually. Eligible studies were observational investigations that quantified dynamic knee valgus during standardized landing tasks, using maximum knee abduction angle or maximum knee abduction moment, in athletes with no previous ACL injury.
Results: The search produced 456 records. After duplicate removal and screening, 16 studies published from 2002 to 2025 were retained. Four studies, 25%, were judged high quality, whereas 12 studies, 75%, were rated moderate quality. Most investigations used laboratory-based three-dimensional motion analysis with force plates and examined athletes aged mainly between 16 and 25 years. Overall, greater valgus angle or moment was commonly linked with higher non-contact ACL injury risk, especially during single-leg landing, in female athletes, and within 40 to 100 ms after initial contact. Female participants generally showed larger valgus values, with mean differences of about 4 to 10 degrees, together with greater hip internal rotation and adduction and more lateral trunk displacement. Reported contributors included reduced hip abductor and external rotator capacity, restricted ankle dorsiflexion, insufficient trunk control, fatigue, and cognitive dual-task demands. Video-based evidence also indicated that multi-planar valgus loading was frequent in actual injury sequences.
Conclusion: The available evidence supports dynamic knee valgus during landing as an observable and trainable biomechanical factor associated with non-contact ACL injury risk, particularly in young female athletes and in single-leg maneuvers. Nevertheless, variation in study designs, landing protocols, and measurement thresholds prevents strong causal inference. Prevention strategies should therefore combine neuromuscular education, technically sound landing practice, targeted hip and quadriceps strengthening, trunk and ankle stabilization, fatigue-resistance training, and lower-limb alignment correction.
Methods: The review was planned and reported according to PRISMA 2020. MEDLINE through PubMed, Web of Science, Scopus, ScienceDirect, SpringerLink, Google Scholar, and the Cochrane Library were searched from database inception to December 2025, and reference lists were screened manually. Eligible studies were observational investigations that quantified dynamic knee valgus during standardized landing tasks, using maximum knee abduction angle or maximum knee abduction moment, in athletes with no previous ACL injury.
Results: The search produced 456 records. After duplicate removal and screening, 16 studies published from 2002 to 2025 were retained. Four studies, 25%, were judged high quality, whereas 12 studies, 75%, were rated moderate quality. Most investigations used laboratory-based three-dimensional motion analysis with force plates and examined athletes aged mainly between 16 and 25 years. Overall, greater valgus angle or moment was commonly linked with higher non-contact ACL injury risk, especially during single-leg landing, in female athletes, and within 40 to 100 ms after initial contact. Female participants generally showed larger valgus values, with mean differences of about 4 to 10 degrees, together with greater hip internal rotation and adduction and more lateral trunk displacement. Reported contributors included reduced hip abductor and external rotator capacity, restricted ankle dorsiflexion, insufficient trunk control, fatigue, and cognitive dual-task demands. Video-based evidence also indicated that multi-planar valgus loading was frequent in actual injury sequences.
Conclusion: The available evidence supports dynamic knee valgus during landing as an observable and trainable biomechanical factor associated with non-contact ACL injury risk, particularly in young female athletes and in single-leg maneuvers. Nevertheless, variation in study designs, landing protocols, and measurement thresholds prevents strong causal inference. Prevention strategies should therefore combine neuromuscular education, technically sound landing practice, targeted hip and quadriceps strengthening, trunk and ankle stabilization, fatigue-resistance training, and lower-limb alignment correction.
Keywords: Dynamic Knee Valgus, Anterior Cruciate Ligament, Non-contact Injury, Landing Biomechanics, Sex Differences, Athletes
Type of Study: Systematic Review |
Subject:
Sport Pathology and Corrective Movements
Received: 29/01/2026 | Accepted: 16/06/2026 | Published: 23/09/2026
Received: 29/01/2026 | Accepted: 16/06/2026 | Published: 23/09/2026
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Copyright © The Author(s);
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Contact Information
