Gender Differences in Lower Extremity Kinematics During High Range of Motion Activities

Activities with high range of motion are performed on a daily basis in some non-Western countries, whereas there is a lack of fundamental information on the joint biomechanics in deep flexion. The objective of this study was to characterize gender differences in lower extremity kinematics during deep squatting and kneeling. Lower extremity kinematics of 35 healthy subjects (16 males and 19 females) was recorded using a motion analysis system while the subjects performed deep squatting and kneeling. Three-dimensional joint kinematics was compared between genders for each activity. Statistical analysis suggested that there was no gender difference in sagittal plane motions at the hip, knee and ankle joints, while females displayed greater non-sagittal plane joint motions (peak hip adduction and internal rotation, peak knee internal rotation, hip range of adduction, knee range of rotation) compared to males, especially at high flexion angles. The gender differences in movement patterns could be linked to a high risk of ligament injury and joint pathologies in females. Additionally, knee kinematics was comparable between genders at around 90 degrees knee flexion (P > 0.05). In conclusion, females, especially those who usually perform high range of motion activities, and individuals who suffer from PCL injury or other joint pathologies should avoid performing activities requiring high flexion angles.