Is There a Relationship Between Landing,

Cutting, and Pivoting Tasks in Terms of the

Characteristics of Dynamic Valgus?
Paul A. Jones,*y PhD, MSc, CSCS, Lee C. Herrington,y PhD, MSCP, CSCS,
Allan G. Munro,yz PhD, and Philip Graham-Smith,y§ PhD, CSCS
Investigation performed at the University of Salford, Salford, UK

Background: Anterior cruciate ligament (ACL) injuries are a major problem among female athletes. Screening for the risk of ACL
injuries tends to focus on landing tasks, which may be limited in sports where changing direction is the main action involved in
noncontact ACL injuries such as soccer.
Purpose: To investigate whether there is a relationship between single-legged landing (SLL), cutting (90° cuts), and pivoting (180°
turns) in terms of the characteristics of dynamic valgus.
Study Design: Controlled laboratory study.
Methods: Twenty female soccer players (mean 6 SD: age, 21.0 6 3.9 years; height, 1.65 6 0.08 m; mass, 58.4 6 6.4 kg) per-
formed a minimum of 6 trials of SLL from a 0.3-m drop height and cutting and pivoting all on the right leg. Kinematics and kinetics
were calculated from 3-dimensional motion analysis.
Results: Strong correlations were found for peak knee abduction angles between tasks (R = 0.63-0.86, P \ .01), whereas only
moderate correlations between SLL and cutting (R = 0.46, P \ .05), cutting and pivoting (R = 0.56, P \ .05), and SLL and pivoting
(R = 0.43, P . .05) were found between tasks for peak knee abduction moments.
Conclusion: The results suggest that female athletes who exhibit poor SLL mechanics perform the same during various changing
direction tasks.
Clinical Relevance: The results support the use of existing screening tests that involve landing tasks to identify at-risk athletes for
noncontact ACL injuries.
Keywords: anterior cruciate ligament injury; preparticipation screening; cutting; pivoting

Landing and cutting maneuvers have had much research have focused on landing mechanics, although in soccer, the
interest in the past 15 years because of their association as majority of noncontact ACL injuries are a result of changing
key mechanisms for anterior cruciate ligament (ACL) inju- direction horizontally such as cutting and pivoting.12 Sex dif-
ries.4,20,30 Investigations into sex differences in landing and ferences in 45° side-step cutting have been observed in high-
cutting mechanics have been performed because of the sex level athletes with regard to knee valgus motion in elite soc-
differences in ACL injury rates. Female athletes have been cer2,25 and collegiate basketball players27 and knee valgus
found to land with less knee and hip flexion,6,34 greater moments in National Collegiate Athletic Association
knee valgus motion14,34 and moments,7 greater normalized (NCAA) basketball23 and soccer players.35 Sex differences
ground-reaction forces (GRFs),32,34 and high quadriceps rela- in valgus motion have also been observed in adolescent bas-
tive to hamstring muscle activity.42 The majority of authors ketball players.15 In addition, Malinzak et al21 found that
female recreational athletes had less knee flexion, greater
knee valgus angles, greater quadriceps activation, and lower
*Address correspondence to Paul A. Jones, Directorate of Sport, hamstring muscle activation compared with male athletes
Exercise and Physiotherapy, University of Salford, Frederick Road, Aller- during cutting, cross-cutting, and running.
ton Building, Salford, M6 6PU, UK (e-mail: [email protected]). A limited number of studies have evaluated whether
y
Directorate of Sport, Exercise and Physiotherapy, University of Sal-
knee valgus motion and moments relate to ACL injuries.
ford, Salford, UK.
z
School of Health Studies, University of Bradford, Bradford, UK. Hewett et al18 have prospectively shown that female ath-
§
Aspire Academy, Doha, Qatar. letes who go on to injure the ACL have significantly
The authors declared that they have no conflicts of interest in the greater knee abduction angles (8°), 2.5 times greater
authorship and publication of this contribution. knee abduction moments, and 20% greater GRFs during
drop jumps than noninjured athletes. This has implica-
The American Journal of Sports Medicine, Vol. 42, No. 9
DOI: 10.1177/0363546514539446 tions for screening female athletes for the risk of ACL inju-
Ó 2014 The Author(s) ries, although the accessibility, time, and financial cost

2095
2096 Jones et al The American Journal of Sports Medicine

limit the widespread application of 3-dimensional (3D) also a vertically orientated task, it may more closely resem-
analysis. This has led to authors suggesting the use of sim- ble cutting and pivoting because they are primarily unilat-
plified 2D analysis of drop jumps, focusing on estimates of eral tasks as opposed to bilateral drop jumping. Thus, knee
frontal plane knee motion.28,31,39 Noyes et al28 have sug- motion and moments observed during SLL may transfer to
gested the use of a normalized knee separation distance horizontal changing direction tasks because of this unilat-
to assess ‘‘dynamic valgus,’’ whereas Willson and Davis39 eral commonality. Furthermore, previous researchers have
suggested a frontal plane projection angle to be more infor- not considered multiple angles of direction change and
mative. Padua et al31 have developed and validated, have focused on frontal plane knee motion and moments
against 3D motion analysis techniques, a qualitative anal- without considering other motions associated with
ysis tool for a drop jump involving 2D video in the frontal ‘‘dynamic valgus,’’ which is considered to be a combination
and sagittal planes. Although 2D estimates of knee valgus of hip adduction, hip internal rotation, knee abduction,
motion have been associated with 3D measurements of knee internal or external rotation, and ankle eversion.18
knee valgus motion during single-legged squats,39 side cut- The aim of this study was to investigate whether there
ting, and jump activities,26 it must be stressed that no is a relationship between SLL, cutting, and pivoting in
study has yet prospectively shown that 2D landing tests terms of the characteristics of ‘‘dynamic valgus.’’ The
can identify at-risk athletes. Smith et al37 have found authors investigated whether there is a relationship in
that qualitative analysis of drop jumps failed to prospec- peak knee abduction angles and peak knee abduction
tively predict the occurrence of ACL injuries in 5024 ath- moments between SLL, cutting, and pivoting.
letes from a combination of landing and cutting sports,
suggesting that the use of landing tasks may fail to identify
athletes with at-risk cutting mechanics. MATERIALS AND METHODS
An important limitation of using either 2D or 3D assess-
ments of landing as a screening test is that it is potentially Participants
more effective in sports (ie, basketball, volleyball) where
landing is the primary mechanism of ACL ruptures. As Twenty healthy female soccer players from local clubs and
mentioned previously, in soccer, the majority of injuries centers of excellence (mean 6 SD: age, 21.0 6 3.9 years;
are a result of changing direction horizontally such as dur- height, 1.65 6 0.08 m; mass, 58.4 6 6.4 kg) acted as partic-
ing cutting and pivoting.12 Therefore, a screening test to ipants for the study. Written informed consent was
identify athletes with poor cutting and pivoting mechanics attained from all participants, and approval for the study
is warranted. McLean et al26 investigated whether a 2D was provided by the university’s ethical committee.
assessment of knee valgus motion relates to knee valgus All participants performed a minimum of 6 trials of 3
motion identified from 3D analysis during a 35° to 60° athletic tasks: an SLL task from a 0.3-m drop height and
side step, side jump, and shuttle run (180° turn); 2D esti- cutting and pivoting on an indoor Mondo running surface.
mates correlated well with 3D data for the side step (R2 The SLL task involved participants stepping off a raised
= 0.58) and side jump (R2 = 0.64) but did not correlate platform and landing on 1 limb onto a force platform.
with the shuttle run, highlighting the difficulty in assess- The SLL task has often been cited as an ACL injury mech-
ing knee valgus motion 2-dimensionally with more vigor- anism.4,20,30 Each participant was instructed to ensure
ous horizontal changes of direction. a homogeneous drop distance in each trial, making sure
Previous researchers have shown relationships between that she dropped the full 0.3 m from the raised platform.
functional screening tests (single-legged and double-legged Trials were disqualified if participants were deemed to
squat, lunge, hop-lunge, and step-down)38; step-down, step down during either of the tasks.
single-legged landing (SLL), and drop jump17; and 45° The cutting task (90° cut) involved running toward
side step, side jump, and shuttle run27 in terms of knee val- a force platform; before the turn, the participant ran
gus motion and moments. Limited published research is through a set of timing lights 5 m from the center of the
available on whether poor landing mechanics transfer to force platform (Figure 1). The participant then made con-
cutting and pivoting, which would validate the use of land- tact with the force platform with the right foot and imme-
ing tests to identify athletes who exhibit poor neuromuscu- diately cut 90° to the left and ran through a second set of
lar control during such maneuvers. O’Connor et al29 have timing lights 3 m away. For the pivoting task (180°
found poor relationships between constrained lateral cut- turn), the participants approached in the same manner,
ting tasks involving an initial landing (ie, stride land and but they turned back to the original starting position
cut, far-box land and cut, and close-box land and cut) and once contacting the force platform with the right leg.
unanticipated side-step cutting, whereas Kristianlund For both tasks, each participant started approximately
and Krosshaug19 found a moderate correlation for peak 5 m behind the first set of timing lights. Some flexibility
knee abduction angles between drop jumping and cutting was allowed for the exact starting point to allow for each
(r = .706) but a poor correlation in terms of external knee participant’s differing stride pattern as she approached
abduction moments (r = .135) in 120 elite female handball the force platform. Participants were allowed time before
players. However, such comparisons have been limited data collection to identify their exact starting point to
solely to drop jumping, which may lack predictive values ensure appropriate contact with the force platform. Each
of ACL injuries that occur during cutting12 and may not participant was instructed to approach along a straight
reflect landing actions in many sports.20,30 While SLL is path toward the force platform, avoid premature turning
Vol. 42, No. 9, 2014 Relationship Between Landing and Changing Direction 2097

cluster sets were placed in the distal third of the thigh to

reduce movement of the cluster set caused by muscle
bulk and swinging of the hands.
Three-dimensional motions of these markers were col-
lected while performing each athletic task using Qualisys
ProReflex (model no. MCU 240) infrared cameras
(240 Hz) operating through Q-Trac Manager software (ver-
sion 1.10.282; Qualisys). The GRFs were collected from an
AMTI force platform (model no. 600900; Advanced
Mechanical Technology Inc) embedded into the running
track sampling at 1200 Hz.
From a standing trial, a 6 degrees of freedom kinematic
model of the lower extremity and trunk was created for
each participant, including the pelvis, thigh, shank, and
foot using Visual3D software (version 3.90.21; C-Motion).
This kinematic model quantified the motion at the hip,
knee, and ankle joints using Cardan angle sequence
x-y-z.16 The local coordinate system was defined at the prox-
Figure 1. A plan view of the experimental setup. imal joint center for each segment. The static trial position
was designated as the participants’ neutral (anatomic zero)
alignment, and subsequent kinematic measures were
of the body before final foot contact, and contact the center related back to this position. Lower limb joint moments
of the force platform to ensure a homogeneous distance of were calculated using an inverse dynamics approach40
travel between trials. Trials were disqualified if partici- through Visual3D software. Segmental inertial characteris-
pants did not adhere to these instructions. The total time tics were estimated for each participant.11 The model
to complete the cut and pivot was measured using a set utilized a CODA (Charnwood Dynamics Ltd) pelvis orienta-
of timing lights (Brower Timing Systems), set at approxi- tion3 to define the location of the hip joint center. The knee
mate hip height for all participants as previously recom- and ankle joint centers were defined as the midpoint of the
mended,41 to ensure that only 1 body part, such as the line between lateral and medial markers.21,33 Joint
lower torso, breaks the beam. The time to complete each moments are defined as external moments. A minimum of
task (cut: 1.85 s 6 10%; pivot: 2.65 s 6 10%) was used to 4 trials was used in the analysis of each participant8-10,33
control for performance within and between participants based on visual inspection of the motion files and retrospec-
during the session. tive analysis of the approach velocity. Trials were disquali-
For each trial, the horizontal x-coordinate in the direc- fied if the approach velocity fell outside of the desired ranges
tion of motion of the right hip joint center was calculated stated above or if the participants slid, turned prematurely,
over the 10 frames before penultimate foot contact to deter- or missed the force platform that went unnoticed during
mine the approach velocity in accordance with McLean data collection. The trials were time normalized for each
et al.23,26,27 This retrospective analysis was conducted to participant with respect to the ground contact time of the
ensure that each trial achieved a target approach velocity cut and pivot. Initial contact was defined as the instant after
of between 4 to 5 m
s–1 and 3.6 to 4.4 m
s–1 for cutting ground contact in which the vertical GRF was higher than
and pivoting, respectively. These target approach veloci- 20 N, and end of contact was defined as the point where
ties were selected based on velocities recorded in several the vertical GRF subsided past 20 N. The SLL trials for
previous studies2,8,23,24,27 and typical approach velocities each participant were normalized from initial contact
achieved for female soccer players in earlier research to the point of maximum knee flexion, which was considered
undertaken in our laboratory. the end of the weight acceptance phase for this task. Using
Reflective markers (14-mm spheres) were placed on the the pipeline function in Visual3D, joint coordinate and force
following body landmarks: right and left iliac crests; ante- data were smoothed with a Butterworth low-pass digital fil-
rior superior iliac spine; posterior superior iliac spine; ter with cut-off frequencies of 12 Hz and 25 Hz, respectively.
greater trochanter; medial epicondyle; lateral epicondyle; Cut-off frequencies were selected based on a residual analy-
lateral malleoli; medial malleoli; heel; and fifth, second, sis40 and visual inspection of the data.
and first metatarsal heads using double-sided adhesive The cuts could only be performed with the right leg
tape. Participants wore a 4-marker ‘‘cluster set’’ (4 retrore- because of limited laboratory space. Thus, comparisons
flective markers attached to a lightweight rigid plastic were only made for right leg variables between tasks.
shell) on the pelvis, right and left thigh, and right and Peak knee abduction angles (abduction negative/adduction
left shin, which would approximate the motion of these positive) and knee abduction moments (abduction positive)
segments during the dynamic trials. This technique is sug- were compared between SLL, cutting, and pivoting along
gested to be more accurate and practical for tracking with abduction range of motion (ROM), which was defined
motion than individual skin markers,1 with 4 markers sug- as the difference between knee abduction angle at initial
gested as optimal.5,22 The thigh and shank cluster sets contact and peak knee abduction angle. Values of frontal
were attached using Velcro-elasticated wraps. The thigh and transverse plane hip angle (abduction negative/
2098 Jones et al The American Journal of Sports Medicine

TABLE 1
Descriptives for the Kinematic Variables Between Each Taska

Task SLL Cutting Pivoting

Hip adduction (1)/abduction (–) angle at peak valgus 3 6 5b –18 6 7 –18 6 7

Hip internal (1)/external (–) rotation angle at peak valgus 10 6 8b 18 6 11 19 6 10
Peak knee abduction (–) angle –7 6 6b –13 6 6 –14 6 8
Knee internal (1)/external (–) rotation angle at peak valgus 5 6 6c 865 6 6 8
Ankle inversion (1)/eversion (–) angle at peak valgus –12 6 6b 464 3 6 7
Hip adduction (–)/abduction (1) ROM –9 6 5b 063 –1 6 4
Hip internal (–)/external (1) rotation ROM –3 6 8 –9 6 9 –5 6 6
Knee adduction (–)/abduction (1) ROM 6 6 5b 11 6 5 10 6 6
Knee internal (–)/external (1) rotation ROM –7 6 6 –11 6 9d –6 6 9
Ankle inversion (–)/eversion (1) ROM 13 6 7b –7 6 7 –6 6 6

a
All values are in degrees. ROM, range of motion; SLL, single-legged landing.
b
Significantly different from cutting and pivoting (P \ .05).
c
Significantly different from cutting (P \ .05).
d
Significantly (P \ .05) different from SLL and pivoting (P \ .05).

adduction positive/internal rotation positive/external rota-

tion negative), transverse plane knee angle (internal rota-
tion positive/external rotation negative), and frontal plane
ankle angle (eversion negative/inversion positive) at peak
valgus (peak knee abduction angle) were also determined
and compared between SLL, cutting, and pivoting. Also,
ROM for each of these variables was determined and
defined as the difference between the angle at initial con-
tact and that at peak valgus (peak knee abduction angle).

Statistical Analysis
All statistical analyses were performed in SPSS for Win-
dows version 17 (SPSS Inc). Normality for each variable
was inspected using the Shapiro-Wilk test. The Pearson cor-
relation coefficient and coefficient of determination were
used to explore relationships in frontal and transverse plane Figure 2. Mean 6 SD normalized peak knee abduction
motion and knee abduction moments between landing, cut- moments during single-legged landing (SLL), cutting, and
ting, and pivoting tasks for parametric data. Relationships pivoting. *Significantly (P \ .001) greater than SLL.
involving nonparametric variables were explored using the
Spearman rank correlation (r). A repeated-measures
ANOVA with Bonferroni post hoc analysis was used to .001) greater knee abduction angles and ROM than SLL,
determine whether there were any significant differences which tended to occur with the hip in a more abducted
between tasks for normally distributed kinematic and and internally rotated position and the knee more inter-
kinetic variables. The Friedman test was used for nonpara- nally rotated in comparison with landing. Also, SLL
metric variables. Significance was set at P \ .05. resulted in significantly (P \ .001) lower knee abduction
moments compared with cutting and pivoting (Figure 2).
No significant differences (P . .05) were observed between
cutting and pivoting for knee abduction angles and
RESULTS
moments (Table 1 and Figure 2).
The mean 6 SD total times and approach velocities before
penultimate contact for the cut and pivot were 1.89 6 Relationship Between SLL and Cutting
0.12 s, 4.2 6 0.4 m
s–1 and 2.69 6 0.15 s, 3.9 6 0.3 m
s–1,
respectively. Normality was confirmed for the majority of Peak knee abduction angle (Table 2) and knee abduction
variables using the Shapiro-Wilk test (P . .05), with the ROM were significantly related (r = 0.61, R2 = 38%, P =
exception of knee abduction ROM in all tasks, pivoting .05) between SLL and cutting (Figure 3). Peak knee abduc-
hip abduction-adduction ROM, SLL knee internal-external tion moments were moderately (Figure 4) but significantly
rotation angle at peak valgus, and cutting hip internal- correlated between SLL and cutting (Table 2).
external rotation angle at peak valgus. Table 1 shows Hip abduction-adduction ROM (R = 0.53, R2 = 29%,
that cutting and pivoting resulted in significantly (P \ P = .018), knee internal-external rotation ROM (R = 0.60,
Vol. 42, No. 9, 2014 Relationship Between Landing and Changing Direction 2099

TABLE 2
Relationship Between SLL, Cutting, and Pivoting
for Peak Knee Abduction Angle and Momenta

Peak Knee Abduction Angle

SLL Cutting Pivoting

Peak knee abduction angle

SLL
Cutting R = 0.63b
R2 = 40%
Pivoting R = 0.76c R = 0.86c
R2 = 57% R2 = 75%

Peak Knee Abduction Moment

SLL Cutting Pivoting

Peak knee abduction moment

SLL
Cutting R = 0.46d
R2 = 21%
Pivoting R = 0.43 R = 0.56d
R2 = 18% R2 = 31%

a
SLL, single-legged landing.
b
P \ .01.
c
P \ .001.
d
P \ .05.

R2 = 36%, P = .006), and angle at peak valgus (r = 0.65,

R2 = 42%, P = .002) were significantly correlated between
SLL and cutting. Ankle inversion-eversion angle at peak
valgus was found to be significantly correlated (R = 0.52,
R2 = 27%, P = .023) between SLL and cutting.

Relationship Between SLL and Pivoting

Peak knee abduction angle (Table 2) and ROM (r = 0.72,
R2 = 51%, P = .001) were significantly correlated between
SLL and pivoting (Figure 3). However, peak knee abduc-
tion moments (Figure 4) did not quite reach significance
(Table 2). Knee internal-external rotation ROM (r = 0.46,
R2 = 21%, P = .05) and angle at peak valgus (r = 0.63,
R2 = 40%, P = .004) were significantly correlated between
SLL and pivoting.

Figure 3. Scatter diagrams illustrating the linear relationship

Relationship Between Cutting and Pivoting
in peak knee abduction angle between single-legged landing
Peak knee abduction angle (Table 2), knee abduction ROM (SLL) and 90° cutting (top), SLL and 180° pivoting (middle),
(r = 0.59, R2 = 35%, P = .006), and peak knee abduction and 90° cutting and 180° pivoting (bottom).
moments (Table 2) were all significantly correlated between
cutting and pivoting (Figures 3 and 4). Knee internal-
ROM (R = 0.75, R2 = 56%, P \ .001) and angle (R = 0.57,
external rotation ROM (R = 0.62, R2 = 38%, P = .004) and
R2 = 32%, P = .009) at peak valgus were both significantly
angle at peak valgus (r = 0.65, R2 = 42%, P = .002) were sig-
correlated between cutting and pivoting.
nificantly correlated between both maneuvers.
Hip abduction (R = 0.60, R2 = 36%, P = .005) and hip inter-
nal rotation angle (r = 0.84, R2 = 70%, P \ .001) at peak DISCUSSION
valgus were also significantly correlated between each
maneuver but not hip abduction-adduction and internal- The present study was designed to investigate whether
external rotation ROM (P . .05). Ankle inversion-eversion there is a relationship between the characteristics of
2100 Jones et al The American Journal of Sports Medicine

and horizontal changing direction tasks. No relationship

was observed between SLL and pivoting tasks in terms of
knee abduction moments. There were further similarities
in terms of knee rotation motion but no apparent relation-
ship between hip and ankle motion between landing and
horizontal changing direction tasks.
The lack of relationship between hip joint kinematic
variables for landing and cutting or pivoting tasks is
unsurprising, as during cutting and pivoting, players often
place the foot laterally toward the direction of travel to
generate a medially directed GRF to facilitate the direction
change. This would involve the thigh being placed in a rel-
atively more abducted position to begin with,9,10 whereas
in landing, it is directly under the body. Furthermore, to
further facilitate the direction change during cutting and
pivoting, more internal hip rotation is required.36 The
absence of a significant correlation in knee abduction
moments between SLL and pivoting could be caused by
the fact that many players during pivoting have both right
and left feet contacting the ground during the weight
acceptance phase, contrary to what happens during an
SLL task. In addition, different technical parameters in
each task will effect knee abduction moments at the knee
such as foot progression angles and internal hip extensor
moments during pivoting.
The results of the present study reveal significantly
(P \ .001) lower knee abduction angles for the SLL task
compared with cutting and pivoting. Furthermore, cutting
and pivoting resulted in significantly (P \ .001) greater
knee abduction moments compared with SLL. Allowing
for slight differences in computation such as biomechanical
models used, filtering methods, identification of the knee
joint axis, and phase of movement, the peak knee abduc-
tion angles during cutting reported in the present study
are similar to values reported during 45° cuts and cross-
cuts21 and side cuts with a mean cutting angle of 69°19
but slightly below values reported for 45° side steps and
side jumps in female NCAA Division I basketball players.27
Cortes et al8 reported comparable knee abduction angles
for pivots compared with the present study, while McLean
et al27 reported similar values for a 180° shuttle run.
Peak knee abduction moments in the present study
were substantially greater than those reported for 45°
cuts elsewhere23,33,35 but lower than values reported by
Kristianlund and Krosshaug.19 The latter case was per-
haps a result of including a static defender and receiving
a pass before cutting, which are known to increase external
knee valgus moments.13,24 For pivoting, the values
reported normalized by height (0.67 6 0.21 Nm
kg–1
m–1)
are similar to those reported by Cortes et al8 in 19 NCAA
Figure 4. Scatter diagrams illustrating the linear relationship Division I female soccer players. The results of the present
in knee abduction moment between single-legged landing study clearly illustrate the increased demand placed on the
(SLL) and 90° cutting (top), SLL and 180° pivoting (middle), knee joint during sharper changes of direction compared
and 90° cutting and 180° pivoting (bottom). with landing and may partially explain the trend in ACL
injury patterns in female soccer.12
The results of the study support previous research
‘‘dynamic valgus’’ between landing, cutting, and pivoting showing a similar relationship between various functional
tasks. The results clearly show that there is a significant and athletic tasks in terms of knee motion and
relationship in terms of peak knee abduction angle, abduc- moments.17,38 Whatman et al38 investigated the associa-
tion ROM, and knee abduction moments between landing tion between functional screening tests (single-legged and
Vol. 42, No. 9, 2014 Relationship Between Landing and Changing Direction 2101

double-legged squat, lunge, hop-lunge, and step-down) and CONCLUSION

jogging in terms of 3D joint kinematics. Transverse and
frontal plane kinematics for the hip, knee, and ankle dur- The present study found significantly moderate to strong
ing the functional tests all showed moderate to high corre- relationships in frontal plane knee motion and moments
lations with jogging. Harty et al17 examined frontal plane between SLL, cutting, and pivoting, confirming the study
knee position and moments in female athletes between hypothesis. The results suggest that female athletes who
step-down, SLL, and drop vertical jumps. Strong correla- exhibit poor SLL mechanics perform the same during var-
tions were observed for knee abduction angles between ious horizontal changing direction tasks. This provides
all tasks, while moderate to strong correlations were also some support for the use of landing screening tests to
observed for knee abduction moments. find at-risk athletes for ACL injuries. However, it should
A limited number of researchers have compared landing be stressed that examining landing alone will give some
and changing direction. Previous published literature has idea of athletes who may exhibit at-risk horizontal chang-
demonstrated a poor correlation between constrained lat- ing direction mechanics; it should not be considered as
eral cutting activities from SLL (stride land and cut, far- a replacement to find athletes with at-risk horizontal
box land and cut, and close-box land and cut) and side- changing direction mechanics when facilities to conduct
step cutting,29 whereas Kristianlund and Krosshaug19 this are available to practitioners.
found moderately strong correlations for peak knee abduc-
tion angles between drop jumps and side-step cutting simi-
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