Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 2, pp 419–426 | Cite as

Sex differences in sagittal plane control emerge during adolescent growth: a prospective investigation

  • Sinead HoldenEmail author
  • Cailbhe Doherty
  • Colin Boreham
  • Eamonn Delahunt



Females athletes have a higher incidence of non-contact knee joint injuries compared to their male counterparts. This may be attributable to sex-specific differences in neuromuscular control, which arise during the pubertal growth spurt. The purpose of this longitudinal study was to assess the development of landing kinematics of adolescent male and female athletes during the adolescent growth-spurt.


One hundred and eighty-four adolescent athletes (55% male, 45% female; mean age = 13 ± 0.3 years) participated. Testing was undertaken at baseline and then repeated at 6, 12, 18 and 24 months. Participants performed three drop vertical jump (DVJ) trials from a 31 cm box. Frontal and sagittal plane knee joint angles were recorded. The average measurement of the three jumps was used for analysis at each time point. To assess maturation status, participants were categorised according to their age from peak height velocity at baseline. Pre-initial contact knee flexion (pre-IC), peak knee flexion and knee valgus displacement were the dependant variables. The categorical independent variables were sex (male versus female) and time.


There was a significant sex*time interaction for pre-IC knee flexion, with males increasing knee flexion with time to a greater extent than females. There was no significant sex*time interaction for knee valgus displacement; although females displayed greater knee valgus displacement across all time points.


Adolescent male and female athletes display differing kinematic profiles across growth and development. This has clinical relevance for emphasising increased knee flexion, as well as decreasing abnormal frontal plane displacement in injury prevention programmes for adolescent females.

Level of evidence



Puberty Sex differences Biomechanics Youth 



Sinéad Holden was funded by an Irish Research Council for Science Engineering and Technology (IRCSET) Postgraduate EMBARK scholarship to carry out this research. The authors would like to thank all the schools, PE teachers, parents and participants involved for facilitating this research.


Sinéad Holden was funded by an Irish Research Council for Science Engineering and Technology (IRCSET) Postgraduate EMBARK scholarship to carry out this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This project was approved by University College Dublin Health Research Ethics Committee (HREC) (LS-12-147-Holden-Delahunt). Informed parental consent and participant assent was obtained from all participants.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  1. 1.A101 School of Public Health, Physiotherapy and Sports Science, Health Sciences CentreUniversity College DublinDublinIreland
  2. 2.Institute for Sport and HealthUniversity College DublinDublinIreland
  3. 3.Insight Centre for Data AnalyticsUniversity College DublinDublinIreland

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