{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:14:38Z","timestamp":1789647278949,"version":"4.0.0"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2011,8,6]],"date-time":"2011-08-06T00:00:00Z","timestamp":1312588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether pre\u2010injury hip muscle weakness is associated with the development of patellofemoral pain (PFP) in high school running athletes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic institution sports medicine center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>High school running athletes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Baseline hip strength of high school running athletes was assessed at the beginning of the running season. Strength testing was repeated in athletes who developed PFP. Peak hip muscle strengths and strength ratios were compared between the injured and non\u2010injured groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six injuries occurred in 5 of the 98 subjects who completed the study. The baseline hip external\u2010to\u2010internal strength ratio was lower in injured than in uninjured subjects (<jats:italic>P<\/jats:italic> = .008). In the injured group, hip abduction and external rotation strengths decreased from pre\u2010injury to post\u2010injury (<jats:italic>P<\/jats:italic> = .002 and <jats:italic>P<\/jats:italic> = .01, respectively). Logistic regression analysis demonstrated that a greater baseline hip abduction strength (odds ratio = 5.35, 95% confidence interval [CI] 1.46\u201019.53; <jats:italic>P<\/jats:italic> &lt; .01) and abduction\u2010to\u2010adduction strength ratio increased the risk of injury (odds ratio = 14.14, 95% CI 0.90\u2010221.06; <jats:italic>P<\/jats:italic> = .05), and a greater pre\u2010injury hip external\u2010to\u2010internal rotation strength ratio decreased the risk of injury (odds ratio &lt; 0.01, 95% CI \u2264 .01, 0.44; <jats:italic>P<\/jats:italic> = .02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The findings of the current study suggest that stronger pre\u2010injury hip abductors (particularly in relation to their hip adductors) and weaker pre\u2010injury hip external rotators (particularly in relation to their hip internal rotators) are associated with the development of PFP. In addition, persons in whom PFP develops appear to lose hip abduction and external rotation strength when compared with their pre\u2010injury strength. Finally, a higher hip external\u2010to\u2010internal rotation strength ratio may protect against the development of PFP.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2011.04.007","type":"journal-article","created":{"date-parts":[[2011,8,8]],"date-time":"2011-08-08T21:47:51Z","timestamp":1312840071000},"page":"792-801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Hip Strength and Knee Pain in High School Runners: A Prospective Study"],"prefix":"10.1002","volume":"3","author":[{"given":"Jonathan T.","family":"Finnoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mederic M.","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Kyle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David 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