{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:56:51Z","timestamp":1790135811156,"version":"4.0.1"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Background\/Objectives: This study examined the link between the Q angle, knee hyperextension, flexibility, strength profiles and injury occurrence in female adolescent soccer players. Methods: Thirty adolescent female soccer players (age range: 15\u201317 years; age: 15.47 \u00b1 0.73 years; weight: 55.91 \u00b1 7.44 kg; height: 160.01 \u00b1 5.58 cm) were recruited for the study. The tests were conducted before the pre-season preparation period, and the players were monitored from the beginning to the end of the season. This study included players who sustained non-contact injuries throughout the season as well as those who did not sustain any injuries for comparison purposes. Players underwent an anthropometric assessment (height, weight, body fat, Q angle, knee hyperextension) and completed a sit-and-reach test and an isokinetic assessment at 60\u00b0\/s. Results: The results showed that 36.67% of players sustained a non-contact injury during the season. Based on the isokinetic assessment at 60\u00b0\/s, significant differences were observed between the two groups in the torque production of the right and left knee extensors [t(28) = 2.32, p = 0.03, d = 0.81 (large effect)] and the right and left knee flexors [t(28) = 2.04, p = 0.05, d = 0.71 (medium effect)], with the injured group demonstrating significantly greater interlimb asymmetries in torque between the right and left knee extensors, as well as the right and left knee flexors. Also, the injured group demonstrated significantly higher knee hyperextension values for both the right [t(28) = 6.12, p &lt; 0.05, d = 2.22 (large effect)] and left legs [t(28) = 5.72, p &lt; 0.05, d = 2.15 (large effect)]. Conclusions: interlimb asymmetries and knee hyperextension may contribute to the occurrence of lower body non-contact injuries in adolescent female soccer players.<\/jats:p>","DOI":"10.3390\/jfmk10010077","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T12:01:17Z","timestamp":1740484877000},"page":"77","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Knee Mechanics, Strength and Flexibility: Assessing Injury Risk in Female Adolescent Soccer Players"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1139-7731","authenticated-orcid":false,"given":"Koulla","family":"Parpa","sequence":"first","affiliation":[{"name":"School of Sciences, University of Central Lancashire, Cyprus Campus, University Avenue 12-14, Pyla, 7080 Larnaka, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-4657","authenticated-orcid":false,"given":"Marcos","family":"Michaelides","sequence":"additional","affiliation":[{"name":"School of Sciences, University of Central Lancashire, Cyprus Campus, University Avenue 12-14, Pyla, 7080 Larnaka, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/sms.12860","article-title":"A comparison of injuries in elite male and female football players: A five-season prospective study","volume":"28","author":"Larruskain","year":"2018","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"288","DOI":"10.2165\/00007256-199519040-00006","article-title":"Knee injuries in female athletes","volume":"19","author":"Hutchinson","year":"1995","journal-title":"Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1080\/00913847.2020.1720548","article-title":"Injury in elite women\u2019s soccer: A systematic review","volume":"48","author":"Alahmad","year":"2020","journal-title":"Phys. Sportsmed."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1080\/00913847.2018.1462651","article-title":"III. Risk factors associated with self-reported injury history in female youth soccer players","volume":"46","author":"Sugimoto","year":"2018","journal-title":"Phys. Sportsmed."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/0363546505284183","article-title":"Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors","volume":"34","author":"Hewett","year":"2006","journal-title":"Am. J. Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1177\/03635465030310061801","article-title":"Risk factors associated with noncontact injury of the anterior cruciate ligament","volume":"31","author":"Uhorchak","year":"2003","journal-title":"Am. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1177\/0363546507313572","article-title":"The effects of generalized joint laxity on risk of anterior cruciate ligament injury in young female athletes","volume":"36","author":"Myer","year":"2008","journal-title":"Am. J. Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1302\/0301-620X.87B6.15833","article-title":"The risk of anterior cruciate ligament rupture with generalised joint laxity","volume":"87","author":"Ramesh","year":"2005","journal-title":"J. Bone Jt. Surg. Br."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1002\/ar.1092300217","article-title":"The restraining function of the cruciate ligaments on hyperextension and hyperflexion of the human knee joint","volume":"230","author":"Fuss","year":"1991","journal-title":"Anat. Rec."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bascevan, S., Gilic, B., Sunda, M., Kesic, M.G., and Zaletel, P. (2024). Isokinetic knee muscle strength parameters and anthropometric indices in athletes with and without hyperextended knees. Medicina, 60.","DOI":"10.3390\/medicina60030367"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"573","DOI":"10.3928\/0147-7447-20000601-15","article-title":"Mechanisms of anterior cruciate ligament injury","volume":"23","author":"Boden","year":"2000","journal-title":"Orthopedics"},{"key":"ref_12","first-page":"97","article-title":"Reliability of the quadriceps angle measurement","volume":"14","author":"Greene","year":"2001","journal-title":"Am. J. Knee Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/S0736-0266(01)00008-0","article-title":"Q-angle influences tibiofemoral and patellofemoral kinematics","volume":"19","author":"Mizuno","year":"2001","journal-title":"J. Orthop. Res."},{"key":"ref_14","first-page":"24","article-title":"Q-angle: An invaluable parameter for evaluation of anterior knee pain","volume":"10","author":"Emami","year":"2007","journal-title":"Arch. Iran. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1177\/03635465980260031001","article-title":"The relationship between intercondylar notch width of the femur and the incidence of anterior cruciate ligament tears: A prospective study","volume":"26","author":"Shelbourne","year":"1998","journal-title":"Am. J. Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"174","DOI":"10.4314\/ahs.v12i2.15","article-title":"Q-angle, pelvic width, and intercondylar notch width as predictors of knee injuries in women soccer players in South Africa","volume":"12","author":"Mohamed","year":"2012","journal-title":"Afr. Health Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/00913847.2019.1642808","article-title":"Knee isokinetic muscle strength and balance ratio in female soccer players of different age groups: A cross-sectional study","volume":"48","author":"Vargas","year":"2020","journal-title":"Phys. Sportsmed."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.26773\/smj.220611","article-title":"Relationship of pre-season strength asymmetries, flexibility and aerobic capacity with in-season lower body injuries in soccer players","volume":"20","author":"Parpa","year":"2022","journal-title":"Sport. Mont."},{"key":"ref_19","first-page":"775","article-title":"The effectiveness of an isokinetic training protocol on muscular imbalances in professional soccer players following an ACL reconstruction","volume":"10","author":"Parpa","year":"2022","journal-title":"Int. J. Hum. Mov."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1055\/a-1014-2911","article-title":"Clinical features and isokinetic parameters in assessing injury risk in elite football players","volume":"40","author":"Liporaci","year":"2019","journal-title":"Int. J. Sports Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1136\/bjsm.2005.025270","article-title":"Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries","volume":"40","author":"Fuller","year":"2006","journal-title":"Br. J. Sports Med."},{"key":"ref_22","unstructured":"Norkin, C.C., and White, D.J. (2009). Measurement of Joint Motion: A Guide to Goniometry, F.A. Davis. [4th ed.]."},{"key":"ref_23","first-page":"250","article-title":"Peak isokinetic torques of football players participating in different levels in Cyprus and lower limb asymmetries","volume":"5","author":"Parpa","year":"2017","journal-title":"J. Sports Sci."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Parpa, K., and Michaelides, M. (2022). Anterior-posterior and inter-limb lower body strength asymmetry in soccer, basketball, futsal, and volleyball players. Medicina, 58.","DOI":"10.3390\/medicina58081080"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Parpa, K., and Michaelides, M. (2022). Age-related differences in the anthropometric and physical fitness characteristics of young soccer players: A cross-sectional study. Children, 9.","DOI":"10.3390\/children9050650"},{"key":"ref_26","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Routledge Academic. [2nd ed.]."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1177\/0363546508316764","article-title":"Strength imbalances and prevention of hamstring injury in professional soccer players: A prospective study","volume":"36","author":"Croisier","year":"2008","journal-title":"Am. J. Sports Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1568","DOI":"10.1080\/00140130500101585","article-title":"Comparison of muscle strength and flexibility between the preferred and non-preferred leg in English soccer players","volume":"48","author":"Rahnama","year":"2005","journal-title":"Ergonomics"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"\u015aliwowski, R., Paillard, T., Bojkowski, \u0141., Dudzi\u0144ski, W., Patek, M., and Marynowicz, J. (2024). Intra-and inter-limb strength imbalance and asymmetry in soccer: A comparison of elite senior and junior players. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0302474"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/JSM.0b013e318190bddb","article-title":"The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes","volume":"19","author":"Myer","year":"2009","journal-title":"Clin. J. Sport. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jshs.2022.01.002","article-title":"Is hamstrings-to-quadriceps torque ratio useful for predicting anterior cruciate ligament and hamstring injuries? A systematic and critical review","volume":"3","author":"Kellis","year":"2023","journal-title":"J. Sport Health Sci."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Danielsson, A., Horvath, A., Senorski, C., Alentorn-Geli, E., Garrett, W.E., Cugat, R., Samuelsson, K., and Hamrin Senorski, E. (2020). The mechanism of hamstring injuries\u2014A systematic review. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03658-8"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/0363546507308189","article-title":"Biomechanical and Anatomical Assessment after Knee Hyperextension Injury","volume":"36","author":"Fornalski","year":"2008","journal-title":"Am. J. Sports Med."}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/10\/1\/77\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:42:25Z","timestamp":1760028145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/10\/1\/77"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jfmk10010077"],"URL":"https:\/\/doi.org\/10.3390\/jfmk10010077","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,25]]}}}