Landing from different heights: Biomechanical and neuromuscular strategies in trained gymnasts and untrained prepubescent girls

The purpose of this study was to examine the biomechanics of the lower limb, during landing in female prepubertal gymnasts and prepubertal untrained girls, aged 9–12 years. Ten healthy participants were included in each group and performed five landings from 20, 40, and 60 cm. Kinematics, ground reaction forces (GRF) and electromyogram (EMG) from the lateral gastrocnemius, tibialis anterior, and vastus lateralis are presented. Gymnasts had higher vertical GRF and shorter braking phase during landing. Compared to untrained girls, gymnasts exhibited for all examined drop heights more knee flexion before and at ground contact, but less knee flexion at maximum knee flexion position. Especially when increasing drop heights the gymnasts activated their examined muscles earlier, and generally they had higher pre- and post landing EMG amplitudes normalized to the peak EMG at 60 cm drop height. Furthermore, gymnasts had lower antagonist EMG for the tibialis anterior compared to untrained girls, especially when landing from higher heights. It is concluded that the landing strategy preferred by gymnasts is influenced by long-term and specialized training and induces a stiffer landing pattern. This could have implications in injury prevention, which requires further investigation.     

Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings

PurposeThe purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ).MethodsFifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM),vastus lateralis(VL)}, {vastus medialis(VM),hamstring medialis(HM)}, {hamstring medialis(HM),hamstring lateralis(HL)} and the {vastus lateralis(VL),hamstring lateralis(HL)}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping.ResultsThe peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05). Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001). The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05). Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001). Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001).ConclusionThis study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior neuromuscular activation (dominant hamstrings medialis activity) during the preparatory and initial contact phase and an increased lateral neuromuscular activation (dominant vastus lateralis activity) during the peak loading phase.     

Agonist versus antagonist muscle fatigue effects on thigh muscle activity and vertical ground reaction during drop landing

BackgroundAgonist and antagonist co-activation plays an important role for stabilizing the knee joint, especially after fatigue. However, whether selective fatigue of agonists or antagonist muscles would cause different changes in muscle activation patterns is unknown.HypothesisKnee extension fatigue would have a higher influence on landing biomechanics compared with a knee flexion protocol.Study designRepeated-measures design.MethodsTwenty healthy subjects (10 males and 10 females) performed two sets of repeated maximal isokinetic concentric efforts of the knee extensors (KE) at 120° s^?1 until they could no longer consistently produce 30% of maximum torque. On a separate day, a similar knee flexion (KF) fatigue protocol was also performed. Single leg landings from 30 cm drop height were performed before, in the middle and after the end of the fatigue test. The mean normalized electromyographic (EMG) signal of the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF) and gastrocnemius (GAS) at selected landing phases were determined before, during and after fatigue. Quadriceps:hamstrings (Q:H) EMG ratio as well as sagittal hip and knee angles and vertical ground reaction force (GRF) were also recorded.ResultsTwo-way analysis of variance designs showed that KE fatigue resulted in significantly lower GRF and higher knee flexion angles at initial contact while maximum hip and knee flexion also increased (p < 0.05). This was accompanied by a significant decline of BF EMG, unaltered EMG of vastii and GAS muscles and increased Q:H ratio. In contrast, KF fatigue had no effects on vGRFs but it was accompanied by increased activation of VM, BF and GAS while the Q:H increased during before landing and decreased after impact.ConclusionFatigue responses during landing are highly dependent on the muscle which is fatigued.     

Effect of landing height on frontal plane kinematics, kinetics and energy dissipation at lower extremity joints

Lack of the necessary magnitude of energy dissipation by lower extremity joint muscles may be implicated in elevated impact stresses present during landing from greater heights. These increased stresses are experienced by supporting tissues like cartilage, ligaments and bones, thus aggravating injury risk. This study sought to investigate frontal plane kinematics, kinetics and energetics of lower extremity joints during landing from different heights. Eighteen male recreational athletes were instructed to perform drop-landing tasks from 0.3- to 0.6-m heights. Force plates and motion-capture system were used to capture ground reaction force and kinematics data, respectively. Joint moment was calculated using inverse dynamics. Joint power was computed as a product of joint moment and angular velocity. Work was defined as joint power integrated over time. Hip and knee joints delivered significantly greater joint power and eccentric work (p<0.05) than the ankle joint at both landing heights. Substantial increase (p<0.05) in eccentric work was noted at the hip joint in response to increasing landing height. Knee and hip joints acted as key contributors to total energy dissipation in the frontal plane with increase in peak ground reaction force (GRF). The hip joint was the top contributor to energy absorption, which indicated a hip-dominant strategy in the frontal plane in response to peak GRF during landing. Future studies should investigate joint motions that can maximize energy dissipation or reduce the need for energy dissipation in the frontal plane at the various joints, and to evaluate their effects on the attenuation of lower extremity injury risk during landing.     

Quantifying plyometric intensity via rate of force development, knee joint, and ground reaction forces

Because the intensity of plyometric exercises usually is based simply upon anecdotal recommendations rather than empirical evidence, this study sought to quantify a variety of these exercises based on forces placed upon the knee. Six National Collegiate Athletic Association Division I athletes who routinely trained with plyometric exercises performed depth jumps from 46 and 61 cm, a pike jump, tuck jump, single-leg jump, countermovement jump, squat jump, and a squat jump holding dumbbells equal to 30% of 1 repetition maximum (RM). Ground reaction forces obtained via an AMTI force plate and video analysis of markers placed on the left hip, knee, lateral malleolus, and fifth metatarsal were used to estimate rate of eccentric force development (E-RFD), peak ground reaction forces (GRF), ground reaction forces relative to body weight (GRF/BW), knee joint reaction forces (K-JRF), and knee joint reaction forces relative to body weight (K-JRF/BW) for each plyometric exercise. One-way repeated measures analysis of variance indicated that E-RFD, K-JRF, and K-JRF/BW were different across the conditions (p < 0.05), but peak GRF and GRF/BW were not (p > 0.05). Results indicate that there are quantitative differences between plyometric exercises in the rate of force development during landing and the forces placed on the knee, though peak GRF forces associated with landing may not differ.     

The effect of leg dominance and landing height on ACL loading among female athletes

Female athletes are more prone to anterior cruciate ligament (ACL) injury. A neuromuscular imbalance called leg dominance may provide a biomechanical explanation. Therefore, the purpose of this study was to compare the side-to-side lower limb differences in movement patterns, muscle forces and ACL forces during a single-leg drop-landing task from two different heights. We hypothesized that there will be significant differences in lower limb movement patterns (kinematics), muscle forces and ACL loading between the dominant and non-dominant limbs. Further, we hypothesized that significant differences between limbs will be present when participants land from a greater drop-landing height. Eight recreational female participants performed dominant and non-dominant single-leg drop landings from 30 to 60 cm. OpenSim software was used to develop participant-specific musculoskeletal models and to calculate muscle forces. We also predicted ACL loading using our previously established method. There were no significant differences between dominant and non-dominant leg landing except in ankle dorsiflexion and GMED muscle forces at peak GRF. Landing from a greater height resulted in significant differences among most kinetics and kinematics variables and ACL forces. Minimal differences in lower-limb muscle forces and ACL loading between the dominant and non-dominant legs during single-leg landing may suggest similar risk of injury across limbs in this cohort. Further research is required to confirm whether limb dominance may play an important role in the higher incidence of ACL injury in female athletes with larger and sport-specific cohorts.     

The effect of hamstring muscle compensation for anterior laxity in the ACL-deficient knee during gait

The hamstring muscles have been recognized as an important element in compensating for the loss of stability in the ACL-deficient knee, but it is still not clear whether the hamstring muscle force can completely compensate for the loss of ACL, and the consequences of increased hamstring muscle force. A two-dimensional anatomical knee model in the sagittal plane was developed to examine the effect of various levels of hamstring muscle activation on restraining anterior tibial translation in the ACL-deficient knee during level walking. The model included the tibiofemoral and patellofemoral joints, four major ligaments, the medial capsule, and five muscle units surrounding the knee. Simulations were conducted to determine anterior tibial translation and internal joint loading at a single selected position when the knee was under a peak external flexion moment during early stance phase of gait. Incremental hamstring muscle forces were applied to the modeled normal and the ACL-deficient knees. Results of simulations showed that the ACL injury increased the anterior tibial translation by 11.8mm, while 56% of the maximal hamstring muscle force could reduce the anterior translation of the tibia to a normal level during the stance phase of gait. The consequences of increased hamstring muscle force included increased quadriceps muscle force and joint contact force.     

Reducing ground reaction forces in gymnastics’ landings may increase internal loading

The aim of this study was to use a subject-specific seven-link wobbling mass model of a gymnast, and a multi-layer model of a landing mat, to determine landing strategies that minimise ground reaction forces (GRF) and internal forces. Subject-specific strength parameters were determined that defined the maximum voluntary torque/angle/angular velocity relationship at each joint. These relationships were used to produce subject-specific ‘lumped’ linear muscle models for each joint. Muscle activation histories were optimised using a Simplex algorithm to minimise GRF or bone bending moments for forward and backward rotating vault landings. Optimising the landing strategy to minimise each of the GRF reduced the peak vertical and horizontal GRF by 9% for the backward rotating vault and by 8% and 48% for the forward rotating vault, compared to a matching simulation. However, most internal loading measures (bone bending moments, joint reaction forces and muscle forces) increased compared to the matching simulation. Optimising the landing strategy to minimise the peak bone bending moments resulted in reduced internal loading measures, and in most cases reduced GRF. Bone bending moments were reduced by 27% during the forward rotating vault and by 2% during the backward rotating vault landings when compared to the matching simulations. It is possible for a gymnast to modify their landing strategy in order to minimise internal forces and lower GRF. However, using a reduction in GRF, due to a change in landing strategy, as a basis for a reduction in injury potential in vaulting movements may not be appropriate since internal loading can increase.     

Hamstring muscle kinematics and activation during overground sprinting

Hamstring muscle strain injury is one of the most commonly seen injuries in sports such as track and field, soccer, football, and rugby. The purpose of this study was to advance our understanding of the mechanisms of hamstring muscle strain injuries during over ground sprinting by investigating hamstring muscle-tendon kinematics and muscle activation. Three-dimensional videographic and electromyographic (EMG) data were collected for 20 male runners, soccer or lacrosse players performing overground sprinting at their maximum effort. Hamstring muscle-tendon lengths, elongation velocities, and linear envelop EMG data were analyzed for a running gait cycle of the dominant leg. Hamstring muscles exhibited eccentric contractions during the late stance phase as well as during the late swing phase of overground sprinting. The peak eccentric contraction speeds of the hamstring muscles were significantly greater during the late swing phase than during the late stance phase (p=0.001) while the hamstring muscle-tendon lengths at the peak eccentric contraction speeds were significantly greater during the late stance phase than during the late swing phase (p=0.001). No significant differences existed in the maximum hamstring muscle-tendon lengths between the two eccentric contractions. The potential for hamstring muscle strain injury exists during the late stance phase as well as during the late swing phases of overground sprinting.     

A mechanics comparison between landing from a countermovement jump and landing from stepping off a box

It is common practice to study jump landing mechanics by having subjects step off a box set at a certain height instead of landing from a jump. This practice assumes that the landing mechanics are similar between stepping off a box and a countermovement jump as long as the heights can be matched. The mechanics of the two methods had never been compared when landing from identical heights. Thus, the purpose of this study was to compare the mechanics of landing from a countermovement jump to landing from a step-off. Participants performed three maximal countermovement jumps. The mechanics of one countermovement jump was compared with a center of mass fall height matched step-off landing. The step-off landing showed a more rapid time to peak ground reaction force (GRF) in both genders and greater GRF peak and loading rate in males only. No difference was observed between joint angles at initial contact; however, the countermovement jump showed significantly greater joint flexion angles at peak GRF for both genders. EMG showed greater muscle activity during the countermovement jump condition in all subjects. It was concluded that countermovement jump landings are different from step-off landings; thus, results from analyses involving step-off landings should be taken with caution if the aim is to relate them to landing from a jump.     

Biarticular hip extensor and knee flexor muscle moment arms of the feline hindlimb

Moment arms are important for understanding muscular behavior and for calculating internal muscle forces in musculoskeletal simulations. Biarticular muscles cross two joints and have moment arms that depend on the angle of both joints the muscles cross. The tendon excursion method was used to measure the joint angle-dependence of hamstring (biceps femoris, semimembranosus and semitendinosus) moment arm magnitudes of the feline hindlimb at the knee and hip joints. Knee angle influenced hamstring moment arm magnitudes at the hip joint; compared to a flexed knee joint, the moment arm for semimembranosus posterior at the hip was at most 7.4 mm (25%) larger when the knee was extended. On average, hamstring moment arms at the hip increased by 4.9 mm when the knee was more extended. In contrast, moment arm magnitudes at the knee varied by less than 2.8 mm (mean=1.6 mm) for all hamstring muscles at the two hip joint angles tested. Thus, hamstring moment arms at the hip were dependent on knee position, while hamstring moment arms at the knee were not as strongly associated with relative hip position. Additionally, the feline hamstring muscle group had a larger mechanical advantage at the hip than at the knee joint.     

The application of musculoskeletal modeling to investigate gender bias in non-contact ACL injury rate during single-leg landings

The central tenet of this study was to develop, validate and apply various individualised 3D musculoskeletal models of the human body for application to single-leg landings over increasing vertical heights and horizontal distances. While contributing to an understanding of whether gender differences explain the higher rate of non-contact anterior cruciate ligament (ACL) injuries among females, this study also correlated various musculoskeletal variables significantly impacted by gender, height and/or distance and their interactions with two ACL injury-risk predictor variables; peak vertical ground reaction force (VGRF) and peak proximal tibia anterior shear force (PTASF). Kinematic, kinetic and electromyography data of three male and three female subjects were measured. Results revealed no significant gender differences in the musculoskeletal variables tested except peak VGRF (p = 0.039) and hip axial compressive force (p = 0.032). The quadriceps and the gastrocnemius muscle forces had significant correlations with peak PTASF (r = 0.85, p < 0.05 and r = ? 0.88, p < 0.05, respectively). Furthermore, hamstring muscle force was significantly correlated with peak VGRF (r = ? 0.90, p < 0.05). The ankle flexion angle was significantly correlated with peak PTASF (r = ? 0.82, p < 0.05). Our findings indicate that compared to males, females did not exhibit significantly different muscle forces, or ankle, knee and hip flexion angles during single-leg landings that would explain the gender bias in non-contact ACL injury rate. Our results also suggest that higher quadriceps muscle force increases the risk, while higher hamstring and gastrocnemius muscle forces as well as ankle flexion angle reduce the risk of non-contact ACL injury.     

Effects of various midsole densities of basketball shoes on impact attenuation during landing activities

The purpose of this study was to examine effects of shoe midsole densities and mechanical demands (landing heights) on impact shock attenuation and lower extremity biomechanics during a landing activity. Nine healthy male college athletes performed 5 trials of step-off landing in each of 9 test conditions, i.e., a combination of landings in shoes of 3 midsole densities (soft, normal, hard) from each of 3 landing potential energy (PE) levels (low, median, high). Ground reaction forces (GRF), accelerations (ACC) of the tibia and forehead, and sagittal kinematic data were sampled simultaneously. A 3 x 3 two-way (surface x height) repeated-measures analysis of variance (ANOVA) was performed on selected kinematic, ACC, and GRF variables; a 3 x 3 x 3 three-way (surface x height x joint) ANOVA was performed on variables related to eccentric muscular work. The GRF results showed that the forefoot peak GRF in the normal and hard midsoles was significantly greater than the soft midsole at the low and median PEs. Rearfoot peak GRF was significantly greater for the hard midsole than for the soft and normal midsoles at the median and high PEs, respectively. The peak head and tibia peak ACC were also attenuated in similar fashion. Kinematic variables did not vary significantly across different midsoles, nor did energy absorbed through lower extremity extensors in response to the increased shoe stiffness. Knee joint extensors were shown to be dominant in attenuating the forefoot impact force across the landing heights. The results showed limited evidence of impact-attenuating benefits of the soft midsole in the basketball shoes.     

Agonist muscle activity and antagonist muscle co-activity levels during standardized isotonic and isokinetic knee extensions

This study aimed to analyze the effects of the contraction mode (isotonic vs. isokinetic concentric conditions), the joint angle and the investigated muscle on agonist muscle activity and antagonist muscle co-activity during standardized knee extensions. Twelve healthy adult subjects performed three sets of isotonic knee extensions at 40% of their maximal voluntary isometric torque followed by three sets of maximal isokinetic knee extensions on an isokinetic dynamometer. For each set, the mean angular velocity and the total external amount of work performed were standardized during the two contraction modes. Surface electromyographic activity of vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF), semitendinosus (ST) and biceps femoris (BF) muscles was recorded. Root mean square values were then calculated for each 10° between 85° and 45° of knee extension (0° = horizontal position). Results show that agonist muscle activity and antagonist muscle co-activity levels are significantly greater in isotonic mode compared to isokinetic mode. Quadriceps activity and hamstrings co-activity are significantly lower at knee extended position in both contraction modes. Considering agonist muscles, VL reveals a specific pattern of activity compared to VM and RF; whereas considering hamstring muscles, BF shows a significantly higher co-activity than ST in both contraction modes. Results of this study confirmed our hypothesis that higher quadriceps activity is required during isotonic movements compared to isokinetic movements leading to a higher hamstrings co-activity.     

Elevated gastrocnemius forces compensate for decreased hamstrings forces during the weight-acceptance phase of single-leg jump landing: implications for anterior cruciate ligament injury risk

Approximately 320,000 anterior cruciate ligament (ACL) injuries in the United States each year are non-contact injuries, with many occurring during a single-leg jump landing. To reduce ACL injury risk, one option is to improve muscle strength and/or the activation of muscles crossing the knee under elevated external loading. This study?s purpose was to characterize the relative force production of the muscles supporting the knee during the weight-acceptance (WA) phase of single-leg jump landing and investigate the gastrocnemii forces compared to the hamstrings forces. Amateur male Western Australian Rules Football players completed a single-leg jump landing protocol and six participants were randomly chosen for further modeling and simulation. A three-dimensional, 14-segment, 37 degree-of-freedom, 92 muscle-tendon actuated model was created for each participant in OpenSim. Computed muscle control was used to generate 12 muscle-driven simulations, 2 trials per participant, of the WA phase of single-leg jump landing. A one-way ANOVA and Tukey post-hoc analysis showed both the quadriceps and gastrocnemii muscle force estimates were significantly greater than the hamstrings (p<0.001). Elevated gastrocnemii forces corresponded with increased joint compression and lower ACL forces. The elevated quadriceps and gastrocnemii forces during landing may represent a generalized muscle strategy to increase knee joint stiffness, protecting the knee and ACL from external knee loading and injury risk. These results contribute to our understanding of how muscle?s function during single-leg jump landing and should serve as the foundation for novel muscle-targeted training intervention programs aimed to reduce ACL injuries in sport.     

Comparison of lower limb kinetics,kinematics and muscle activation during drop jumping under shod and barefoot conditions

This study was to investigate the acute effects of wearing shoes on lower limb kinetics, kinematics and muscle activation during a drop jump. Eighteen healthy men performed a drop jump under barefoot and shod conditions. Vertical ground reaction force (GRF) was measured on a force plate during the contact phase of a drop jump, and GRF valuables were calculated for each condition. The angles of the knee and ankle joints, and the foot strike angle (the angle between the plantar surface of the foot and the ground during ground contact) as well as the electromyography of 7 muscles were measured. The shod condition showed a significant larger first peak GRF, longer time to first peak GRF from the initial ground contact and lower initial loading rate than the barefoot condition. The shod condition showed a significant larger ankle joint angle at initial ground contact, smaller knee joint angle between the second peak GRF and take-off as well as smaller foot strike angle at both initial ground contact and take-off than the barefoot condition. There were significant correlations between relative differences in ankle joint at the initial ground contact and relative differences in the initial loading rate. The muscle activity of all muscles during foot ground contact did not differ between two conditions; however, in the shod condition, muscle activation of 150 ms before foot ground contact was significantly higher in the rectus femoris, whereas it was lower in the biceps femoris and tibialis anterior muscles than the barefoot condition. These results indicate that wearing shoes alternates the GRF variables at initial ground contact, joint kinematics at the ground contact and muscle activation before foot ground contact during a drop jump, suggesting that the effects of wearing shoes on drop jump training differ from being barefoot.     

The relationship between external knee moments and muscle co-activation in subjects with medial knee osteoarthritis

PurposeExternal knee moments are reliable to measure knee load but it does not take into account muscle activity. Considering that muscle co-activation increases compressive forces at the knee joint, identifying relationships between muscle co-activations and knee joint load would complement the investigation of the knee loading in subjects with knee osteoarthritis. The purpose of this study was to identify relationships between muscle co-activation and external knee moments during walking in subjects with medial knee osteoarthritis.Methods19 controls (11 males, aged 56.6 ± 5, and BMI 25.2 ± 3.3) and 25 subjects with medial knee osteoarthritis (12 males, aged 57.3 ± 5.3, and BMI 28.2 ± 4) were included in this study. Knee adduction and flexion moments, and co-activation (ratios and sums of quadriceps, hamstring, and gastrocnemius) were assessed during walking and compared between groups. The relationship between knee moments and co-activation was investigated in both groups.FindingsSubjects with knee osteoarthritis presented a moderate and strong correlation between co-activation (ratios and sums) and knee moments.InterpretationMuscle co-activation should be used to measure the contribution of quadriceps, hamstring, and gastrocnemius on knee loading. This information would cooperate to develop a more comprehensive approach of knee loading in this population.     

Wide step width reduces knee abduction moment of obese adults during stair negotiation

PurposeAn increased likelihood of developing obesity-related knee osteoarthritis may be associated with increased peak internal knee abduction moments (KAbM). Increases in step width (SW) may act to reduce this moment. The purpose of this study was to determine the effects of increased SW on knee biomechanics during stair negotiation of healthy-weight and obese participants.MethodsParticipants (24: 10 obese and 14 healthy-weight) used stairs and walked over level ground while walking at their preferred speed in two different SW conditions – preferred and wide (200% preferred). A 2 × 2 (group × condition) mixed model analysis of variance was performed to analyze differences between groups and conditions (p < 0.05).ResultsIncreased SW increased the loading-response peak knee extension moment during descent and level gait, decreased loading-response KAbMs, knee extension and abduction range of motion (ROM) during ascent, and knee adduction ROM during descent. Increased SW increased loading-response peak mediolateral ground reaction force (GRF), increased peak knee abduction angle during ascent, and decreased peak knee adduction angle during descent and level gait. Obese participants experienced disproportionate changes in loading-response mediolateral GRF, KAbM and peak adduction angle during level walking, and peak knee abduction angle and ROM during ascent.ConclusionIncreased SW successfully decreased loading-response peak KAbM. Implications of this finding are that increased SW may decrease medial compartment knee joint loading, decreasing pain and reducing joint deterioration. Increased SW influenced obese and healthy-weight participants differently and should be investigated further.     

Knee muscle forces during walking and running in patellofemoral pain patients and pain-free controls

One proposed mechanism of patellofemoral pain, increased stress in the joint, is dependent on forces generated by the quadriceps muscles. Describing causal relationships between muscle forces, tissue stresses, and pain is difficult due to the inability to directly measure these variables in vivo. The purpose of this study was to estimate quadriceps forces during walking and running in a group of male and female patients with patellofemoral pain (n=27, 16 female; 11 male) and compare these to pain-free controls (n=16, 8 female; 8 male). Subjects walked and ran at self-selected speeds in a gait laboratory. Lower limb kinematics and electromyography (EMG) data were input to an EMG-driven musculoskeletal model of the knee, which was scaled and calibrated to each individual to estimate forces in 10 muscles surrounding the joint. Compared to controls, the patellofemoral pain group had greater co-contraction of quadriceps and hamstrings (p=0.025) and greater normalized muscle forces during walking, even though the net knee moment was similar between groups. Muscle forces during running were similar between groups, but the net knee extension moment was less in the patellofemoral pain group compared to controls. Females displayed 30–50% greater normalized hamstring and gastrocnemius muscle forces during both walking and running compared to males (p<0.05). These results suggest that some patellofemoral pain patients might experience greater joint contact forces and joint stresses than pain-free subjects. The muscle force data are available as supplementary material.