So why the concern over having greater hip and core strength in the cases of athletes with femoral anteversion?
There’s evidence that femoral anteversion results in a decrease activation of the gluteus medius and VMO. There’s also evidence from simulated hip modeling that the hip abductors need to increase force output to maintain a level pelvis during activity when the distal attachment of the hip abductors is positioned more anteriorly as in the case of femoral anteverion. This will then potentially affect lower extremity alignment and stability in the frontal and transverse planes.
The end result is greater potential for non-contact knee injuries. As femoral anteversion is more prevalent in females than males, and considering that the incidence of serious knee injury is higher in females than in males, it stands to reason that developing greater hip and core strength in your female athletes as well as all athletes with femoral anteversion is essential.
Here’s a video of Craig’s Test that we use in our assessments at IFAST.
Position the athlete prone. Flex one knee to 90 degrees. Rotate the hip internally and externally while palpating the greater trochanter until the trochanter is most prominent laterally. Measure the hip rotation angle at the point where the trochanter is most prominent. Norms for males is 8 degrees of internal rotation, females up to 14 degrees. Anything greater than 15 degrees would be considered excessive.
References:
J Bone Joint Surg. Am. 1965 Apr; 47: 462-76.
J Electromyogr Kinesiol. 2004 Apr; 14(2): 255-61.