Same Same but Different: Why Both Sport-Specific Cutting Tasks and Generic Change-of-Direction Tasks Might Need to Be Considered to Prevent ACL Injury

OBJECTIVES: To compare knee abduction moment (KAM) magnitudes between a generic 180° pivot turn (modified 505 change-of-direction test [m505]) and a handball-specific sidestep cut, to assess ranking consistency, and to examine the resultant ground reaction force (GRF) and its frontal plane moment arm to the knee to comprehend their contributions to KAM. STUDY DESIGN: Observational laboratory study. METHODS: High-level female handball players (n = 45) performed the m505 and the handball-specific sidestep cut. The resultant GRF and its frontal plane moment arm to the knee as well as KAM were obtained and subsequently compared between tasks. Rank correlation coefficients were employed to assess if the variables of both tasks were related. RESULTS: Peak KAM was similar for the m505 and the sidestep cut (median [range], 1.79 [0.95-3.53] Nm/kg vs 1.64 [0.34-3.60] Nm/kg; r b = .25; P = .14). The ranking of the players’ peak KAM differed substantially ( r s = .26; P = .084), suggesting that different tasks could classify the same player with different injury risk. The m505 generated lower resultant GRFs (24 ± 4 N/kg, 95% CI [23, 24] vs 33 ± 9 N/kg, 95% CI [31, 35]; d = 1.30; P<.001) but longer frontal plane moment arms (7.8 ± 1.8 cm, 95% CI [7.3, 8.4] vs 5.4 ± 1.5 cm, 95% CI [5.0, 5.8]; d = 1.36; P<.001) compared to those generated by the sidestep cut. CONCLUSION: A difference in individual anterior cruciate ligament injury risk assessment depending on movement type was revealed. While KAM magnitudes were similar across direction-change tasks, player rankings differed. The contributions of resultant GRF and frontal plane moment arms to peak KAM varied between tasks, underscoring the importance of task-specific and individualized injury prevention. JOSPT Open 2025;3(2):162-170. Epub 4 December 2024. doi:10.2519/josptopen.2024.0076