Muscle function of the lower limb—Do we really test what we are looking for?

Established measures of lower-limb muscle function repeatedly show weak, inconsistent or absent association and predictive value for injury, re-injury and other musculoskeletal complaints. Progress in prevention, rehabilitation, and return-to-sport decision-making is unlikely to come from recombining or modifying them. The question is whether the quantity they capture is unsuitable-calling for a change in what is measured. Muscle-function assessment should match the demand it sets out to capture: non-contact injuries occur when muscles must stabilise a joint and adapt to a rising external load. This adaptive, stabilising control is largely unaddressed by established measures. Shifting the focus from muscle strength to muscle stability-from producing force against a resistance to holding a position while adapting to a rising external load (Adaptive Force)-may bring assessment closer to what actually determines joint protection and clinical outcome.

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Publication Details

Journal
Knee Surgery Sports Traumatology Arthroscopy
Published
2026-08-03
DOI
https://doi.org/10.1002/ksa.70560
Primary Topic
Sports injuries and prevention
Type
article
Field-Weighted Citation Impact
0.00
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article

Muscle function of the lower limb—Do we really test what we are looking for?

Laura V. Schaefer, Jaali Ulrich, Frank N. Bittmann, Robert Prill et al.
Knee Surgery Sports Traumatology Arthroscopy
Sports injuries and prevention
article

Muscle function of the lower limb—Do we really test what we are looking for?

Laura V. Schaefer, Jaali Ulrich, Frank N. Bittmann, Robert Prill, Roland Becker
article en

Abstract

Established measures of lower-limb muscle function repeatedly show weak, inconsistent or absent association and predictive value for injury, re-injury and other musculoskeletal complaints. Progress in prevention, rehabilitation, and return-to-sport decision-making is unlikely to come from recombining or modifying them. The question is whether the quantity they capture is unsuitable-calling for a change in what is measured. Muscle-function assessment should match the demand it sets out to capture: non-contact injuries occur when muscles must stabilise a joint and adapt to a rising external load. This adaptive, stabilising control is largely unaddressed by established measures. Shifting the focus from muscle strength to muscle stability-from producing force against a resistance to holding a position while adapting to a rising external load (Adaptive Force)-may bring assessment closer to what actually determines joint protection and clinical outcome.

Knee Surgery Sports Traumatology Arthroscopy
University of Potsdam (DE), University of Applied Sciences Potsdam (DE), Universitätsklinikum Brandenburg an der Havel (DE), Brandenburg University of Technology Cottbus-Senftenberg (DE)
Peace, Justice and strong institutions
Openalex Percentile: Top 8%
Sports injuries and prevention
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