Abstract
BACKGROUND: Nordic combined (NC) and ski jumping (SJ) athletes have a high prevalence of chronic hip pathology, which may lead to altered knee and ankle biomechanics. PURPOSE: The purpose of this study was to determine the relationship among athlete-reported lower extremity outcomes in a proximal-to-distal sequence. STUDY DESIGN/LEVEL OF EVIDENCE: cross-sectional study, Level IV. METHODS: Elite SJ and NC athletes who competed at the national and international levels were prospectively recruited to complete a survey eliciting information about their Hip Disability and Osteoarthritis Outcome Score (HOOS), International Knee Demographic Committee (IKDC) score, and Foot and Ankle Outcome Score (FAOS). Univariate linear regressions modeling IKDC scores and FAOS subscores were performed for each of the following independent variables: age, sex, body mass index, Nordic event (NC or SJ), HOOS subscore, and FAOS subscore or IKDC score, respectively. RESULTS: A total of 22 athletes were included in the study. HOOS symptoms subscores were significantly lower (worse) among SJ athletes compared with NC athletes (P = .002). HOOS quality of life subscores were lower for female athletes compared with male athletes (54 ± 21, 73 ± 4.0; P = .029) in the entire cohort. An increase in the HOOS pain subscore (0.54 ± 0.20, P = .016) and HOOS sports subscore (0.40 ± 0.17, P = .042) was associated with a significant increase in the IKDC score. An increase in the HOOS symptoms subscore (0.63 ± 0.21, P = .011) was associated with a significant increase in the FAOS symptoms subscore. CONCLUSION: Elite NC and SJ athletes are at high risk of hip pain, which increases their risk of developing knee and ankle pain as well. These findings strongly suggest that training targeted at hip strength and conditioning may optimize knee and ankle outcomes in elite NC and SJ athletes. CLINICAL RELEVANCE: The results of this study may help guide physicians, allied health personnel, and coaches to alter lower extremity training regimens to decrease the risk of injury.