External vs Combined Focus Effects on Landing in Female Athletes

Female athletes are at higher risk of knee injuries, particularly non-contact anterior cruciate ligament (ACL) injuries, often caused by dynamic knee valgus during landing. Proper landing techniques and neuromuscular training are crucial for injury prevention. Attentional focus strategies, such as external focus (EF) and internal focus (IF), can influence movement patterns, muscle activation, and skill transfer during landing tasks. EF generally promotes safer and more controlled landings, while IF offers certain kinematic benefits. However, real-world sports often require a combination of attentional strategies, and the effects of combined EF + IF instructions on landing mechanics and muscle activation have not been fully studied. This study will investigate the effects of EF and combined attentional focus instructions on lower extremity and trunk movement, muscle activation, and skill transfer in young female athletes with asymptomatic dynamic knee valgus. The investigators aim to determine whether combined attentional focus training provides greater improvements in landing mechanics, muscle activation, and skill transfer than EF training alone.

Inclusion Criteria: Females aged between 18-30 years old BMI between 18.5-25 kg/m² Dynamic knee valgus \>10° during single-leg squat test (Richardson et al., 2020) Being recreationally active (engage in moderate physical activities at least 3 times a week, with each session lasting at least 30 minutes in the past 4 weeks) (Heinert, 2008) Exclusion Criteria: Trunk, lower back, or lower extremity pain greater than 3/10 on numeric pain rating scale (0-10) in the past 6 months History of surgeries in the lower extremity or lower back that may affect the landing mechanism Currently participating in any lower extremity biomechanics modification program Any medical or physical condition that would prevent safe jumping from a 20-cm box