The eagle has landed: a soft landing prevents a multitude of injuries in female athletes

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Paper Title: The relationship between Landing Error Scoring System performance and injury in female collegiate athletes

Publication: International Journal of Sports Physical Therapy

Publication date: December 2021


Lower limb musculoskeletal injuries are common in collegiate sport, especially in sports that require constant acceleration, deceleration, and rapid changes in direction. These injuries are prevalent in female athletes, who have higher severe time-loss injury rates than their male counterparts. These high injury rates have led researchers to develop assessment tools, such as the Landing Error Scoring System (LESS), to identify potentially modifiable intrinsic risk factors for lower limb injury. Identifying LESS item errors related to injury may be useful in injury prevention as practitioners can target specific abnormal movement patterns with equally specific intervention programs. Therefore, this study aimed to examine the association between LESS scores and lower limb injuries in female collegiate athletes.


Before the competitive season, 116 female collegiate athletes completed LESS testing. The test involved standing on a 30cm high box and jumping forwards and vertically to land with both feet just past a designated mark located 90cm anterior to the box. Investigators used a modified LESS scoring rubric to score the test results. A higher LESS score suggests a greater number of landing errors or altered movement patterns during the performance of the jumping test. Investigators followed up with the athletes throughout one competitive season.


The LESS total score was not associated with an increased odds of lower limb injury. Therefore, practitioners should be cautious when using the LESS score as a stand-alone injury prediction tool. Also observed in this study was that uninjured athletes were more likely to have an error in lateral trunk movement at initial contact than their injured counterparts. Notably, trunk displacement during landing is a strong predictor of future lower limb injury. Therefore, future studies should examine the relationship between individual LESS scores and injury in different sporting populations, as these individual items may have clinical application in injury prevention models.

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