The cutting mechanism

JAMES R. ANDREWS, M.D., WILLIAM D. McLEOD, Ph.D., TERRY WARD,

Ph.D., AND KENNY HOWARD
From the Hughston Orthopaedic Clinic, Columbus, Georgia, and the Athletic Department, Auburn University,
Auburn, Alabama

1 l unning athletes change direction by the

mechanism known as cutting. Actually, mecha- a
Cutting can mean a directional change of only
few degrees to better than 90°, and the execu-
nisms for change of direction exist for standing, tion of the cutting mechanism varies substantially
walking, or running. In this paper we deal only from one individual to another and from one
with the cutting mechanism as it applies to run- sport to another. The cutting mechanism, how-
ning gait, because this represents the most haz- ever, can be defined in general terms; this is
ardous situation for the ligaments of the knee. necessary to identify the stresses imposed on the
Inman et al.1 have defined the human walking knee joint and their relationship to knee instabil-
gait well. Significant differences between the ities.
walking gait and the running gait were described
by Slocum and Bowerman.2 Although the specif- MATERIALS AND METHODS
ics of running gait differ among various sports,
High speed motion pictures (500 frames/sec)
James and Brubaker3have provided a good gen-
were made of eight Auburn University football
eral working definition. Two phases of running
players while they were executing a cut. Two
gait have been described: the support phase and cameras at right angles to one another took si-
the recovery phase. Furthermore, each phase has multaneous pictures. Each player performed a
been divided into three periods. The support
cut of 90° using two techniques, first a sidestep
phase consists of foot strike, midsupport, and cut and second a crossover cut. These films were
takeoff, and the recovery phase consists of follow studied to allow determination of the specific
through, forward swing, and foot descent. A mechanisms within the cutting mechanism that
&dquo;float&dquo; section has been described for normal are common among the players filmed.
running gait, which is the period between takeoff
on one foot and heel strike on the other foot.
DEFINITIONS
Cutting interrupts the orderly progression of the
running gait.
Cutting techniques
Presented at the American Orthopaedic Society for
Sports Medicine Meeting, July 11 to 14, 1976, Dur- Two separate cutting techniques can be defined
ango, Colorado. as follows:

Sidestep Cut: An athlete performs the sidestep

James R. Andrews, M.D., 105 Physicians Building, cut by planting the foot opposite to the direction
Columbus, Georgia 31901.
he wishes to go (Fig. lA), using the other leg for
William D.McLeod, Ph.D., 105 Physicians Building, the first step in the new direction (Fig. 1B).
Columbus, Georgia 31901. Crossover Cut: A player executes the crossover
cut by planting the foot on the same side as the
Terry Ward, Ph.D., Tallahassee, Florida.
new direction (Fig. 2A) and then crossing the

Kenny Howard, Athletic Trainer, Auburn University, opposite leg in front to provide the acceleration
Auburn, Alabama. in the new direction (Fig. 2B).

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Cutting phases With the knee extended, no backward motion of
the foot before foot strike occurs. As the heel
As defined by James and Brubaker,3 a gait cycle touches, the foot immediately plantar flexes to
consists of the period between the heel strike of allow the full foot to contact the turf (Fig. 3A).
one foot and the next heel strike of the same With the body moving forward, a deceleration
foot. Each gait cycle, then, consists of two steps, force develops. The torso becomes more erect
each step being defined as heel strike on one foot and the foot dorsiflexes until the tibia angles
to heel strike of the opposite foot. ahead of the vertical (Fig. 3B). Now, the deceler-
Both of the above types of cuts, that is, side- ation force becomes maximum. Both quadriceps
step and crossover, consist of three different and gastrocnemius provide the muscular power
phases: preliminary deceleration, plant and cut, for deceleration. Knee joint flexion compensates
and takeoff. for dorsiflexion of the foot so that the center of
Preliminary Deceleration: A player running near mass remains posterior to the planted foot. When

top speed must reduce his momentum before the center of the player’s mass passes the contact
changing direction by as much as 90°. To attempt point, the planted foot only supports the player’s
this in one cycle is to invite injury. Preliminary weight. In many instances the knee flexes as
deceleration may be accomplished over several much as 90°.
gait cycles. Because all deceleration cycles are Unlike a normal gait step, the second step of
similar, however, we can describe the case with the deceleration cycle can be a passive step; that
just one cycle. is, no change in velocity occurs. Usually deceler-
Deceleration requires a significant alteration in ation takes place during this step only if further
the normal gait. The cycle starts on the same foot reduction of the player’s momentum is needed to
that is to be planted for the cut. First, the foot allow safe control of the directional change.
descent period of the recovery phase is modified. Plant and Cut: The player accomplishes the

FIG. 1. Sidestep cut.

112
 FIG. 2. Crossover cut.

FIG. 3. Preliminary deceleration phase.

change in the direction of momentum during this force in the new direction (Fig. 4C). Details of

phase. While the planted foot provides the final the mechanics of this phase differ for the two
deceleration along the initial path, the hip rota- types of cut:
tors turn the torso toward the direction the player Sidestep Cut: Players enter this cycle with the
intends to go (Fig. 4A). The free leg then swings body erect, the hips already flexed, and the knee
in the new direction to provide some acceleration of the leg to be planted (hereafter called the pivot
(Fig. 4B). When the planted leg has completed leg) fully extended (Fig. 5A). Behavior of the
its deceleration function, the hips and torso have pivot leg during the first step of the plant and cut
been rotated; it then adds the major accelerating cycle is identical to the first step of the decelera-
113
 FIG. 4. Plant and cut phase.

tion cycle. Keeping his center of mass back of the At this point the femur of the pivot leg is flexed
planted foot, the player fully stops his motion in and relatively externally rotated, the knee has
the initial direction. flexed to about 60°, and the foot has dorsiflexed.
During the deceleration the torso and pelvis By pushing off, the pivot foot starts acceleration
are rotated internally on the femur to provide the in the new direction with hip and knee extending
change in the player’s direction (Fig. 5B). This and ankle coming into full plantar flexion (Fig.
body rotation allows the free leg to accelerate in 5C). Once the torso rotates fully toward the new
the new direction. direction, the free leg then swings in that direc-
114
115
116
tion to provide directional acceleration and rota-
tory deceleration. Beginning here the free leg
follows the normal running gait pattern progress-
ing from forward swing to foot descent (Fig. 5D).
During foot strike, midsupport, and takeoff the
player accelerates and regains his previous mo-
mentum. His body is well forward, causing the
hips to be somewhat more flexed than under
normal running conditions.
Crossover Cut: In the crossover cut the player
accomplishes the change in body direction differ-
ently. Rather than internal pelvic rotation about
the femur of the pivot foot, in the crossover cut
there is external pelvic rotation about the pivot
leg. This rotation can be achieved by rotating the
pelvis and torso directly using the normal exter-
nal pelvic rotators (i.e., internal femoral rota-
tors). The external pelvic rotation can also be
accomplished by internally rotating and adduct-
ing the free leg. This second rotational mecha-
nism is not available to the sidestep cut.
Once again the first portion of this step of the
plant and cut cycle duplicates the first step of the
deceleration cycle (Fig. 6A). After the foot is
planted, the deceleration forces develop, the an-
kle dorsiflexes, the hip and knee flex, and the
FIG. 7. Takeoff phase.
tibia angles ahead of the vertical (Fig. 6B).
Coincidental with this deceleration the pelvis is
externally rotated about the femur of the pivot
leg. When rotation is complete the free leg enters
into the forward swing of the normal running gait
to provide acceleration in the new direction (Fig.
6C).
As the pelvis externally rotates on the pivot
leg, hip and knee are flexed and ankle is dorsi-
flexed. When the momentum in the initial direc-
tion stops, the player then uses the pivot leg to
accelerate in the new direction by full extension
of hip and knee and plantar flexion of the ankle
(Fig. 6D). Now the center of the player’s mass
lies well ahead of the contact point.
Takeoff: This cycle includes the same phases as
normal running gait, except that it requires the
player to lean forward more than usual in order
to accelerate in the new direction (Figs. 7 and 8).

DISCUSSION
From anunderstanding of the cutting mechanism
we can study the forces imposed on the knee
joint and perhaps predict problems facing players
who have specific rotatory instabilities of the
knee.
I

Deceleration during cutting generates forces . ....

on the joint strictly in an anterorposterior direc- FIG. 8

117
 FIG. 9. In the sidestep cut, there is external rotatory torque on the femur.

tion. As the deceleration forces develop with the in the case of the crossover cut. Again, we must
foot planted, the ankle dorsiflexes slightly be- analyze the forces imposed by both types of cut.
yond the neutral position (Fig. 8). Previously we During deceleration the anterior-posterior forces
showed that both tibial plateaus slope anteriorly are well established and during the plant and cut
when the tibia is approximately 10° ahead of the phase additional rotatory cutting forces are ap-
vertical. During deceleration some posteriorly plied to the capsular ligaments of the knee. These
directed force must be applied on the femur to forces must be analyzed for each type of cut.
prevent anterior subluxation. This force comes Sidestep Cut: When the player’s forward mo-
from at least two sources. Primarily, the extensor mentum slows enough to allow rotation of the
mechanism generates such a force through the torso, the internal pelvic rotator muscles (i.e.,
patellofemoral joint with some help from the external femoral rotators) are used to produce
gastrocnemius. Secondarily, the deceleration the required pelvic and trunk rotation. But at the
force comes through the ligamentous attach- same time internal rotation of the pelvis creates
ments. Capsular ligaments, collateral ligaments, an external rotatory torque on the femur. Figure
and especially the posterior cruciate ligament 9 shows these forces. As shown, these rotational
tighten as the femur tends to slide anteriorly on forces add to the already present deceleration
the tibia. Very little danger to these ligaments forces on the medial side but subtract from the
exists in this situation, because the main deceler- forces on the lateral side. Clinically, this means
ating force is provided by the extensor mecha- that additional stresses are placed on the medial
nism. Players with rotatory instability should ligaments of the pivot leg with the sidestep cut.
have no difficulties running, accelerating, or de- Logically, these dynamic (intrinsic) forces should
celerating in a straight line. make it very difficult for a player with antero-
On the other hand, the plant and cut phase medial rotatory instability to execute a sidestep
puts severe stress on the capsular ligaments, me- cut using the unstable knee for the pivot leg.
dially in the case of the sidestep cut and laterally Crossover Cut: During the plant and cut phase of

118
 FIG. 10. During the plant and cut phase of the crossover cut, the pelvis and torso are rotated externally on the
femur.

the crossovercut, the pelvis and torso are rotated and the lateral ligaments are exposed to extra

externally on the femur. Figure 10 shows that stressesduring the crossover cut.
this torque adds to the preexisting deceleration Certainly there are many variations to these
forces on the lateral ligaments but subtracts from two basic types of cuts. This study has been
the stress on the medial ligaments. This overload limited to a few parameters and their affect on
is applied to the lateral ligaments of the knee and the knee joint alone. It is, however, a good
is opposite the overload applied by the sidestep starting point for further investigation and offers
cut. Clinically, these dynamic overload forces some guidelines for nomenclature and future
make it very difficult for a player with anterolat- studies.
eral rotatory instability to execute a crossover cut
REFERENCES
using the unstable knee for the pivot leg.
1. Saunders JBM, Inman VT, Eberhart HD: The
CONCLUSION major determinants in normal and pathological
gait. J Bone Joint Surg 35A: 543, 1953
2. Slocum DB, Bowerman W: The biomechanics of
In this preliminary study of the cutting mecha- Clin Orthop 23: 39, 1962
running.
nism we have concentrated on the function of the 3. James SL, Brubaker CE: Biomechanics of run-
knee during two major types of cutting, the sides- ning. Orthop Clin North Am 4: 605, 1973
tep cut and the crossover cut. The forces applied
to the knee of the pivot leg during both types of
EDITORIAL COMMENT
cuts have been analyzed. Although these are Dr. James A. Nicholas: For anyone who is inter-
certainly not the only forces applied, it appears ested in the study of motion, the running mecha-
that the medial ligaments of the pivot leg are nism and its variations present a variable night-
exposed to extra stresses during the sidestep cut mare of difficulties. We have studied thousands

119
 of feet of film innumber of ways, and have not
a in relation to running and to its change in direc-
yet published findings because of the vari-
our tion when one cuts; Marey, in 1882, was the first
ables which exist from person to person which to use photography in analysis of movements in
affect the measurement of running, cutting, running, and Muybridge followed within the year
jumping, kicking, walking, and other compo- with his voluminous encyclopedic study; Braune
nents of gait. Some of these variables include (1) and Fisher in 1895 described the body curves,
the abnormalities in the shoulder, trunk, and the mechanisms used when we walk, when we
pelvic curves, not amenable to photographic run, and when we pivot. They analyzed the path-
studies in the X,Y,Z axis because of the inability ways, the velocities, the accelerations, and the
to categorize spinal curves, short leg contrac- muscular effects as well as other kinesiological
tures, and differences in running styles; (2) the functions in the exact terms that are heard today,
inability to relate subtalar and ankle axis effects together with X,Y,Z axis analysis of the shoul-
to the spine and hips, so as to decide the toler- der, trunk, and hip as it related to stance, float-
ance to cut; (3) the inability to study the effect of ing, and pivoting of the leg on impact. Believe it
foot fixation and load compression on the knee or not, to this day these accounts have not been

during cuts; (4) the ability of athletes to cut to 90° changed, in spite of our sophisticated ability to
or more in various directions by using hip, spine, study movement.
knee, foot, or ankle in various summated de- There are many complicated reasons for this.
grees. For example, Plagenhoef estimated that there
One can turn 90° from the hip, or the foot, or a are 100 internal forces that must be calculated to
little of each-one can stutter step, sidestep, obtain the moments of force at a joint in a cut.
crossover cut, decelerate, accelerate, stop and Imagine, then, the cutting mechanism in the un-
go, zigzag, lurch the body, and lean back, all of stable knee, and what the factors are that control
which affect the loads of the cutting mechanism. these moments of force to keep an unstable knee
Thus, a study of this mechanism as the authors from buckling. All body motion has rotational
have attempted, in terms of purely what happens components, and these multiple segments must
at the knee, in relation to acceleration and in be capable of moving simultaneously in a multi-
movement, and then an attempt to postulate tude of directions. It is too simplistic to assume
what happens with knees with instability, impose that this is a function only of ligaments and of
a severe task. What is amazing to me and has instability. Importantly, Basmajian described
always been is the ability of individuals with un- &dquo;spurt muscles and shunt muscles.&dquo; Spurt mus-
stable knees to do everything anyone else can do, cles are in a position best to produce the speed of
and this has been visible too on films taken at movement, whereas the shunt muscles are used
2,000 frames/sec. to aid in joint stabilization. What happens in a
I think it is important for the audience, there- cut if there is weakness? Motion of an unstable
fore, if they wish to jump into sophisticated mo- knee is best attributed by referral to the domi-
tion analysis, first to study the traditional bibliog- nant group of muscles for an instantaneous posi-

raphy of gait and the running mechanism. In- tion, obtained from the joint movements of
deed, the audience should know that the running force. Indeed, there are also prime stoppers
and cutting mechanism, although elaborated which are used in the cutting mechanisms which
upon by Inman, James, Slocum, and Brubaker in are primarily simultaneously antagonistic con-

our lifetime, was first described in 1836 by the tractions which fulfill deceleration of movement,
Weber brothers. It was they who established (1) running from the arms to the feet. When we at
the rhythm of alternation, both in running and the Institute got into motion analysis 5 years ago,
walking, as well as (2) restraint, by observational starting with the simplistic approach to the varia-
rather than calculative means. They pointed out tions of running and cutting, we rapidly learned
that the principal act of running was to increase that it deserved further study, and we have been
the speed of progression, whereas cutting led very quickly to factors that must be consid-
changed direction. Indeed, they described the ered in today’s context before we can state what
double float phase in running, and actually dem- makes a knee buckle. Such factors include the
onstrated inside and outside leg cuts. In succes- individual patient’s ability to develop balance,
sion thereafter, Carelet in 1872 described the coordination, and agility, how he uses this
forward inclination of the body which must occur strength, his tolerance to fatigue, and his neuro-
120
muscular righting mechanisms to protect himself. elude a known as a cut, and a
right angle pivot,
Even when on clinical maneuvers, he has a wob- reverse cut, which is a crossover step. In sports
bly knee. language, these are called inside cuts and outside
I congratulate the authors, and I think that cuts. There are also additional components in-
their study is important, but I also caution read- cluding diagonal, circular, backward, lateral-
ers to recognize that the simplistic approach to ward, zigzag, stop-go, stutter, jump to run, uphill
the study of human motion, as much as we would and downhill, and inclination facts as well as
like using it in our freeze frame analysis tech- factors in water, on ice, and in the air. I do not
niques, is simply not in the cards at this time, mean this discussion in any way to be discourag-
until we learn what it is about performance in ing, but we must point out the very difficult task
individuals that controls the problems I have de- that lies ahead for those interested in this area.
scribed. I want to summarize, finally, the running They must start with the fundamentals dating
variations that we should know, for nomencla- back to Steindler and Plato Schwaytz as well as
ture is important. These running variations in- those I have enumerated.

121