Gender difference in distance of tibiofibular syndesmosis to joint dynamics of lower extremities during squat

The incidence of lower extremity injury is greater in women than men, indicating gender difference in lower extremity function. Here we investigate the role of the ankle during squatting in young men and women by measuring the tibiofibular syndesmosis (TFS) distance and the angles of hip, ankle and knee joints. TFS distance was positively correlated to body mass in men, but not in women, suggesting some factor(s) affecting TSF distance in women. When divided into two groups with wide and narrow TFS distances, men apparently used ankle and hip joints evenly during squatting, but women, specifically those with a narrow TFS distance, used the hip joint more effectively than ankle. Estimated knee moment was positively correlated to TFS distance in women, but not in men. These results suggest that the women possessing a wider TFS distance use ankle function rather than hip junction when performing lower-extremity exercises (i.e. squatting), presumably accounting for the higher incidence of ankle injury in women during such activities.