Restoration Of Functional Muscle Strength After Knee Injury Or Surgery
Functional muscle strength refers to whole limb force expression during multi-joint, multi-muscle group movements specific to a person’s unique activity or purpose.
With regard to the lower limb, force production predominantly occurs in a closed kinetic chain (CKC), and functional muscle strength of the lower limb is expressed during the concentric phase of CKC activities such as sit-to-stand, stair ascent, and taking off from a jump. Conversely, force absorption also predominantly occurs in a CKC, and so functional muscle strength of the lower limb is also expressed during the eccentric phase of stand-to-sit, stair descent, and landing from a jump.
Relative to the simple functional observations just described, it is not surprising that CKC muscle performance tests such as one repetition maximum (1RM) squat or leg press demonstrate a stronger relationship to lower limb function defined by hopping, jumping, and running tasks than open kinetic chain (OKC) muscle performance tests such as a 1RM knee extension. This, in turn, indicates that CKC training methods (e.g. squats) should eventually be the dominant method of strength training if enhanced performance in hopping, jumping, and running tasks is desired.
Soon after knee injury or surgery, however, OKC strength training should first be used as the dominant training method in order to reverse isolated knee muscle weakness and prepare the knee for functional training, after which CKC strength training should become the dominant training method to optimize whole lower limb function. Thus, both OKC and CKC training methods should be used throughout the rehabilitation process. The key is to implement the correct training method at the correct time.
Here are some links for you that look at some of the above further:
1.
http://bjsm.bmj.com/content/38/3/285.full.pdf+html
2.
http://www.ncbi.nlm.nih.gov/pubmed/9440034
3.
http://www.ncbi.nlm.nih.gov/pubmed/9617729
Regards,
Nick.
Nicholas Clark.
Knee Consultant Physiotherapist.
SKS Group Moderator.
Business Website:
http://integratedphysiotherapy.com/
Business Facebook Page:
http://www.facebook.com/pages/Integrated-Physiotherapy-and-Conditioning/245721042146590?sk=wall
With regard to the lower limb, force production predominantly occurs in a closed kinetic chain (CKC), and functional muscle strength of the lower limb is expressed during the concentric phase of CKC activities such as sit-to-stand, stair ascent, and taking off from a jump. Conversely, force absorption also predominantly occurs in a CKC, and so functional muscle strength of the lower limb is also expressed during the eccentric phase of stand-to-sit, stair descent, and landing from a jump.
Relative to the simple functional observations just described, it is not surprising that CKC muscle performance tests such as one repetition maximum (1RM) squat or leg press demonstrate a stronger relationship to lower limb function defined by hopping, jumping, and running tasks than open kinetic chain (OKC) muscle performance tests such as a 1RM knee extension. This, in turn, indicates that CKC training methods (e.g. squats) should eventually be the dominant method of strength training if enhanced performance in hopping, jumping, and running tasks is desired.
Soon after knee injury or surgery, however, OKC strength training should first be used as the dominant training method in order to reverse isolated knee muscle weakness and prepare the knee for functional training, after which CKC strength training should become the dominant training method to optimize whole lower limb function. Thus, both OKC and CKC training methods should be used throughout the rehabilitation process. The key is to implement the correct training method at the correct time.
Here are some links for you that look at some of the above further:
1.
http://bjsm.bmj.com/content/38/3/285.full.pdf+html
2.
http://www.ncbi.nlm.nih.gov/pubmed/9440034
3.
http://www.ncbi.nlm.nih.gov/pubmed/9617729
Regards,
Nick.
Nicholas Clark.
Knee Consultant Physiotherapist.
SKS Group Moderator.
Business Website:
http://integratedphysiotherapy.com/
Business Facebook Page:
http://www.facebook.com/pages/Integrated-Physiotherapy-and-Conditioning/245721042146590?sk=wall
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