Great post by @dr.surdykapt.
You know I can talk ACLs all day and this is an important aspect in rehab I think is neglected. Many people are discharged from PT at 5-6 months because they “look” strong but the neuromuscular component is never fully addressed in rehab. In the later stages of rehab I work on neuromuscular imbalances every session with balance and plyos. Using a wide variety of exercises to continuously challenge them is crucial for full recovery. With neuromuscular control with balance and landing tasks, limiting trunk, hip and knee control is key.
The content below was written by @dr.surdykapt.
As one of the most common and impactful lower extremity injuries among the athletic population, especially in females, anterior cruciate ligament (ACL) injuries are frequently examined in the scientific literature to determine ways to reduce their incidence. While complete prevention is ideal, it is simply not possible due to many uncontrollable variables. Instead, we strive for injury reduction.
To reduce the rate of an injury, we must first understand how it occurs. ACL injuries generally share three common characteristics:
- 1. They are usually non contact. While direct impact to the leg may be associated with an ACL rupture, the injury is more common during movements such as landing, pivoting, and decelerating.
- 2. They usually happen at the position of no return which was defined by Dr. Ireland as hip internal rotation and adduction, knee valgus with minimal flexion, and tibial external rotation on a pronated, externally rotated foot.
- 3. They usually occur during dynamic movements with relatively high loads to the knee. You're unlikely to tear your ACL while walking around the park.
One way to combat these issues is by addressing neuromuscular imbalances. Neuromuscular imbalances, defined in the referenced study as "muscle strength or activation patterns that lead to increased joint load", may put an individual at risk for injury by exposing the ACL to excessive forces. The four neuromuscular imbalances are ligament dominance, quadriceps dominance, leg dominance, and trunk dominance.
Throw up a 🤚 if you want to know the differences and