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Starting Strong in ACL Rehab
A strong start in ACL rehab is crucial for a successful return to play and to avoid long-term issues like increased OA risk, reduced quality of life, and diminished function.
Arthrogenic Muscle Inhibition (AMI) can delay this good start by hindering quadriceps activation. This article covers early intervention strategies to address AMI for quicker recovery and better outcomes.
What is AMI?
AMI reduces motor neuron availability and voluntary activation, often due to pain, patellar issues, swelling, and lack of quadriceps contraction.
Therapeutic Intervention Classification:
🦵 Grade 0: Normal contraction.
🦵 Grade 1: Inhibited contraction, no extension deficit.
🦵 Grade 2: Inhibited contraction, knee extension deficit due to hamstring contracture.
🦵 Grade 3: Chronic extension deficit from posterior capsular retraction.
These classifications are based on clinical experience with limited validation.
Clinician Observations:
Minimal activation: SLR without lag, sensing quadriceps contraction.
Adequate activation: Full knee extension, qualitative quadriceps contraction, and patient feedback.
Fast activation: Important in later rehab phases, especially for plyometric activities.
AMI Treatment Modalities:
Muscle interventions: BFR, hamstring fatigue exercises.
Brain interventions: Virtual Reality, Cross Education Therapy, EMG Biofeedback, Motor Imagery, Vibration.
Nerve interventions: NMES, TENS, Cryotherapy, Percutaneous Electrical Stimulation.
Enjoy the article and learn more about our online ACL rehab resources, including our patient handbook, blog posts, podcasts, and newsletter.
[…] to all the external collaborations, Aspetar has also led to publications about BFR and AMI after […]