Anterior Cruciate Injuries are frequently associated with fractures
This study in the Journal of Orthopaedic and Sports Physical Therapy evaluated the contact and shear forces during nine weight-bearing exercises. Most of the studied functional exercises are commonly used in lowly rehabilitation. Estimated loading on the tibia femoral and patellofemoral joints can then be used to great different exercises and provide insights for the staging of rehabilitation programs following the injury or surgical intervention. During rehabilitation, the challenge is to protect the joint structures from excessive forces, while providing sufficient stimuli to regain muscle control and strength to restore normal function.
implications for rehabilitation guidelines
This study in the Journal of Orthopaedic and Sports Physical Therapy evaluated the contact and shear forces during nine weight-bearing exercises. Most of the studied functional exercises are commonly used in lowly rehabilitation. Estimated loading on the tibia femoral and patellofemoral joints can then be used to great different exercises and provide insights for the staging of rehabilitation programs following the injury or surgical intervention. During rehabilitation, the challenge is to protect the joint structures from excessive forces, while providing sufficient stimuli to regain muscle control and strength to restore normal function.
The exercises studied were: stand-up, sit down, squat, gate, ascend steps, descend steps, forward lunge, side lunge, singling hop with weight acceptance, and single leg hop with push off.
An example of where this may have some clinical relevance is with exercise selection after anterior cruciate ligament reconstruction. In the early phase rehab i.e. in the first 12 weeks, the aim is to increase muscle strength particularly in the quadriceps, and we need to do so in such a way that the anterior cruciate graft is protected. From the following table (these exercises marked with an arrow) we can see that the lunge movement has a greater sheer force than squatting by a significant amount. Therefore you will teach patient to squat before they can lunge in this scenario in order to minimise shear forces on the anterior cruciate graft.
