“Optimising ACL Reconstruction Pre-habilitation: A Gym-Focused Approach”
Preparing for anterior cruciate ligament (ACL) reconstruction involves more than just building strength. It requires enhancing joint stability, restoring full range of motion, and ensuring flexibility. A comprehensive prehabilitation (prehab) programme can significantly influence post-surgery recovery and long-term knee health.
🔄 Closed vs. Open Kinetic Chain Exercises
Understanding the distinction between closed kinetic chain (CKC) and open kinetic chain (OKC) exercises is crucial for effective ACL prehab.
Closed Kinetic Chain (CKC) Exercises: These involve movements where the foot remains in contact with a stable surface, engaging multiple joints and muscle groups. Examples include squats and leg presses. CKC exercises are beneficial for enhancing joint stability and mimicking functional movements.
Open Kinetic Chain (OKC) Exercises: These involve movements where the foot is not in contact with a surface, isolating specific muscles. Leg extensions are a common example. While useful for targeting particular muscles, OKC exercises may place more stress on the knee joint and should be approached with caution during prehab.
Research indicates that CKC exercises are more effective in improving knee function and strength post-ACL reconstruction. A study found that patients who engaged in CKC exercises showed greater improvements in knee flexion and thigh circumference compared to those who performed OKC exercises .
🏋️♀️ Recommended Gym Exercises for ACL Prehabilitation
Incorporating the following exercises can help build strength, stability, and flexibility:
Squats: Enhance quadriceps, hamstring, and glute strength.
Leg Press: Targets lower body muscles with controlled movement.
Hamstring Curls: Focus on hamstring strength and flexibility.Health
Step-Ups: Improve functional movement patterns and stability.
Lunges: Enhance balance and coordination.
Balance Training: Utilise balance boards or stability balls to improve proprioception.
These exercises should be performed under the guidance of a fitness professional to ensure proper technique and prevent injury.
🧘♂️ Importance of Range of Motion, Stability, and Flexibility
Focusing solely on strength can lead to imbalances and hinder recovery. It's essential to also work on:
Range of Motion (ROM): Regular stretching and mobility exercises can help restore full knee movement, which is vital for daily activities and athletic performance.
Knee Stability: Incorporating balance and proprioception exercises can enhance joint stability, reducing the risk of re-injury.
Hamstring Flexibility: Stretching the hamstrings can alleviate tension, improve flexibility, and support overall knee function.
A comprehensive approach that includes strength, flexibility, and stability training can lead to better outcomes and a quicker return to activity post-surgery.
⚠️ Gym Exercises to Approach with Caution
Certain exercises may place excessive strain on the knee joint and should be limited or avoided during prehab:
Leg Extensions: These OKC exercises can stress the knee joint and may not be suitable in the early stages of prehab.
Deep Squats: Performing squats beyond a 90-degree knee bend can increase joint stress.
High-Impact Activities: Jumping or running exercises can be too strenuous before the knee has fully healed.
Always consult with a healthcare provider or fitness professional before engaging in these exercises.
🧠 The Role of Prehabilitation in Post-Surgery Recovery
Strengthening the leg muscles before surgery can lead to quicker rehabilitation and better outcomes. A study highlighted that patients who engaged in prehab exercises had improved knee function and returned to sports activities more rapidly post-surgery .PubMed
Incorporating a balanced prehab programme that includes CKC exercises, flexibility training, and stability work can set the foundation for a successful ACL reconstruction and a swift recovery.
📚 References
Giesche, F., et al. (2020). Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review. PLOS ONE, 15(10), e0240192. https://doi.org/10.1371/journal.pone.0240192PubMed
Nadeem, N., et al. (2022). Comparison of effects of open kinetic chain exercises with closed kinetic chain exercises on strength of quadriceps muscles and knee functional activity level after ACL reconstruction. Pakistan Journal of Medical & Health Sciences, 16(5), 15. https://pjmhsonline.com/index.php/pjmhs/article/download/969/958PJMH Online
ResearchGate. (2022). Evaluation of Open and Closed Kinetic Chain Exercises in Rehabilitation Following Anterior Cruciate Ligament Reconstruction. https://www.researchgate.net/publication/270003471_Evaluation_of_Open_and_Closed_Kinetic_Chain_Exercises_in_Rehabilitation_Following_Anterior_Cruciate_Ligament_ReconstructionResearchGate