REFERENCE LINKS AND NOTES
2013 Jan;41(1):216-24. doi: 10.1177/0363546512459638. Epub 2012 Oct 5.
Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction.
Related most to:
Hip rotation control (IR), frontal plane knee motion during landing (adduction), sagittal plane knee moment asymmetries at initial contact (hamstring/quad contractions), postural stability deficits on surgical leg (trunk side bend, poor control);
Quadriceps strength- need to make sure > 90% compared to opposite side; emphasis on proper activation if needed (NMES)
Gait mechanics- need to make sure get back proper shock absorption at loading (moving from extension into flexion)
Loading: look at Drop jumps and SL jumping (tend to still land more on non surgical leg at 2 years out)
Need to train single leg
Large % of patients do not go back to same level of sports due to fear (kinesiophobia): use sport specifics when able
Orthop J Sports Med. 2017 Nov 14;5(11):. eCollection 2017 Nov.
SingleLeg Hop Test Performance and Isokinetic Knee Strength After Anterior Cruciate Ligament Reconstruction in Athletes.
Looked at single-leg hop and isokinetic knee strength testing in athletes who underwent anterior cruciate ligament reconstruction (ACLR) upon returning to sport participation
The strongest correlation between the hop tests and knee strength was found between the total distance of the hop tests and flexion total work/body weight and between the timed 6-m hop test and flexion peak torque/body weight.
J Athl Train. 2016 Sep;51(9):669-681. Epub 2016 Oct 10.
Changing Sagittal-Plane Landing Styles to Modulate Impact and Tibiofemoral Force Magnitude and Directions Relative to the Tibia.
Looked at ground reaction force and tibiofemoral force vectors with changing single leg jump landing, using 3D kinetics and kinematics
Patients performed single leg landing using 1) self selected, 2) leaning forward on toes, and 3) body upright foot flat.
The upright foot flat landing: less time to peak tibial axis forces, smaller knee flexion angles, greater magnitude and anteriorly directed ground reaction force vector= greater peak tibial axial and anterior shear forces
The leaning forward and landing on toes: resulted in longer time to peak tibial axial forces, greater knee flexion angles, and reduced magnitude and a more posterior incline ground reaction force vector to the tibia = lowest peak tibial axial and largest posterior shear forces.
J Athl Train. 2017 Nov 20. doi: 10.4085/1062-6050-52.11.25. [Epub ahead of print]
Landing Kinematics and Kinetics at the Knee During Different Landing Tasks.
Kinematic and kinetic analysis Comparing lower extremity biomechanics across 5 commonly used landing tasks: (double- and single-legged drop landing, double- and single-legged stop jump, and forward jump to single-legged landing)
Single-legged landings generated higher vertical GRF and lower peak knee-flexion values except for forward jump to single-legged landing, which had the lowest peak knee-flexion value and the second highest peak vertical GRF. The single-legged drop landing generated the highest vertical and posterior GRFs. Peak knee-valgus moment was higher during the double-legged drop landing
- Star excursion balance test (Y test)
o Risk for injury: Ant direction < 4cm, and total composite score < 94%
- Landing Error Scoring System (LESS) (side and front views jumping off step)
o Excellent 0-3, Score > 7 is poor
- Noyes Hop tests
o Single, Triple, cross over, 6 meter timed –need to stick landing for 2 seconds; > 90% compared to opposite side