Exercise Won’t Selectively Activate the VMO but Electric Stimulation Will

Effects of electrical stimulation of vastus medialis obliquus muscle in patients with patellofemoral pain syndrome: an electromyographic analysis. Garcia FR1, Azevedo FM, Alves N, Carvalho AC, Padovani CR, Negrão Filho RF. Rev Bras Fisioter. 2010 Nov-Dec;14(6):477-82. Abstract BACKGROUND: The use of surface electromyography (SEMG) has been considered a tool for quantitative assessment of patellofemoral pain … Read more

Return to NBA after ACL Reconstruction

Return-to-Sport and Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players. Harris JD, Erickson BJ, Bach BR Jr, Abrams GD, Cvetanovich GL, Forsythe B, McCormick FM, Gupta AK, Cole BJ. Sports Health. 2013 Nov;5(6):562-8. Abstract BACKGROUND: Anterior cruciate ligament (ACL) rupture is a significant injury in National Basketball Association (NBA) players. HYPOTHESES: NBA … Read more

Muscle Strength Protective Against Arthritis

The role of muscles in joint degeneration and osteoarthritis. J Biomech. 2007;40 Suppl 1:S54-63. Epub 2007 Apr 16. Herzog W1, Longino D. Abstract The purpose of this work was to establish a controlled and reversible muscle weakness model for studying the effects of weakness on joint degeneration leading to osteoarthritis (OA). The knee extensor muscles … Read more

Resistance Training Improves Running Biomechanics

Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clin Biomech (Bristol, Avon). 2009 Jan;24(1):26-34. Snyder KR, Earl JE, O’Connor KM, Ebersole KT. Abstract BACKGROUND: Movement and muscle activity of the hip have been shown to affect movement of the lower extremity, and been related to injury. … Read more

Patellofemoral Pain & Orthotics, Predicting Who Will Benefit

A clinical prediction rule for identifying patients with patellofemoral pain who are likely to benefit from foot orthoses: a preliminary determination. Br J Sports Med. 2010 Sep;44(12):862-6. 26. Vicenzino B1, Collins N, Cleland J, McPoil T. Abstract OBJECTIVE: To develop a clinical prediction rule to identify patients with patellofemoral pain (PFP) who are more likely … Read more

Tibial Stress Fractures in Runners: It’s All the Same Problem

Distinct hip and rearfoot kinematics in female runners with a history of tibial stress fracture. Journal of Orthopaedic & Sports Physical Therapy. 2010 Feb;40(2):59-66. Milner CE1, Hamill J, Davis IS. STUDY DESIGN: Cross-sectional controlled laboratory study. OBJECTIVES: To investigate the kinematics of the hip, knee, and rearfoot in the frontal and transverse planes in female … Read more

Kinesio Tape Sure Smells Like Placebo

Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. J Physiother. 2014 Mar;60(1):31-9. Parreira Pdo C, Costa Lda C, Hespanhol Junior LC, Lopes AD, Costa LO. Abstract Questions: Is Kinesio Taping more effective than a sham taping/placebo, no treatment or other interventions in people with musculoskeletal conditions? Is the … Read more

Runners with Patellofemoral Pain, Have Altered Hip and Knee Rotational Stress

Patellofemoral joint stress during running in females with and without patellofemoral pain. Knee. 2012 Oct;19(5):703-8. Wirtz AD1, Willson JD, Kernozek TW, Hong DA. Abstract Patellofemoral pain (PFP) is a common complaint among female runners. The etiology for PFP is frequently associated with increased patellofemoral joint stress (PFJS) and altered hip and knee joint kinematics during … Read more

Foot Orthotics Help Some with Patellofemoral Pain

Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Br J Sports Med. 2009 Mar;43(3):169-71. Collins N1, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Abstract OBJECTIVE: To compare the clinical efficacy of foot orthoses in the management of patellofemoral pain syndrome with flat inserts or physiotherapy, and … Read more

Total Knee Functional Outcome Measure Doesn’t Measure Function

Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM&R. 2011 Jun;3(6):541-9 Stevens-Lapsley JE1, Schenkman ML, Dayton MR. Abstract OBJECTIVE: To characterize patient outcomes after total knee arthroplasty (TKA) by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis Outcome Score [KOOS]) and performance measures … Read more

Running Volume Increase Effects on Injury

Can GPS be used to detect deleterious progression in training volume among runners? J Strength Cond Res. 2013 Jun;27(6):1471-8. Nielsen RO1, Cederholm P, Buist I, Sørensen H, Lind M, Rasmussen S. Abstract There is a need to ascertain if an association exists between excessive progression in weekly volume and development of running-related injuries (RRI). The … Read more

Marathon Runners, Running >30 Km/Wk Decreases Risk of Injury

Weekly running volume and risk of running-related injuries among marathon runners. International Journal of Sports Physical Therapy. 2013 Apr;8(2):111-20. Rasmussen CH, Nielsen RO, Juul MS, Rasmussen S. Abstract PURPOSEBACKGROUND: The purpose of this study was to investigate if the risk of injury declines with increasing weekly running volume before a marathon race. METHODS: The study … Read more

Patellofemoral Pain Most Associated with Hip Weakness

Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health. 2011 Sep;3(5):455-65. Meira EP, Brumitt J. Abstract CONTEXT: Patellofemoral pain syndrome (PFPS) is one of the most common conditions limiting athletes. There is a growing body of evidence suggesting that dysfunction at the hip may be a contributing factor in … Read more

Total Knee Replacement: More than 85% Last at Least 20 Years

What is the evidence for total knee arthroplasty in young patients?: a systematic review of the literature. Clin Orthop Relat Res. 2011 Feb;469(2):574-83. Keeney JA1, Eunice S, Pashos G, Wright RW, Clohisy JC. Abstract BACKGROUND: TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is … Read more

Post Total Knee Replacement; If You Can Walk Fast for 6 Minutes, You Can Walk Fast for 30.

The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord. 2013 Apr 24;14:145. Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. Abstract BACKGROUND: The Six-minute walk (6 MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty … Read more

ACL Repair: Abnormal Gait, Future Arthritis Due to Low Strength

The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon). 2002 Jan;17(1):56-63. Lewek M1, Rudolph K, Axe M, Snyder-Mackler L. From the study: BACKGROUND: Individuals following anterior cruciate ligament rupture often demonstrate reduced knee angles and moments during the early stance phase of gait. Alterations in gait can … Read more

Rehabilitation after ACL Reconstruction: Leg Extensions, Knee Laxity, and Training Load (Not What You Would Expect)

Is knee laxity change after ACL injury and surgery related to open kinetic chain knee extensor training load? Am J Phys Med Rehabil. 2009 May;88(5):369-75. Morrissey MC, Perry MC, King JB. From the study: OBJECTIVE: The purpose of this study was to evaluate whether knee anterior laxity changes after anterior cruciate ligament injury and surgery … Read more

Wall Squats Not so Good after ACL Reconstruction

Tibial displacement and rotation during seated knee extension and wall squatting: a comparative study of tibiofemoral kinematics between chronic unilateral anterior cruciate ligament deficient and healthy knees. Knee. 2013 Oct;20(5):346-53. Keays SL1, Sayers M, Mellifont DB, Richardson C. From the study: “Following anterior cruciate ligament (ACL) rupture, the knee becomes unstable with alterations in joint … Read more

ACL Reconstruction, Leg Extensions Safe but Timing is Everything

Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study. Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):402-14. Epub 2007 Jan 12. Heijne A, Werner S. From the study: Abstract The purpose of the present investigation was to evaluate physical outcome after … Read more

After ACL Repair, Closed Kinetic Chain Exercises Not Enough to Restore Quadriceps Strength

Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc. 2000;8(6):337-42.  Mikkelsen C1, Werner S, Eriksson E. From the study: Abstract Rehabilitation after anterior cruciate ligament (ACL) reconstruction … Read more

Without Aggressive Rehabilitation Function Usually Diminished 1 Year Post-Op after Total Knee Replacement

Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Physical Therapy. 1998 Mar;78(3):248-58. From the study: SUBJECTS: Twenty-nine individuals 1 year following TKA (13 women, 16 men) and 40 age- and gender-matched control subjects (18 women, 22 men) were assessed. METHODS: Walking speed, stair-climbing ability, knee … Read more

Electric Muscle Stimulation Prevents Atrophy after Total Knee Replacement

Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Physical Therapy. 2012 Feb;92(2):210-26. Stevens-Lapsley JE1, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. From the study: “Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation … Read more

Physical Therapy after Total Knee Arthoplasty: Neuromuscular Electrical Stimulation Causes a Significant Boost in Quadriceps Strength

Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2004 Jan;34(1):21-9. Abstract STUDY DESIGN: A case series. OBJECTIVES: The purpose of this case series was to assess the effect of high-intensity neuromuscular electrical stimulation (NMES) on quadriceps strength and voluntary activation following … Read more

Physical Therapy and EMS after Total Knee Arthoplasty: More Current = More Muscle

Relationship between intensity of quadriceps muscle neuromuscular electrical stimulation and strength recovery after total knee arthroplasty. Physical Therapy. 2012 Sep;92(9):1187-96. Abstract BACKGROUND: Neuromuscular electrical stimulation (NMES) can facilitate the recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet the optimal intensity (dosage) of NMES and its effect on strength after TKA have yet … Read more

Electric Muscle Stimulation Well Tolerated by Patients at Sufficient Intensities to Strengthen Muscle after Total Knee Replacement

Response of male and female subjects after total knee arthroplasty to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle. Am J Phys Med Rehabil. 2010 Jun;89(6):464-72. Abstract OBJECTIVES: To examine responses to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle in male and female subjects after total knee arthroplasty.   DESIGN: Sixty-four subjects … Read more

Cortisone, Eccentric vs Heavy Slow Resistance for Patellar Tendinopathy

Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Kongsgaard M, Kovanen V, Aagaard P, Doessing S, Hansen P, Laursen AH, Kaldau NC, Kjaer M, Magnusson SP. Scand J Med Sci Sports. 2009 Dec;19(6):790-802. Epub 2009 May 28. Abstract A randomized-controlled single-blind trial was conducted to investigate the clinical, structural … Read more

Electric Muscle Stimulation BEFORE Total Knee Replacement Improves Outcomes

“Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study. BMC Musculoskelet Disord. 2010 Jun 14;11:119. ” <br) BACKGROUND: Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve … Read more

Physical Therapy and EMS: Restores Activation, Strength 1 Year Post TKA

”The use of neuromuscular electrical stimulation to improve activation deficits in a patient with chronic quadriceps strength impairments following total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2006 Sep;36(9):678-85.” This was a single-patient case study of a patient who had high level function but persistent quadriceps weakness and activation deficits 13.5 months post op. … Read more

Muscle Deficits Usually Persist Long after Total Knee Replacement

“Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation. Physical Therapy. 2009 Oct;89(10):1072-9.” From the study: “Participants were 29 women and 19 men who were 55 to 75 years old and had undergone unilateral knee replacement surgery an average of 10 months earlier. The maximal torque and power of the knee extensor and … Read more

How Soon Is Too Soon to Lift Weights after Total Knee Arthroplasty?

Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible? Disabil Rehabil. 2012;34(12):1034-40. From the study: “Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition … Read more

Standard PRE as Good as Eccentric Exercise for Jumper’s Knee in Season Volleyball

No effect of eccentric training on jumper’s knee in volleyball players during the competitive season: a randomized clinical trial. Visnes H, Hoksrud A, Cook J, Bahr R. Clin J Sport Med. 2005 Jul;15(4):227-34. Abstract BACKGROUND: The effect of surgery on patellar tendinopathy (jumper’s knee) is questionable, and conservative treatment protocols have not been properly documented. … Read more

Decline Squats for Volleyball Players with Patellar Tendinopathy

Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H. Br J Sports Med. 2005 Feb;39(2):102-5. Erratum in: Br J Sports Med. 2005 Apr;39(4):246. Abstract BACKGROUND: Conservative treatment of patellar tendinopathy has been minimally … Read more

Decline Squats for Patellar Tendinopathy

A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM. Br J Sports Med. 2004 Aug;38(4):395-7. Abstract OBJECTIVES: This non-randomised pilot study investigated the effect of eccentric quadriceps training on 17 patients (22 tendons) with painful chronic … Read more

Drop Squats vs. Leg Extension/ Curl for Jumper’s Knee

A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper’s knee in athletes: pilot study. Cannell LJ, Taunton JE, Clement DB, Smith C, Khan KM. Br J Sports Med. 2001 Feb;35(1):60-4. Abstract OBJECTIVES: To compare the therapeutic effect of two different exercise protocols in athletes … Read more

Isokinetic Eccentric Exercise for Recurrent Tendinitis

Treatment of recurrent tendinitis by isokinetic eccentric exercise. Croisier J-L, Forthomme B, Foidart-Dessalle M, Godon B, Crielaard J-M. Isokinetics and Exercise Science. 2001;9:133-141.  Diagnosis:  9 Achilles, 10 patellar, and 15 lateral epicondyllar Outcome:  15/34 patients had complete relief of symptoms, 10/34 had marked decrease in symptoms, 5/34 had moderate decrease in symptoms, and 4/34 had … Read more

Hip Abduction Strength More Important to Function than Quadriceps after TKA

Hip abduction strength more important to function than quadriceps after Total Knee Arthroplasty. Physical Therapy. Feb 2011; 91(2): 225–233. From the study: Measurements Strength of quadriceps muscles and hip abductors was measured using an isokinetic dynamometer. Performance-based physical function was assessed with 4 measures: self-selected walking speed, the Figure-of-8 Walk Test, the Stair Ascend/Descend Test, … Read more

Evaluation of Eccentric Exercise in Treatment of Patellar Tendinitis

Evaluation of eccentric exercise in treatment of patellar tendinitis. Jensen K, Di Fabio RP. Physical Therapy. 1989 Mar;69(3):211-6. Abstract The purpose of this study was to analyze the effects of a quadriceps femoris muscle eccentric training program on strength gain in patients with patellar tendinitis. The effect of an eight-week eccentric exercise program on quadriceps … Read more