Closed Chain Kinetic Exercises In Accelerated Acl Rehab

Tearing of the anterior cruciate ligament, or ACL, happens to a variety of athletes who are often interested in the quickest way to rehabilitate the joint. Accelerated ACL rehab -- where weight-bearing exercise and full leg extension is begun almost immediately after surgery -- is quickly becoming the standard in care. Closed chain kinetic exercises are often recommended, as they generally provide more joint stability and are considered safer than other types of exercise.

Open and Closed Chain Exercises

The linking of your bones and muscles is considered a "chain," particularly in terms of exercise. When you lift weights, such as a biceps curl with a dumbbell, the chain of your shoulder, arm and hand is free to move in almost any direction. This type of exercise is considered an open chain movement. A closed chain movement occurs when the farthest point of the chain -- your hands or feet -- is in a constant, fixed position. Pushups and squats are examples of closed chain movements; your feet and hands do not move. According to American Fitness Professionals and Associates, close chain exercises provide better joint stability than open chain.

Joint Movement

During normal movement of your knee, one of the tasks entrusted to your ACL is to keep your shin bone, or tibia, in place. Anterior translation of your tibia -- when your shin bone moves forward while your upper leg moves back -- happens if the ACL is torn. According to the University of Kentucky, closed chain exercises lead to less anterior translational force than other exercises. Using closed chain movements in accelerated rehab procedures may be safer than other therapy methods.

Research

Early studies of closed chain kinetic exercises found ACL recovery was quicker and more effective than open chain. According to a study published in the "American Journal of Sports Medicine" in July 1995, closed chain exercises produce better results than open chain. Overall, up to 95 percent of all participants regained full range of motion in the knee after one year, although patients who performed closed chain kinetic exercises experienced less front knee pain, were more satisfied with results and reported returning to normal daily activities and sports sooner than expected. Open chain movements are not necessarily harmful and are also beneficial if done correctly. Your doctor will decide which activities are right for you.

Rehabilitation Exercises

During accelerated rehabilitation, your doctor will recommend full extension of your leg and specific closed chain exercises beginning the first day of your recovery. You will also put some weight on your injured leg with the help of your crutches. Static quadriceps contractions, leg press, toe raises, heel digs, bridge pose, squats and standing hamstring curls are examples of closed chain kinetic exercises your doctor may recommend. Weight is gradually added as your strength improves and you regain more range of motion in your knee.