Decreased Quadriceps Activation Measured Hours Prior to a Non-Contact Anterior Cruciate Ligament Tear: A Case Report

STUDY DESIGN: Case Report. BACKGROUND: Decreased quadriceps activation has been shown to be present following anterior cruciate ligament (ACL) injury, but its presence prior to ACL injury is unknown.  The purpose of this case report was to describe the level of quadriceps activation measured hours before a non-contact ACL injury in an individual who previously demonstrated known biomechanical risk factors for ACL injury. CASE DESCRIPTION: A 23 year old female (height= 176.9 cm, mass= 72.4 kg), sustained a left non-contact ACL injury while landing from a jump-stop during a recreational basketball game.  This case was unique because data regarding landing biomechanics and quadriceps force and activation were gathered in 2 separate, unrelated studies prior to injury. OUTCOMES: Peak external knee abduction moment (-65.3 Nm)  during a drop jump landing, 8 months prior to injury, indicated elevated risk for ACL injury.  Involved quadriceps central activation ratios (CAR) were obtained 1 week (CAR =0.81) and 4 hours (CAR =0.77) prior to injury.  Strength and CAR (0.76) measurements changed very little within 36 hours of injury and both strength and activation (CAR =0.90) improved following surgical reconstruction and formal rehabilitation. DISCUSSION: An individual with known biomechanical risk factors for ACL injury may compound their risk for non-contact ACL injury if decreased quadriceps activation is also present.

J Orthop Sports Phys Ther., Epub 25 April 2008. doi:10.2519/jospt.2008.2761

KEY WORDS: ACL, biomechanics, knee, muscle inhibition

The purpose of this case report was to describe the level of quadriceps activation measured hours before a non-contact anterior cruciate ligament (ACL) injury in an individual who previously demonstrated known biomechanical risk factors for ACL injury.