Arthrogenic Muscle Inhibition Explained. Quad atrophy following ACL injury is mind blowing. It wasn’t until I experienced this personally with my. 0bjectives:To define the concept of arthrogenic muscle inhibition (AMI), to discuss Pain and disuse are often blamed for the inhibition and muscle atrophy. Key factors of muscle deconditioning are 1) muscle atrophy and 2) arthrogenic muscle inhibition (AMI); however their interaction and underlying mechanisms are.

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Rectified motor evoked potential MEP recorded from the quadriceps during active muscle contraction. Strength Training may help attenuate quadriceps and hamstrings CAD. Evidence from epidural recordings. Along with quad strengthening and NMES, using cryotherapy immediately following injury will help with both effusion and pain.

The CSP duration was collected during the active condition only. Transcranial magnetic stimulation was used to measure quadriceps motor evoked potential area, short-interval intracortical inhibition, intracortical facilitation and cortical silent period duration before and after experimental knee joint effusion. AMI has been linked to knee joint swelling, pain and structural damage [ 1 ].

J Orthop Sports Phys Ther.

Neuromuscular quadriceps dysfunction prior to osteoarthritis of the knee. Other factors such as joint effusion, pain, and disuse may also contribute to quadriceps and hamstrings inhibition after joint injury.

Quadriceps & Hamstrings Activation Failure

Dependent variables were collected from all 17 participants during the active condition. Author information Article notes Copyright and License information Disclaimer. You are commenting using your WordPress. Four participants had a history of knee joint pathology in the contralateral untested limb. Pressures in normal and acutely distended human knee joints and effects on quadriceps maximal voluntary contractions.


The pain sensation evoked by the joint infusion was measured after the withdrawal of the cannula from the joint and just prior to the post infusion measurements. This observation was made with the muscle at rest and during a voluntary contraction. Articular sensory receptors disruption. For this reason, strength training alone does not seem to be an effective modality for Quadriceps Activation Failure particularly for those whose weakness is centrally mediated.

Great butt workout, but poor quad workout. J Bone Joint Surg Am. Clin Sci Lond ; Conclusion In conclusion, we observed an increase in quadriceps corticomotor excitability following experimental knee joint infusion.

: Quadriceps & Hamstrings Activation Failure

Ongoing quadriceps weakness is clinically important, as it is associated with impaired dynamic knee-joint stability [ 10 ] and physical function [ 1112 ]. Quadriceps arthrogenic muscle inhibition: Experimental knee pain reduces muscle strength.

Role of joint afferents in motor control exemplified by effects on reflex pathways from Ib afferents. The cortical silent period: Today, I worked leg extensions and could at best do half of what my non-affected side could do. High intensities result in greater gains in strength and hypertrophy if used arthrogeniv a sufficient length of time, however these higher intensities are often uncomfortable for patients.

J Orthop Sports Phys Ther. Diagram illustrating the study protocol. Possible mechanisms of quadriceps femoris weakness in patients with ruptured anterior cruciate ligament.

WTH Happened To My Quads? Arthrogenic Muscle Inhibition Explained – The Khaki-Free Sports PT

Our findings provide no evidence for a cortical contribution to quadriceps AMI and suggest that ongoing spinal reflex inhibition may be sufficient to explain the marked neural activation deficit that occurs following acute knee injury, knee surgery and in chronic knee joint pathologies. Both joint afferent discharge [ 23 ] and quadriceps AMI [ 18 ] have a stronger correlation with intra-articular pressure compared to intra-articular volume.


AMI is most severe in the first few days after joint damage, plateaus mid-term up to 6 months and then slowly declines in the longer term months ; 7 however, AMI may still be present years after joint damage. Muscle pain differentially modulates short interval intracortical inhibition and intracortical facilitation in primary motor cortex.

Though it is a protective mechanism initially, it persists and will make it brutally difficult to achieve a good quad index. Interestingly, pain-free, experimental knee joint effusions with as little as 20—30 ml of saline have been shown to produce quadriceps activation failure. My guess is that they do not. Wood L, Ferrell WR. J Bone Joint Surg Br. Maximum effort voluntary contractions MVC of the quadriceps were performed prior to the first measurements of the dependent variables.

Data are mean and one standard error of the mean. Further exclusion criteria were previous history of pathology in both knee joints, a history of lower limb or spinal surgery, or a history of neurological disease. Rehab can begin within 48 hours after surgery and continue for several weeks. This site uses cookies. National Center for Biotechnology InformationU. Marked weakness of the quadriceps muscles is typically observed following injury, surgery or pathology affecting the knee joint.

A Key to Scientific Research Literature. Despite these consistent findings across many different studies, we observed a significant increase in quadriceps MEP area after experimental joint inhkbition, suggesting an increase, rather than a decrease, in quadriceps corticomotor excitability.