SPEAKER_01 36:54–38:31
So something I will see in pretty much every ACL case—more so than other post-op cases—but ACL in general. At some point along the way in rehab, when we start introducing activities like split squats, step downs, or anything vertically moving their center of mass that isn't bilaterally symmetrical, and especially with higher-velocity movements involving single-leg landings—I guess the best way to describe it would be a traditional representation of closed-chain dorsiflexion where they just don't get the knee going forward as much. I'd attribute that early on to anterior knee sensitivity. They describe not wanting to let that knee go forward because the more it bends, the more it hurts. But then at a certain point, they're not really feeling active discomfort, yet they still aren't letting the knee translate forward as much. I was curious your thoughts, especially regarding what we've discussed about the axis of rotation changing. Is this a manifestation of the fact that they just don't have as much local midfoot propulsive representation because they're missing tibial internal rotation? So that makes me wonder if my expectation should be that they just aren't going to get as far without some other compensatory strategy.
ACL rehabilitationknee mechanicstibial internal rotationaxis of rotationcompensatory strategies