Does your Physio know how Strong you are?
Alright, so I need to hold my hands up.
This post is not strictly about testing strength.
Technically I am referring to whether your Physiotherapist is truly assessing your ability to produce a Force output.
You may be thinking is this even important?
However, has your Physio ever said to you.
‘’ your left is weaker than your right’’
or
‘’ you need to work more on your quadriceps as they aren’t strong enough yet’’.
Just stop and think for a second.
How did they measure it?
For years Physiotherapists have entrusted the power of feel to influence statements like the ones above. This is all while Elite Sports teams and Researchers have used super expensive testing rigs to give accurate feedback of force.
I too have relied purely on the power of feel in the past.
Whilst this was always in combination with other functional tests to assess your strength + force production abilities I have recently been dissatisfied with the lack of accuracy.
Why is it important ?
If you are recovering from an injury or surgery you are probably all too aware off the need to improve your strength. Following on from Knee surgery your quadriceps will inevitably go through an initial metamorphosis into a shadow of their previous form.
Some of this is avoidable with the right advice and work (more on this at a later date).
However, some muscle atrophy is almost guaranteed.
What we also know is that returning to activity or sports following surgery with inadequate strength development places you at a higher risk of reinjury, and therefore the pain of going through the whole process again!
Physiotherapists jobs are to avoid that exact thing happening.
Our Job is to maximise your chances of flourishing when you return to your chosen activities with confidence at an all time high.
But…
Does it even matter?
Research has shown that following ACL reconstruction patients have better outcomes and are more satisfied if they achieve 3 newton meters per KG of body weight (leave that bit for us to work out). This is when compared to patients who fail to achieve this level of force production.
Additionally, we know that if patients can get a pre surgery measure of force production from their non-injured leg. This can act as an effective minimum target to achieve in the surgical leg before return to sport.
Ok, so how can you test me?
Unfortunately, Injury Armour is yet to invest in an isokinetic dynamometer (price of a very nice German car).
However, we have recently purchased a handheld version that can provide real time feedback and allows recording of your force production.
I am confident this will result in a greater accuracy of testing for our patients and hopefully further enhance the success of sustainably return to sport and exercise without injury.
The series of images and videos below demonstrate how testing can be performed with videos and images of the data returned.
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If you are interested in how force testing can benefit your rehab journey feel free to get in touch
I will be sure to let you know what Injury Armour Physiotherapy in Taunton can do for you.
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Adam
Lisee, C., Lepley, A.S., Birchmeier, T., O'Hagan, K. and Kuenze, C., 2019. Quadriceps Strength and Volitional Activation After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Sports Health-a Multidisciplinary Approach, 11(2), pp. 163-179.
Pietrosimone, B., Lepley, A.S., Harkey, M.S., Luc-Harkey, B.A., Blackburn, J.T., Gribble, P.A., Spang, J.T. and Sohn, D.H., 2016. Quadriceps Strength Predicts Self-reported Function Post-ACL Reconstruction. Medicine and Science in Sports and Exercise, 48(9), pp. 1671-1677.
Wellsandt, E., Failla, M.J. and Snyder-Mackler, L., 2017. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury. Journal of Orthopaedic & Sports Physical Therapy, 47(5), pp. 334-338.