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Physiotherapy clinic in Tambaram Are you Looking for Physiotherapy Treatment in Tambaram, Sunshine Super Speciality Physiotherapy Clinic, We Provide Electrotherapy, Exercise and Manual Therapy, Orthopedic, Neuro, Cardio, Pediatric, Sports and Geriatric Rehabilitation, Post Operative Physiotherapy Treatment, Fracture Rehabilitation, pain free movement. The Use of Elastic Resistance Bands to Reduce Dynamic Knee Valgus in Squat-Based Movements 🏋 🤔 In order to reduce medial knee collapse or knee valgus, physical therapist and exercise physiologists often use elastic resistance bands on the distal thighs (just proximal to the patella, s. picture) for example in the treatment of patellofemoral pain or in ACL injury prevention and rehabilitation https://www.jospt.org/doi/10.2519/jospt.2023.11628, https://pubmed.ncbi.nlm.nih.gov/21713231/, https://pubmed.ncbi.nlm.nih.gov/23072049/. 👉 Forman and colleagues published a narrative review on the effects of elastic resistance bands to reduce dynamic knee valgus in squat-based movements. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547095/ 📊 Their results could be summarized as follows: 🦵 Muscle Activity 🏋 Elastic bands do promote increased external rotation of the hip while performing squat movements, which is not particularly surprising. For most studies, participants were repeatedly given verbal instruction to actively resist the external force provided by the elastic band and to keep the band tight throughout the entire exercise/movement. This forces participants to produce an additional external hip rotation moment on top of the exercise they are already performing, and assuming other aspects of the movement are not sacrificed in the process (such as a loss of knee range of motion, https://pubmed.ncbi.nlm.nih.gov/30526370/), the overall workload of the exercise is increased. This is shown by increases in gluteus maximus, gluteus medius, and biceps femoris muscle activity. https://pubmed.ncbi.nlm.nih.gov/21713231/, https://pubmed.ncbi.nlm.nih.gov/32095265/, https://pubmed.ncbi.nlm.nih.gov/35997376/, https://pubmed.ncbi.nlm.nih.gov/28900561/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396979/ 🏋‍♂One study showed an even great EMG activity of the gluteus medius and the gluteus maximus after placing the band around the forefeet (at the level of the metatarsophalangeal joints) during squats. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9396979/ 🦵 Kinematics 🏋 Regarding a possible reduction of knee valgus, findings suggest that the use of an elastic band while performing squat-based movements does not acutely reduce knee valgus. In fact, it either has no effect, https://pubmed.ncbi.nlm.nih.gov/28900561/, https://pubmed.ncbi.nlm.nih.gov/25446268/ or it may actually increase knee valgus acutely (https://pubmed.ncbi.nlm.nih.gov/21713231/, https://pubmed.ncbi.nlm.nih.gov/23072049/, https://pubmed.ncbi.nlm.nih.gov/32095265/, https://pubmed.ncbi.nlm.nih.gov/30526370/, https://pubmed.ncbi.nlm.nih.gov/37181264/. 🏋 This may seem at odds with the previously discussed increases in gluteal muscle activity, which should have led to an increase in hip external rotation. What may be happening is that, while elastic bands do successfully promote activation of the hip external rotators, the ensuing increase in external rotation torque is either equal to or less than the external force provided by the bands themselves, resulting in either no change in knee alignment or an increase in knee valgus. ‼It is crucial to understand that elastic band usage throughout this literature has only been examined ACUTELY (single session studies). Thus, even if participants throughout the literature had presented with medial knee collapse at study onset (no study pre-screened their participants for medial knee collapse by the way), the possible effects of elastic band usage were only quantified within a single acute session. To properly assess the validity of this potentially corrective training aid, elastic bands and their effect on medial knee collapse should be examined after chronic elastic band usage. 🏋 Of the evidence that is presently available, elastic band usage while performing squat-based movements appears capable of enhancing hip external rotator muscle activity, which may be of benefit to individuals who exhibit medial knee collapse because of insufficient hip external rotation. 🤔 Over time, chronic elastic band usage could potentially strengthen this musculature and/or lead to permanent neuromuscular adaptations, which would result in improved knee alignment. But: this is currently an unproven hypothesis. 🤔 On the one hand, stronger bands likely yield greater levels of lower limb muscle activity, which may be beneficial in training the external rotators of the hip for squat-based movements, on the other hand, they also result in greater medial knee collapse. ⁉ Perhaps the obvious application of these findings is that trainees should simply use the lightest elastic band possible if attempting to reduce knee valgus. ⭕ As a general caveat, it is unclear whether changes in movement control are related to changes in the clinical symptoms in people with knee osteoarthritis and ACL injury, while reduced movements of the knee and hip in the frontal plane were strongly to moderately correlated with improvements in pain and function in patellofemoral pain patients. https://www.jospt.org/doi/10.2519/jospt.2023.11628, 📸 Figure: A) Depiction of what has traditionally been considered proper knee alignment while performing a squat-based movement. B) Depiction of medial knee collapse, or medial knee movement in the frontal plane while performing a bodyweight squat. C) Example of the typical location that elastic bands are placed (denoted by the two arrows) while performing squat movements. This location is normally on the distal thighs just proximal to the patella. D) Example of an elastic band, and its location on the distal thighs, being used during a bodyweight squat. SUNSHINE ® SUPER SPECIALITY PHYSIOTHERAPY CLINIC - #DrParthiban #Sunshinephysioclinic.in #Physiotherapyclinicintambaram DR.M.P. PARTHIBAN.M.P.T (Ortho), Chief Orthopedic Physiotherapist, Call for Appointments: - 9345122177 East Tambaram, CHENNAI