Despite being common in post-ACL surgery patients, arthrogenic muscle inhibition (AMI) remains underdiagnosed and poorly managed.
This article summarises the key point s from the publication "Advancing Clinical Evaluation and Treatment of Arthrogenic Muscle Inhibition: A Need for Validation and Innovation—Response" and highlights the current challenges in diagnosing and treating this neuromuscular condition.
Arthrogenic muscle inhibition (AMI) refers to a reflex inhibition of muscle activity, particularly the quadriceps, due to joint injury or inflammation. It is frequently seen in patients recovering from anterior cruciate ligament (ACL) surgery and can severely affect recovery by limiting muscle activation and delaying return to sport.
Despite its prevalence, AMI is insufficiently recognised by many practitioners. A recent survey cited in the publication found that 30% of respondents were unable to correctly define AMI. Even more striking: a search for "arthrogenic muscle inhibition" on The American Journal of Sports Medicine website yielded only 17 results, of which only two focus on the condition. This gap highlights a disconnect between scientific literature and clinical practice.
In their response to criticism, the authors defend their proposed clinical classification of AMI, which is based on the subjective assessment of volitional quadriceps activation and observable extension deficits. While laboratory tools like the Hoffmann reflex or interpolated twitch technique offer precise measures, these are rarely used in everyday clinical settings due to their complexity and required equipment.
The challenge, then, is to find a reliable, simple and widely applicable method for assessing AMI in routine practice. The proposed clinical classification, though imperfect, provides a pragmatic tool that clinicians can use to identify patients at risk of prolonged inhibition and adjust rehabilitation protocols accordingly.
The authors highlight that AMI is not just a diagnostic label, it has clear clinical implications. Extension deficits, quadriceps inhibition, and gait abnormalities are all linked to AMI and can lead to serious consequences such as:
These complications justify the importance of early recognition and targeted interventions to address muscle inhibition as part of ACL rehabilitation.
The article underscores the urgent need for better clinical tools and greater awareness of arthrogenic muscle inhibition in ACL rehabilitation. It calls for a bridge between laboratory research and practical treatment strategies to improve patient outcomes.
Whether you are a patient recovering from ACL reconstruction or a practitioner seeking reliable rehabilitation strategies, Prof. Cavaignac's expertise ensures rigorous, up-to-date care at every stage.
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