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Maria,
Though I know some people may disagree, but
"core/balance training", or putting people onto
unstable surfaces (i.e. a core balance disc), is not
what I would recommend for someone coming out of knee
surgery. It might do you some good to look at some
previous discussions on here such as "Stability or
Control of Instability" and "What triggers a motor
program--a wrong one?". I mention these two because
we first need to understand the forces that are put on
the body on an everyday basis and how we teach the
body to do the things we want it to do. Someone who
is coming off of surgery typically has extremely weak
muscles: they are in a somewhat contracted state, or
weak binding state, and this is why they tend to have
a limited range of motion. Because of this the first
concern needs to be getting these muscles back into
strong binding states. This is done by moving them
through the largest ranges of motion possible and
forcing the body to recruit as many motor units as
possible without excessively overloading the muscles
and causing reinjury. Now many will argue that
"balance/core training" does this exact thing. The
problem is that this may be an excessive overload for
many coming out of knee sugery where stabilizing
themselves in space on a hard flat surface is
typically hard enough for them (see "Stability or
control of instability"
this is the motor program that is being taught. When
doing "core/balance training" the body will not be
recruiting the motor-units, and thus fibers, of the
appropriate muscles and in the appropriate order at
the appropriate times. In other words an improper
motor program may be being taught which could
eventually lead to reinjury, or even cause reinjury in
the rehab process, or just teach the body to not be as
effective as it could otherwise be.
Lastly, I would like to dispell the usage of the term
"proprioception" when referring to this kind of
training. Proprioception is generally defined as the
ability to determine where a particular body part is
in space. Because part of the proprioceptive sense is
believed to be regulated by the sensory neurons in the
inner ear many people directly associate it with
balance (and for good reason, without the
proprioceptive sense we wouldn't be able to "balance"
at all). However, proprioception is used just as
effectively, or even more effectively during many
stable surfaced exercises, i.e. squats (especially one
legged), bench press, and any of the Olympic Lifts.
Call it "core training" or "balance training" or
whatever else you want, but to suggest that it teaches
someone to better understand where their body is at in
space is completely not accurate (this is not a hit on
Maria's use of the term, it's not her fault that this
is what many people call it, just the fact that the
use of this terminology in reference to this kind of
training ever started).
Chad Scheitel, MA, CSCS
Minneapolis, MN
--- carruthersjam <Carruthersjam@
>
> > > --- In Supertraining@
> Huntsman
> > > <dizzipurple@
> > > >
> > > > Hi all,
> > > >
> > > > Can anyone recommend a link or a website
> where I can find
> > > information and some proprioreception exercises
> for helping
> someone
> > > recover from a knee injury? I have only read
> about
> propriorecption
> > > training being beneficial after an injury to a
> joint and would
> like
> > > to learn more. Also, a friend who has recently
> been released
> from
> > pt
> > > has asked me to help him with a conditioning
> program. He
> recently
> > > had knee surgery. I thought the
> proprioreception training would
> > be
> > > a nice compliment to the strength and
> conditioning program.
> Please
> > > let me know if you need more specifics about the
> surgery in order
> > to
> > > answer my question.>>>
>
> ******
> Noah Wasielewski, PhD, ATC, CSCS kindly forwarded
> the below
> information to the group:
>
> There is *very* little research in this area. I
> have a few
> references that pertain to ACL reconstructed persons
> and a couple for
> osteoarthritis. See below:
>
> Systematic Reviews
> Cooper RL, Taylor NF, Feller JA A systematic review
> of the effect of
> proprioceptive and balance exercises on people with
> an injured or
> reconstructed anterior cruciate ligament Research in
> Sports Medicine
> 2005;13(2):163-
>
> ------------
>
> Clinical Trials
> Cooper RL, Taylor NF, Feller JA. A randomised
> controlled trial of
> proprioceptive and balance training after surgical
> reconstruction of
> the anterior cruciate ligament. Research in Sports
> Medicine 2005 Jul-
> Sep;13(3):217-
>
> Liu-Ambrose T, Taunton JE, MacIntyre D, McConkey P,
> Khan KM. The
> effects of proprioceptive or strength training on
> the neuromuscular
> function of the ACL reconstructed knee: a randomized
> clinical trial.
> Scandinavian Journal of Medicine & Science in Sports
> 2003 Apr;13
> (2):115-123.
>
> Lin DH, Lin YF, Chai HM, Han YC, Jan MH. Comparison
> of proprioceptive
> functions between computerized proprioception
> facilitation exercise
> and closed kinetic chain exercise in patients with
> knee
> osteoarthritis. Clinical Rheumatology 2007
> Apr;26(4):520-
>
> Dracoglu D, Aydin R, Baskent A, Celik A. Effects of
> kinesthesia and
> balance exercises in knee osteoarthritis. Journal of
> Clinical
> Rheumatology 2005 Dec;11(6):303-
>
> ============
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