Rehabilitation following an ACL injury or reconstruction is a critical component of recovery, with a well-structured exercise plan being essential for restoring knee function, strength, and stability. Traditionally, much attention has been given to the type and timing of exercises—specifically open kinetic chain (OKC) and closed kinetic chain (CKC) exercises. But what are these exercises and how are they used in rehab?
In OKC exercises, the foot is not fixed and can move freely. An example is a seated leg extension. These exercises are often used to isolate and strengthen specific muscle groups, such as the quadriceps. In CKC exercises, the foot remains in contact with the ground or a surface, meaning the movement involves multiple joints and muscle groups. What makes them particularly beneficial is their ability to promote co-contraction of the quadriceps and hamstrings, helping to protect the knee joint and ACL during movements. Exercises like squats and lunges are typical CKC movements.
Both OKC and CKC exercises were found to have no significant difference in their effects on knee laxity. This suggests that concerns over OKC exercises causing increased laxity may be unfounded when used appropriately. Patients can engage in both OKC and CKC exercises without increased risk of knee looseness post-surgery. When it comes to pain management, CKC exercises are shown to be slightly better, particularly in the early stages of recovery. Patients often report less discomfort with CKC exercises because they engage more muscle groups and distribute the load more evenly across the joints.
For patients recovering from ACL surgery or injury, a combination of open and closed kinetic chain exercises is essential for a successful recovery. The timing of when to introduce these exercises is flexible, and both can be safely included in the rehabilitation program. By focusing on both muscle strength and functional movement, patients can achieve better knee stability and return to normal activities with confidence.
