Neuromuscular Control and Muscle Strength
The function of good quality muscles and muscle strength is to act as a shock absorber to the load bearing and reduce peak impact forces. Muscle strength in combination with endurance and flexibility is therefore important to help dissipate the forces over the knee joint.
Sometimes after injury the quadriceps muscle can be inhibited by pain and therefore there is no shock absorber protection on the joint surfaces.
It is important to understand the relation of contact forces, shear forces and the influence of taking weight on the joint surface. This needs to be understood in relation to activities of daily living and then return to sport.
Muscle function is also important to control knee movement and prevent abnormal loading. When muscles are tired then fatigue results in different knee movements and increased tendency for injury.
Neuromuscular control is particularly important when considering core stability as this substantially affects hip and knee function. Muscle exercises therefore need to be aimed at both strength and fine functional control including dynamic stability, proprioception, strength and endurance.
Early activities can work on strength prior to working on core stability in order to have the influence of reducing impact load across the joint. Agility drills come later as muscle function improves. Neuromuscular exercises such as balance board work and proprioception exercises need to be undertaken in addition to muscle strengthening exercises and both are additive.