The Effect of Creatine Supplementation on Strength Recovery after Anterior Cruciate Ligament (ACL) Reconstruction

Tyler, Timothy F.; Nicholas, Stephen; Hershman, Elliott B.; Glace, Beth W.; Mullaney, Michael J.; McHugh, Malachy P.

doi:10.1177/0363546503261731

Cited by 31 publications

(36 citation statements)

References 28 publications

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“…Furthermore, the perceived weakness of the quadriceps after ACL reconstruction (e.g. reduced ability to exert an extension moment) (Rosenberg, et al, 1992;Tyler, et al, 2004) might be in part due to the reduced stiffness of the patellar tendon after removal of its central third. Future studies should consider the effects of removal of the central third of the patellar tendon on patellofemoral biomechanics in-vivo.…”

Section: Discussionmentioning

confidence: 99%

The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion

DeFrate

Nha

Papannagari

et al. 2007

Journal of Biomechanics

107

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Few studies have investigated the function of the patellar tendon in-vivo. This study quantified the three-dimensional (3D) kinematics of the patellar tendon during weight-bearing flexion.Eleven subjects were imaged using magnetic resonance (MR). Sagittal plane images were outlined to create a 3D model of the patella, tibia, and femur and included the attachment sites of the patellar tendon. Each attachment site was divided into central, medial, and lateral thirds. Next, the subjects were imaged using fluoroscopy from two orthogonal directions while performing a single-leg lunge. The models and fluoroscopic images were used to reproduce the motion of the patella, tibia, and femur. The apparent elongation, sagittal plane angle, and coronal plane angle of each third of the patellar tendon was measured from the relative motion of the attachment sites.All three portions of the patellar tendon deformed similarly with flexion. The length of the patellar tendon significantly from full extension to 30°. From 30°-110°, no significant change in the length of the patellar tendon was observed. The patellar tendon was oriented anteriorly at flexion angles less than 60° and posteriorly thereafter. From full extension to 60°, the medial orientation of the patellar tendon decreased significantly with flexion. These data may have important implications for anterior cruciate ligament reconstruction using patellar tendon autografts and for the design of rehabilitation regimens for patients of patellar tendon repair.

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Section: Discussionmentioning

confidence: 99%

The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion

DeFrate

Nha

Papannagari

et al. 2007

Journal of Biomechanics

107

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“…The magnitude of atrophy and strength loss often exceeds 20% and 30%, respectively, during the first 3 months following surgery. 7,15,22,25,26,[29][30][31][32]34 Resistance exercises during postoperative rehabilitation predictably mitigate these deficits; however, a 10% decrease in muscle size and a 10% to 20% decrease in strength may persist years after surger y. 1,5,[7][8][9]12,19,22,25,28 Regaining quadriceps size and strength is clearly difficult following ACL-R and continues to be a rehabilitation challenge requiring novel interventions.…”

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confidence: 99%

Early Application of Negative Work via Eccentric Ergometry Following Anterior Cruciate Ligament Reconstruction: A Case Report

Gerber

Marcus

Dibble

et al. 2006

J Orthop Sports Phys Ther

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Study Design: Case report.Objectives: To present a progressively increasing negative-work exercise program via eccentric ergometry early after anterior cruciate ligament reconstruction (ACL-R) and to suggest the potential of negative work to amplify the return of quadriceps size and strength. Case Description: The patient was a 26-year-old highly active recreational athlete who sustained an ACL tear while skiing in January 2004 and then again while skiing in February 2005. This individual underwent an arthroscopically assisted ACL-R with a double-loop semitendinosusgracilis autograft initially, then a patellar tendon autograft following his ACL graft rupture. Beginning within 3 weeks after surgery, a progressive negative-work exercise program was initiated using an eccentric ergometer. The patient completed 31 training sessions of 5 to 30 minutes in duration over a 12-week period following the ACL-R and 33 training sessions of the same frequency and duration following the ACL revision. Outcomes: Following ACL-R, quadriceps volume increased 28% (involved lower extremity) and 14% (uninvolved lower extremity) during the 12-week training program. Following revision, quadriceps volume returned to similar levels at the same postoperative period as those achieved after the initial surgery (2% less on the involved side and 2% greater on the uninvolved side). Quadriceps strength, 15 weeks after ACL-R, exceeded preoperative measures by an average of 20% (involved) and 14% (uninvolved). Quadriceps strength after ACL revision exceeded all previous measures. Discussion: This case report suggests that if gradually and progressively applied, negative work via eccentric ergometry can be both safe and efficacious early after ACL-R. Eccentric exercise may mitigate the prevalent muscle size and strength deficits commonly observed after ACL-R. The results of this case suggest a need for continued research with early negative work interventions following ACL-R.

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“…It has been Buford et al [31] proposed that there is no difference between following a CR supplementation programme to increase PCr stores, and completing a carbohydrate loading programme to enhance glycogen stores [31]. It is worth noting that many researchers have argued that banning CR would in fact be unethical as it has been linked to reductions in musculoskeletal injuries [57], heat stress [58], and decreases in rehabilitation periods [59], as well as being a naturally occurring compound.…”

Section: Renal Problems Recordedmentioning

confidence: 99%

An Update on Effects of Creatine Supplementation on Performance: A Review

Dorrell¹,

Gee²,

Middleton³

2016

Sports Nutr Ther

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Supplementary creatine, available in many different forms but most commonly monohydrate, is a legal and reportedly safe to consume nutritional ergogenic aid. After searching internationally recognised research databases, this review provides and update on the current literature on the physiological effects of creatine supplementation on performance whilst also discussing the underlying physiology regarding the synthesis and dietary provision of creatine as well as addressing issues of safety and the ethical considerations of usage. Research has shown that regular consumption of supplementary creatine can raise associated content within skeletal muscle. Subsequently, there is an extensive, and still growing, body of the literature supporting the efficacy of creatine supplementation on enhancing exercise performance, exercise tolerance, muscle strength and lean body mass. Moreover, little scientific evidence exists showing any unfavourable effects on individuals who are free from illness and disease. This review consolidates the current literature and provides application to the athletic setting which is purposeful for those choosing to either recommend or consume this nutritional ergogenic aid. At this current time, a traditional loading and maintenance supplementation protocol is advised as contemporary research studies are still to unravel the benefits of alternative approaches.

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The Effect of Creatine Supplementation on Strength Recovery after Anterior Cruciate Ligament (ACL) Reconstruction

Abstract: The results demonstrate that patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after ACL reconstruction.

Cited by 31 publications

References 28 publications

The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion

The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion

Early Application of Negative Work via Eccentric Ergometry Following Anterior Cruciate Ligament Reconstruction: A Case Report

An Update on Effects of Creatine Supplementation on Performance: A Review

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