Rate of Force Development for ACL Rehab
RFD refers to the ability to produce force quickly and is integral during ACLR rehab - yet is often not trained well enough.
It's been shown that 30% RFD deficits are evident between limbs at 6 months post op despite full restoration of maximal knee extensor strength (Angelozzi et al 2013).
The problem is typical strength programs (3-4 sets of 8-12 reps) aren't good enough to manipulate RFD.
RFD however can be trained via heavy loads (<5 reps per set), and plyometrics and significant gains be seen in as little as 4-8 weeks.
The challenge for us clinicians is to know when the time is right to introduce this type of high intensity training.
Clinical reasoning is key and making sure that the athlete is competent in a more basic strengthening program (8-12 rep sets), and importantly that the knee is showing that it is tolerant of these basic loads before progressing to a program that is looking to increase RFD.
This paper by Buckthorpe is a beauty and I strongly urge anyone working with ACLR patients to give this one a read
If you're interested in learning more about ACL rehab, consider taking Learn.Physio ACLR Masterclasses here