If you’re an athlete with quadricep activation failure:

… Retrain your muscle with biofeedback treatment under a physical therapist’s supervision.
… Follow a custom strengthening plan to rebuild muscle.
… Exercise at home to prevent atrophy.

It’s easy to take for granted your muscles and the movements they perform every day until they fail you.

Following knee surgery, it isn’t uncommon to lose muscle mass and function from lack of use. For athletes and other active individuals, this loss of strength can be particularly disconcerting. For instance, most athletic people have strong quadricep muscles from frequent exercise, so when those muscles atrophy and you experience knee instability, it can be especially frustrating.

This kind of muscle atrophy is called “quad activation failure” in the medical community, but you also might hear it called “quad not firing” or “quad shut down.” Either way, it can be very debilitating during normal activities and sports.

What Is Quad Activation Failure?

At its most basic, quad activation failure is the inability to squeeze or tighten your quadriceps. This means you can’t lock your knee or stabilize it to stand, walk or run properly, much less play a sport.

Quad activation failure is caused by arthrogenic muscle inhibition when your knee swells up after a surgery like ACL surgery or total joint replacement. To reduce pain, your nervous system shuts down normal neural stimulation to the muscle to protect the knee joint from the pressure of muscle movement. This is a protective mechanism at first, but if it persists, atrophy sets in and the muscle weakens.

Working With a Physical Therapist to Reactivate Your Quad Muscle

Quadricep activation failure is not something that will magically resolve on its own. If not treated, it can last for years and keep athletes from enjoying their sport.

If you are experiencing quad shut down, you should notify your physician. They can advise you about treatments that will retrain your brain to take back normal control of your muscle and strengthen it. They likely will refer you to a physical therapist who can guide you through the necessary steps to reactive the quad muscle and get its nerves firing again.

1 – Your physical therapist will help you follow a quadricep activation system known as biofeedback. For a biofeedback system, you’ll wear electrodes attached to your quadricep through which a low-level electrical current will be transmitted. The current will cause your muscle to spasm, reminding your body how to contract that muscle and flex it properly.

2 – After you regain control of that muscle, your physical therapist will create a custom strength and conditioning program for you. They’ll consider your unique physiology and athletic activities and goals to help you rebuild strength in your atrophied muscle.

3 – Activities like cycling, weight training, using an elliptical machine and walking backward on an inclined treadmill are common choices for building up muscle strength, mass and function again.

You also might discuss adopting a high-protein diet to support muscle growth and health. Your physical therapist can offer guidance or refer you to a nutritionist to ensure any diet changes you make are safe and healthy.

Working on Quad Activation at Home

It is vital to the function of your quads and your knee after surgery to stay appropriately active and prevent more atrophy. Your physical therapist likely will give you exercises to do at home to treat your quad atrophy.

Follow your therapist’s instructions, but these at-home exercises are known to help quad shut down:

…Heel slides
…Straight leg raises
…Terminal knee extensions
…Leg presses
…Heel raises
…Hamstring curls
…Any of your preferred core-strengthening exercises

If you’re an athlete anticipating knee surgery, you even may be able to practice these exercises at home before surgery as long as they do not exacerbate an existing injury. Always check with your doctor first, but keeping the knee and quadriceps active can help prevent post-operation atrophy.

Another great way to prevent atrophy is to avoid injury to begin with. An expert sports physical therapist can help you, as an athlete, examine the mechanics of your sport, improve your technique, and follow good strength and conditioning training to prevent the need for knee surgery in the future!

True Sports Physical Therapy – Where Maryland Athletes Rehab

At True Sports, we’re sports-focused because you’re sports-focused. The best physical therapists in Baltimore and Maryland provide the highest level of sports physical therapy and expertise you need to get back to your sport.

With six convenient state-of-the-art locations to choose from, any athlete who takes their rehab seriously can get awesome care and extraordinary results. Select your location and schedule an appointment, and have True Sports get you back to your team.

For questions about insurance or self-pay rates, please call our office at (401) 946-1672.