Lower Limb Rehabilitation

  • J. Espregueira-Mendes
  • R. Barbosa Pereira
  • A. Monteiro


This short chapter presents the critical thinking behind the guidelines concerning rehabilitation of the lower limb, a wide but incomplete field. Rehabilitation involves the management of injuries, essentially through the use of several different physical agents and therapeutic exercises. Knowledge related to the time frame of tissue healing, inflammatory process, basic training principles, the underlying science, and biomechanics is of utmost importance to every sports medicine professional. Here, essential information is provided about four of the most prevalent injuries of the lower limb: hamstring ruptures, patellar tendinopathy, anterior cruciate ligament rupture (reconstruction), and acute ankle sprains. Rehabilitation goals, treatment strategies, new assessment devices, criteria to return to play, and promising new therapies are discussed. The discussion of injury prevention provides the most up-to-date evidence related to ACL rupture. The current focus is on strength, balance, proprioceptive, and neuromuscular training programs.


Eccentric Exercise Ankle Sprain Patellar Tendinopathy Therapeutic Exercise Neuromuscular Training 
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  1. 1.
    Crosier JL, Ganteaume S, Binet J et al (2008) Strength imbalances and prevention of hamstring injury in professional soccer players: a prospective study. Am J Sports Med 36:1469–1475CrossRefGoogle Scholar
  2. 2.
    Brown LE (2000) Isokinetics in human performance. Human Kinetics, Champagne, ILGoogle Scholar
  3. 3.
    Johns Hopkins University (2009) Students Embed Stem Cells In Sutures To Enhance Healing. ScienceDaily. Retrieved November 30, 2009, from http://www.sciencedaily.com /releases/2009/07/090720191145.htmGoogle Scholar
  4. 4.
    Khan KM, Cook JL, Mafulli N et al (2000) where is the pain coming from in tendinopathy? It may be biochemical, not only structural, in origin. Br J Sports Med 34:81–83PubMedCrossRefGoogle Scholar
  5. 5.
    Khanna A, Nelmes RTC, Gougoulias N et al (2009) The effects of LIPUS on soft-tissue healing: a review of literature. Brit Med Bull 89:169–182PubMedCrossRefGoogle Scholar
  6. 6.
    Leeuwen MTV, Zwerver J, Akker-Scheek IVD (2008) Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature. Br J Sports Med 43:163–168PubMedCrossRefGoogle Scholar
  7. 7.
    Rompe JD, Furia J, Mafulli N (2008) Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy. J Bone Joint Surg Am 90:52–61PubMedCrossRefGoogle Scholar
  8. 8.
    Jonsson P, Alfredson H (2005) Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomised study. Br J Sports Med 39:847–850PubMedCrossRefGoogle Scholar
  9. 9.
    Waldá M, Hagglund M, Ekstrand J (2006) High risk of new knee injury in elite footballers with previous anterior cruciate ligament injury. Br J Sports Med 40:158–162CrossRefGoogle Scholar
  10. 10.
    Gustavsson A, Neeter C, Thomeé P et al (2006) A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14:778–788PubMedCrossRefGoogle Scholar
  11. 11.
    Paterno MV, Ford KR, Myer GD et al (2007) Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med 17:258–262PubMedCrossRefGoogle Scholar
  12. 12.
    Gilchrist J, Mandelbaum BR, Melancon H et al (2008) A randomised controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Am J sports Med 36:1476–1483PubMedCrossRefGoogle Scholar
  13. 13.
    Lamb SE, Marsh JL, Hutton JL et al (2009) Mechanical supports for acute severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet 373:575–581PubMedCrossRefGoogle Scholar
  14. 14.
    Engebretsen AH, Mykelebust G, Holme I et al (2010) Intrinsic risk factors for acute ankle injuries among male soccer players: a prospective cohort study. Scand J Med Sci Sports Epub 2010 Mar 11 PMID:20338006Google Scholar
  15. 15.
    Handoll HH, Rowe BH, Quinn KM et al (2001) Interventions for preventing ankle ligament injuries. Cochrane database Syst Rev (3):CD000018Google Scholar

Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • J. Espregueira-Mendes
  • R. Barbosa Pereira
  • A. Monteiro

There are no affiliations available

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