Rehab and Performance Lab: A Medbridge Podcast

Rehab and Performance Lab Episode 17: Quad Recovery at Risk: Can You Afford to Skip NMES and Strength Testing?

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Jul 15, 2025

Dr. Lynn Snyder-Mackler, an esteemed expert in knee rehabilitation and ACL recovery, joins Phil Plisky to discuss the critical role of measuring quadriceps strength post-injury. They uncover why quad strength measurement is vital and tackle the shortcomings of traditional testing methods. Lynn shares practical alternatives for clinics lacking advanced equipment and highlights the effectiveness of neuromuscular electrical stimulation (NMES) in enhancing recovery. Tune in for actionable insights to elevate your approach to ACL rehabilitation!

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INSIGHT

Quad Strength Measurement Is Essential

Measuring quadriceps strength is essential to know whether your interventions are working.
Closed-chain tasks hide quad deficits because hip and ankle compensate for knee weakness.

INSIGHT

Functional Symmetry Can Mask Quad Loss

Functional tests (hop, jump, leg press) can appear symmetrical despite quad weakness.
Redundancy in lower-extremity movement masks isolated quadriceps deficits.

ADVICE

Use Isolated Knee Extension Tests

Use an isolated knee extension test (1RM or fixed dynamometry) when isokinetics aren't available.
Strap a handheld dynamometer or inline strain gauge to create a stable isometric test at your target angle.

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Dr. Lynn Snyder-Mackler, internationally renowned researcher and clinician in knee injury rehabilitation, returns to join host Phil Plisky for an in-depth conversation on strength testing and electrical stimulation after ACL reconstruction. Together, Phil and Lynn dig into why measuring quad strength isn't just important—it's essential—and explore practical, clinic-ready solutions when isokinetic equipment isn’t available. From overcoming neuromuscular inhibition to reframing patient conversations around NMES, you’ll walk away with tools to rethink your post-op ACL approach and better track progress where it matters most.

Learning Objectives

Analyze the evidence supporting the use of neuromuscular electrical stimulation (NMES) and objective strength testing as essential interventions in post-operative ACL rehabilitation

Apply evidence-based strategies to implement NMES and strength testing methods in clinical practice to assess and improve quadriceps activation and strength

Evaluate patient case scenarios involving NMES and strength testing after ACL reconstruction to identify appropriate measurement tools, interpret results, and make informed rehabilitation decisions

Timestamps

(00:00:00) Welcome
(00:01:23) Introduction to strength testing and electrical stimulation
(00:02:55) Importance of measuring quad strength
(00:06:13) Challenges in assessing quad strength
(00:09:06) Strength training and testing techniques
(00:12:04) Options for measuring quad strength
(00:14:46) Activation failure and electrical stimulation
(00:18:12) Research on electrical stimulation benefits
(00:20:54) Practical applications of electrical stimulation
(00:23:48) Patient engagement and education
(00:26:48) Key takeaways and future directions

Rehab and Performance Lab is brought to you by Medbridge. If you’d like to earn continuing education credit for listening to this episode and access bonus takeaway handouts, log in to your Medbridge account and navigate to the course where you’ll find accreditation details. If applicable, complete the post-course assessment and survey to be eligible for credit. The takeaway handout on Medbridge gives you the key points mentioned in this episode, along with additional resources you can implement into your practice right away.

To hear more episodes of Rehab and Performance Lab, visit ⁠⁠⁠https://www.medbridge.com/rehab-and-performance-lab⁠⁠⁠

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