Arthrogenic muscle inhibition (AMI) is a neuromuscular impairment commonly observed following anterior cruciate ligament reconstruction (ACLR). This condition, characterized by persistent quadricep inhibition due to altered afferent feedback, significantly impacts neuromuscular recovery, delaying return to running and sport. Despite advancements in rehabilitation strategies, AMI may persist for months or even years after ACLR, leading to muscle strength asymmetries, altered biomechanics, and an increased risk of reinjury. The mechanisms underlying AMI involve both peripheral (joint effusion, mechanoreceptor dysfunction) and central (corticospinal inhibition, neuroplasticity alterations) components, which collectively hinder voluntary muscle activation and movement control. AMI alters gait mechanics, reduces knee stability, and promotes compensatory patterns that increase injury risk. Current return-to-sport protocols emphasize strength symmetry and functional performance but often neglect neuromuscular deficits. A comprehensive assessment integrating neuromuscular, biomechanical, and proprioceptive evaluations is needed at specific stages to optimize rehabilitation and minimize reinjury risk. Future research should explore targeted interventions such as neuromuscular stimulation, cognitive–motor training, and advanced gait analysis to mitigate AMI’s impact and facilitate a safer, more effective return to sport.

Purpose: This study aimed to evaluate neuromuscular control and muscle activation patterns in individuals following anterior cruciate ligament (ACL) reconstruction, compared to healthy controls. Methods: A cross-sectional comparative study was conducted following STROBE guidelines, including 16 participants (ACL group: n = 9; control group: n = 7). Participants performed the single-leg squat (SLS) test and the single-leg drop landing (SLDL) test. Neuromuscular control was assessed using the Qualitative Analysis of Single-Leg Loading Score (QASLS), while gluteus medius and vastus medialis activation were recorded using surface electromyography. Results: The ACL group showed significantly higher QASLSs in the SLS test (p = 0.0113), indicating poorer movement quality, while no difference was found in the SLDL test (p = 0.5484). Gluteus medius activation was lower in the ACL group during the SLS test (p = 0.0564), and vastus medialis activation was higher but not significantly different (p = 0.095). Conclusions: These findings highlight persistent neuromuscular deficits post-ACL-reconstruction, particularly in SLS tasks, reinforcing the need for targeted rehabilitation strategies focusing on hip stabilization and quadriceps motor control to optimize movement quality and reduce reinjury risk.

(1) Background: Shoulder pathologies are mostly found in overhead sports. Many risk factors have been identified, in particular a deficit in the kinetic chain. The aim of this review was to find out whether prevention by strengthening the kinetic chain can have an impact on the rate of shoulder injury in overhead pitching athletes. (2) Methods: A systematic review of the literature was carried out, including studies on the role of the kinetic chain in the prevention of overhead athletes. The studies used were works published over the last 10 years searched on PubMed, Cochrane Library, PEDro and Science Direct. They were also analyzed by methodological quality scales: the PEDro scale and the Newcastle–Ottawa scale. (3) Results: Eight studies met the inclusion criteria. The studies analyzed revealed a significant correlation between the use of the kinetic chain and the prevention of shoulder injuries, associating factors such as muscle strength, physical performance in tests (CMJ, FMS), static and dynamic balance and the ability to transfer energy from the lower to the upper body. (4) Conclusions: It is important to integrate core stability work and lower limb strengthening to minimize excessive stress on the shoulder complex, while optimizing force production and performance.

Purpose: Anterior cruciate ligament reconstruction (ACLR) using the hamstring graft is commonly performed to restore knee stability; however, it induces significant neuromuscular and biomechanical changes, particularly in the hamstring. This study aimed to evaluate the changes in maximum effective angle, hamstring strength, and hamstring-to-quadriceps (H/Q) strength ratio at 3 and 6 months post-ACLR and compare these outcomes to a control group. Methods: This prospective controlled study included 20 ACLR patients and 20 age- and gender-matched controls. Hamstring peak torque, maximum effective angle (MEA), and the H/Q ratio were assessed using isokinetic dynamometry at 60°/s. The ACLR group was evaluated postoperatively at 3 and 6 months, while the control group underwent a single evaluation. Results: At 3 and 6 months, the ACLR group exhibited significantly lower MEA (26.3° ± 8.2 and 28.2° ± 9.4) compared to the control group (36.4° ± 12.0; p < 0.01). Hamstring peak torque and H/Q ratios were also lower in the ACLR group but showed slight improvements over time. The H/Q ratio increased significantly between 3 and 6 months (51% to 56%; p = 0.041). Conclusion: The use of hamstring graft in ACLR leads to persistent MEA and strength deficits despite rehabilitation. Advanced, targeted rehabilitation protocols are essential to address these deficits, optimize recovery, and reduce the risk of reinjury.