The synergistic action of the ACL and the thigh muscles in maintaining joint stability was studied experimentally. The EMG from the quadriceps and hamstring muscle groups was recorded and analyzed in three separate experimental procedures in which the knee was stressed. The test revealed that direct stress of the ACL has a moderate inhibitory effect on the quadriceps, but simultaneously it directly excites the hamstrings. Similar responses were also obtained in patients with ACL damage during loaded knee extension with tibia subluxation, indicating that an alternative reflex arc unrelated to ACL receptors was available to maintain joint integrity. The antagonist muscles (hamstrings) were clearly demonstrated to assume the role of joint stabilizers in the patient who has a deficient ACL. The importance of an appropriate muscle-conditioning rehabilitation program in such a patient is substantiated.

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The objective of this study was to quantify the coactivation patterns of the knee flexor and extensor muscles as part of continued efforts to identify the role of the antagonist muscles in maintaining joint stability. The simultaneous EMG from the flexor and extensor muscles of the knee were recorded during maximal effort, slow isokinetic contractions (15 deg/sec) on the plane parallel to the ground to eliminate the effect of gravity. The processed EMG from the antagonist muscle was normalized with respect to its EMG as agonist at maximal effort for each joint angle. The plots of normalized antagonist EMG versus joint angle for each muscle group were shown to relate inversely to their moment arm variations over the joint range of motion. Additional calculations demonstrated that the antagonist exerts nearly constant opposing torque throughout joint range of motion. Comparison of data recorded from normal healthy subjects with that of high performance athletes with hypertrophied quadriceps demonstrated strong inhibitory effects on the hamstrings coactivations. Athletes who routinely exercise their hamstrings, however, had a coactivation response similar to that of normal subjects. We concluded that coactivation of the antagonist is necessary to aid the ligaments in maintaining joint stability, equalizing the articular surface pressure distribution, and regulating the joint's mechanical impedance. The reduced coactivation pattern of the unexercised antagonist to a hypertrophied muscle increases the risk of ligamentous damage, as well as demonstrates the adaptive properties of the antagonist muscle in response to exercise. It was also concluded that reduced risk of knee injuries in high performance athletes with muscular imbalance could result from complementary resistive exercise of the antagonist muscle.

The electromyographic (EMG) coactivation patterns of the knee flexors and extensors when acting as antagonists were studied as a function of limb velocity to assess their contribution to joint stiffness and laxity. Normalized antagonist coactivation patterns developed from surface EMG recordings from the hamstrings and quadriceps during maximal effort isokinetic extension and flexion, respectively, demonstrated characteristic variations as the joint velocity increased from 15 deg/sec up to 240 deg/sec. The two-tailed t-test (P less than 0.01) was performed on the data obtained from eight normal knees. The results indicate that both hamstrings and quadriceps demonstrate a significant increase (greater than 100%) in their antagonist coactivation pattern during the final 40 degrees of fast extension and flexion movements, respectively, as limb velocity increases. A minor decrease in antagonist activity of the hamstrings (24%) and quadriceps (8%) was evident during the initial phase of the extension and flexion movements, respectively, as joint velocity increased. We concluded that as limb velocity is increased, there is a substantial reflexive (unintentional) increase in the contribution of the antagonist musculature to joint stiffness and reduction of laxity. The results also suggest that strength training of the hamstrings (rather than quadriceps) should be considered as a modality for conservative treatment of ACL deficiencies, as well as an adjunct to surgical reconstruction. Such training can also reduce the risk of high performance athletes in a reflexive manner by increasing joint stiffness.

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Static flexion of the lumbar spine is an extremely imposing function on its viscoelastic tissues, resulting in spasms and requiring long periods of rest before normal functions are re-established.

Prolonged flexion of the lumbar spine results in tension-relaxation and laxity of its viscoelastic structures, loss of reflexive muscular activity within 3 minutes and electromyogram spasms in the multifidus and other posterior muscles.