Relationship between quadriceps femoris muscle volume and muscle torque after anterior cruciate ligament rupture

  • Yu KonishiEmail author
  • Toshiaki Oda
  • Satoshi Tsukazaki
  • Ryuta Kinugasa
  • Norikazu Hirose
  • Toru Fukubayashi



The purpose of this study was to obtain evidence to support the hypothesis that motor unit recruitment is reduced in the quadriceps femoris (QF) of patients with ACL rupture.


We compared muscle torque per unit volume in the QF from injured and uninjured sides to normal subjects. If high-threshold motor unit recruitment is reduced in patients with ACL rupture, this reduction will theoretically lead to a reduction in muscle torque per unit volume compared to the control group. The subjects included 22 patients with ACL rupture and 22 subjects with no history of knee injury. To identify the muscle torque per unit volume, the isokinetic peak torque was divided by QF volume which was obtained by MRI.


Tests revealed that the mean muscle torque per unit volume of the uninjured and injured sides was significantly lower than those of the control group.


This study demonstrated that the values of the muscle torque per unit volume of both injured and uninjured sides of patients with ACL rupture were significantly lower than those of the control group, thereby providing indirect evidence of the hindrance of motor unit recruitment in these patients. The results of the present study also indicate that there may be bilateral QF weakness in patients with ACL rupture. Since persistent QF weakness is a significant barrier to effective rehabilitation in patients with ACL injuries, a better understanding of the underlying mechanisms will allow clinicians and scientists to develop more effective therapeutic strategies for patient rehabilitation.


Muscle volume Torque Anterior cruciate ligament rupture Quadriceps femoris weakness 



This project was supported by a research grant from the Yamaha Motor Foundation for Sports. The authors would also acknowledge Mr. Kasai, Mr. Ootaki, Mr. Igarashi, Mr. Taguchi, and Mr. Kasuga who are the stuffs of radiological department at Japan Self Defense Force Yokosuka Hospital for their invaluable technical and lab assistance.


  1. 1.
    Akima H, Kano Y, Enomoto Y, Ishizu M, Okada M, Oishi Y, Katsuta S, Kuno S (2001) Muscle function in 164 men and women aged 20–84 year. Med Sci Sports Exerc 33:220–226PubMedCrossRefGoogle Scholar
  2. 2.
    Avela J, Kyrolainen H, Komi PV (1999) Altered reflex sensitivity after repeated and prolonged passive muscle stretching. J Appl Physiol 86:1283–1291PubMedGoogle Scholar
  3. 3.
    Bongiovanni LG, Hagbarth KE, Stjernberg L (1990) Prolonged muscle vibration reducing motor output in maximal voluntary contractions in man. J Physiol 423:15–26PubMedGoogle Scholar
  4. 4.
    Dowling J, Cardone N (1994) Relative cross-sectional areas of upper and lower extremity muscles and implications for force prediction. Int J Sports Med 15:453–459PubMedCrossRefGoogle Scholar
  5. 5.
    Feiring DC, Ellenbecker TS, Derscheid GL (1990) Test-retest reliability of the biodex isokinetic dynamometer. J Orthop Sports Phys Ther 11:298–300PubMedGoogle Scholar
  6. 6.
    Folland JP, Williams AG (2007) The adaptations to strength training: morphological and neurological contributions to increased strength. Sports Med 37:145–168PubMedCrossRefGoogle Scholar
  7. 7.
    Fukunaga T, Miyatani M, Tachi M, Kouzaki M, Kawakami Y, Kanehisa H (2001) Muscle volume is a major determinant of joint torque in humans. Acta Physiol Scand 172:249–255PubMedCrossRefGoogle Scholar
  8. 8.
    Gandevia SC (1998) Neural control in human muscle fatigue: changes in muscle afferents, motoneurones and motor cortical drive [corrected]. Acta Physiol Scand 162:275–283PubMedCrossRefGoogle Scholar
  9. 9.
    Kawakami Y, Abe T, Kuno S, Fukunaga T (1995) Training-induced changes in muscle architecture and specific tension. Eur J Appl Physiol Occup Physiol 72:37–43PubMedCrossRefGoogle Scholar
  10. 10.
    Kent-Braun JA, Ng AV, Young K (2000) Skeletal muscle contractile and noncontractile components in young and older women and men. J Appl Physiol 88:662–668PubMedGoogle Scholar
  11. 11.
    Konishi Y, Aihara Y, Sakai M, Ogawa G, Fukubayashi T (2007) Gamma loop dysfunction in the quadriceps femoris of patients who underwent anterior cruciate ligament reconstruction remains bilaterally. Scand J Med Sci Sports 17:393–399PubMedCrossRefGoogle Scholar
  12. 12.
    Konishi Y, Fukubayashi T, Takeshita D (2002) Mechanism of quadriceps femoris muscle weakness in patients with anterior cruciate ligament reconstruction. Scand J Med Sci Sports 12:371–375PubMedCrossRefGoogle Scholar
  13. 13.
    Konishi Y, Fukubayashi T, Takeshita D (2002) Possible mechanism of quadriceps femoris weakness in patients with ruptured anterior cruciate ligament. Med Sci Sports Exerc 34:1414–1418PubMedCrossRefGoogle Scholar
  14. 14.
    Konishi Y, Ikeda K, Nishino A, Sunaga M, Aihara Y, Fukubayashi T (2007) Relationship between quadriceps femoris muscle volume and muscle torque after anterior cruciate ligament repair. Scand J Med Sci Sports 17:656–661PubMedCrossRefGoogle Scholar
  15. 15.
    Konishi Y, Konishi H, Fukubayashi T (2003) Gamma loop dysfunction in quadriceps on the contralateral side in patients with ruptured ACL. Med Sci Sports Exerc 35:897–900PubMedCrossRefGoogle Scholar
  16. 16.
    Konishi Y, Suzuki Y, Hirose N, Fukubayashi T (2003) Effects of lidocaine into knee on QF strength and EMG in patients with ACL lesion. Med Sci Sports Exerc 35:1805–1808PubMedCrossRefGoogle Scholar
  17. 17.
    Kouzaki M, Shinohara M, Fukunaga T (2000) Decrease in maximal voluntary contraction by tonic vibration applied to a single synergist muscle in humans. J Appl Physiol 89:1420–1424PubMedGoogle Scholar
  18. 18.
    Kubo K, Kanehisa H, Fukunaga T (2001) Effects of different duration isometric contractions on tendon elasticity in human quadriceps muscles. J Physiol 536:649–655PubMedCrossRefGoogle Scholar
  19. 19.
    Kubo K, Kanehisa H, Fukunaga T (2002) Effects of resistance and stretching training programmes on the viscoelastic properties of human tendon structures in vivo. J Physiol 538:219–226PubMedCrossRefGoogle Scholar
  20. 20.
    Kubo K, Kanehisa H, Ito M, Fukunaga T (2001) Effects of isometric training on the elasticity of human tendon structures in vivo. J Appl Physiol 91:26–32PubMedGoogle Scholar
  21. 21.
    Lorentzon R, Elmqvist LG, Sjostrom M, Fagerlund M, Fuglmeyer AR (1989) Thigh musculature in relation to chronic anterior cruciate ligament tear: muscle size, morphology, and mechanical output before reconstruction. Am J Sports Med 17:423–429PubMedCrossRefGoogle Scholar
  22. 22.
    Miller A, MacDougall J, Tarnopolsky M, Sale D (1993) Gender differences in strength and muscle fiber characteristics. Eur J Appl Physiol Occup Physiol 66:254–262PubMedCrossRefGoogle Scholar
  23. 23.
    Rice DA, McNair PJ (2009) Quadriceps arthrogenic muscle inhibition: neural mechanisms and treatment perspectives. Semin Arthritis Rheum doi: 10.1016/j.semarthrit.2009.10.001
  24. 24.
    Snyder-Mackler L, De Luca PF, Williams PR, Eastlack ME, Bartolozzi AR 3rd (1994) Reflex inhibition of the quadriceps femoris muscle after injury or reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 76:555–560PubMedGoogle Scholar
  25. 25.
    Urbach D, Awiszus F (2002) Impaired ability of voluntary quadriceps activation bilaterally interferes with function testing after knee injuries. A twitch interpolation study. Int J Sports Med 23:231–236PubMedCrossRefGoogle Scholar
  26. 26.
    Urbach D, Nebelung W, Weiler HT, Awiszus F (1999) Bilateral deficit of voluntary quadriceps muscle activation after unilateral ACL tear. Med Sci Sports Exerc 31:1691–1696PubMedCrossRefGoogle Scholar
  27. 27.
    Walton J, Roberts N, Whitehouse G (1997) Measurement of the quadriceps femoris muscle using magnetic resonance and ultrasound imaging. Br J Sports Med 31:59–64PubMedCrossRefGoogle Scholar
  28. 28.
    Welsman J, Armstrong N, Kirby B, Winsley R, Parsons G, Sharpe P (1997) Exercise performance and magnetic resonance imaging-determined thigh muscle volume in children. Eur J Appl Physiol Occup Physiol 76:92–97PubMedCrossRefGoogle Scholar
  29. 29.
    Young A (1993) Current issues in arthrogenous inhibition. Ann Rheum Dis 52:829–834PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Yu Konishi
    • 1
    Email author
  • Toshiaki Oda
    • 2
  • Satoshi Tsukazaki
    • 3
  • Ryuta Kinugasa
    • 4
  • Norikazu Hirose
    • 4
  • Toru Fukubayashi
    • 4
  1. 1.Department of Physical EducationNational Defence AcademyYokosuka CityJapan
  2. 2.Living Matter Simulation Research Team, RIKENSaitamaJapan
  3. 3.Department of Orthopedic SurgeryJapan Self Defense Force Yokosuka HospitalKanagawaJapan
  4. 4.Department of Sports ScicneWaseda UniversityTokyoJapan

Personalised recommendations