Anterior Cruciate Ligament Injury and Whole Body Vibration
The Anterior Cruciate Ligament (ACL) is one of four ligaments that provide stability to the knee joint. It
attaches to the back of the bottom end of the femur, and then crosses anteriorly through the knee joint
to attach to the front of the tibia. The purpose of the ACL is to prevent the tibia from displacing forward
from the femur. The Posterior Cruciate Ligament (PCL) crosses the ACL in the other direction at the knee
joint and prevents backwards displacement of the tibia from the femur. The two ligaments are
important for providing stability at the knee during fast directional changes in sports or activities, such
as football and basketball, which involve fast lateral/sideways movements. ACL injury or tear is a
common sports injury, which is caused by twisting of the knee while the lower leg is in a fixed position. It
can also result from a direct blow to the outside of the knee, which also causes injury to the medial
meniscus and medial collateral ligament. An audible pop can sometimes be heard during the initial
injury to the ACL. The knee joint immediately feels unstable with an intense amount of pain. Diffuse
swelling results and the individual often has difficulty fully extending the leg. There is also a mild
tenderness felt around the joint. Surgery is usually done following an ACL tear, especially if the
individual is young and physically active. Surgery involves repairing or replacing the torn ligament, and
recovery and return to competitive levels of sport may take from six months to one year. Pre-surgery
rehabilitation focuses on reducing the swelling and strengthening the muscles around the knee.
Postoperative rehabilitation will depend on where in the recovery process an individual is. Swelling and
regaining full range of motion is a priority immediately following surgery. Subsequent rehabilitation will
focus on sport-specific training with a goal of returning an individual to pre-injury activities.
There is one study that has looked at the effects of Whole Body Vibration (WBV) on individuals that have
had ACL reconstruction. The purpose of the study was to compare WBV to a conventional training
program with respect to knee proprioception and postural stability1. Significant improvements were
found in measures for both knee proprioception and postural stability following 12 sessions of WBV1.
Another study concluded that one session of WBV at 30 Hz had a positive effect on knee stability in
healthy individuals2. It is thought that the observed effects are a short-term neuromuscular adaptation2.
Individuals with a total knee arthroplasty showed improvements in strength and function after using
both WBV and traditional progressive strengthening exercises3. In healthy younger and older women, an
improvement in knee extensor strength, comparable to a traditional exercise program, was found
following the use of WBV4, 5.
Although there has been one study showing benefits with WBV on ACL reconstruction, as well as
improvements in knee strength and function with other populations, it is essential that an individual
who has sustained an ACL injury or has had an ACL reconstruction speak with a physician before adding
THIS IS FOR EDUCATIONAL PURPOSES ONLY. WE DO NOT DIAGNOSE OF PRESCRIBE. PLEASE CONSULT YOUR
HEALTH PROVIDER.
25 Curity Avenue, Unit 2A, Toronto, ON M4B 3M2
416-285-6055 fax 416-285-8918
info@t-zonehealth.com www.t-zonevibration.com
-2it to an exercise routine. This is so that the physician can help the individual determine if the benefits to
using WBV outweigh any potential risks or contraindications. More research examining WBV and ACL
injury and reconstruction is needed to determine both the benefits and risks for this population.
Without research, it cannot be determined if the benefits to using WBV would outweigh any potential
risks. Due to the lack of research, or when there is a known consequence, contraindications are
recommended. For example, recent surgical wounds, synthetic implants, and acute inflammation are
considered contraindications to using WBV. This list is by no means conclusive. The concern with recent
surgical wounds is a delay in healing, while the concern with newly place implants is implant migration.
If an individual has been cleared by a physician to use WBV, it should be initiated at a reduced intensity
and duration. This is so an individual can become accustomed to the machine and monitor for any
changes in symptoms. An individual should watch for changes in pain, swelling and knee stability that
may occur, and should discontinue the use of the platform if symptoms worsen. New symptoms should
be discussed with a physician. If symptoms remain stable or improve, intensity and duration can be
increased and exercises added within the individual’s fitness level. It is also important to discuss the use
of WBV with an appropriate rehabilitation specialist to determine safe and appropriate exercises to
perform while on the platform. In general, if an individual experiences any pain, dizziness or shortness in
breath while using WBV, it should be discontinued immediately.
References
1. Moezy A, Olyaei G, Hadian M, Razi M, Faghihzadeh S. 2008. A comparative study of whole body
vibration training and conventional training on knee proprioception and postural stability after
anterior cruciate ligament reconstruction. British Journal of Sports Medicine, 42(5), 373-8.
2. Johnson AW, Myrer JW, Hunter I, Feland JB, Hopkins JT, Draper DO, Eggett D. 2010. Whole-body
vibration strengthening compared to traditional strengthening during physical therapy in
individuals with total knee arthroplasty, Physiotherapy Theory and Practice, 26(4), 215-25.
3. Melnyk M, Kofler B, Faist M, Hodapp M, Gollhofer A. 2008. Effect of a whole-body vibration
session on knee stability, International Journal of Sports Medicine, 29(10), 839-44.
4. Roelants M, Delecluse C, Verschueren SM. 2004. Whole-body-vibration training increases kneeextension strength and speed of movement in older women, Journal of American Geriatric
Society, 52(6), 901-8.
5. Roelants M, Delecluse C, Goris M, Verschueren S. 2004. Effects of 24 weeks of whole body
THIS IS FOR EDUCATIONAL PURPOSES ONLY. WE DO NOT DIAGNOSE OF PRESCRIBE. PLEASE CONSULT YOUR
HEALTH PROVIDER.
25 Curity Avenue, Unit 2A, Toronto, ON M4B 3M2
416-285-6055 fax 416-285-8918
info@t-zonehealth.com www.t-zonevibration.com
-3vibration training on body composition and muscle strength in untrained females, International
Journal of Sports Medicine, 25(1), 1-5.
Various models and machines on the market have been used for the purpose of conducting research.
Also, a variety of frequencies (speeds) and amplitudes (platform variation) which may or may not be
known to us have been used. We do not guarantee or claim users will achieve similar results with our TZone Whole Body Vibration machine.
THIS IS FOR EDUCATIONAL PURPOSES ONLY. WE DO NOT DIAGNOSE OF PRESCRIBE. PLEASE CONSULT YOUR
HEALTH PROVIDER.
25 Curity Avenue, Unit 2A, Toronto, ON M4B 3M2
416-285-6055 fax 416-285-8918
info@t-zonehealth.com www.t-zonevibration.com