Occlusion Training in ACL Rehab

I've commented on this issue in the past:

http://joestrainingroom.blogspot.com/2009/06/blog-post.html

I didn't realize it had crept into ACL reconstruction rehab.  I'm going on record here as saying don't do it.

I understand arthrogenic muscle inhibition (AMI) is an issue in knee injury; it's well documented in vitro and vivo.  However, neuromuscular facilitation is a lot more complex and time consuming than increasing the size of a sarcomere.  Unless I'm wrong, all of the research on the topic has been at the myofibril level.

Don't be a reductionist; think global, think functionally.  Think about what is taking place here.  You are applying a tourniquet to a limb.  You have have no doppler studies.  The risk here is deep vein thrombosis.  If you think I'm being reactionary here, that DVT following ACL surgery is a rare occurance, take a look at this study-

http://www.orthosupersite.com/view.aspx?rid=22838

If your goal is to hypertrophy the quads, there are safer, more tried and true ways to do it.  We did it in the past with our old NK tables, leg extension machines, orthotrons, KinComs etc.  Those quads came back fast!  Obviously it wasn't the answer.  I know it's frustrating when an orthopedist judges return to play by plopping your kid on the table and putting a tape measure across their thighs.  Stay focused.