Open kinetic chain vs closed kinetic chain

July 21, 2023 Tom Heeley

The role of a therapist at Optimum Derby is to assist you back to the level you were at before injury. We want to assist you in increasing your performance to a desired level with correct movements, strengths, exercises and dynamic mobility changes. Our sports injury clinic can help you achieve this.

An example of exercises we may use are open kinetic chain drills and closed kinetic chain drills. What is the difference between the two?

Open kinetic chain (OKC) drills are described as those where the lower limb is free to move. However, closed kinetic chain (CKC) drills are the opposite where the foot and lower limb is fixed to a surface and not free to move.

It is well thought that post anterior cruciate ligament (ACL) reconstruction, OKC drills place more stress on the knee and therefore increase laxity, in comparison to a CKC drill which is completed with a fixed foot, more stability and less knee laxity.

Having now reviewed the two drills, let’s investigate these different types of exercises and how they impact ACL rehabilitation, their impacts on performance and the time it takes an individual to recover.

What do we know?

Pain was measured in many studies and thought to be higher in patients with a greater emphasis on OKC. However, the current research highlights there are no differences between both types of exercises, leading to the conclusion that both need to be included in rehabilitation.

Strength outcome was very similar between both who complete early OKC and those groups who introduced OKC later in rehab. This highlights to us that there is no reason to risk OKC early on in rehabilitation.

Laxity was analysed during the studies to view how much tibial translation there is. The reported 2mm top end limit is widely accepted as normal but OKC and CKC showed laxity up to 1.4mm, deeming both safe to introduce early into rehabilitation.

However, at Optimum we must consider the type of graft utilised during surgery, any other complications, what ranges we are working within and how the exercises can be programmed effectively. When is the best time to introduce these two different types of drills? What repetitions and how many sets? Which weights to use? These are all things we take into consideration at Optimum Derby.

To book your session at Optimum Derby, visit https://optimum-derby.co.uk/online-booking