{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:43:24Z","timestamp":1791312204532,"version":"4.3.1"},"reference-count":41,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: A complete avulsion of the proximal rectus femoris muscle is a rare but severity injury. There is a lack of substantial information for its operative treatment and rehabilitation; in particular there is a lack of biomechanical data to evaluate long-term outcomes. Case presentation: The case report presents the injury mechanism and surgical treatment of a complete avulsion of the proximal rectus femoris muscle in a 41-year-old recreational endurance athlete. Moreover, within a one-year follow-up period, different biomechanical tests were performed to get more functional insights into changes in neuromuscular control, structural muscle characteristics, and endurance performance. Within the first month post-surgery, an almost total neuromuscular inhibition of the rectus femoris muscle was present. A stepwise reduction in inter-limb compensations was observable (e.g., in crank torque during cycling) during the rehabilitation. Muscular intra-limb compensations were shown at six months post-surgery and even one year after surgery, which were also represented in the long-term adaption of the muscle characteristics and leg volumes. A changed motor control strategy was shown by asymmetric muscle activation patterns during ergometer cycling, while the power output was almost symmetric. During rehabilitation, there might be a benefit to normalizing neuromuscular muscle activation in ergometer cycling using higher loads. Conclusions: While the endurance performance recovered after six months, asymmetries in neuromuscular control and structural muscle characteristics indicate the long-term presence of inter- and intra-limb compensation strategies.<\/jats:p>","DOI":"10.3390\/ijerph18168727","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T10:54:35Z","timestamp":1629284075000},"page":"8727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rehabilitation after a Complete Avulsion of the Proximal Rectus Femoris Muscle: Considerations from a Case Report"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6258-3537","authenticated-orcid":false,"given":"Christian","family":"Baumgart","sequence":"first","affiliation":[{"name":"Department of Movement and Training Science, University of Wuppertal, Fuhlrottstra\u00dfe 10, 42119 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casper","family":"Grim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Trauma Surgery, Klinikum Osnabr\u00fcck, Am Finkenhuegel 1, 49076 Osnabrueck, Germany"},{"name":"Department of Human Science, University of Osnabrueck, Barbarastrasse 22c, 49076 Osnabrueck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2897-5411","authenticated-orcid":false,"given":"Rafael","family":"Heiss","sequence":"additional","affiliation":[{"name":"Institute of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Ehrenstein","sequence":"additional","affiliation":[{"name":"Practice OrthoPro Duesseldorf, Breitestr 69, 40213 Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Freiwald","sequence":"additional","affiliation":[{"name":"Department of Movement and Training Science, University of Wuppertal, Fuhlrottstra\u00dfe 10, 42119 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias Wilhelm","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Institute of Movement and Training Science, University of Leipzig, Jahnallee 59, 04109 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.mric.2005.08.005","article-title":"MR imaging of the proximal rectus femoris musculotendinous unit","volume":"13","author":"Rosenberg","year":"2005","journal-title":"Magn. 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