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Steven Kolumban Application Paper: The Knee 1. 3. 2. 1. In diagram one, the soccer player is getting ready to kick the ball. His leg is at a near 90 degree angle which means the knee is in flexion and the biceps femoris, semitendinosus, semimembranosus, popliteus, gastrocnemius, and the sartorious are the agonist or primary movers. The rectus femoris, vastus lateralis, vastus intermedius, tensor facia latae, and vastus medialis are the antagonist muscles as well as the neutralizers. The gracilis acts aboth because it deals with knee flexion and adduction. Most of the support in diagram one comes from the knee’s muscular support. The Muscles: Biceps Femoris- Plane of Motion- sagittal, transverse. Origin- ischial tuberosity (long head). Lower half of the linea aspera, and lateral condyloid ridge (short head). InsertionHead of the fibula and lateral condyle of the tibia. Innervention- sciatic nerve- tibial division (long head). Sciatic nerve- peroneal division (short head). Strengthening- Hamstring Curls with a hamstring curl machineis a good way to strengthen the biceps femoris. Flexibility- put feet shoulder width apart and bend over to reach for your toes, or lay on your back while keeping both legs straight lift one leg till you feel your leg stretch. Semimembranosus- Plane of Motionsagittal, transverse. Origin- ischial tuberosity. Insertion- Posteromedial surface of the medial tibial condyle. Innervention- Sciatic nerve- tibial division. Strengthening- Hamstring Curls with a hamstring curl machine is a good way to strengthen your semimembranosus. Flexibility- Put your feet shoulder width apart and bend over to reach your toes, or lay on your back while keeping both legs straight lift one leg till you feel your leg stretch. Semitendinosus- Plane of Motion- sagittal, transverse. Origin- ischial tuberosity. Insertion- Upper anterior medial surface of the tibia just below the condyle. Innervention- Sciatic nerve- tibial division. StrengtheningHamstring Curls with a hamstring curl machine is a good way to strengthen your Semitendinosus. Flexibility- Put your feet shoulder width apart and bend over to reach your toes, or lay on your back while keeping both legs straight lift one leg till you feel your leg stretch. Popliteus- Plane of Motion- Transverse, sagittal. Origin- Posterior surface of the lateral condyle of the femur. Insertion- Upper posterior medial surface of the tibia. Innervention- Tibial nerve. Strengthening- hang from a bar with the legs flexed at the knees, strenuously exercises the popliteus. Flexibility- Passive external rotation with the knee flexed approximately 20-30 degrees. Sartorius- Plane of Motion- Sagittal, transverse, frontal. OriginAnterior superior iliac spine aand notch just below the spine. Insertion- Anterior medial surface of the tibia just below the condyle. Innervention- Femoral nerve. Strengthening- Flexing the hip or knee will strengthen the Sartorius. Flexibility- Stretching the Sartorius can be achieved by having partner passively taking the hip into extreme extension, adduction, and internal rotation with the knee extended. Gracilis- Plane of Motion- Frontal, sagittal, transverse. Origin- Anteromedial edge of the descending ramus of the pubis. Insertion- Anterior medial surface of the tibia below the condyle. Innervention-Obturator nerve. Strengthening- Use the scissors exercise, which requires the subject to sit on the floor with the legs spread wide while a partner puts his/her legs or arms inside each lower leg to provide resistance. FlexibilityAbduct the extended and internally rotated hip and extend the knee. In diagram two as the kick progresses, the knee begins to change from flexion to extension. This means that the vastus lateralis, vastus intermedius, vastus medialis, and the tensor facia latae are now transitioning to being and the primary movers of diagram one are becoming the antagonist and neutralizer muscles. 2. In diagram three the knee is now in complete extension. The primary of the knee at this point is its bony and ligamentous structures. Te primary extensors are now in full control. Rectus femoris- Plane of Motion- Sagittal. Origin- Anterior inferior iliac spine of the illium and groove (posterior) above the acetabulum. Insertion- Superior aspect of the patella tendon to tibial tuberosity. Innervation- Femoral nerve. Strengthening- Knee extension exercises against manual resistance. Flexibility-Lay in a side lying position by having a partner take the knee into full flexion and simultaneously take the hip into extension. Vastus Lateralis- Plane of Motion- Sagittal. Origin- Intertrochanteric line, anterior and inferior borders of the greater trochanter, gluteal tuberosity, upper half of the linear aspera, and the entire lateral inter muscular septum. Innervation- Femoral nerve. Strengthening- Knee extension exercises against manual resistance. FlexibilityPull the knee into maximum flexion. Vastus intermedius- Plane of Motion- Sagittal. Origin- Upper two thirds of the anterior surface of the femur. Insertion- Upper border of the patella and patellar tendon to the tibial tuberosity. Innervation- Femoral nerve. Strengthening- Squats with barbells of varying weights on the shoulders. Flexibility- Pull the knee into maximum flexion. Vastus medialis- Plane of Motion- Sagittal. OriginWhole length of the linear aspera and medial condyloid ridge. Insertion- Medial half of the upper border of the patella and patellar tendon to the tibial tuberosity. InnervationFemoral nerve. Strengthening- Squats, knee extensions, leg presses. Flexibility- Pull the knee into maximum knee flexion. Tensor facia latae- Plane of Motion- Frontal, sagittal, transverse. Origin- Anterior iliac crest and the surface of the illium just below the crest. Insertion- One-fourth of the way down the thigh into the illiotibial tract, which in turn inserts onto Gerdy’s tubercle of the antero lateral tibial condyle. Innervation- Superior gluteal nerve. Strengthening- Perform hip abduction exercises against gravity and resistance while in a side lying position. Flexibility- Remain on your side and have a partner passively move the downside hip into full extension adduction, and external rotation. Gracilis- Plane of Motion- Frontal, sagittal, transverse. OriginAnteromedial edge of the descending ramus of the pubis. Insertion- Anterior medial surface of the tibia below the condyle. Innervation- Obturator nerve. StrengtheningUse the scissors exercise, which requires the subject to sit on the floor with the legs spread wide while a partner puts his/her legs or arms inside each lower leg to provide resistance. Flexibility- Abduct the extended and internally rotated hip and extend the knee. Bibliography R.T. Floyd. Manual of Structural Kinesiology. New York: Mcgraw-Hill; 2012. Muscles of the Knee. Available at: http://www.innerbody.com/image/musc09.html. Accessed April17,2013. Knee Anatomy. Available at: http://www.sports-injury-info.com/knee-anatomy.html. Accessed April 17, 2013.