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Upper Extremities Parts Shoulder Girdle Shoulder Joint Elbow Joint Radioulnar Joint Wrist Joint Muscle Contribution to Joint Stronger Muscles = More Joint Stability Angles of Pull influence Joint Stability Stabilizing Angles = < 90 angle of pull Dislocating Angles = > 90 angle of pull Shoulder Girdle Involved in Reaching/Grasping Motions Designed for Mobility Unstable joint Strength of Muscles VERY important Shoulder Joint Involved in a wide variety of motions Designed for Mobility, Unstable joint Rotator Cuff & Deltoids = small angle pull Wheel-Axle Mechanism Overarm Throw Pattern “cocking action” = extreme lateral rotation rapid medial rotation and protraction Strengthen Medial Rotators BOTH Concentrically and Eccentrically Elbow Joint Only Flexion and Extension Stable joint due to bony structure Muscle arrangement = stabilizing effect How to Strengthen Elbow Extensors Elbow Extensions with shoulder flexed figure 2.5e on page 61 Shoulder Hyperextensions with elbow extended figure 2.5d on page 61 3 Ways to Strengthen Elbow Flexors 1. Elbow flexion from anatomical position 2. Elbow flexion with shoulder Hyperextended 3. shoulder flexion figure 2.5j on pg 62 Radioulnar Joint Unstable due to weak bony arrangement Pronate = turn inward [medial] away from anatomical position Supinate = turn outward [lateral] back toward anatomical position figure 5.12 left side of picture pronated page 185 right side of picture supinated Wrist Joint MSDs - musculoskeletal disorders 1. angle of the work surface 2. position requirements of the work 3. magnitude & direction of applied forces 4. Degree of repetition CTS - Carpal Tunnel Syndrome see Force guidelines per task on page 189 Hip Joint Medial rotation involved in kick, throw & strike Wheel-Axle - figure 6.5 and 6.6 [page 197] A: medial B: lateral hip rotation Hip Joint Bending/Stooping = increase FA resistive to achieve equilibrium, hip extensors must provide high Tension/Force [hams, back] FIG 9-30 page 296 “Basic Biomechanics” 4th Edition by Susan J. Hall Knee Joint • Biarticulate Muscles - work knee and hip • Muscular Imbalances: 1. Hams - lateral vs. medial lateralis 2. Quads - vastus lateralis and medialis • Positions for potential injury 1. Foot fixed while hip/trunk rotates 2. Squats [FIG 6.11 pg 204] 3. Whip kick in Breaststroke [FIG 6.12 pg 205] Knee Joint: Potential Injury Positions page 205 Knee Joint: Potential Injury Positions turning the body while foot is fixed FIG 6.8 page 200 Knee Joint: Potential Injury Positions Deep Squat changing axis of rotation from knee joint to calf/thigh area FIG 6.11 page 204 Knee Joint: Potential Injury Positions rehabilitation of knee injuries page 260: studies on ACL stress, shear forces, petellofemoral contact ANKLE JOINT Bony arrangement = stability Ligaments play major role in stability flexion = dorsiflexion extension = plantar flexion FIG 6.13 page 207 SUBTALAR JOINT allows foot to navigate uneven surfaces inversion (sole in) and eversion (sole out) inversion with plantar flexion eversion with dorsiflexion FIG 6.15 page 209 Inversion during Plantar Flexion Muscles of Ankle & Foot Strength important on all sides Muscular imbalance = misalignment misalignment = line of g eccentric to joints weak dorsiflexors may cause shin splints overdeveloped inversion/plantar flexion muscles = prone to lateral ankle sprains Stretching Achilles Tendon Preventative measure for shin splints Achilles tendon = extension of both gastrocnemius and soleus muscles 2 dorsiflexion stretches: 1. with knee extended 2. with knee flexed Plantar Fasciitis Overuse Syndrome injury overload of stress at insertion of plantar surface fascia on calcaneous chronic therapy involves: 1. Strengthen plantar & dorsiflexors 2. Increase ROM in dorsiflexion see page 210 re Kibler et al study Walking LOCOMOTION Running Long support phase [65%] Shorter support phase always support phase non-support phase F vertical = 3 x body wt Ideal Alignments: LEG Lower extremities like columns supporting a roof Ideally as vertically aligned and as straight as possible to support the forces from above FIG 6.19 page 213 Ideal Alignments: FOOT FIG 6.20 page 214 a is Ideal FIG 6.21 Leg Length Inequities Anatomical - due to bone structure Functional - due to tilted pelvis Environmental - due to uneven ground Femoral Femur rotated medial medial facing patella frequent in FEMALES treatment: 1. Strengthen lateral hip rotators 2. Stretch medial hip rotators TORSION Tibial Tibia rotated lateral lateral facing patella frequent in MALES treatment: - muscular balance in all 3 hamstrings must be developed VARUS INWARD angle from proximal to distal lateral stress is proximal medial distal stress is VALGUS OUTWARD angle from proximal to distal medial stress is proximal lateral distal stress is Key Features of Good Shoes Heel well cushioned Heel Counter firm Arch Support firm Sole Width reasonable for stability Forefoot flexible & cushioned Toe Box with reasonable room Traction, Durability, Permeability