Chapter 1: Foundations Kinesiology and Body Mechanics - Kinesiology: study of motion or human movement - Anatomic kinesiology: study of human musculoskeletal system and musculotendinous system - Biomechanics: application of mechanical physics to human motion - Structural kinesiology: study of muscles as they are involved in science of movement. - Both skeletal and muscular structures are involved - Bones are different sizes and shapes particularly at the joints, which allow or limit movement. - Muscles vary greatly in size, shape, and structure from one part of body to another. - More than 600 muscles are found in the human body. Who need Kinesiology? - Anatomists - Coaches - Strength and conditioning specialists - Athletic trainers - Personal trainers - Nurses - Physical educators - Physical therapists - Occupational therapists - Physicians - Massage therapists and others in health-related fields Why Kinesiology? - Should have an adequate knowledge and understanding of all large muscle groups too teach others how to strengthen, improves, and maintain optimal function of the human body - Should not only know how and what to do in relation to conditioning and training but also know why specific exercises are done in conditioning and training of athletes - Through kinesiology and analysis of skills, physical educators can understand and improve specific aspects of physical conditioning - Understanding aspects of exercise physiology is also essential too coaches and physical educators. Reference and Body Positions - Basis from which to describe joint movements o Anatomical position o Fundamental position o Prone o Short sitting o Supine - Anatomical position - o Most widely used for accurate for all aspects of the body o Standing in an upright posture, facing straight ahead, feet parallel and close, with palms facing forward Fundamental position o Is essentially same as anatomical position except arms are at the sides and palms facing the body Fetal position o Lying on either side, spine flexed, head flexed toward chest and extremities flexed and drawn toward torso Hook lying or dorsal recumbent position o Supine with hips flexed approximately 45 degrees and knees flex approximately 90 degrees with feet flat on surface Lateral recumbent or lateral decubitus position o Lying on right or left side, knees and hips may be straight or slighting flexed Long sitting position o Sitting with legs extended forward, toes painted; trunk erect and hands on hips Prone position o Face-downward position of the body; lying on the stomach Short sitting position o Sitting upright with knees flexed and hanging over the edge of the surface Supine position o Face-upward position of the body; lying on the back Reference Lines - To further assist in understanding the location of one body part in relation to another o Mid-axillary line ▪ Line running vertically down surface of body passing through apex of axilla (armpit) o Mis-sternal line ▪ Line running vertically down surface of body passing through middle of sternum o Anterior axillary line ▪ Line parallel to mid-axillary line and passing through anterior axillary skinfold o Posterior axillary line ▪ Line that is parallel to mid-axillary line and passes through posterior axillary skinfold o Mid-clavicular line ▪ Line running vertically down surface of body passing through midpoint of clavicle o Mid-inguinal point ▪ Point midway between anterior superior iliac spine and pubis symphysis o Scapular line ▪ Line running vertically down posterior surface of body passing through inferior angle of scapula o Vertebral line ▪ Line running vertically down through spinous processes of spine Anatomical Directional Terminology - Anterior o In front of in the front part - Anteroinferior o In front and below - Anterosuperior o In front and above - Anterolateral o In front and to the side, especially the outside - Anteromedial o In front and toward the inner side or midline - Anteroposterior o Relating to both front and rear - Posterior o Behind, in back, or in the rear - Posteroinferior o Behind and below; in back and below - Posterolateral o Behind and to one side, specifically to the outside - Posteromedial o Behind and to the inner side - Posterosuperior o Behind and at the upper part - Contralateral o Pertaining or relating to the opposite side - Ipsilateral o On the same side - Bilateral o Relating to the right and left sides of the body or of a body structure such as the right and left extremities - Inferior (infra) o Below in relation to another structure; caudal - Superior (supra) o Above in relation to another structure; higher, cephalic - Inferolateral o Below and to the outside - Inferomedial o Below and toward the midline or inside - Superolateral o Above and toward the midline or inside - Caudal o Below in relation to another structure; inferior - Cephalic o Above in relation to another structure; higher, superior - - Rostral o Near, or toward the head, especially the front of the head Caudocephalad o Directionally from tail to head in the long axis of the body Cephalocaudal o Directionally from head to tail in the long axis of the body Deep o Beneath or below the surface; used to describe relative depth or location of muscles or tissue Superficial o Near the surface; used to describe relative depth or location of muscles or tissue Distal o Situated way from the center or midline of the body, or away from the point of origin Proximal o Nearest the trunk or the point of origin Proximodistal o From the center of the body out towards the distal Lateral o On or to the side; outside, farther from the median or midsagittal plane Medial o Relating to the middle or center; nearer to the medial or midsagittal plane Median o Relating to the middle or center; nearer to the median or midsagittal plane Dexter o Relating to or situated to the right or on the right side of something Sinister o Relating to or situated to the left or on the left side of something Dorsal o Relating to the back; being or located near, on, or toward the back, posterior part, or upper surface of o Also relating to the top of the foot Ventral o Relating to the belly or abdomen, on or toward the front, anterior part of Palmer o Relating to the palm or volar aspect of the hand Volar o Relating to palm of the hand or sole of the foot Fibular o Relating to fibular (lateral) side of knee, leg, ankle, or foot; also referref to as peroneal when specifically referring to the lateral leg Tibial o Relating to tibial (medial) side of knee, leg, ankle, or for Radial o Relating to radial (lateral) side of forearm or hand Ulnar o Relating to ulnar (medial) side of forearm or hand Anatomical Directional Terminology - Scapular plane o In line with normal resting position of scapular as it lies on posterior rib cage, movements in scapular plane are in line with scapular which is at angle of 30 to 45 degrees form frontal plane Alignment Variation Terminology - Anteversion o Abnormal or excessive rotation forward of a structure, such as femoral anteversion - Retroversion o Abnormal or excessive rotation backward of a structure, such as femoral retroversion - Kyphosis o Increased curving of the spine outward or backward in the sagittal plane - Lordosis o Increased curving of the spine inward or forward in the sagittal plane - Scoliosis o Lateral curving of the spine - Recurvatum o Bending backward, as in knee hyperextension - Valgus o Outward angulation of the distal segment of a bone or joint, as in knock-knees - Varus o Inward angulation of the distal segment of a bone ro joint, as in bowlegs Planes of Motion - Imaginary two-dimensional surface through which a limb or body segment is moved - Motion through a plane revolves around an axis - There is a ninety-degree relationship between a plane of motion an its axis Cardinal Planes of Motion - 3 basic or traditional o In relation to the body, not in relation to the earth - Anteroposterior or sagittal plane - Lateral or frontal plane - Transverse or horizontal plane - Sagittal or anteroposterior plane (A P) o Divides body into equal, bilateral segments o It bisects body into 2 equal symmetrical halves or a right and left half ▪ Ex: sit-up - Frontal, lateral, or coronal plane o Divides the body into (front) anterior and (back) posterior halves ▪ Ex: jumping jacks - Transverse, axial or horizontal plane o Divides body into (top) superior and (bottom) inferior halves when the individual is an anatomic position ▪ Ex: spinal rotation to left or right Diagonal Planes of Motion - Diagonal plane: involves combination of movements from traditional planes and occurs in joints that are capable of movement in two or more planes o Ex: high diagonal, low diagonal - Most obvious at multiaxial joints such as shoulder and hip but can involve biaxial joints - High diagonal o Upper limbs at shoulder joints o Overhand skills ▪ Ex: baseball pitch - Low diagonal o Upper limbs at shoulder joints o Underhand skills ▪ Ex: discuss thrower o Lower limbs at the hip joints ▪ Ex: kickers and punters Axes of Rotation - For movement to occur in a plane, it must turn or rotate about an axis as referred to previously - The axes are names in relation to their orientation - Frontal, coronal, lateral, mediolateral, or bilateral axis o Has same orientation as frontal plane of motion and runs from side to side perpendicular to sagittal plane of motion o Runs medial/lateral o Commonly includes flexion, extension movements o X-axis - Sagittal or anteroposterior axis o Has some orientation as sagittal plane of motion and runs from front to back perpendicular to frontal plane of motion o Runs anterior/posterior o Commonly includes abduction, adduction movements o Z-Axis - Vertical, long or longitudinal axis o Runs straight down through top of head is perpendicular to transverse plane of motion o Runs superior/inferior o Commonly includes internal rotation, external rotation movements o Y-Axis - Diagonal or oblique axis o Also known as the oblique axis o Runs at a right angle to the diagonal plane Body Regions - Axial o Cephalic (head) ▪ Cranium and face o Cervical (neck) o Trunk ▪ Thoracic (thorax), dorsal (back), abdominal (abdomen), and pelvic (pelvis) - Appendicular o Upper limbs ▪ Shoulder, arm, forearm, and manual o Lower limbs ▪ Thigh, leg, and pedal Skeletal System Osteology - Adult skeleton - 206 bones o Axial skeleton ▪ 80 bones o Appendicular ▪ 126 bones - Occasional variations Skeletal Functions - Protection of heart, lings, brain, etc. - Support to maintain posture - Movement by serving as points of attachment for muscles and acting as levers - Mineral storage such as calcium and phosphorus - Hemopoiesis: in vertebral bodies, femurs, humerus, ribs, and sternum o Process of blood cell formation in the red bone marrow Types of Bones - Long bones: humerus, fibula o Composed of a long cylindrical shaft with relatively wide, protruding ends o Shaft contains the medullary canal ▪ Ex: phalanges, metatarsals, metacarpals, tibia, fibula, femur, radius, ulna, and humerus - Short bones: carpals, tarsals o Small, cubical shaped, solid bones that usually have a proportionally large articular surface in order to articulate with more than one bone ▪ Ex: are carpals and tarsals - Flat bones: skull, scapula o Usually have a curved surface and vary from thick where tendons attach to very thin - ▪ Ex: ilium, ribs, sternum, clavicle, and scapula Irregular bones: pelvis, ethmoid, ear ossicles o Include boens throughout the entire spine and ischium, pubis, and maxilla Sesamoid bones: patella o Small bones embedded within tendon od a musculotendinous unit that provide protection and improve mechanical advantage of musculotendinous units ▪ Patella ▪ 1st metatarsophalangeal ▪ 1st metacarpophalangeal ▪ Mat be bipartite or tripartite Typical Bony Features - Diaphysis: long cylindrical shaft - Cortex: hard, dense compact bone forming walls of diaphysis - Periosteum: dense, fibrous membrane covering outer surface of diaphysis - Endosteum: fibrous membrane that lines the inside of the cortex - Medullary (marrow) cavity: between walls of diaphysis, containing yellow or fatty marrow - Epiphysis: ends of long bones formed from cancellous (spongy or trabecular) bone - Epiphyseal plate: (growth plate) thin cartilage plate separated diaphysis and epiphyses - Apophyses o Bony process with an independent center of ossification and associated growth plate, which serves as a point of attachment for a ligament or tendon o Close with skeletal maturity but are often inflamed with exercise or forces in adolescence ▪ Particularly tibial tuberosity (Osgood-Schlatter), calcaneus (Server’s), medial humeral epicondyle (Little League Elbow) and numerous locations on pelvis - Articular (hyaline) cartilage: covering the epiphysis to provide cushioning effect and reduce friction Bone Growth - Endochondral bones o Develop from hyaline cartilage o Hyaline cartilage masses at embryonic stage o Grow rapidly intro structures shaped similar to the bones which they will eventually become o Growth continues and gradually undergoes significant change to develop into ling bone - Longitudinal growth continues as long as epiphyseal plates are open - Shortly after adolescence, plates disappear and close - Most close by age 18, but some may be present until 25 - Growth in diameter continues throughout life - Internal layer of periosteum builds new concentric layers on old layers - Simultaneously, bone around sides of the medullary cavity is resorbes so that diameter is continually increased - Osteoblasts: cells that form new bone Osteoclasts: cells that resorb old bone Bone Properties - Composed of calcium carbonate, calcium phosphate, collagen and water o 60 to 70% of bone weight: calcium carbonate and calcium phosphate o 25 to 30% of bone weight: water - Collagen provides some flexibility and strength in resisting tension - Aging causes progressive loss of collagen and increases brittleness, particularly when accompanied by reduced activity and exercise - Most outer bone is cortical with cancellous underneath - Cortical bone: low porosity, 5 to 30% nonmineralized tissue - Cancellous: spongy, high porosity, 30 to 90% - Cortical is stiffer and can withstand greater stress, but less strain than cancellous - Cancellous is spongier and can undergo greater strain before fracturing - Wolff’s Law o Bone size and shape are influenced by the direction and magnitude of forces that are habitually applied to them o Bones reshape themselves based upon the stresses placed upon them o Bone mass increases over time with increased stress Bone Marking - Processes (including elevations and projections) o Processes that form joints ▪ Condyle ▪ Facet ▪ Head o Processes to which ligaments muscles or tendons attach ▪ Crest ▪ Epicondyle ▪ Line ▪ Process ▪ Spine (spinous process) ▪ Suture ▪ Trochanter ▪ Tubercle ▪ Tuberosity o Cavities (depressions): including opening and grooves ▪ Facet ▪ Foramen ▪ Fossa ▪ Fovea ▪ Meatus ▪ Sinus ▪ Sulcus (groove) Classification of Joints - Articulation or arthroses o Connection of bones at a joint usually to allow movement between surfaces of bones - Type and range of movements are similar in all humans; but the freedom, range, and vigor of movements are limited by configuration of bones where they fit together, ligaments and muscles - 3 major classifications according to structure and movement characteristics - Synarthrodial o Immoveable joints o Suture such as skull structures o Gomphosis such as teeth fitting into mandible or maxilla - Amphiarthrodial o Slightly moveable joints o Allow a slight amount of motion to occur ▪ Syndesmosis • Two bones joined together by a strong ligament or an interosseus membrane that allows minimal movement between the bones • Bones may or may not touch each other at the actual joint o Ex: coracoclavicular joint, distal tibiofibular joint ▪ Symphysis • Joint separated by a fibrocartilage pad that allows very slight movement between the bones o Ex: symphysis pubis and intervertebral discs ▪ Synchondrosis • Type of joint separated by hyaline cartilage that allows very slight movement between the bones o Ex: costochondral joints of the ribs with the sternum ▪ Diarthrodial • Known as synovial joints • Freely moveable • Composed of sleeve like joint capsule • Secretes synovial fluid to lubricate joint cavity - Diarthrodial Joints o Capsule thickenings form tough nonelastic ligaments that provide additional support against abnormal movement or joint opening o Articular or hyaline cartilage covers the articular surface ends of the bones inside the joint cavity ▪ Absorbs shock ▪ Protect the bone o Slowly absorbs synovial fluid during joint unloading or distraction o Secretes synovial fluid during subsequent weight bearing and compression maintaining and utilizing a joint through its normal range o Range of motion are important to sustaining joint health and function o Some diarthrodial joints have specialized fibrocartilage disks ▪ o o o o o o o o o Provide additional shock absorption, load distribution and further enhance joint stability • Medial and lateral menisci • Glenoid labrum • Acetabular labrum Diarthrodial joints have motion possible in one or more planes Degrees of freedom: corresponf to the cardinal planes of motion ▪ Motions in 1 plane = 1 degree of freedom ▪ Motion in 2 planes = 2 degrees of freedom ▪ Motion in 3 planes = 3 degrees of freedom Six types Each has a different type of bony arrangement ▪ Arthrodial ▪ Ginglymus ▪ Trochoid ▪ Condyloid ▪ Enarthrodial ▪ Sellar Arthrodial (gliding) joints ▪ 2 planes or flat bony surfaces which butt against each other ▪ Little motion possible in any 1 joint articulation ▪ Usually work together in series of articulations • Ex: Vertebral facets in spinal column, intercarpal and intertarsal joints ▪ Motions are flexion, extension, abduction, adduction, diagonal abduction and adduction and rotation (circumduction) Ginglymus (hinge) joint ▪ A uniaxial articulation ▪ Articular surfaces allow motion in only one plane • Ex: elbow, knee, talocrural (ankle) Trochoid (pivot, screw) joint ▪ Also uniaxial articulation • Ex: Atlantoaxial joint; odontoid which turns in a bony ring, proximal and distal radioulnar joints Condyloid (knuckle joint) ▪ Biaxial and socket joint ▪ One bone with an oval concave surface received by another bone with an oval convex surface ▪ Ex: 2nd, 3rd, 4th, and 5th metacarpophalangeal or knuckles joints, wrist articulation between carpals and radius ▪ Flexion, extension, abduction and adduction (circumduction) Enarthrodial ▪ Multiaxial or triaxial ball and socket joint ▪ Bony rounded head fitting into a concave articular surface ▪ Ex: hap and shoulder joint ▪ Motion are flexion, extension, abduction, adduction, diagonal abduction and adduction, rotation and circumduction o Sellar (saddle) joint ▪ Unique triaxial joint ▪ 2 reciprocally concave and convex articular sirfaces ▪ Example is 1st capometacarpal joint at thumb (some include sternoclavicular) ▪ Flexion, extension, adduction and abduction, circumduction and slight rotation Stability and Mobility of Diathrodial Joints - The more mobile a joint, the less stable and vice-versa o Both heredity and developmental factors (Wolff’s Law for bone and Davis’ Law for soft tissue) contribute to variances - Davis’ Law o Ligaments, muscle and other soft tissue when placed under appropriate tension will adapt over time by lengthening and conversely when maintained in a loose or shorted state over a period of time will gradually shorten - 5 major factors affect total stability and consequently mobility of a joint o Bones ▪ Usually very similar in bilateral comparisons within an individual ▪ Actual anatomical configuration at joint surfaces in terms of depth and shallowness may vary significantly between individual o Cartilage ▪ Structure of both hyaline cartilage and specialized cartilaginous structures (knee menisci, glenoid labrum and acetabular labrum) further assist in joint congruency and stability ▪ Normally the same in bilateral comparisons within but may vary between individuals in size and configuration o Ligaments and connective tissue ▪ Provide static stability to joints ▪ Variances exist between individuals in degree of restrictiveness of ligamentous tissue ▪ Amount of hypo- or hyperlaxity of an individual is primarily due to proportional amount of elastin versus collagen within joint structures ▪ Individuals with proportionally higher elastin to collagen ratios are hyperlax or “loose-jointed” whereas individuals with proportionally lower ratios are tighter o Muscles ▪ Provide dynamic stability to joints when actively contracting ▪ Without active tension via a contraction muscles provide minimal static stability ▪ Strength and endurance are significant factors in stabilizing joints ▪ Muscle flexibility may affect the total range of joint motion possible o Proprioception and motor control ▪ Proprioception and motor control • - Proprioception: subconscious mechanism by which body is able to regulate posture and movements by responding to stimuli originating in proprioceptors embedded in joints, tendons, muscles and inner ear • Motor control: process by which body actions and movements are organized and executed • To determine the appropriate amount of muscular forces and joint activations needed o Sensory information from environment and body must be integrated and then coordinated in a cooperative manner between central nervous system and musculoskeletal system • Muscle strength and endurance are not very useful in providing joint stability unless activated precisely when needed 5 factors affecting total joint stability and mobility o Structural integrity may be affected by acute or chronic injury o Structures adapt over time both positively and negatively to specific biomechanical demands placed upon them o When any above factos are compromised additional demands are placed on remaining structures to provide stability which, in turn, may compromise their integrity, resulting in abnormal mobility o This abnormal mobility (hypermobility or hypomobility) may lead to further pathological conditions such as tendinitis, bursitis, arthritis, internal derangement and joint subluxations Open Packed versus Closed Packed Joint Positions - Any diarthrodial joint may be have more or less stability depending upon the position it is in related to its full range of motion o Close packed joint position ▪ Joints are most stable to translatory movement when in a close-packed postion; typically maximal extension for most joints ▪ Minimal joint volume with maximal congruency and area of surface contact between joint surfaces ▪ Ligaments and capsular structures are farthest apart taut ▪ Joint is mechanically compressed and is at its least distractible point • Ex: include full extension of knee, hip and elbow o Open or loose packed joint position ▪ Joint positions where the ligaments and capsular structures are in their slackest position ▪ Minimal joint surface contact and congruency with maximal joint volume ▪ Minimal stability; allows maximal distraction of the joint surfaces ▪ For most joints, typically midway between the extremes of a joint’s range of motion • Ex: approximately 70 degrees of elbow flexion, 25 degrees of knee flexion, and 30 degrees of flexion and abduction for the hip o Open packed versus close packed joint positions ▪ ▪ ▪ ▪ Some joints permit only flexion and extension Other permit a wide range of movements, depending largely on the joint structure Goniometer: used to measure amount of movement in a joint or measure joint angles Inclinometers: may also be used Range of Motion - Area through which a joint may normally be freely and painlessly moved - Measurable degree of movement protentional in joints or joints - Measured with a goniometer in degrees 0 to 360 Movements in Joints - Goniometer axis is placed even with axis of rotation at joint line - As joint is moved, goniometer arms are held in place either along or parallel to long axis of bones on either side of joint - Joint angle is then read from goniometer - Normal range of motion for a particular joint varies in people - Terms are used to describe actual change in position of bones relative to each other - Angles between bones change - Movement occurs between articular surfaces of joint o “Flexing the knee” results in leg moving closer to thigh o “flexion of the leg” = flexion of the knee - Movement terms describe movement occurring throughout the full range of motion or through a very small range o Example 1: flex knee through full range by beginning in full knee extension (zero degrees of knee flexion) and flex it fully so that the heel comes in contact with buttocks, which is approximately 140 degrees of flexion o Example 2: begin with knee in 90 degrees of flexion and then flex it 30 degrees which results in a knee flexion angle of 120 degrees, even though the knee only flexed 30 degrees ▪ In both example 1 and 2 knee is in different degrees of flexion o Example 3: begin with knee in 90 degrees of flexion and extend it 40 degrees, which would result in a flexion angle of 50 degrees ▪ Even though the knee extended, it is still flexed - Some movement terms describe motion at several joints throughout body - Some terms are relatively specific to a joint oor group of joints o Additionally, prefixes may be combines with these terms to emphasize excessive or reduced motion ▪ Hyper- or hypoo Hyperextension is the most commonly used Movement Terminology General - Abduction - - - - - - - - o Lateral movement away from anatomical position in lateral plane o Raising arms or thighs to side horizontally Adduction o Movement medially toward and/or across midline of trunk in lateral plane o Lowering arm to side or thigh back to anatomical position Flexion o Bending movement that results in a decrease of angle in joint by bringing bones together, usually in sagittal plane o Elbow to joint when hand is drawn to shoulder Extension o Straightening movement that results in an increase of angle in joint by moving bones apart, usually in sagittal plane o Elbow joint when hand moves away from shoulder Circumduction o Circular movement of a limb that delineates an arc or describes a cone o Combination of flexion, extension, abduction, and adduction o When shoulder joint and hip joint moves in a circular fashion around a fixed point o Also referred to as circumflexion Diagonal abduction o Movement by a limb through a diagonal plane away from midline of body Diagonal adduction o Movement by a limb through a diagonal plane toward and across midline of body External Rotation o Rotary movement around longitudinal axis of a bone away from midline of body o Occurs in transverse plane o A.K.A. rotation laterally, outward rotation and lateral rotation Internal rotation o Rotary movement around longitudinal axis of a bone toward midline of body o Occurs in transverse plane o A.K.A. rotation medially, inwards rotation and medial rotation Ankle and Foot (Subtalar and Transverse Tarsal) o Eversion ▪ Turning subtalar and transverse tarsal joints outward or laterally in frontal plane ▪ Standing with weight on inner edge of foot o Inversion ▪ Turning subtalar and transverse tarsal joints inward or medially in frontal plane ▪ Standing with weight on outer edge of foot Ankle (Talocrural) and Foot o Dorsal flexion ▪ Flexion movement of ankle that results in top of foot moving toward anterior tibia o Plantar flexion ▪ Extension movement of ankle that results in foot moving away from body Ankle and Foot o Pronation ▪ A combination of ankle dorsiflexion, subtalar eversion, and forefoor abduction (toe-out) o Supination ▪ A combination of ankle plantar flexion, subtalar inversion and forefoot adduction (toe-in) - Radioulnar Joint o Pronation ▪ Internally rotating radius where it lies diagonally across ulna, resulting in palm-down position of forearm o Supination ▪ Externally rotating radius where it lies parallel to ulna, resulting in palmup position of forearm Radioulnar Joint - Pronation o Internally rotating radius where it lies diagonally across ulna, resulting in palmdown position of forearm - Supination o Externally rotating radius where it lies parallel to ulna, resulting in palm-up position of forearm Shoulder (Scapulothoracic) Girdle - Depression o Inferior movement of shoulder girdle o Returning to normal position from a shoulder shrug - Elevation o Superior movement of shoulder girdle o Shrugging the shoulders - Protraction o Forward movement of shoulder girdle away from spine o Abduction of the scapula - Retraction o Backward movement of shoulder girdle toward spine o Adduct6ion of the scapula - Rotation downward o Rotary movement of scapula with inferior angle of scapula moving medially and downward - Rotation upward o Rotary movement of scapula with inferior angle of scapula moving laterally and upward Shoulder (Glenohumeral) Joint - Horizontal abduction o Movement of humerus in horizontal plane away from midline of body o Also known as horizontal extension or transverse abduction - Horizontal adduction - o Movement of humerus in horizontal plane toward from midline of body o Also known as horizontal extension or transverse adduction Scaption o Movement of the humerus away from the body in the scapular plane o Glenohumeral abduction in a plane 30 to 45 degrees between the sagittal and frontal planes Spine - Lateral flexion (side bending) o Movement of head and/or trunk laterally away from midline o Abduction of spine - Reduction o Return of spinal column to anatomic position from lateral flexion o Adduction of spine Wrist and Hand - Palmer flexion o Flexion movement of wrist with volar or anterior side of hand moving toward anterior side of forearm - Dorsal flexion (dorsiflexion) o Extension movement of wrist in the sagittal plane with dorsal or posterior side of hand moving toward posterior side of forearm - Radial flexion (radial deviation) o Abduction movement at wrist of thumb side of hand toward forearm - Ulnar flexion (ulnar deviation) o Adduction movement at wrist of little finger side of hand toward forearm - Opposition of the thumb o Diagonal movement of thumb across palmer surface of hand to make contact with the hand and/or fingers - Reposition of the thumb o Diagonal movement of the thumb as it returns to the anatomical position from opposition with the hand and/or fingers Physiological Movements versus Accessory Motions - Physiological movement: flexion, extension, abduction, adduction, and rotation o Occur by bones moving through planes of motion about an axis of rotation at joint - Osteokinematic motion: resulting motion of bones relative to 3 cardinal planes form these physiological movements - For osteokinematic motions to occur there must be movement between the joint articular surfaces - Arthrokinematics: motion between articular surfaces - 3 specific types of accessory motion o Spin o Roll o Glide - - If accessory motion is prevented from occurring, then physiological motion cannot to any substantial degree other than by joint compression or distraction Due to most diarthrodial joints being composed of a concave surface articulating with a convex surface roll and glide must occur together to some degree Example 1: as a person from a squatted position the femur must roll forward and simultaneously slide backward on the tibia for the knee to extend o If not for the slide, the femur would roll off the front of the tibia o If not for the roll, the femur would slide off the back of the tibia Spin may occur in isolation or in combination with roll and glide As the knee flexes and extends spin occurs to some degree o In example 1, the femur spins medially or internally rotates as the knee reaches full extension Roll (rock): a series of points on one articular surface contacts with a series of points on another articular surface Glide (slide) (translation): a specific point on one articulating surface comes in contact with a series of points on another surface Spin: a single point on one articular surface rotates about a single point on another articular surface o Motions occurs around some stationary longitudinal mechanical axis in either a clockwise or counterclockwise direction Concave-Convex Rule - States that when any convex joint surface moves on a concave surface roll and glide must occur in opposite direction AND that when a concave surface moves on a convex surface roll and glide occur in same direction o Example: Tibiofemoral joint (convex on concave) with tibia (concave) stationary and femur (convex) moves from flexion into extension representing convex movement on a concave surface; femur must slide backward as it rolls forward o When going down from extension to flexion in a squat, femur must roll backward as it slides forward o Example: Tibiofemoral joint (concave on convex) in standing with knee flexed and going into knee extension, femur (convex) is stationary and tibia (concave) moves from flexion to extension; tibia slides forward as it rolls forward o When going from knee extension into knee flexion as in a standing hamstring curl, knee is flexing by tibia sliding and rolling backward on femur
