Chapter 4:
Kinesiology and Biomechanics
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction
• Anatomical terminology
• Kinesiology
• Body system conditions
• Biomechanics
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anatomical Terminology
• Kinesiology
– Study of human movement
• Biomechanics
– Study of effect of internal and external factors on
movement of living creatures
• Body mechanics
– Efficient and effective use of body while performing
massage
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anatomical Terminology—(cont.)
• Anatomical position
– Standing
– Feet shoulder-width
apart
– Arms at sides
– Palms facing forward
– Used as reference when
describing locations of
body structures
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Planes of Division
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Directional Terms
Term
Definition
Example
Anterior
Front side of body
Nose anterior to ears
Deep
More internal, deeper into body
Lungs deep to ribs
Distal
Farther from attachment point
Fingers distal to elbow
Inferior
Lower or toward the feet
Xiphoid process inferior to
sternal notch
Lateral
Farther away from midline
Ear lateral to eye
Medial
Closer to midline
Eye medial to ear
Posterior
Back side of the body
Spine posterior to sternum
Proximal
Closer to attachment point
Knee proximal to ankle
Superficial
Closer to the surface of the skin Skin superficial to muscle
Superior
Higher or toward the head
Nose superior to navel
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Directional Terms
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Anterior Body Regions
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Posterior Body Regions
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Kinesiology
• Arthrology (study of joints)
– Joint
• Mechanical structure where neighboring bones are
connected with connective tissue and cartilage
• Passive structure that allows movement to occur
• Provides stability and shock absorption
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Kinesiology—(cont.)
• Types of joints (by amount of movement allowed)
– Synarthrotic
• Nearly immovable, fibrous (skull sutures)
– Amphiarthrotic
• Slightly movable, cartilaginous (pubis symphysis,
between vertebrae)
– Diarthrotic (synovial)
• Freely movable, joint capsule with synovial fluid
(shoulder, hip, knee, elbow)
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Kinesiology—(cont.)
• Components of diarthrotic (synovial) joints
– Articular cartilage
– Bursae
– Joint capsule
– Joint cavity
– Ligaments
– Synovial membrane
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Types of Synovial Joints
Type of Joint
Characteristics
Location
Ball-and-socket Allows movement in all
directions
Shoulder and hip joints
Condyloid
Allows movement in
two planes
Metacarpophalangeal joints
Gliding
Bones slide past each
other (side to side)
Between carpals, between
tarsals
Hinge
Allows movement in
one plane
Elbow and knee joints
Pivot
Allows rotational
movement
Between C1 (atlas) and C2
(axis), between radius and
ulna
Saddle
Allows movement in
many directions
Carpometacarpal joint of the
thumb
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Kinesiology—(cont.)
• Range of motion (ROM)
– Amount of movement that occurs at a joint
– Normal ROM: distance and direction a joint can sustain
without damage to surrounding tissues
– Active ROM: client actively moves own joint
– Passive ROM: therapist moves client’s joint
– Resisted ROM: client moves joint while therapist resists
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Myology: The Study of Muscles
• Skeletal muscle contraction
– Nerve supply to muscles
• Cervical, brachial, lumbar, and sacral plexuses
– Neuromuscular junction
– Energy requirements (ATP)
• Direct phosphorylation
• Anaerobic cellular respiration
• Aerobic cellular respiration
– Proprioceptors
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Mechanisms for Generating ATP
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Myology: The Study of Muscles—(cont.)
• Types of muscle fibers
– Slow-twitch
• Smaller, red, aerobic
• Slow to contract, less powerful, long duration
– Fast-twitch
• Anaerobic
• Contract quickly and powerfully in short bursts
• Type IIa: pink and slightly larger than slow-twitch fibers
• Type IIx: white (no blood supply) and largest fibers
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Myology: The Study of Muscles—(cont.)
• Skeletal muscle activity
– Static contractions (isometric)
– Dynamic contractions
• Concentric
• Eccentric
– Extreme conditions
• Atrophy
• Hypertrophy
• Tetany
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Types of Contractions
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Myology: The Study of Muscles—(cont.)
• Muscle movement and coordination
– Prime movers
– Synergists
• Fixators (stabilizers or supporters)
– Antagonists
• Effects of exercise on muscles
• Effects of stretching on muscles
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Myology: The Study of Muscles—(cont.)
• Body movements
– Flexion/extension
– Abduction/adduction
– Horizontal
abduction/adduction
– Lateral flexion left/right
– Lateral/medial rotation
– Upward/downward
rotation
– Circumduction
– Opposition
– Lateral deviation
– Plantarflexion/
dorsiflexion
– Inversion/eversion
– Elevation/depression
– Protraction/retraction
– Pronation/supination
– Inhalation/exhalation
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Biomechanics
• Components of good body mechanics
– Efficient structural alignment
• Leaning
• Lifting
– Symmetric stance
– Asymmetric stance
– Ergonomics
• Equipment
• Workspace design
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Symmetric Stance
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Asymmetric Stance
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Sitting on a Chair to Conserve Energy
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Body Awareness
• Am I using my whole body?
• Is there a straight line formed by my head, hips, and
back foot?
• Are my hips and front foot facing my work?
• Are my wrists, hands, and shoulders relaxed?
• Are any of my joints hyperextended?
• Am I breathing?
• Does my body hurt anywhere?
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Improper Body Mechanics
• Body areas prone to injury
– Neck and shoulders
– Wrist and hands
– Back
– Knees
– Ankles and feet
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Improper Body Mechanics—(cont.)
• Injury prevention: stretching before and between
sessions
– Breathe deeply.
– Relax.
– Stretch slowly to avoid the stretch reflex.
– Hold the stretch for at least 10 seconds to trigger the
tendon reflex, which comfortably enhances the stretch.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Improper Body Mechanics—(cont.)
• Injury prevention: general guidelines
– Consistently use all components of good body mechanics.
– Rest body and hands by scheduling clients 15 minutes apart.
– Stretch before and after massage sessions.
– Use proper table height.
– Make sure you have plenty of room to move around table.
– Use a variety of techniques in your massage session.
– Be cautious with applications of sustained pressure.
– Increase physical fitness and endurance; get sleep and rest.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Summary
• Learn body mechanics in the classroom from your
instructor.
• Practice concepts of body mechanics outside the
classroom.
• Adopt working stances that minimize stress on your
body.
• Practice body awareness to find proper stances.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins