Muscles Introduction: The muscles are classified into: 1. Skeletal 2. Cardiac 3. Smooth.

Skeletal muscles are the prime movers of the human body. The forces they produce under the control of the nervous system act on the bones to which they are attached to create the propulsive forces necessary for human movement. an has !"# skeletal muscles of many shapes and si$es % from the tiny stapedius muscle of the middle ear to the massive hip e&tensor' the (luteus ma&imus). uscles are situated across *oints and are attached at two or more points to bony levers. +ach muscle is well adapted to provide an appropriate ran(e' direction and force of contraction to meet the habitual re,uirements at the articulations over which it passes. -roperties of Skeletal uscles: 1. Irritability : is the ability of the muscle to respond to stimulus. 2. Contracility: is the capacity of the muscle to produce tension between it.s ends. 3. /ela&ation: is the opposite of contraction and is the (ivin( up of tension. 0oth contraction and rela&ation pro(ress from $ero to ma&imal values over a finite time. ". 1istensibility: is the ability of the muscle to be stretched or len(thened up to a certain limit by an outside force2 e.(. pull of an anta(onist muscle' of (ravity or by an opponent. The muscle suffers no harm so lon( as it is not stretched beyond its physiolo(ical limits. 3. +lasticity: is the ability of the muscle to recoil to its ori(inal len(th when an outside force is removed unless it has been overstretched.

Biomechanics - PHTH 208

Factors Influencing Muscle Function

Shape and Fascicular Architecture

Myoglobin contents and fiber type

Contraction type

Muscular attachment

Muscle Function

Physiological cross section

Relation to joint structure and muscle length Number of joints traversed

Interaction in joint movement

Biomechanics - PHTH 208

10

4unction of the skeletal uscles: 1. Create the propulsive force responsible for human movement and positionin( of the bony se(ments of the body. 2. 5ive shape to body se(ments. 3. 4orm supportive walls. Classification of uscles: 1. 6ccordin( to the shape and fascicular architecture: a. b. c. -arallel: spindle. 7bli,ue: e.(. pinnate. Spiral: Supinator.

The muscles desi(ned for stren(th are of pinnate type and the ones desi(ned for speed have parallel fibers. 2. 6ccordin( to the myoglobin content: a. /ed: contain more red fibers and they are responsible for movement' which re,uire slow action for a lon( time e.( anti(ravity muscles. b. 8hite: contain more white fibers and they are responsible for movement' which re,uire rapid action for a short time. 3. 6ccordin( to the type of contractile activity: a. Tonic muscles 9stabili$ers): it demonstrates continuous low level of contractile activity which is re,uired to maintain a (iven posture. b. -hasic muscle 9mobili$ers): it demonstrates rapid 9fast twitch) activity which is re,uired when chan(in( from one position to another. ". 6ccordin( to (eneral limb appearance: a. Contractors: those muscles pull the body into appro&imation of the fetal position e.(. fle&or adductors and medial rotators.

Biomechanics - PHTH 208

11

b. +&panders: those muscles which e&pand or open up the body e.(. e&tensors. 6bductors and lateral rotators. 3. 6ccordin( to the relative magnitude of their stabilizing and rotatory components 9muscle attachments): a. Spurt: mainly rotator muscles which have their ori(in away from the *oint and their insertion near to the *oint e.(. biceps muscle. b. Shunt: mainly stabili$er muscles which have ori(in near the *oint and their insertion away from the *oint e.(. brachio:radialis. !. 6ccordin( to the orientation of the line of pull to the *oint structure: 9 e.(. fle&ors' e&tensors' abductors and adductors) The muscle located anterior to a *oint may be e&tensor as in the case of the knee *oint or may be fle&or as in the case of the elbow *oint. The possible a&es of motion are determined by the structure of the *oint itself. ;. 6ccordin( to the number of joints over which the muscle crosses: a. 7ne *oint muscle 9 e.(. vastus mediales). b. Two *oint muscle9 e.(. rectus femoris). c. ulti:*oint muscle 9 e.(. fin(er fle&ors). <. 6ccordin( to the type of muscle action or function 9their interaction in *oint movement): 7ne action of the *oint is not only the responsibility of one muscle but it is the responsibility of different (roups of muscles' which can be classified as follows: 6(onists' anta(onists' syner(ists' fi&ators.

Biomechanics - PHTH 208

12

Types of muscle actions or functions: 1. Agonists: 6nta(onists are the muscles which contract to perform a certain action and they include: a) Prime movers: uscles which make the ma*or contribution in any contraction 9 e.(. iliopsoas in hip fle&ion movement). b) Secondary movers: uscles which cross the same *oint but make less contribution in the movement. They are also called accessory or assisted movers. They act sometimes as prime movers when the force re,uired increases or paralysis occurs 9e.(. Sartorius in hip fle&ion). 2. Antagonists:

They are muscles which oppose the prime movers as they rela& and len(then pro(ressively to allow a(onists to move. Therefore' the movement is controlled but not impeded. 4or every action' there are a(onists and anta(onists 9e.(. 5luteus ma&imus is anta(onist for iliopsoas). . !ynergists:

Syner(ists are muscles that work to(ether in a close cooperation as they either contract or rela& to modify the action of the a(onist. Their aim is: : To make the a(onist stron(er. To eliminate the action of undesired movement. They may alter the direction of pull and that depends on their power in relation to the a(onist muscle. Types of Syner(ists: a) Conjoint. b) Neutralizer. c) Stabilizer.

Biomechanics - PHTH 208

13

a) Conjoint: They are the two muscles actin( to(ether to produce a certain movement which neither of them could produce it alone. They are considered as prime movers of a(onists and they are parallel to each other. +.(. tibialis anterior and peroneous tertious work to(ether to produce dorsifle&ion. b) Neutralizer: They are the muscles that neutrali$e or cancel the undesired action of other muscles of prime movers or secondary movers. This is more apparent in two: *oint muscles which pass across more than one *oint and they are capable of performin( more than one action which are not needed' so the other muscles or neutrali$ers must contract to counteract the undesired movement. 1. =eutrali$ers around the tar(et *oint: i. To oppose the undesired action of the prime movers if it crosses bi: or multi:a&ial *oints 9e.(. lateral rotators neutrali$e undesired motion of adductors of medial rotation durin( hip adduction). ii. To oppose the undesired action of the secondary movers 9e.(. internal rotators neutrali$e the action of sartorius durin( hip fle&ion). 2. =eutrali$ers for undesired motion on another *oint in case of two *oint muscles. 4or e&ample: Contraction of the fin(er fle&ors to (rasp an ob*ect also tend to fle& the wrist. The unwanted wrist fle&ion is neutrali$ed by wrist e&tensors. c) Stabilizers: Stabili$ers are the muscles that surround the pro&imal *oint. They contract and become firm to allow distal *oint to move smoothly. Their contraction is (enerally isometric 9e.(. the rotator cuff muscles all contribute their opposin( tension to support the humeral head a(ainst the (lenoid fossa when the arm is moved away from the body and the hand reaches for an ob*ect). ". Fi#ators: 4i&ators are the muscles which contract in both a(onists and anta(onists simultaneously and that occur especially under stress conditions. The tension will develop inside both (roups of muscles to prevent any de(ree of freedom. That occurs in normal physiolo(ical conditions durin( strenuous effort and increased demand 9e.(. durin( standin( on one le().
Biomechanics - PHTH 208 14

/an(e of uscle +&tensibility and Contractility: The ma&imal de(ree of an(ular displacement of a body se(ment possible at (iven *oints affects all muscles crossin( that *oint. The full ran(e of e&tensibility and contractility of a muscle is called functional e&cursion or it.s amplitude. The e&cursion depends on the arran(ement of muscle fibers and whether the muscle is a one: *oint or a multi: *oint muscle with an avera(e ma(nitude of 3;> of their restin( len(th. 1. 2. 3. ". 3. 6ny muscle crossin( a sin(le *oint is normally capable of shortenin( sufficiently e&tensible to permit a full ran(e of motion in the opposite direction. The absolute amount by which any muscle can shorten depends on: ?en(th of arran(ement of fibers 9for pinnate muscles it depends on cos an(le of theta of the tendon). Structure of *oint. =umber of *oint traversed. /esistance of anta(onists. -resence of load that oppose the muscle.

6ny muscle crossin( more than one *oint produce motion at the same time in these *oints whenever it (enerates tension up its certain len(th. Its efficiency in movin( +ach *oint depends on the instantaneous len(th of the moment arm at each *oint and the amount of force that the muscle is e&ertin( for e.(. the rectus femoris muscle is more effective as knee e&tensor than hip fle&or because its moment arm at the hip *oint is about 3'" cm at the knee *oint is about "'" cm. The two *oint muscles have two different patterns of action which are: 1. Concurrent pattern occur when simultaneous movement of fle&ion or e&tension occur in two *oints. 2. Countercurrent pattern occur when one of the two *oint muscles shorten rapidly at both *oints its anta(onist len(thens correspondin(ly and thereby (ains tension at both ends.

Biomechanics - PHTH 208

15

+.(. the rapid loss of tension in the rectus femoris and correspondin( (ain of tension in the hamstrin(s when the hip is fle&ed and the knee is e&tended simultaneously. Tendon 6ction of two *oint muscles: Tendon action is a passive tension without active muscles contraction that may produce movement of the *oint if the muscle is elon(ated over two *oints or more than two simultaneously. +.(. if the wrist is allowed to fle& by the wei(ht of the hand the di(its will automatically e&tend without contraction of the fin(er e&tensors. 0y reversin( the wrist movement' the fin(ers will partially fle&.

$A%%&'(! )F M*!+,& A+%I)( 1. 2. +oncurrent Same movement on both *oints simultaneously. @ip fle&ion A knee fle&ion by B /ectus 4emorisC D @amstrin( E two muscles or more +ounter-current 1. 7pposite movement on both *oints. 2. @ip fle&ion A knee e&tension by /ectus 4emoris E only one muscle or (roup of muscles in one direction. 3. The muscle will be shortened at both ends simultaneously.

3. +ach muscle has a shortened end and an elon(ated end simultaneously.

". Tension will be transmitted from the ". Tension will be transmitted from the shortened end to the elon(ated end of shortened muscle to the opposite the same muscle. elon(ated (roup of muscles.

Biomechanics - PHTH 208

16

uscle Insuffisciency: If a muscle which crosses two or more *oints produces simultaneous movement at all of the *oints that it crosses' it soon reaches a len(th of which it can no lon(er (enerate a useful amount of tension. I.e. The muscle can not shorten beyond a certain limit without loosin( tension and this is called active insufficiency 9 e.(. ma&imal hip fle&ion with knee e&tension from a supine lyin( position). 8hen a full ran(e of motion at any *oint or *oints that the muscle crosses is limited by that muscle len(th' it is called passive insufficiency. It is defined as follows: the muscle can not e stretched beyond certain limits without causin( pain. 9e. (. when a person tries to fle& the hip fully with ma&imal knee e&tension' he usually feels pain in the hamstrin( muscle if he has ti(ht hamstrin(s. =.0.: 8hen active insufficiency is present in one (roup of muscles' this does not mean that the opposite (roup of muscles will suffer from passive insufficiency.

-hysiolo(ical Cross section of a muscle: The physiolo(ical cross section of a muscle determine its potential force of contraction 9absolute muscle stren(th is reco(ni$ed to be 3:" k( per s, cm cross section). -hysiolo(ical cross section is defined as the area of a section that cut every muscle fibers makin( up of the muscle and its level of hypertrophy. It is an indication of the muscle .or/ capacity to(ether with the distance which the muscle can shorten as its functions in the human body : 9 work) E 9 force & distance).

Biomechanics - PHTH 208

17

Types of bodily movements ovements can be classified into: 1. $assive: Sub*ect is rela&ed and movement is performed by any outside force. 2. Active: Is volitionally performed or refle& reaction to an e&ternal stimulus. It is divided into: a. Slow or rapid tension movement that involve constant application of force. b. Ballistic movement: ovement is initiated by vi(orous muscular contraction and completed by momentum. 0allistic movement is terminated by: - Contraction of anta(onist muscles. - /eachin( the limit of motion and it will be stopped by the passive resistance of li(aments or muscles. - Interference of an obstacle.

Biomechanics - PHTH 208

18

0oints 1efinition: Foint is the articulation between any of ri(id component parts of the skeleton whether bones or cartila(e by different tissues. 4unctions of the *oints: 1. 6llowin( movements of body se(ments by providin( the bones with a mean of movin( or rather of bein( moved. 2. -rovidin( stability without interferin( with the desired motion. The function of the *oints depends upon: 1. The shape of the contours of the contactin( surfaces. 2. @ow well it fits to(ether. The lar(er conve& surface is termed the male surface where as the smaller concave surface is called the female surface. ovements of the *oint surfaces: 1. Spinnin(. 2. /ollin(. 3. Slidin(. 1. In spinnin(' the contact point of one surface rotates around a lon(itudinal a&is. 2. In rollin(' e,uidistant points touch each other in the course of motion. 3. In slidin(' a point of a shallow concave (lidin( surface sweeps over a lar(er surface of the other conve& *oint body. /an(e of motion: /an(e of motion is the ma&imum amount of displacement possible at any *oint.
Biomechanics - PHTH 208 19

%1$&! )F 0)I(% M)2&M&(%! 1) 2) 3) Spinnin( /ollin( Slidin(

+)(3'*&(+& )F A'%I+*,A' !*'FA+&! a) C?7S+:-6CG+1 -7SITI7= 74 T@+ F7I=T . b) ?77S+: -6CG+1 -7SITI7=

Biomechanics - PHTH 208

20

0ody link System and Ginematic Chains: 0ody link system: Body lin! is the distance between *oint a&es and it unites *oint a&es. 6 body link is the central strai(ht link that e&tends between two *oint a&es of rotation. In the case of hands and feet' the terminal links are considered to e&tend from the wrist and ankle *oint centers to the center of the mass of these so: called and members. ?ink systems are interconnected by *oints that predetermine the particular type of motion permitted to the functional se(ments. The link system is used to make calculations re(ardin( different body se(ments in different positions. Ginematic chain : It is a combination of several successively arran(ed *oints constitutin( a comple& motor system. "inematic chain is when a number of links are united in series. The kinematic chain may be open or closed. In a closed !inematic chain' the distal se(ment is fi&ed and the end se(ments are unite to form a rin( or a circuit. 8hen one link moves all the other links will move in a predictable pattern. e.(. the rib ca(e. In an open !inematic chain' the distal se(ment terminates free in space. +ach se(ment of an open chain has a characteristic de(ree of freedom of motion2 the distal possessin( a hi(her de(ree of freedom than the pro&imal ones. Such linka(e system allows the de(rees of freedom of the many *oints in the chain to be pooled (ivin( the se(ments 9particularly those more distal) (reater

Biomechanics - PHTH 208

21

potential for achievin( a variety of movements than any one *oint could possibly have on its own. e.(. when reachin( forward to pick up a small ob*ect from a hi(h shelf.

4inematic chains

#P$N C%&'N The distal end terminates free in space. It has a characteristic de(ree of freedom. The distal se(ments possess hi(her de(rees of freedom than the pro&imal one. Such linka(e system allows the de(ree of freedom of many *oints in the chain to be pooled (ivin( the se(ments (reater potential for achievin( a variety of movements than can any one *oint could possibly have on its own.

C(#S$) C%&'N The distal se(ment is fi&ed and 1) the terminal *oint meets with (reat resistance which restraints its free motion. e.(. chinnin( oneself on hori$ontal bar or stance phase of (ait cycle. 2) end se(ments are united to form a rin( when one link moves' the other links will move in a predictable pattern e.(.rib ca(e.

8alkin( and ascendin( and descendin( stairs are e&amples of alternation between open and closed chains

#pen !inematic chains are the most common type in the human body

Biomechanics - PHTH 208

22

1e(ree of 4reedom: )e*ree of freedom is a term desi(nated to describe mechanics re(ardin( possible movements around a fi&ed or relatively fi&ed a&is. 6 *oint may have one de(ree of freedom if it allows movements around one a&is only' e.(. fle&ion and e&tension of the elbow *oint. 6 *oint with two de(rees of freedom allows movement to take place about two main a&es2 e.(. fle&ion and abduction and adduction and e&tension of metacarpo: phalan(eal *oint. 6 *oint which possess three de(rees of freedom' such as the shoulder *oint' allows fle&ion' abduction' and internal and e&ternal rotation. 4actors 6ffectin( Foint Stability 9 /esistance to 1isplacement) 1. Shape of the bony structure: e.(. depth of the acetabulum of the hip *oint and shallowness of the (lenoid fossa of the shoulder *oint. 2. (i*aments &rran*ement: the li(aments attach the ends of the bones that form a movable *oint and help in maintainin( them in the ri(ht relationship to each other. They check the movement when it reaches its normal limits and the resist the movements for which the *oint is not constructed' e.( collateral li(ament of the knee. The importance of this factor remains as lon( as the li(aments remain undama(ed. 3. +ascia: 6ccordin(ly to the location and function of the fascia' it may vary from thin to tou(h and fibrous membranes. ". ,uscular &rran*ement: They play part in the stability of *oints especially in those *oints whose bony structure contribute little to stability2 e.(. rotator cuff of the shoulder have stron( inwards pull on the humeral head toward the (lenoid fossa.

Biomechanics - PHTH 208

23

3. &tmospheric Pressure: It plays a role mainly in the hip *oint.

4actors 6ffectin( /an(e of otion: 1. Shape of articular surfaces. 2. /estrainin( effect of the li(aments and muscles crossin( the *oint as well as overlyin( skin. 3. Controllin( and restrainin( action of the muscles e.(. hamstrin( muscles ti(htness when attemptin( to touch the floor. ". 0ody build: esomorph and ectomorph have usually a (reater fle&ibility than endomorph. !. The bulk of tissue in the ad*acent se(ments. ;. -ersonal e&ercise habits. <. Current state of physical fitness. %. 6(e. 1#. @eredity. =.0.: 6pparent ran(e of motion can be affected by the close relationship that e&ists between certain *oints. +.(. relationship of pelvic tiltin( to movement of the hip and relationship of the shoulder (irdle articulation to movement of the shoulder *oint.

Biomechanics - PHTH 208

24

Classification of Foints

Biomechanics - PHTH 208

25

Close: packed and ?oose: packed -ositions Close -acked -osition: Close packed position is the position where the surfaces fit precisely to(ether and where there is ma&imal contact between the male and female surfaces. It is the position where the articular surfaces are pressed firmly to(ether and no movement becomes possible between them. The li(aments are taut and twisted. This position is the final limitin( position of the *oint. In this position' the *oint is liable to traumatic dama(e. C?7S+ H -6CG+1 -7SITI7= 74 F7I=TS 9 in alphabetical order) F7I=T 6cromioclavicular 6nkle +lbow 9 radiohumeral) +lbow 9 ulnohumeral) 4acet 9 spine) 5lenohumeral @ip Interphalen(eal 9 fin(ers) Interphalen(eal 9 toes) Gnee etacarpophalen(eal 9 thumb) etacarpophalen(eal 9 fin(ers) etactarsophalen(eal idtarsal C?7S+: -6CG+1 -7SITI7= Shoulder abducted to 3# de(rees a&imal dorsifle&ion +lbow fle&ed at %# de(rees 3 de(rees of supination a&imal elbow e&tension a&imal e&tension a&imal shoulder abduction and lateral rotation a&imal e&tension of the hip and ma&imal medial rotation of the hip a&imal e&tension of I- *oints a&imal e&tension of I- *oints a&imal e&tension and ma&imal lateral rotation a&imal opposition a&imal fle&ion a&imal e&tension of - *oints a&imal supination

Biomechanics - PHTH 208

26

/adiocarpal /adioulnar 9 distal) /adioulnar 9pro&imal) Sternoclavicular Subtalar Tarsometatarsal ?oose -acked -osition:

a&imal e&tension and ma&imal ulnar deviation 3 de(rees of supination 3 de(rees of supination a&imal shoulder elevation a&imal supination a&imal supination

It is the position at which the *oint is not in the close packed position. In these positions' the articular surfaces do not fit each other well and allow surfaces *oint movements to occur such as spinnin(' rollin( and (lidin(. There is la&ity of the capsular structures. In a ma&imum loose packed position' the *oint capsule is most rela&ed but not the musculature 9rollin(' spinnin( and slidin(). It also decreases friction between the articular surfaces and allows lubrication. The ma&imum loose packed position is the position in which the capsule and the li(aments are most la& and separation of *oint surfaces is (reatest. ?77S+ : -6CG+1 -7SITI7= 74 F7I=TS 9 in alphabetical order) F7I=T 6nkle Carpometacarpal +lbow9 radiohumeral) +lbow9 ulnohumeral) 4acet 9 spine) 5lenohumeral @ip Interphalan(eal 9fin(ers) Interphalan(eal 9toes) Gnee etacarpophalan(eal etatarsophalan(eal idtarsal /adiocarpal /adioulnar9 distal)
Biomechanics - PHTH 208

?77S+ H -6CG+1 -7ISTI7= 1# de(rees of plantar fle&ion 6natomical position of the wrist 6natomical position ;# de(rees of elbow fle&ion' 1# de(rees of supination idway between fle&ion and e&tension 33 de(rees of shoulder abduction' 3# de(rees of hori$ontal adduction 3# de(rees hip fle&ion' 3# de(rees of hip abduction and sli(ht lateral rotation of the hip Sli(ht fle&ion of I- *oints Sli(ht fle&ion of I- *oints 23 de(rees of knee fle&ion Sli(ht fle&ion of C- *oints idran(e position idran(e position 6natomical position relative to fle&ion and e&tension with sli(ht ulnar deviation 1# de(rees of supination
27

/adioulnar9pro&imal) Sternoclavicu2ar Subtalar Tarsometatarsal Temporomandibular

;# de(rees of elbow fle&ion' 33 de(rees of supination Shoulder in anatomical position idran(e position idran(e position outh sli(htly open +enter of 3ravity

5efinitions: The center of (ravity is defined as: The balancin(' e,uilibrium or pivotin( point if the body. It is the point where the sum of all the forces and force movements actin( on the body is $ero. It is the point at which all the wei(ht of the body may be considered to be concentrated and about which all the parts e&actly balance. ,ocation: In the human body' when standin( in the anatomical position it is located anterior to the second sacral vertebra. Its location remains fi&ed as lon( as the body does not chan(e shape. The location of the center of (ravity can be outside the human body durin( activities dependin( on relationship of body se(ments.

,ine of 3ravity: The line of (ravity is an ima(inary vertical line passin( throu(h the center of (ravity down to a point in the base of support. In the human body it passes from the verte& throu(h the body of the second sacral vertebra down to a point between the feet when standin( in the anatomical position:

Biomechanics - PHTH 208

28

The (ravitation pull actin( at the center of (ravity of any se(ment is also e&pressed by a vertical line called line of (ravity

4actors affectin( ?ocation of the Total 0ody Center of 5ravity: 1. 6(e:

Since body se(ments differ in proportion to total hei(ht from birth to maturity' the transverse plane of the center of (ravity will lie in a different section of the body as a(e increase' but the proportion of hei(ht will be constant. The level of the C75 9 Center of 5ravity) will (radually decrease till it reaches the level of the second sacral vertebra at adulthood. 2. Se&:

Since the distribution of body mass differ from males to females the C75 will be located hi(her in males than in females. 3. Chan(e in position:

The chan(e in position of limbs from the anatomical position 9 when the arran(ement of the body shifts)' e.(. raisin( both arms will raise the C75. ". 6ddition to subtractions of wei(ht in some parts of the body: a. 6ddition of wei(ht: carryin( wei(ht will move the C75 towards the location of load. +.(. carryin( a wei(ht above the head will raise it upwards. Carryin( a wei(ht behind the trunk will move the C75 backwards. b. Subtraction of wei(ht' e.(. amputation of one limb will move the C75 upwards and towards the sound side.

Biomechanics - PHTH 208

29

3. !.

0ody build. @ei(ht.

Calculation of the Center of 5ravity 1. Se(mental C75: a. 0y multiplyin* the se(mental len(th by "I; measured from the distal end of the se(ment. b. 0y calculation from a projected film ima*e.

2. Total body C75: a. By location as a percenta*e of standin( hei(ht above the base of support. i. 6ccordin( to -almer 4ormula: 33'; > of body hei(ht measured from the feet 1." cm 9for men and women). ii. 6ccordin( to the Crosky 4ormula: : 33'""> of body hei(ht measured from the feet. 9for men). : 33.1<> of body hei(ht measured from the feet 9for women). iii. 6ccordin( to the @ellebrandt and associates formula: : 33'1;> of the body hei(ht from the feet 9for women). b. Se*mental method: 0y calculation from a pro*ected film ima(e and is usually used in dynamic situations. c. By usin* balancin* board.

Biomechanics - PHTH 208

30

!tability and &6uilibrium 6. ST60I?ITJ: 1efinition of Stability: Stability is defined as resistance to overthrowin( or sudden chan(es. In other words the ability to maintain balance in static and dynamic situations. 4actors affectin( Stability: 1. /elationship of line of (ravity to base of support. 2. The hei(ht of then Center of 5ravity. 3. The si$e and shape of base of support. ". The mass of the body. 3. Supportin( surface 9 friction inclination' irre(ularities). !. Se(mentation. ;. Kisual and psycholo(ical factors. <. -hysiolo(ical factors. %. Speed 9decrease re,uirement of lateral stability).

Biomechanics - PHTH 208

31

0. +LMI?I0/IM 1efinition of +,uilibrium: +,uilibrium id defined as any condition in which all actin( forces are cancelled by others resultin( in a stable balanced system.

Types of +,uilibrium: 1. Stable. 2. Mnstable. 3. =eutral. 1. Stable $-uilibrium: 8hen the ob*ect is sli(htly displaced' it tends to return to its position. It cannot be overturned without first raisin( its C75' and the (reater the distance the C75 is raised' the (reater its stability. The human body cannot be in a state of stable e,uilibrium e&cept when fully supported in lyin(. .. /nstable $-uilibrium: 8hen the ob*ect is sli(htly displaced it tends to increase its displacement. The C75 is lowered and falls outside the base of support . The hi(her the C75 is' the more unstable the body is. It occurs durin( activity. 3. =eutral +,uilibrium:

Biomechanics - PHTH 208

32

8hen the ob*ect is sli(htly displaced' it remins in that displaced position. The C75 is neither raised nor lowered. It occurs durin( activity.

7uman $osture The concept of human posture has different meanin(s to different persons: 1. To the orthopedic sur(eon' it may be an indication of the soundness of the musculoskeletal system. 2. To he Ginesiolo(ist' it is a measure of mechanical efficiency of muscles' balance and of neuromuscular coordination. 3. It is considered as the relative arran(ement of parts of the body. It chan(es with the positions and movements of the body throu(hout life and throu(hout the day. ". It is the attitude which is assumed by body parts to maintain stability and balance with minimum effort and least strain durin( supportive and non supportive positions.

1efinition of a B 5ood -ostureC: 1. 6 (ood posture is the state of muscular and skeletal balance which protects the supportin( structures of the body a(ainst in*ury and pro(ressive deformities' irrespective of the attitude in which these structures are workin( or restin(. Mnder these conditions' the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal or(ans. 2. There is no sin(le best posture for all individuals. +ach person must take the body he I she has and make the best of it. The B (ood -ostureC is the one that suits one.s own condition and the condition of the environment. e.(. durin( attention. The normal posture will be erect' while in e&treme fati(ue' the normal posture will be that conserves ener(y.

Biomechanics - PHTH 208

33

3.

The B(ood postureC is the posture in which the body se(ments are balanced in the position of least strain and ma&imum support.

Factors affecting $osture: 1. echanical 4actors: a) The relationship of line of (ravity to body se(ments:

: The line of (ravity bears a definite relation to certain anatomic landmarks. : In a (ood standin( posture' its pathway is as follows: 4rom 4ront or 0ack Kiew: The line of (ravity passes from the verte& throu(h S2 to a point between the two feet in the base of support. 4rom lateral Kiew: The line of 5ravity passes throu(h: a. Kerte&. b. astoid process9 behind). c. .6nterior to the a&is of fle&ion and e&tension of the neck. d. 6cromion -rocess 9 bisectin() e. 0ody of C1'C!'T11' ?3' S1 9 it passes posterior to the a&es of rotation of the cervical and lumbar vertebrae and anterior to thoracic vertebrae. f. Kia or behind the a&is of the hip *oint. (. 6nterior to the a&is of the knee *oint. h. 3 cm anterior to lateral malleolus. : 0ecause of the posture sway durin( standin(' there is normal $one within which the line of (ravity mi(ht reasonably be e&pected to lie. : 8hen the line of (ravity passes via a *oint' no moment will be created. : If the line of (ravity passes anteriorly or posteriorly to a *oint a&is' a moment will be created dependin( on the structure of this *oint.

Biomechanics - PHTH 208

34

: If the *oint structure allows movements in this direction' a moment will be created and movements occur in this direction which is counter balanced by an opposite movement created by muscles to maintain (ood ali(nment. : If the *oint structure does not allow movement in this direction' the line of (ravity will act as moment to stabili$e the *oint. The more nearly vertical the lon( a&is of every se(ment' the (reater the stabili$in( effect of (ravity. 9 see table 1). b) -elvic Inclination: : It is measured from N:/ay of the pelvis and is determined by measurin( the an(le formed between : a line from a point in the lumbo:sacral *unction or from posterior Hsuperior iliac spine to the simphysis pubis. and a hori$ontal line . Its normal value is between 3# to !# de(rees and this value is affected by increased or decreased lumbar lordosis. : If the lumbar lordodis decreases its value will be decreased and if the lumbar lordosis increases the pelvic inclination will increase. :It is (reater in females than in males.

Biomechanics - PHTH 208

35

c) 0ody -hysi,ue: 9 +ctomorph ' esomorph ' +ndomorp ) d) 4le&ibility of the structure of the wei(ht bearin( se(ments. e) Stren(th of anti(ravity muscles D balance of anta(onistic muscles. 2. 6natomical factors : a. Inte(rity of musculoskeletal system. b. =eural control. c. Kisual D kinesthetic awareness. 3. 1emand of work place. ". Social D cultural traditions. 3. -sycholo(ical factors. !. -hysiolo(ical factors. : The human body can not be said to have a sin(le posture . -ostural norms are appropriate only for the avera(e fi(ure D apply only to the static standin( position.

-ostural Control: : -ostural control refers to the ability to maintain the stability of the body as a whole and body se(ments Ba(ainst (ravityC or Bmovement of different body se(mentsC or Bchan(es in the supportin( surfaceC.

Biomechanics - PHTH 208

36

: Control depends on the inte(rity of nervous system' muculoskeletal system and special senses.

Types of -ostures 1. +asy posture 2. 4ati(ue posture. 3. /i(id posture. 1. +asy -osture: It is a *ood symmetrical and balanced position thou(h this position cannot be maintained for a lon( time. The sub*ect will therefore shift his wei(ht in a swayin( movement in order to prevent fati(ue and to maintain a (ood circulation in the postural muscles of the le(s when standin(. 0y alternatin( the main support from one le( to another' the muscles become periodically unloaded and rela&ed. The pelvic inclination is about !#. 2. 4ati(ue -osture: It is an asymmetrical or sa**in* posture. This position s rela&ed and can be maintained for a lon( time as most of the body.s *oints are in semi: fle&ion. The load on the muscles will decrease and the ener(y e&penditure is 1# > less than easy posture. The pelvic inclination decreases due to posterior tiltin( of the pelvis. 3. /i(id -osture: It is called normal stellun* posture or posture of attention. It doesn.t mean normal posture. This position cannot be assumed for a lon( time as most of body.s *oints are in

Biomechanics - PHTH 208

37

e&tension. Therefore' the load will increase on the *oints and muscles and the ener(y e&penditure is 2#> more than in the easy posture. The pelvic inclination increases due to the anterior tiltin( of the pelvis.

4aulty -osture

6 faulty posture results from: 1. 4aulty relationship of the various body parts which produces increased strain on the supportin( structures. 2. Inade,uate balance over the base of support. -ostural deviations will occur with an increase or decrease of body curvatures and pelvic inclination.

4aulty posture leads to prolon(ed posture strain which causes: 1. (i*aments stretch which' if becomin( permanent' will lead to *oint instability O increased faulty posture. 2. /neven pressure on joint cartila*e which will cause abnormal friction' which in turn will lead to *oint dama(e O increased faulty posture.

Biomechanics - PHTH 208

38

!imple Machines 8 %heir Anatomic +ounterparts 6 machine is a device which enables work to be done more easily and P or more ,uickly by applyin( forces. The most important machines for physical therapists are: 1. ?evers. 2. -ulleys. 3. 8heel D 6&le 1. ,evers It is a device for transmittin( force' and it is able to do work when work is done on it. It is a ri(id bar or mass which rotate around a fulcrum on an a&is perpendicular to the plane of motion. The rotation is caused by a force applied to this bar. If the force is used to overcome a resistance it is called effort' and all parts of the lever between the a&is D the point of application of this force is called the effort arm. The resistin( force is called the resistance. The distance between the line of application of this force D the fulcrum is called the resistance arm. In anatomical lever' the ri(id bar is the bone9it does not necessarily resemble bars)'the fulcrum is the *oint a&is' the effort is applied by the muscle D its point of application is at the insertion of the muscle. The resistance is the (ravitational force alone or plus any outside force D its point of application is at the C75 of the se(ment or the combined C75 of both masses. In the anatomic levers with few e&ceptions' the effort arm is shorter than the resistance arm' so it tends to favor speed D ran(e in e&pense of effort. echanical advanta(e 9 .6.) of a lever :
Biomechanics - PHTH 208 39

It is a measure of the efficiency of the lever in terms of statin( the Bout putC of this machine relative to its BinputC . It is the ratio between the effort applied to the lever D the resistance overcome by the lever. So' +.6. .6. E :::::: or ::::::::: / /.6. Classification of ?evers ?evers fall in three classes dependin( upon the relationship between the effort' fulcrum and resistance. 1. 4irst Class ?ever: In this arran(ement' the fulcrum is located between the effort and the resistance. 1ependin( upon the relative distance of the effort and resistance arms' it may take a small effort to lift a lar(e resistance or the effort may act at a small distance to move the resistance a (reater distance. Its mechanical advanta(e can be either (reater or less than one. The direction of the effort and resistance is always opposite to each other e.(. the triceps muscle when e&tendin( the elbow a(ainst (ravity. 9 4i(. 1). 2. Second Class ?ever: In this arran(ement the resistance is located between the effort and the fulcrum. Its mechanical advanta(e is always (reater than one because the effort arm is always (reater than the resistance arm. The effort will be less than the resistance and will always move a (reater distance than the resistance. The direction of movement of effort and resistance will be the same. It is doubtful that this class of lever may be found in the human body. 0ecause of this arran(ement' this class of levers ma(nifies force at the e&pense of ran(e and speed. 3. Third Class ?ever: In this arran(ement' the effort is located between the fulcrum and the resistance. The effort arm is always less than the resistance arm. To support the resistance' the effort must be of (reater ma(nitude than the resistance' but the effort moves less distance than the resistance. So' there is a loss of effort but a (ain in distance and speed.
Biomechanics - PHTH 208 40

The direction of movement of the effort and resistance will be the same. 6natomical e&ample is the biceps muscle actin( on a fle&ed forearm. In (eneral most of the anatomic levers are of this class 9 4i( 2). %he principle of levers: 6 lever of any class will balance when the product of the effort and the effort arm e,uals the product of the resistance and the resistance arm. 2. $ulleys 6 pulley is a simple mechanical machine and consists of a wheel that turns readily on an a&le. The wheel is usually (rooved for a rope or a wire cable. There are three types of pulleys: 1. 6 sin(le fi&ed pulley. 2. 6 sin(le movable pulley. 3. -ulley combination. 1. & sin*le fi0ed pulley: It chan(es the direction of the force actin( on it and its ma(nitude remains the same on either sides of the pulley rope irrespectively to the an(le of pull of the force. It.s mechanical advanta(e is 91). 4i(.". 2. & sin*le movable pulley: It acts as a second:class lever. It.s mechanical advanta(e is 92) as it ma(nifies force. 4i(. 3. 3. Pulley combination: There are many combinations and the simplest one is a combination of one fi&ed and one movable pulley as used in the 5uthrie:Smith suspension frame. The mechanical advanta(e of pulley combination will be e,ual to the number of strands supportin( the movable pulley. 4i(.!.

Biomechanics - PHTH 208

41

Anatomical $ulleys: In the human body' in most cases the pulley is replaced by a bone' cartila(e or li(ament and the cord is replaced by a muscle tendon. The tendon is lubricated in a manner so that it may easily slide over the pulley. Classification of anatomical pulleys : There are four classes of pulleys' the first three of them are e&amples of fi&ed pulleys and the fourth one is an e&ample of a movable one. Class I:

6n improved muscle action comes from the muscle tendon passin( over an e&ternal support' the e&ternal support servin( as pulley. e.(. The presence of the patella 9 the pulley) improves the efficiency of the ,uadriceps muscle as the pulley will increase the an(le of insertion of the patella li(ament into the tibial tuberosity. Class II: The action of the muscle at the *oint is altered because of the pulley: e.(. 1: %he pulley is a bone : e.(. the lateral malleolus of the fibula acts as a pulley for the perobneus lon(us muscle. If it was not for the malleolus' this muscle instead of passin( behind the lateral malleolus to be inserted in the base of the first metatarsal and to produce ankle plantar fle&ion and eversion' it would have produced ankle dorsifle&ion and eversion because of its passa(e in front of the ankle *oint. 2: %he pulley is a cartilage : e.(. The trochlea of the eye allows the superior obli,ue muscle of the eye when it passes over it to rotate the eye obli,uely. 8ithout this pulley' the muscle would have little effect on the eye.
Biomechanics - PHTH 208 42

3: %he pulley is a ligament: e.(. the fle&ur retinaculum of the hand acts as a pulley for the fle&ors of the fin(ers to prevent its bowstrin(. 8ithout this action' these muscles will not be effective in movin( these *oints.

Class III: The *oint serves as the pulley. The si$e of the epicondyles of the femur (ives the (racilis tendon a favorable an(le of insertion as the tendon insert on the tibia. 7r the middle part of the deltoid as it passes over the shoulder *oint. Class IK: The muscle acts as a pulley the muscle is its own pulley e.(. as the biceps muscle increases in si$e' its an(le of insertion will increase. The muscle underneath acts as pulley for another muscle' which passes over it e.(. brachialis ms.' will raise the biceps (ivin( it a better an(le of insertion. 4or this to be effective' the overridin( ms. must not have the same insertion as the bulky ms.

". 9heel 8 A#le It is a machine that consists of a wheel attached to a central a&le about which it revolves. 4orces may be applied to the wheel either at the rim or at the a&le. Class I:

The force is applied at the rim it resemble second:class lever D ma(nify force at the e&pense of speed D distance. Its mechanical advanta(e is more than 9 1 ). The lar(er the diameter of the wheel the (reater the ma(nitude of force. The turnin( effect of the wheel is the product of the force D radius. In this class the resistance is applied close to the a&le. 94i( ;). Class II:

Biomechanics - PHTH 208

43

The effort is applied to the a&le and the resistance is applied to the rim of the wheel. It resembles a third class lever and its mechanical advanta(e is less than one. This class favors speed and ran(e at the e&pense of force. ost of the e&amples of the wheel and a&le in the body are of the second class' however both kinds are represented 9 4i(. <).

+&amples of wheel and a&le: 8hen takin( a cross section of the upper trunk' the rib ca(e represents the wheel and the spinal column represents the a&le. In Class I 8heel and a&le' the obli,ue abdominal muscles e&ert their force on the rim of the wheel 9the ribs) and the small rotators of the vertebral column 9multifidus) provide the resistance to the a&le 9vertebral column) durin( the rotation of the rib ca(e. In Class II 8heel and a&le' the effort is applied by the small rotator of the spine to the a&le and the resistance is provided by the thoracic ca(e. 6lso a cross section of the arm or thi(h presents the characteristics of a wheel and a&le. The lon( bone will be the a&le and the surroundin( tissues will be the wheel. /otation of the limb about its mechanical a&is constitute a movement of the wheel and a&le. 8ith the effort bein( provided by the muscles producin( the rotation and the resistance by the anta(onistic muscles or e&ternal resistance. In this arran(ement' the resistance is applied to the a&le from the same distance like the effort.

Biomechanics - PHTH 208

44