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
4
th
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
LOCOMOTION
Walking Running
Long support phase
[65%]

always support phase
Shorter 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
TORSION
Femoral Tibial
Femur rotated medial
medial facing patella
frequent in FEMALES
treatment:
1. Strengthen lateral hip
rotators
2. Stretch medial hip
rotators
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 stress is
distal

VALGUS
OUTWARD angle
from proximal to
distal

medial stress is
proximal

lateral stress is
distal

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