Upper Extremities Parts

1
Upper Extremities Parts

• Shoulder Girdle
• Shoulder Joint
• Elbow Joint
• Radioulnar Joint
• Wrist Joint

2
Muscle Contribution to Joint

• Stronger Muscles More Joint Stability
• Angles of Pull influence Joint Stability
• Stabilizing Angles lt 90? angle of pull
• Dislocating Angles gt 90? angle of pull

3
Shoulder Girdle

• Involved in Reaching/Grasping Motions
• Designed for Mobility
• Unstable joint
• Strength of Muscles VERY important

4
Shoulder Joint

• Involved in a wide variety of motions
• Designed for Mobility, Unstable joint
• Rotator Cuff Deltoids small angle pull
• Wheel-Axle Mechanism

5
Overarm Throw Pattern

• cocking action extreme lateral rotation
• rapid medial rotation and protraction
• Strengthen Medial Rotators BOTH Concentrically
  and Eccentrically

6
Elbow Joint

• Only Flexion and Extension
• Stable joint due to bony structure
• Muscle arrangement stabilizing effect

7
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

8
3 Ways to Strengthen Elbow Flexors

• Elbow flexion from anatomical position
• Elbow flexion with shoulder Hyperextended
• shoulder flexion figure 2.5j on pg 62 ?

9
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 pronatedpage
185 right side of picture supinated
10
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

11
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
12
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 Biomechanics4th
Edition by Susan J. Hall
13
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

14
Knee Joint Potential Injury Positions
page 205
15
Knee Joint Potential Injury Positions
turning the bodywhile foot is fixed
FIG 6.8 page 200
16
Knee Joint Potential Injury Positions
Deep Squatchanging axis of rotationfrom knee
jointtocalf/thigh area
FIG 6.11 page 204
17
Knee Joint Potential Injury Positionsrehabilita
tion of knee injuries
page 260 studies on ACL stress, shear forces,
petellofemoral contact
18
ANKLE JOINT

• Bony arrangement stability
• Ligaments play major role in stability
• flexion dorsiflexion
• extension plantar flexion

FIG 6.13page 207
19
SUBTALAR JOINT

• allows foot to navigate uneven surfaces
• inversion (sole in) and eversion (sole out)
• inversion with plantar flexion
• eversion with dorsiflexion

FIG 6.15page 209Inversion during Plantar
Flexion
20
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

21
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

22
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

23
LOCOMOTION Walking
Running

• Long support phase 65
• always support phase

• Shorter support phase
• non-support phase
• F vertical 3 x body wt

24
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 6.19page 213
25
Ideal Alignments FOOT
FIG 6.20page 214
a is Ideal FIG 6.21
26
Leg Length Inequities

• Anatomical - due to bone structure
• Functional - due to tilted pelvis
• Environmental - due to uneven ground

27
TORSION Femoral
Tibial

• Tibia rotated lateral
• lateral facing patella
• frequent in MALES
• treatment
• - muscular balance in all 3 hamstrings must be
  developed

• Femur rotated medial
• medial facing patella
• frequent in FEMALES
• treatment
• 1. Strengthen lateral hip rotators
• 2. Stretch medial hip rotators

28
VARUS

• INWARD angle from proximal to distal
• lateral stress is proximal
• medial stress is distal

29
VALGUS

• OUTWARD angle from proximal to distal
• medial stress is proximal
• lateral stress is distal

30
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