musculoskeletal biomechanics

8/8/2019 Musculoskeletal Biomechanics

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KNEE BIOMECHANICS

Andrew Crosby

The Musculoskeletal Sy

stemThe Musculoskeletal System


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11. Anatomy:. Anatomy:The science or study of bodyThe science or study of body

structurestructure

22. Physiology:. Physiology:The study of functionThe study of function

33. Functional Human Anatomy. Functional Human Anatomy

UNDERSTANDING THEUNDERSTANDING THE

STRUCTURESTRUCTURE

AS IT RELATES TO FUNCTIONAS IT RELATES TO FUNCTION


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Origin

Insertion

Musculoskeletal BiomechanicsMusculoskeletal Biomechanics

Modeling of the MSK systemwith the objective of identifyingforces exerted/acting on the

Bones, Joints, Muscles andother soft tissues;

Application to Trauma,

Prosthetics and OrthopedicImplant Design


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The Skeletal SystemThe Skeletal System

The human skeleton isThe human skeleton is

composed ofcomposed of 208208 toto 212212

1717%% of the total weightof the total weight

1. (bone)

2. (cartilage)


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Cartilage

chondrocytes matrix matrix 2 fiber collagen fiber

elasticfiber ground substance glycosaminoglycans chondrocyte matrix

fiber matrix 3

1. Hyaline cartilage

2. Elastic cartilage 3. Fibro cartilage


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1.Hyaline cartilage

, (larynx), (trachea),bronchus,costal cartilage articularcartilage

Hyaline cartilage perichondrium articularcartilage


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2.Elastic cartilage

hyaline cartilagematrixcollagenfiber elasticfiber

Eustatiantube (epiglottis)


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3.Fibrocartilage dense connective

tissue hyaline cartilage perichondrium pubic symphysis

(intervertrebral disk)(ligament) (tendon)


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Bones


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Function ofBones

Store Minerals Bones store calcium, phosphorus and otherminerals used by your body.

ProtectsProtects Bones help protect the body from injury. The spine andskull protect the CNS (Central Nervous System).

MovementMovement Bones provide form and structure for muscles to workagainst. Muscles can contract, but not extend. Using bones as leversone muscle can contract to extend another.

Blood CellsBlood Cells Red blood cells and some white blood cells are formedin the epiphysis of long bones. Red blood cells carry oxygenthroughout the body. White blood cells help fight off infections.

Structure and SupportStructure and Support The skeletal system provides a framework ofsupport for the body to be built upon. The bones of the legs andback support the body's entire weight


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(Microscopic structure)

1. (Osteoblast)-

(osteoprogenitorcells)

- (osteoid)

-


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2. (Osteocyte)

(lacuna)

(canaliculi)


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3. (Osteoclast)

(monocytestem cells)

(bone remodeling)

(acidphosphatase)


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(Gross structure of bone)

2

1.Cancellous (spongy) bone (trabeculae) trabeculae (bone marrow)

)


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DiaphysisDiaphysis compactbonecompactbone spongybonespongybonediaphysisdiaphysismarrowmarrow cavitycavity ((medullarymedullary cavitycavity))

EpiphysesEpiphyses spongyspongy bonebone compactcompactbonebone


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(periosteum)

2 fibrous layer osteogenic

layerfibroblastosteoblast

articularsurface


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(Haversian canal)

(bone cells)


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33

1.Growth epiphyseal plate

peak bone mass 20-30 2.Bone modeling

growth

3.Bone remodeling


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2 1.Axial skeleton

29 26 (

24 (12 11 12 )

1


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2.Appendicular skeleton cortical compact trabecularcortical 126

- 30

- 30 - 1 -1

- 1


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Types of BonesTypes of Bones

11.Long Bones.Long Bones

The classification body which is longer than itis wide, with growth plates (epiphysis) at either

end,

Both ends ofthe bone are covered in hyalinehyaline

cartilagecartilage to help protect the bone and aid shock

absorption

The femurs, tibias, fibulas, humeri, radii,

ulnas, metacarpals, metatarsals, phalanges, and

clavicles


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2.Short Bones

defined as being approximately as wide as they are long

primary function ofproviding support and stability with little movement

.the Carpals and Tarsals in the wrist and foot.

They consist ofonly a thin layerthin layer ofcompactofcompact, hard bone with cancellous

bone on the inside along with relatively large amounts of bone marrow.


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3.Flat Bones

the main function of providing protection to the bodies vital

organs and being a base for muscular attachment the Scapula (shoulder blade). The Sternum (breast bone), Cranium

(skull), Pelvis and Ribs

Anterior and posterior surfaces are formed ofcompact bone to

provide strengthfor protection with the centre consisting of

cancellous (spongy) bone and varying amounts of bone marrow. In adults, the highest number ofred blood cells are formed in flat

bones.


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44.Irregular Bones.Irregular Bones

non-uniform shape. Good

examples ofthese are the Vertebrae,Sacrum and Mandible (lower jaw).


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5.Sesamoid Bones

short or irregular bones, imbedded in a tendon.The most obvious example ofthis is the Patella (knee

cap) which sits within the Patella or Quadriceps tendon.

Other Pisiform (smallest ofthe Carpals) and the two small

bones at the base ofthe 1st Metatarsal.

Sesamoid bones are usually present in a tendon where

it passes over a joint which serves to protect the tendon.


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Bones as Components of JointsBones as Components of JointsClassification of Joints

By Structure

1.Fibrous jointfibrous tissue

2.Cartilagenous joint

3.Synovial jointsynovial membrane synovial fluid


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(Fibrous joints=) (dense

connective tissue)

joint capsule

(Sutures) =Skull

(Syndesmosis) =Ulnars , Radius

densefibrous tissue

distal tibiofibularjoint

(Gomphosis) =(maxilla,mandible)


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(Cartilaginous joint)

(Synchondrosis) (hyaline cartilage)

(Symphysis) (Fibrocartilage) (intervertebral discs)(intervertebral discs)


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(Synovial joint)(Synovial joint)

jointcapsule ligament

(articular capsule)

(synovial fluid)

articular discmeniscus


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By functionBy function

degree of movement 31. Synarthrosis

2. Amphiarthrosis

3. Diarthrosis


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((DiarthrosisDiarthrosis))Joint Type Movement at joint Examples Structure

HingeHinge

Flexion/Extension Elbow/Knee Hinge joint

Pivot

Rotation of one bone

around another

Top of the neck

(atlas and axis bones)

Pivot Joint


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Joint TypeJoint Type Movement at jointMovement at joint ExamplesExamples StructureStructure

Socket

---

Flexion/Extension/Ad

duc

tion/Abduction/Internal &

External Rotation

Shoulder/Hip Ball and socket joint

Saddle

Flexion/Extension/Ad

duction/

Abduction/Circumduc

tion

CMC joint ofthe

thumb

Saddle joint


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Joint TypeJoint Type Movement at jointMovement at joint ExamplesExamples StructureStructure

Condyloid

Flexion/Extension/Adduction

/Abduction/Circumduction

Wrist/MCP & MTP

joints

Condyloid joint

GlidingGliding

Gliding movements Intercarpal joints Gliding joint


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(tendon) VS (ligament)

(ligament)

(tendon)


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Biomechanics of the SpineBiomechanics of the Spine (Biomechanics of

the cervical spine)

1.Occipitoatlanto axial complex

-(occiput)1 (cup-shaped)

-(rotation) -(flexion/extension)


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2.Lower cervical spine (C3-C7)

intervetebral disc facet joints

(Facet joint)

Facet

Facet


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flexion, extension, lateralbending rotation


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(Biomechanics of the lumbar spine)

lumbar spine thoraciccervical spine

facet joints Sagittalplane

(flexion/extension) thoracic spine

12


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0o 60o lumbar spine

60o


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(bendingmoment) lumbar spine (W)lever arm(Lw) lumbar spine

(compression) (tension)


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L3 disc

L3 disc

100%


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Biomechanics of Shoulder, elbow, and wristBiomechanics of Shoulder, elbow, and wrist

Shoulder, elbow, and wrist


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ShoulderShoulder

Shoulder forward flexion = zero to 180 degrees.

Shoulder abduction = zero to 180 degrees.

Shoulder external rotation = zero to 90 degrees.

Shoulder internal rotation = zero to 90 degrees


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Shoulder dislocation () 90%


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Rotatorcuff


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Elbow Anatomy

Elbow flexion = zeroto 145 degrees.

Forearmsupination = zeroto 85 degrees.

Forearmpronation = zeroto 80 degrees


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Medial Elbow Injuries The Ulnar Collateral

Ligament


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Medial Elbow Injuries The Ulnar

Collateral Ligament


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the ulnar collateral ligamentor"UCL - pulls the forearmforward with the rotating upper armWhen improper mechanics are used or arm muscles becomefatigued, the load placed on the UCL may be increased to morethan it can withstand, causing small "micro"-tears in the UCL.

Microtears in muscles or ligaments can heal when given enough


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Golferselbow

Golferselbow

()(medialepicondyle) tenniselbow

(lateralepicondyle)


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1. Superficial extensor muscles forearms back-hand 2. lateral epicondyle


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Wrist Biomechanics

Wrist dorsi flexion (extension) = zero to 70degrees.

Wrist plantar flexion = zero to 80 degrees.

Wrist radial deviation = zero to 20 degrees Wrist ulnar deviation = zero to 45 degrees


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TennisWrist injuryTennisWrist injury

Overuseinjuriesofthewristaretendinitis, nerveconditions

carpaltunnelsyndrome


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These symptoms can be

evident when driving, holding

newspapersCarpal tunnel is defined by

compression of the median

nerve at the level of the

wrist(help you bend yourfingers)


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DeQuervain's Syndrome: Also

known as "washerwoman's

sprain

this syndrome can be a

product of overuse

rapid, repetitive movementsof the thumb and wrist


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Fractures

Common types of hand and wrist fractures

include Distal Radial Fracture, Smith'sFracture, and Scaphoid Fracture

an outstretched hand or on to the back of the

hand


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HipHip --BiomechanicsBiomechanicsForces across hip joint combination of:

Body weight

Ground rea

ction

forces

Abductor muscle forces


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ACTIVITYACTIVITY

Hi f ti


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Hip range of motion:

(Movement offemur as it rotates in the acetabulum.)

Flexion = 0 to 125 degrees

Extension = 0 to 30 degrees.

Adduction = 0 to 25 degrees.

Abduction = 0 to 45 degrees.

External rotation = 0 to 60 degrees.

Internal rotation = 0 to 40 degrees


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Knee joint

Flexion = 0 to 140 degrees.

Extension - zero degrees =full extension.


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Knee (Femur) (Tibia)

(Patella)

3 (Articular cartilage)(Synovial membrane)

C


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(Knee Stabilizer)

1. (Lateral collateral ligament)2. (Medial collateral ligament)3. (Anterior cruciate ligament)4. (Posterior cruciate ligament)

Themedial

collateralligament (MCL)andlateral

Themedial

collateralligament (MCL)andlateral

collateralligament (LCL)arethemostoftencollateralligament (LCL)arethemostofteninjuredingolfinjuredingolf


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,,


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St t d F ti l


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StructureandFunctionalAnatomyoftheAnkle


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Ankle range of motion

Pronation

Abduction, dorsiflexion, eversion

SupinationAdduction, plantarflexion, inversion

dorsiflexion is 0 to 20 degrees; plantar flexion is0 to 45 degrees.


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1.lateral ankle sprain


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lateral ankle ligaments : lateral angleligaments ligament 31. Anterior talofibular ligaments

2. Caleaneofibular ligaments3. Posterior talofibular ligament anterior talofibular ligament anterior subluxation talus

planter flexion ligament inversion

A hili t d


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Achilis tendon(Achilles tendon ruptures)

- Overuse injuries

Achilles tendon gastrochemiussoleuscomplex

2 ten ion


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Planes


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Planes


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SagittalPlane Movements (bilateral axis)1. Flexion joint angle increases*.

2. Extension joint angle decreases*

3. Hyperextension continued extension beyond starting position.

Frontal Plane Movements (anteroposterior axis)1. Abduction movement away from midline ofthe body

2. Adduction movement toward midline ofthe body

3. Lateral Flexion lateral bending oftrunk or head

Transverse Plane Movements (vertical axis)1. Rotation# anterior aspect turns left or right.

2. Supination outward rotation offorearm

3. Pronation inward rotation offorearm

#the shoulder can rotate in all three planes

Fundamental movements:


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Axis of Rotation


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Standard Reference Terminology

Anatomical Reference Axes

An imaginary axis ofrotation that passes

through a joint to which it is attached

Mediolateral or frontal axis

Anterioposterior or sagittal axis

Longitudinal axis


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Joint Movement Terminology

In anatomical position, all body segments are

considered to be positioned at zero degrees.

Sagittal Plane Movements

Frontal Plane Movements

Transverse Plane Movements

Other Movements


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2-6

Sagittal plane movements


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2-8



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2-13



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2-16

Other Movements


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2-19


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Spatial Reference Systems

Used to standardize the measurements taken

Cartesian Coordinate system

Movements primarily in a single direction, or

planar, can be analyzed using a two-

dimensional Cartesian

X (horizontal) direction

Y (vertical) direction

3-dimensional by adding a z-axis


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Cartesian Coordinate System


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Dimensions ofMovement

0 Dimensions - point.

1Dimension - line.

2 Dimensions - plane.

3 Dimensions - cube, sphere, etc.

4 Dimensions - 3 Dimensions + time.

Movement occ

urs in all 4 dimensions (time andspace).


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Positional Reference Systems

These are designed to identify location

or position

1. Anatomical2. Linear

3. Angular (rotational or radial)

Directional Terms Used in


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Describing Anatomy

SUPERIOR Directed upwards or towards the

head

INFERIOR Directed downwards or towards

the feet

ANTERIOR Directed towards the front ofthe

body

POSTERIOR Directed towards the back ofthebody


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Serratus Anterior


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Serratus Anterior

Serratus Posterior

Superior


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Serratus Anterior

Serratus Posterior

Superior

Serratus Posterior

Inferior



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Describing Anatomy MEDIAL Nearer the midline ofthe body

LATERAL Farther from the midline ofthe body

PROXIMAL Nearer to the attachment ofa limb to

the trunk DISTAL Farther from the attachment ofthe limb to

the trunk

SUPERFICIAL Located on or near the surface ofthe

body

DEEP Away from the surface ofthe body


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The Anatomical Position

The position ofreference for

all movements.

Also called the standing

supine position


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ardinal Planesof

the Body

1. Sagittal Divides

thebody intoleft

and righthalves.2. Frontal Divides

thebody intofront

and backhalves.

3. Transverse

Dividesthebody

intotopand

bottomhalves.



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(Forward & Backward Movements)

Whole Body Forward and backward

movement such as front or back flips

Segmental

Flexion

Extension

Hyperextension

Dorsiflexion

Plantar flexionAnkle


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Backflipsand

frontflipsare

wholebody

sagittalplanemovements.


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Fora

cyclist, the

legmovements

occurinthe

sagittal

plane.


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Forward and

backwardmovementsat

specificjoints

suchasthe

shoulderandanklearesagittal

plane

movements.

F t l Pl M t


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(Sideward & Vertical Movements)

Whole Body Sideward movement as seen

in sideward cartwheels



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(Sideward & Vertic

al Movements) Segmental Abduction

Adduction

Lateral flexion

Elevation and depression ofthe shoulder girdle(or scapula)

Upward and downward rotation oftheshoulder girdle (or scapula)

Radial deviation

Ulnar deviationWrist


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Hipabductionandadduction.

Ulnarand radial

Deviation.


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Elevationand depressionofthe

shouldergirdle.


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ateralflexionofthetrunk.

T Pl M t


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(Horizontal Movement) Whole Body

Horizontal

movement orrotation as in a

skaters or dancer's

pirouette.

Trans erse Plane Mo ements


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(Rotation Around a Vertical Axis) Segmental

Medial (inward) rotation

Lateral (outward) rotation

Left / right rotation ofthe trunk, neck, or head

Supination - forearm

Pronation forearm

Horizontal abduction (transverse flexion)

Horizontal adduction (transverse extension) Pronation ofsubtalar joint abduction + eversion

Supination ofsubtalar joint adduction + inversion


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Horizontaladductionand

abductionare

segmentaltransverseplane

movements.

Cardinal Axes ofthe Body


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y

(Axes is plural for axis.)

X-Axis (Transverse, Mediolateral, Frontal, orBreadth Axis)

Y-Axis (Longitudinal, Vertical, or Length Axis) Z-Axis (Anteroposterior, Sagittal, or Depth Axis)

Movement, both whole body and segmental, takes

place in the cardinal planes and around thecardinal axes.

Th lli t


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Theellipserepresents

thetransverseplaneand

theblacklinerepresentsthe Y-axis. (Theplaneis

likearecord turntable

and theaxisislikethe

spindlethatholdstherecord inplace.) The Y-

axisisperpendicularto

thetransverseplane.

Thereforeapointwhichrotatesaround the Y-axis

willmoveinthe

transverseplane.

Transverse

Plane

Y-axis

X A i


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X-Axis

Passes from side to side.

Rotation in the sagittal plane takes place

around the x-axis.

Y Axis


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Y-Axis

Passes from top to bottom.

Rotation in the transverse plane takes place

around the y-axis.

Z Axis


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Z-Axis

Passes from front to back.

Rotation in the frontal plane takes placearound the z-axis.

Y AxisThe cardinal axes


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ZAxis

X Axis

CenterofGravity

Thecardinalaxes

lieatthe

intersectionofthecardinalplanes.

Thecardinal

planesand axes

allintersectatthecenterof

gravity (c-g).


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