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04/08/23 1
Structural Kinesiology
Prepared by DENNIS N. MUÑOZ, RN, RM, PTRP,MANDENNIS N. MUÑOZ, RN, RM, PTRP,MAN
04/08/23 2
Anatomical Review
• Skeletal System
• Muscular System
• Nervous System
• Human Movement
• Basic Biomechanics
• Application of Kinesiology to Physical Activity
04/08/23 3
CHAPTER 1
FOUNDATIONS OF STRUCTURAL KINESIOLOGY
• Understand the skeletal system
• Understand directional terminology
• Understand planes of motion
• Understand joint movements
04/08/23 4
Skeletal Systems
• 206 bones make up the skeletal system• Functions of the skeletal system
– Provides support– Provides protection– Provides a structure for muscles to attach– Provides levers (joints) for human movement– Provides a place for mineral storage– Provides a place for blood cell formation
04/08/23 5
Skeletal Systems
• Appendicular skeleton– Upper extremity & shoulder girdle– Lower extremity & pelvic girdle
• Axial skeleton– Skull– Vertebral column– Ribs– Sternum
04/08/23 6
Bones
• Skull
• Frontal bone
• Zygomatic bone
• Parietal bone
• Temporal bone
• Occipital bone
• Maxilla
• Mandible
scapula
• Axillary border
• Vertebral border
• Spine of the scapula
• Acromion process
• Coracoid process
• Inferior angle
04/08/23 7
Bones
• Pelvic girdle
• Iliac crest
• Ilium
• Ischium
• Ischial tuberosity
• pubis
• Sacrum
• coccyx
• Femur
• Greater trochanter
• Lesser trochanter
• Medial femoral condyle
• Lateral femoral condyle
• Patella
04/08/23 8
Bones
• Thoracic cage• Manubrium• Sternum• Xiphoid process• Ribs• Thoracic Vertebrae
• Arm• Humerus• Greater tubercle• Lesser tubercle• Radius• Ulna• Carpal bones• Metatarsals• phalanges
04/08/23 9
Bones
• Lower leg
• Tibia
• Tibial tuberosity
• Medial malleolus
• Fibula
• Fibular head
• Lateral malleolus
• Ankle and foot
• Calcaneus
• Talus
• Tarsal bones
• Metatarsal
• phalanges
04/08/23 10
Anatomical Directional Terminology
• Anterior: in front of
• Anteroinferior: in front and below
• Anterolateral: in front and to the side
• Anteromedial: in front and toward the midline
• Anteroposterior: relating to both front and rear
• Anterosuperior: in front and above
04/08/23 11
Anatomical Directional Terminology
• Contralateral: opposite side
• Ipsilateral: same side
• Deep: below the surface
• Distal: away from the midline
• Dorsal: relating to the backside
• Inferior: below another structure
• Lateral: away from the median
• Medial: nearer to the median
04/08/23 12
Anatomical Directional Terminology
• Posterior: in the rear
• Posteroinferior: behind and below
• Posterolateral: behind and to one side
• Posteromedial: behind and to the inner side
• Posterosuperior: behind at the upper part
04/08/23 13
Anatomical Directional Terminology
• Prone: the body facing downward
• Supine: the body facing upward
• Proximal: nearest the trunk or point of origin
• Superficial: near the surface
• Superior: above in relation to another structure
• Volar: relating to the palm of the hand or the sole of the foot
04/08/23 14
Planes of Motion
• Sagittal Plane: divides the body into right and left halves.
• Frontal Plane: divides the body into front and back halves.
• Horizontal Plane: divides the body into superior and inferior halves.
• Diagonal Plane: is a combination of more than one plane.
04/08/23 15
Types of Bones
• Long Bones
• Short Bones
• Flat Bones
• Irregular Bones
• Sesamoid Bones
04/08/23 16
Bony Features• Bone growth
– Epiphyseal plates– Osteoblasts, Osteoclasts– Osteocytes
• Bone properties– Made of calcium, collagen, and water– Size and shape are influenced by outside forces
• Bone markings– Processes– Cavities
04/08/23 17
Types of Joints
• Synarthrodial: immovable
• Ampiarthrodial: slightly movable
• Diarthrodial: freely movable
04/08/23 18
Diarthrodial Joints
• Arthrodial (gliding) joint: usually two flat bones make up this joint and they permit limited gliding movement:
– intercarpal joint – scapular-thoracic joint
04/08/23 19
Diarthrodial Joints
• Condyloidal (biaxial ball-and-socket) joint: bones with a concave and convex surface which allow movement in two planes without rotation.
– Radial-carpal joint– Metacarpophalangeal joints
04/08/23 20
Diarthrodial Joints
• Enarthrodial (multiaxial ball-and-socket) joint: concave and convex bones which allow movements in all planes
– Glenohumeral joint– Illiofemoral joint
04/08/23 21
Diarthrodial Joints
• Ginglimus (hinge) joint: usually concave and convex surfaces which allow movement in only one plane
– Radioulnar joint (elbow)– Tibiotalar joint (ankle)– Tibiofemoral joint (knee)
04/08/23 22
Diarthrodial Joints
• Sellar (saddle) joint: two concave surfaces which permit ball-and-socket movement without rotation.
– Carpometacarpal joint (thumb)
04/08/23 23
Diarthrodial Joints
• Trochoidal (pivot) joint: a concave and convex joint which allows for rotation around a long axis.
– Radioulnar joint
04/08/23 24
Movements in Joints
• Measured by a goniometer
• Limited by:– Skeletal structue– Muscular structure– Ligamentous structure– Fat– Cartilage
04/08/23 25
Movements in Joints
• General– Abduction: away from the midline– Adduction: toward the midline– Flexion: decreased angle of a joint– Extension: increased angle of a joint– Circumduction: circular movement
04/08/23 26
Movements in Joints
• General– Diagonal abduction: away from the
midline in a diagonal plane.
– Diagonal adduction: toward the midline in a diagonal plane.
04/08/23 27
Movement in Joints
• General– External Rotation: rotary movement around a
longitudinal axis of a bone away from the midline.
– Internal Rotation: rotary movement around the longitudinal axis of a bone toward the midline.
04/08/23 28
Movement in Joints
• Ankle– Eversion– Inversion– Dorsiflexion– Plantarflexion
04/08/23 29
Movement in Joints
• Radioulnar– Pronation– Supination
04/08/23 30
Movement in Joints• Shoulder Girdle and Joint
– Depression– Elevation– Horizontal abduction– Horizontal adduction– Protraction (abduction)– Retraction (adduction)– Downward rotation– Upward rotation
04/08/23 31
Movement in Joints
• Spine– Lateral flexion (side bending)– Reduction (return to anatomical position)– Slight flexion & Extension
04/08/23 32
Movement in Joints• Wrist and Hand
– Palmar flexion– Radial deviation– Ulnar deviation– Opposition of the thumb
04/08/23 33
CHAPTER 2NEUROMUSCULAR
FUNDAMENTALS• Review basic anatomy• To learn and understand terminology• To learn and understand muscle contraction• To learn and understand basic
neuromuscular concepts• To understand neural mechanisms for
movement
04/08/23 34
INTRODUCTION
• Over 600 muscles
• Muscle contraction causes joint (body) movement
• Muscle provide protection for bones and organs of the body
• Muscles contribute to posture and support
• Muscles create body heat
04/08/23 35
MUSCLE NOMENCLATURE
• Muscles are usually named and grouped for their characteristics.• Visual appearance• Anatomical location• Function • (see pages 22 & 23)
04/08/23 36
MUSCLES
• Sternocleidomastoid
• Trapezius
• Deltoid
• Pectoralis Major
• Supraspinatus
• Infraspinatus
• Teres minor / major
04/08/23 37
MUSCLES
• Triceps brachi• Biceps brachi• Brachioradialis• Extensor carpi radialis longus• Extensor carpi radialis brevis• Extensor carpi ulnaris• Flexor carpi ulnaris• Anconeus
04/08/23 38
MUSCLES• Extensor digitorum communis
• Abductor pollicis longus
• Extensor pollicus brevis
• Pronator teres
• Brachialis
• Coracobrachialis
• Brachioradialis
• Flexor carpi radialis
04/08/23 39
MUSCLES• Extensor carpis radialis longus
• Extensor digitorum communus
• Palmaris longus
• Abductor pollicus longus
• Extensor pollicus brevis
04/08/23 40
MUSCLES
• Latissimus dorsi
• Serratus anterior
• Recuts sheath
• External oblique
• Interanl oblique
04/08/23 41
MUSCLES• Tensor fasciae latae• Sartorius• Iliopsoas• Pectineus• Gluteus maximus• Iliotibial band• Adductor longus• Adductor Magnus• Gracilis
04/08/23 42
MUSCLES
• Biceps femoris
• Semitendinosus
• Semimembranosus
04/08/23 43
MUSCLES
• Rectus femoris
• Vastus lateralis
• Vastus medialis
• Vastus intermedius
04/08/23 44
MUSCLES
• Tibialis anterior
• Tibialis posterior
• Peroneus longus
• Peroneus brevis
• Extensor digitorum longus
• Extensor hallucis longus
• Gastrocnemius
• Soleus
• Plantaris
• Achilles tendon
04/08/23 45
MUSCLES SHAPE AND ARRANGEMENT
• Force Generating Capacity is Effected By:– Cross sectional diameter– Pennation of muscles
• Range of Motion is Effected By:– Ability of a muscle to shorten and lengthen– Parallel muscles
04/08/23 46
MUSCLES SHAPE AND ARRANGEMENT
• Flat: thin and broad (external oblique)
• Fusiform: spindle-shaped (brachialis)
• Strap Muscles: long parallel manner (sartorius)
• Radiate: fan shaped (pectoralis major)
• Sphincter: circular muscles which close openings upon contraction (anal sphincter)
04/08/23 47
MUSCLES SHAPE AND ARRANGEMENT
• Pennate muscles have shorter fibers that are arranged obliquely to their tendons.– Unipennate: muscle fibers run obliquely from
one side of the tendon (biceps femoris).– Bipennate: muscle fibers run obliquely from
both sides of the tendon (rectus femoris).– Multipennate: muscles have several tendons
with fibers running obliquely between them (deltoid).
– (see page 26)
04/08/23 48
MUSCLE TISSUE PROPERTIES
• Irritability: sensitive to chemical, electrical, and mechanical stimuli.
• Contractility: ability to contact and develop force against resistance.
• Extensibility: ability of a muscle to return to its original length after contraction.
• Elasticity: ability of a muscle to return to its orginal length following stretching.
04/08/23 49
Muscle Terminology• Intrinsic: internal
• Extrinsic: external
• Action: the joint movement that occurs from a muscle contraction
• Innervation: a segment of the nervous system that causes a muscle to contract
• Amplitude: the range of muscle fiber length between maximal and minimal lengthening.
• Origin: proximal attachment
• Insertion: distal attachment
04/08/23 50
Types of Muscle Contractions
• Isometric Contraction: a maximum static contraction that is equal to the resistance and therefore no joint movement occurs.
• Isotonic Contraction: a shortening or lengthening of the muscle to develop tension.– Concentric Contraction: muscle shortening under
tension to create joint movement.
– Eccentric Contraction: muscle lengthening under tension to allow joint movement.
04/08/23 51
The Role of Muscles
• Agonist: the prime mover of a joint.
• Antagonist: the opposing muscle of a joint
• Stabilizers: contract to stabilize a joint.
• Synergist: muscles that assist in the action of the agonist.
• Neutralizers: contract to resist specific actions of other muscles.
04/08/23 52
The Role of Muscles
• Several factors decide the action of a muscle:– Motor units activated– Joint position– Muscle length– Contraction vs Relaxation– The action of all muscles involved.
04/08/23 53
The Role of Muscles
• Determination of Muscle Action– Lines of pull
• Palpation: feeling a muscle contract
• Use of a rubber band: simulation of a muscle contraction using origin and insertion.
• Electromyography: detects neural impulses when a muscle contracts.
• Electrical muscle stimulation: causes muscle contraction which can then determine the action of the muscle.
04/08/23 54
The Role of Muscles
• Determination of Muscle Action– Line of Pull
• Rotary component: when the line of muscular force is at 90 degrees to the bone of which it attaches, all of the force is rotary in nature
• Stabilizing component: if the angle of pull is less than 90 degrees it has a % of stabilizing force.
• Dislocating component: if the angle of pull is greater than 90 degrees it has a % of dislocating force.
04/08/23 55
Neural Control of Voluntary Movement
• All voluntary movement is a result of both the muscular and nervous systems working together.– Every muscle fiber is innervated by a somatic
(efferent) motor neuron.– Senses create communication to the CNS
through (afferent) neurons
04/08/23 56
Neural Control of Voluntary Movement
• Levels of the Central Nervous System– 1: Cerebral cortex:
creates voluntary gross motor movements and interprets senses.
04/08/23 57
Neural Control of Voluntary Movement
– 2: Basal Ganglia: white matter below the cerebral cortex that controls the maintenance of posture and equilibrium, and learned motor movements.
04/08/23 58
Neural Control of Voluntary Movement
– 3: Cerebellum: located behind the brain stem and is the major integrator of sensory information and provides feedback relative to motion. It also controls the timing and intensity of muscle activity to assist in the refinement of motor movements
04/08/23 59
Neural Control of Voluntary Movement
• Levels of the Central Nervous System– 4: Brain Stem: integrates all CNS
activity through excitation and inhibition of desired muscle activity
– 5: Spinal Cord: the common pathway between the CNS and the peripheral nervous system. Specific control and integrates spinal reflexes.
04/08/23 60
Neural Control of Voluntary Movement
– 6: Peripheral Nervous System: sends the impulse to the specific muscle for contraction or relaxation. (afferent vs efferent, see pg. 34)• Nerve roots: 12 cranial,
8cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
04/08/23 61
Neural Control of Voluntary Movement
• The Cell Body (nucleus)• The Dendrites
– the receivers• The Axon
– the transmitter– contains the axon
terminals– contains the synaptic knobs that
release chemicals known as neurotransmitters.
– The axon hillock decides if the impulse is a graded potential or an action potential.
04/08/23 62
Neural Control of Voluntary Movement
• Dermatomes
• Myotomes
• Proprioception: internal receptors located in the skin, joints, muscles and tendons which provide feedback to muscle length, tension, and contraction state of muscle.– Muscle spindles are sensitive to stretch (contract)
– Golgi tendon organs are sensitive to tension (relax)
• Kinesthesis: awareness of the position and movement of the body in space.– Kinesthetic receptors provide joint feedback
04/08/23 63
Neuromuscular Concepts
• All or None Principle: muscle fibers within a given motor unit will either fire and contract maximally or not at all.
• Muscle Length-Tension Relationship: the greatest amount of tension can be developed when a muscle is stretched between 100% and 130% (stretch reflex) of its resting length
04/08/23 64
Neuromuscular Concepts
• Biarticular and Multiarticular Muscles– Cross over two joints– Can move two joints– Can control length tension relationship– Examples
• Biceps• Rectus femorus• Gastrocnemius• Hamstrings
04/08/23 65
Neuromuscular Concepts
• Autogenic Inhibition: relaxation of the agonist muscle after contraction
• Reciprocal Inhibition: relaxation of the antagonist muscles when the agonist muscles contract.– Example: PNF stretching
• Contract – relax
• Contract – hold - relax
04/08/23 66
Neuromuscular Concepts
• Active Insufficiency: when the muscle becomes shortened to the point that it can not generate or maintain active tension.– Rectus femorus: in hip flexion can not extend the knee with
as much force.
• Passive Insufficiency: when an opposing muscle becomes stretched to the point where it can no longer lengthen and allow movement.– Rectus femorus: hamstrings won’t allow hip flexion
04/08/23 67
Types of Training
• Isometric
• Isotonic
• Isokinetic
• Plyometrics
04/08/23 68
Modes of Training• Free weights• Nautilus• Hydraulics• Friction• Rubber tubing• Cybex• Bow-flex• Box-jumps• Hydrotherapy• Etc.
04/08/23 69
Web Sites
• MUSCLES www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/dissector/mml/
• PROPRIOCEPTION
http://sportsmedicine.about.com/library/weekly/aa062200.htm
• MUSCLES CONTRACTINGhttp://users.rcn.com/jkimball.ma.ultranet/BiologyPages/M/Muscles.html
• MUSCLES CONTRACTINGwww.ebsa.org/npbsn41/intro_muscle.html
04/08/23 70
Chapter 3Basic Biomechanical Factors and Concepts
• Biomechanics: the study of the mechanics as it relates to the functional and anatomical analysis of the human body.– Statics: involves all forces acting on the body being
in balance, resulting in the body being in equilibrium.
– Dynamics: involves the study of systems in motion while unbalanced due to unequal forces acting on the body.
04/08/23 71
Chapter 12Basic Biomechanical Factors and Concepts
– Kinematics: the description of motion.• Time
• Displacement
• Velocity etc.
– Kinetics: is the study of forces associated with the motion of a body.• Force
• Resistance
04/08/23 72
Levers
• Lever: a rigid bar that turns about an axis.– Force– Axis – Resistance
• The “Dog Principle”– “A” in the middle– “R” in the middle– “F” in the middle
04/08/23 73
First Class Levers• Axis is in the middle• Produces balanced movements
when the axis is centered in the middle.
• When the axis is close to the force it provides speed and range of motion.
• When the axis is close to the resistance it provides greater force.
• Examples: elbow, ankle
04/08/23 74
Second Class Levers
• Resistance is in the middle• Designed to produce forceful
movements.• There are relatively few
occurrences of second class levers in the body.
• Examples: – Plantar flexion– Scapular rotation
04/08/23 75
Third Class Levers
• Force is in the middle
• Designed to produce speed and range of motion movements.
• Most of the levers in the human body are third class.
• Examples:– Elbow (bicep)
– Elbow (brachialis)
– Knee (hamstrings)
– Many others…
04/08/23 76
Factors In Use of Anatomical Levers• Torque: force which causes a turning effect.
– Force X Force Arm = Torque
04/08/23 77
Factors In Use of Anatomical Levers
• Eccentric Force: force that is applied in a direction not in line with the center of rotation.
04/08/23 78
Factors In Use of Anatomical Levers
• Force Arm: the distance between the axis and the point of force.
• Resistance Arm: The distance between the axis and the point of resistance.
04/08/23 79
Factors In Use of Anatomical Levers
• The longer the force arm, the less force required to move the lever.
• A greater resistance may be moved by shortening the resistance arm.
04/08/23 80
Factors In Use of Anatomical Levers
F X FA = R X RALbs. inches lbs. inches
04/08/23 81
Factors in Use of Anatomical Levers
Force =
Force Arm = 3 inches
Resistance Arm = 5 inches
Resistance = 20 lbs
What is the force required?
How much force is required if the
FA equals 2 inches?
04/08/23 82
Factors In Use of Anatomical Levers
• The system of leverage in the human body is built for speed and range of motion at the expense of force.– Short force arms– Long resistance arms
• The human body is a system of levers that have to work together to create athletic movement.
04/08/23 83
Factors In Use of Anatomical Levers
• Sports also use the advantage of longer levers– Longer golf clubs– Longer tennis racquets– Long arms for pitching
• What limitations are there with longer levers?
04/08/23 84
Factors In Use of Anatomical Levers
• Angle of Pull: the angle between the line of pull of the muscles and the bone on which it inserts.– With every degree of joint motion, the angle of pull
changes.– The angle of pull decreases as the bone moves away
from its anatomical position.– The range of motion depends on the type of joint,
the bony structure, and other considerations.
04/08/23 85
Factors In Use of Anatomical Levers
• 3 Components of Muscular Force– Rotary component: muscular force that acts
perpendicular to the long axis of the bone.– Stabilizing component: the muscular force pulls the
bone toward the joint at less than 90 degrees.– Dislocating component: the muscular force pulls the
bone away from the joint at greater than 90 degrees.
04/08/23 86
Laws Of Motion and Physical Activities
• Two Types of Motion– Linear motion: motion along a line
• Rectilinear: motion along a straight line
• Curvilinear: motion along a curved line
– Angular (rotary) motion: motion around an axis• Example: motion around a joint axis
04/08/23 87
Laws Of Motion and Physical Activities
• Displacement: refers to a change in location of an object from its original position.– Angular displacement: change in location of a
rotating body.– Linear displacement: change in location of a body
moving in a straight line.• Distance: length of measurement the body travels.• Speed: how fast a body is moving per distance.• Velocity: the rate of displacement.
04/08/23 88
Laws Of Motion and Physical Activities
• Law of Inertia: A body in motion tends to remain in motion at the same speed in a straight line unless acted on by a force; a body at rest tends to remain at rest unless acted on by a force.
04/08/23 89
Laws Of Motion and Physical Activities
• Law of Acceleration: A change in the acceleration of a body occurs in the same direction as the force that caused it. The change in acceleration is directly proportional to the force causing it and inversely proportional to the mass of the body (A = F / M)– Mass: the amount of matter in a body which affects the
speed and acceleration in physical movements.– baseball vs shot put
– Lineman vs runningback
04/08/23 90
Laws Of Motion and Physical Activities
04/08/23 91
Laws Of Motion and Physical Activities
• Law of Reaction: for every action there is an opposite and equal reaction.
04/08/23 92
Laws Of Motion and Physical Activities
• Centripetal Force: a force which pulls an object toward the center of motion in a circular path (axis).
• Centrifugal Force: the equal and opposite reaction to centripetal force, causing the object to pull away from the center of motion (eccentric force).
04/08/23 93
Balance, Equilibrium, and Stability
• Balance: is the ability to control equilibrium.– Equilibrium: the state of zero acceleration or change
in direction.• Static equilibrium: a state of complete motionlessness
• Dynamic equilibrium: when forces of motion are acting on a moving body to keep it balanced
• Center of Gravity: the point at which the body’s mass and weight is equally balanced.
04/08/23 94
Balance, Equilibrium, and Stability
• Balance is Enhanced by:– Wide base of support
– Low center of gravity
– Increased weight
– Relationship of center of gravity to base of support
– Increased friction of supporting structures
– Rotation about an axis aids balance
– Kinesthetics sense• Inner ear, touch, vision, practice etc.
04/08/23 95
Balance, Equilibrium, and Stability
• Force: a strength or energy exerted to cause motion or change.– Force = Mass X Acceleration– Baseball vs shot put
04/08/23 96
Balance, Equilibrium, and Stability
• Momentum: the quantity of motion– Momentum = Mass X Velocity– Running back vs Lineman– The greater the momentum the
greater the resistance to change in inertia.
04/08/23 97
Balance, Equilibrium, and Stability
• Summation of Forces: the forces accumulated from each muscle to a joint and each joint to an activity.– Throwing a baseball– Swinging a golf club
• Skillful performance requires– The regulation (speed) of force – The control (direction) of force
04/08/23 98
A Kinesiological Analysis is a Summary of all Components of A
Movement• Anatomy used for the activity• Directional terminology• Planes of motion• Types of bones and joints
– Types of levers– Mechanical advantages
• Types of muscle contractions• Laws of motion• Balance, Equilibrium, and Stability
04/08/23 99
Chapter 2The Shoulder Girdle
• Objectives– Identify bones and landmarks– Identify shoulder girdle muscles– Identify shoulder girdle movements
• Planes
• Axis of rotation
– Palpate the muscles of the shoulder girdle– Palpate the joints of the shoulder girdle
04/08/23 100
Bones• Scapula
• Acromion process• Glenoid cavity• Infraspinatus fossa• Lateral border• Posterior surface• Inferior angle• Medial border• Spine of the scapula• Supraspinatus fossa• Superior angle• Coracoid process• Subscapular fossa
04/08/23 101
Bones• Clavicle
• Manubrium
• Sternum
04/08/23 102
Movements
• Abduction (protraction)
• Adduction (retraction)
• Elevation
• Depression
• Upward Rotation
• Downward Rotation
04/08/23 103
Muscles
04/08/23 104
LEVATOR SCAPULAE MUSCLE
04/08/23 105
LEVATOR SCAPULAE MUSCLE
• Innervation:
– Dorsal scapula nerve C5 and branches of C3 and C4.
• First Class Lever
04/08/23 106
LEVATOR SCAPULAE MUSCLE
• Origin:
– Transverse processes of the upper four cervical vertebrae.
• Insertion:
– Medial border of the scapula above the base of the scapular spine.
04/08/23 107
LEVATOR SCAPULAE MUSCLE
• Action:– Elevates the medial margin of the scapula, as
seen in shoulder elevation.
• Synergist:– Trapezius, Rhomboid Muscles
• Antagonist:– Part 3 of the Trapezius, Pectoralis Minor
04/08/23 108
LEVATOR SCAPULAE MUSCLE
• Strengthening Exercises:– Shoulder shrugs are the major strengthening exercise for
the Levator Scapulae Muscle.
– Four-way neck machine can also be used to do neck extensions and lateral flexion to strengthen the Levator Scapulae Muscle.
• Stretching:– Best stretched by rotating the head approximately 45
degrees to the opposite side and flexing the cervical spine actively while maintaining the scapula in a relaxed, depressed position.
04/08/23 109
NECK EXTENSION
04/08/23 110
CERVICAL LATERAL FLEXION
04/08/23 111
SHOULDER SHRUGS
04/08/23 112
STRETCHING
04/08/23 113
LEVATOR SCAPULAE MUSCLE
• Sporting Activities Where Muscle is Used:– When in stance waiting to hit a baseball, you
must elevate your shoulders using this muscle along with the Trapezius , and the Rhomboid Major and Minor.
– During Football, whenever you brace your neck to initiate or withstand impact, you are using your Levator Scapulae Muscle.
04/08/23 114
SPORTING ACTIVITIES
04/08/23 115
RHOMBOIDSRHOMBOIDSMajor and
Minor
04/08/23 116
Physiological Information
• Innervation- Dorsal scapula nerve (C5)• Lever- 3rd Class• Origin: Spinous process of the last cervical
and the first five thorasic vertebrae.• Insertion: Medial border of the scapula,
below the spine.• Relation to other muscles: Deep to the
trapezius muscle
04/08/23 117
Actions
• Both major and minor work together.• Adduction: draw the scapula toward the
spinal column.• Rotation downward: from the upward
rotated position; they draw the scapula into downward rotation.
• Elevation: slight upward movement, accompanying adduction.
04/08/23 118
Actions, cont.
• Elevation, cont.: elevates the medial border of the scapula.
• Stabilizes the scapula.
04/08/23 119
Other Helpful Muscles
• SYNERGISTS
• Trapezius
• Posterior Deltoid
• Levator scapulae
• ANTAGONISTS
• Pectoralis major
• Latissimus dorsi
• Anterior Deltoid
• SITS
04/08/23 120
WORKOUTS
• Chin ups
• Dips
• Seated rows
• Low rows
• Push-ups
• Theraband activity
04/08/23 121
Chin ups
04/08/23 122
Dips
04/08/23 123
Seated Rows
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Incline Rows
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Push-ups
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Theraband
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SPORTS
• Rowing
• Hockey (slap shot wind up)
• Pitching (wind-up)
• Javelin (preparatory)
• Pretty much any sport where the scapula adduct!
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Rowing
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Hockey
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Pitching
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Quarterback
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Javelin
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STRETCHES
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STRETCHES cont.
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STRETCHES cont.
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Muscle Analysisof the
Serratus Anterior
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Overviewof the
Serratus Anterior• Anterior shoulder girdle muscles are the serratus
anterior, pectoralis minor, and subclavius and function primarily in abduction and depression.
• Provides dynamic stability of the scapula so that it can serve as a relative base of support for the shoulder joint while holding the scapula against the thoracic wall.
• An example of a 1st class lever
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Nerve Innervation
• Innervated by the long thoracic nerves C5 – C7
C5 slips from ribs 1 & 2C6 slips from ribs 3 & 4
C7 slips from ribs 5 – 8
A winged scapula condition indicates a weakness of the muscle resulting from injury to the long thoracic nerves.
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Origin & Insertion
• Origin is located on the surface of the upper nine ribs at the side of the chest and intercostal membranes from the midclavicular line.
• Insertion is near the anterior aspect of the whole length of the medial border of the scapula.
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Actions
• Primarily abduction and depression
• Abduction (protraction) draws the medial border of the scapula away from vertebrae.
• Rotation upwards is present with the longer, lower fibers drawing the inferior angle of the scapula farther away from the vertebrae,
thus rotating the scapula slightly upward.
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Role of Other Muscles
• Synergists include the other anterior shoulder girdle muscles of the subclavius and pectoralis minor and major.
• Antagonists primarily include the trapezius, rhomboid, and often the levator scapula.
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Strengthening Exercises
Bench Press Overhead Press
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Strengthening Exercises
Seated Upright Rows Dumbbell Rows
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Strengthening Exercises
Push-ups
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Stretching Exercises
Wall Push Sit and Reach (Scapular Adduction)
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Applications
• The serratus anterior is used commonly in movements drawing the scapula forward with slight upward rotation.
• It works with the pectoralis major (synergist) in typical action such as throwing a baseball.
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Relevant Athletic Activities
Swinging a Bat Throwing a Baseball
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Relevant Athletic Activities
Tackling in Football Shooting a Basketball
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Pectoralis MinorPectoralis Minor
Innervated by the Medial Pectoral Nerve (C8-T1)
1st Class Lever (force- ribs, axis- shoulder joint,
resistance- weight on scapula)
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Pectoralis MinorPectoralis Minor
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OriginsOrigins InsertionsInsertions
• Anterior surfaces of the 3rd, 4th, & 5th ribs (outer surface & upper margin)
• Medial & upper surface of coracoid process of scapula
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Actions of the MuscleActions of the Muscle
•Abduction (protraction): draws the scapula forward and tends to tilt the lower border away from the ribs
•Downward rotation: as it abducts, it draws the scapula downward
•Depression: when the scapula is rotated upward, it assists in depression
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SynergistSynergist AntagonistAntagonist
• Serratus anterior (abduction)
• Rhomboid muscles (downward rotation)
• Rhomboid muscles (depression and abduction)
• Levator scapulae muscle (depression)
• Serratus anterior (downward rotation)
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Strengthening ExercisesStrengthening Exercises
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Bench Press
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Chin-Ups
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Dips
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Push-Ups
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Standing Fly
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StretchesStretches
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Wall Pectoralis Minor Stretch
• Keep back against the wall with a step away
• Arms at 90º against the wall
• Push arms and shoulders into the wall while raising and lowering as far as possible
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Doorway Modified Chest Stretch
• Arm at 90º against wall
• Stand a step away
• Lean into the wall while turning your body away from the wall
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Wall Push-Up Stretch
• Push your shoulders toward the corner
• Hold for 15 seconds
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Sporting Activities that use Sporting Activities that use the Pectoralis Minorthe Pectoralis Minor
• Gymnastics• Softball • Bowling• Tennis• Golf
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KINESIOLOGY
TRAPEZIUS Muscle
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CHARACTERISTICS
* INNERVATION*– Dorsal scapula nerve C5 – Branches of C3 and C4
* CLASS LEVER*– THIRD
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ORIGIN
• Upper fibers: base of skull, occipital protuberance, and posterior ligaments of neck
• Middle fibers: spinous processes of seventh cervical and upper three thoracic vertebrae
• Lower fibers: spinous processes of fourth through twelfth thoracic vertebrae
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INSERTION
• Upper fibers: posterior aspect of the lateral third of the clavicle
• Middle fibers: medial border of the acromion process and upper border of the scapular spine
• Lower fibers: triangular space at the base of the scapular spine
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ACTIONS
• Upper fibers: elevation of the scapula, extension of the head at the neck
• Middle fibers: elevation, upward rotation, and adduction of the scapula
• Lower fibers: depression, adduction, and upward rotation of the scapula
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SHOULDER GIRDLE MUSCLE
* SYNERGIST· Primarily adduction
and elevation
· Rhomboid
· Levator Scapula
* ANTAGONIST
· Primarily abduction and depression
· Pectoralis Minor
· Serratus Anterior
· Subclavius
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STRENGTHENING EXERCISES
• Shoulder-shrugging exercises
• Bent rowing from a prone position
• Side arm shoulder joint abduction
• Lawn mowers
• Upright row
• Sitting row
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•
Seated Row
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Lawn Mowers (Low Row)
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Lateral Flys
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Upright Row
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STRETCHES
• Use one hand to pull the head and neck forward into flexion or slight ipsilateral flexion to the opposite side while the ipsilateral hand is hooked under a table edge to maintain the scapula in depression
• Use a partner to pull the scapula into protraction
• Move the scapula into max elevation and protraction
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SPORTING ACTIVITIES
• THROWING
• ROWING
• X-C SKIING
• REBOUNDING
• TACKLING
• BATTING
• BLOCKING
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Subclavius Muscle
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Origin
• Superior aspect of first rib at its junction with its costal cartilage
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Insertion
• Inferior groove in the mid-portion of the of the clavicle
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Action
• Stabilizes and protects the sternoclavicular joint during upper extremity movements
• Assists the depression of the clavicle
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Lever• Third-class lever system
-force(subclavius) is being applied between the axis (origin) and the resistance (insertion)
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Role of Subclavius
• SynergistAssists in the depression of the
clavicle
• Stabilizer
Protects and stabilizes the sternoclavicle joint
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List of Sporting Activities
• Baseball
- the motion of throwing a ball
• Shot Put
- tossing a shot
• Basketball
-the motion of shooting
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Exercises
Dips, Lat Pulldowns
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Dips
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Lat Pulldown
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Stretches
• Extreme elevation of the shoulder girdle
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Sporting Activities
• THROWING
• ROWING
• X-C SKIING
• REBOUNDING
• TACKLING
• BATTING
• BLOCKING
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The Deltoid Muscle• The deltoid muscle overlies most of the
anterior shoulder to the middle of the lateral humorous.– The Deltoid is used in virtually any lifting
movement– Innervated by the Axillary nerve (C5, C6)
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Origin/Insertion
• There are three points of origin for the deltoid muscle.– Anterior Fibers:
• Anterior lateral third of the clavical
– Middle Fibers:• Lateral aspect of the acromion
– Posterior Fibers:• Inferior edge of the spine of the scapula
• The insertion of the deltoid is the deltoid tuberosity on the lateral humerus.
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Actions of the Deltoid
• Actions of the deltoid are separated into actions produced by three categorized fibers of the muscle.– Anterior fibers– Middle fibers– Posterior fibers
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Anterior Fibers
• Abduction, flexion, horizontal adduction, and internal rotation of the glenohumeral joint
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Middle Fibers
• Abduction of the glenohumeral joint
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Posterior Fibers
• Abduction, extension, horizontal abduction, and external rotation of the glenohumeral joint
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Levers
• Because the insertion of the deltoid muscle lies at the deltoid tuberosity of the lateral humerus, this is a 3rd class lever.– In all cases, the force (muscle insertion) is in
the middle, between the axis (shoulder joint) and the resistance (anything being lifted).
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Synergists/Antagonists
• Depending on the task being performed by the deltoid muscle, various other muscles play a role in the action.
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Strengthening Exercises
• Anterior Deltoid • Dumbbell front raise
– Grasp the dumbbells in both hands– Raise one dumbbell with elbows fixed in a 10°
to 30° angle throughout until upper arm is parallel to the floor.
– Continue with alternate arm.
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Dumbbell Front Raise
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Dumbbell Front Raise
• Synergists– Pectoralis major, middle and lower trapezius,
serratus anterior
• Antagonist– Latissimus dorsi
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Strengthening Exercises
• Lever Shoulder Press– Sit at machine, and grasp the bar with an
overhand grip.
– Press lever until arms are extended overhead. – Lower and repeat.
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Lever Shoulder Press
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Lever Shoulder Press
• Synergists– Pectoralis major, triceps brachii, middle and
lower trapezius, serratus anterior
• Antogonist– Latissimus dorsi, biceps brachii
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Strengthening Exercises
• Lateral Deltiod• Barbell upright row
– Grasp bar with shoulder width or slightly narrower overhand grip.
– Pull bar to neck with elbows leading. Allow wrists to flex as bar rises.
– Lower and repeat.
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Barbell Upright Row
• Synergists– Anterior deltoid, supraspinatus, brachialis,
briachioradialis, biceps brachii, middle and lower trapezius, serratus anterior, infraspinatus, teres minor
• Antagonists– Lattisimus dorsi
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Strengthening Exercises
• Posterior Deltoid• Row
– Sit on platform with knees slightly bent. – Grasp cable attachment. – Pull cable attachment with upper arm
perpendicular to trunk until upper arms is just beyond parallel to one another.
– Return and repeat.
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Seated Row
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Row
• Synergists– Infraspinatis, teres minor, lateral deltoid,
middle and lower trapezius, rhomboids, brachialis, brachioradialis
• Antagonists– Triceps brachii, latissimus dorsi
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Anterior Deltoid Stretch
• Doorway front deltoid stretch– Stand at end of wall or in doorway facing
perpendicular to wall.
– Position palm on surface of wall slightly lower than shoulder.
– Bend elbow slightly.
– Turn body away from positioned arm. Hold stretch for 20 seconds.
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Doorway Front Deltoid Stretch
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Lateral Deltoid Stretch
• Position arm across chest. Place opposite hand on elbow.
• Push elbow toward chest. Hold stretch for 20 seconds.
• Repeat with opposite arm.
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Lateral Deltoid Stretch
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Posterior Deltoid Stretch
• Position arm across neck. Place opposite hand on elbow.
• Push elbow toward neck. Hold stretch for 20 seconds.
• Repeat with opposite arm.
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Posterior Deltoid Stretch
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Sports Using Deltoids
• Baseball
• Football
• Track and Field
• Gymnastics
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Structural Kinesiology:
Supraspinatus Muscle
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Supraspinatus Muscle
• (sú pra-spi-ná tus)
• Origin: Medial two thirds of the Supraspinatus fossa
• Insertion: Superiorly on the greater tubercle of the humerus
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Palpation
• The Supraspinatus cannot be palpated
• This muscle lies:
• under the deltoid muscle distally– Distal: situated away from the center or midline of the
body, or away from the point of origin
• under the trapezius proximally– Proximal: nearest the trunk or the point of origin
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Innervation
• Suprascapular nerve (C5)
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3rd Class Lever
• Axis - shoulder joint
• Force - the muscle inserts at the greater tubercle of the humerus
• Resistance - is the weight held in the hand
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Strengthening Exercises
• “empty can exercise”
• shoulder abduction with the use of Theraband
• lateral dumbbell raises
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“Empty can exercise”
Finish Start
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Shoulder Abduction with Theraband
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Lateral dumbbell raise
Start Finish
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Stretches
• Adducting the arm behind the back with the shoulder internally rotated and extended stretches the supraspinatus
• Lying supine with elbow at ninety degree angle with hand pronated (partner applies pressure to the dorsal side of hand)
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Athletics Utilizing Supraspinatus
• Baseball - throwing, batting
• Basketball - shooting, passing
• Football - throwing, blocking
• Golf - full motion of swing
• Softball - throwing, batting
• Volleyball - hitting, digging
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Synergists
• Deltoid
• Infraspinatus
• Teres minor
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Antagonists
• Coracobrachialis
• Subscapularis
• Teres major
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Infraspinatus
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Nerve InnervationSuprascapular Nerve
(C5,6)
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Actions*External rotation of the glenohumeral joint
*Horizontal abduction of the glenohumeral joint
*Extension of the glenohumeral joint
*Stabilization of the humeral head in the glenoid fossa
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Origin/Insertion*Origin: Medial aspect of the infraspinatus fossa just below the spine of the scapula
*Insertion: Posteriorly on the greater tubercle of the humerus
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SynergistsTeres Minor, Subscapularis, Deltoid
AntagonistsDeltoid, Pectoralis Major
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Palpation*Immediately below the spine of the scapula and the posterior fibers of the deltoid muscle
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3rd Class LeverAxis- glenohumeral joint
Force-is at the insertion: posteriorly on the greater tubercle of the humerus
Resistance-in the hand
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Stretching
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Exercises
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Sports
Baseball
Tennis
Rowing
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Teres Minor Muscle
By Chris Laz
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Innervation
• The axillary nerve innervates the teres minor as well as the deltoid and the skin over the deltoid tuberosity of the humerous.
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Lever Class
• If the scapula is stabilized this muscle becomes a first class lever with the axis being the insertion point, the force being applied to contract the muscle and the resistance being applied on the humerous.
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Origin/Insertion
• Origin: Posteriorly on the upper and middle aspect of the lateral border of the scapula.
• Insertion: Posteriorly on the greater tubercle of the humerous.
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Actions of the teres minor
• External rotation of the glenohumeral joint: Rotary movement around the longitudinal axis of the bone away from the center of the body; turning the upper arm outward.
• Horizontal abduction of the glenohumeral joint: moving the upper arm away from the chest with the elbows facing down.
• Extension of the glenohumeral joint
• Stabilization of the humeral head in the glenoid fossa
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Synergist Muscles
• The infraspinatus helps the teres minor in stabilizing the glenohumeral joint posteriorly.
• The supraspinatus and the subscapularis muscles also are involved in the rotator cuff in order to make sure the humeral head stays in its proper location within the glenoid cavity.
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Antagonist Muscles
• Anterior Deltoid
• Latissimus Dorsi
• Subscapularis
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Strengthening Exercises
• Chin-Ups
• Rope Climbing
• Dips on a parallel bar
• Rotating the arm against resistance in the 0-degree and the 90-degree abducted
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Chin-Ups
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Climbing Rope
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Dips
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Stretches
• Internally rotating the shoulder while moving into extreme horizontal adduction.
• Externally rotating the shoulder in a 90-degree abducted position.
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Broomstick
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Bent-Over Stretch
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Seated Bent-Over
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Sporting Activities
• Several sporting exercises use the rotator cuff. The teres minor is involved in swimming, tennis, volleyball, golf, and throwing any object.
-Kick serve to the backhand
-Hitting a hook
-Throwing a slider
-Swimming butterfly
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Subscapularis
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Origin• Entire anterior surface of the subscapular
fossa
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Insertion• Lesser tubercle of the humerus
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Innervation
• Upper and lower supscapular nerve (C5-C6)
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Action
• Glenohumeral head depressor
• (Medial) Internal rotation of glenohumeral joint
• Adduction of the glenohumeral joint
• Extension of the glenohumeral joint
• Stabilization of the humeral head in the glenoid fossa
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Third Class Lever
• During stabilization of the scapula
• Force – insertion at humeral head
• Axis – glenohumeral joint
• Resistance – weight of arm or dumbell
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First Class Lever
• Stabilization of the glenohumeral joint
• Force – supscapularis
• Axis – scapular rotation
• Resistance – weight of scapula
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Supscapular Exercises
• Synergists – Pectoralis Major, Latissimus Dorsi, Teres Major, Deltoid – anterior
• Stabilizers – Pectoralis minor, Rhomboids, Levator scapulae, Wrist Flexors
• Antagonists – Teres minor, Infraspinatus, Deltoid - posterior
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Cable Internal Rotation
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Dumbbell Internal Rotation
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Broom Stick Subscapularis Stretch
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Doorway Subscapularis Stretch
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Sporting Activities
• Baseball – throwing a pitch
• Swimming – freestyle, butterfly
• Tennis – forehand swing
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Tennis
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Swimming
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Baseball
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Structural Kinesiology
TERES MAJOR
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Teres Major
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Origin• Posteriorly on the inferior third of the lateral
border of the scapula and just superior to the inferior angle
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Insertion
• Medial lip of the intertubercular groove of the humerus
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Actions
• Extension of the glenohumeral joint, particularly from the flexed position to the posteriorly extended position
• Internal rotation of the glenohumeral joint• Adduction of the glenohumeral joint,
particularly from the abducted position down to the side and toward the midline of the body
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Palpation Innervation
• Posterior scapular surface, moving diagonally upward from the inferior angle of the scapula
• Lower subscapular nerve, C5,6
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Synergists Antagonists
• Latissimus dorsi, Pectoralis major, and the Subscapularis in all three major actions of Teres Major
• Teres minor and Infraspinatus in extension of glenohumeral joint
• Coracobrachialis in adduction of glenohumeral joint
• Deltoid, Teres Minor, Supraspinatus and Infraspinatus in adduction
• Coracobrachialis in extension
• Teres Minor and Infraspinatus in internal rotation
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Third Class Lever
A: The glenohumeral joint of the shoulder
F: Muscle attaches at medial lip of intertubercular groove of the humerus
R: Resistance in your hand
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How to stretch theTeres Major
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How to strengthen theTeres Major
Lat Pulldowns
Rope Climbing
Internal Rotation using Theraband
Adduction using Theraband
Extension using Theraband
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Lat Pull-Down
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Rope Climbing
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Internal Rotation
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Adduction with Theraband
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Extension using Theraband
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Sports that use theTeres Major
Internal rotation in the follow through of the swing
Extension while pulling yourself upwards
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Sports that use the Teres Major
Left: Extension following serve
Below: Extension in the free style
Extension in the row
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Sports that use the Teres Major
From abduction (left) to adduction (right) in the rings
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Latissimus Dorsi
Posterior shoulder
joint muscle
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Origin
• Posterior crest of the ilium
• Back of sacrum
• Spinous processes of the lumbar vertebrae (L1-5) and lower 6 thoracic vertebrae (T7-12)
• Slips from the lower 3 ribs
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Insertion
• Medial side of the intertubercular groove of the humerus
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Palpation
Posterolateral aspect of the trunk below the armpit
(Don’t tickle your partner)
Innervation
Thoracodorsal nerve (C6-8) from brachial plexus
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Synergists
• Rhomboids
• Pectoralis major
• Teres major
Stabilizers• Triceps
• Biceps
Antagonists
• Pectorals
• Deltoids
• Rotator cuff muscles Supraspinatus
Infraspinatus
Subscapularus
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Lever Type
• Third class leverforce- insertion on humerus
axis- shoulder joint
resistance- varies depending on movement
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Actions
• Adduction of the glenohumeral joint• Extension of the glenohumeral joint• Internal rotation of the glenohumeral joint• Horizontal abduction of the glenohumeral
joint
(Accompanied by depression, downward rotation, and adduction of the scapula)
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Strengthening Exercises
• Chin-ups (assisted or weighted)
• Pull-ups (over or underhand)
• Dips
• Lat pull downs (front and rear)
• Lat pullovers (Lat pulls)
• Seated rows (keep elbows close to body)
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Pull-up
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Dips
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Pulldowns(can be done in front or back)
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Pullovers (Lat Pulls)
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Seated Rows(should be done with elbows kept close to body)
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Stretches
• Bent-over lat stretch
• Overhead lat stretch
• Wall lat stretch
• Side-to-side bends
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Bent-over Lat Stretch
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Overhead Lat Stretch
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Wall Lat Stretch
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Side-to-side Bends
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Sports
• Baseball
*throwing, hitting
• Running
• Soccer throw-ins
• Rope/rock climbing
• Gymnastics
• Volleyball
*serve, block
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Biceps Brachii Muscle
• The bicep is known as a two-joint muscle. Although it should be a three joint muscle—the shoulder, elbow, and radioulnar.
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Origin
• Two Heads– Long Head: supraglenoid tubercle above the
superior lip of the glenoid fossa– Short head: coracoid process of the scapula
and upper lip of the glenoid fossa
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Insertion
• Tuberosity of the radius and bicipital aponeurosis
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Innervation
• Musculocutaneous nerve (C5, C6)
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• SynergistsElbow Flexion:
Brachialis BrachioradialisPronator teres
Supination of the forearm:brachioradialisSupinator muscle
Flexion of the Shoulder joint:Coracobrachialis
• AntagonistsElbow Fexion:
Triceps BrachiiAconeus
Supination of the forearm:Pronator quadratusPronator teres muscle
Flexion of the Shoulder joint:Triceps brachii
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Action
• Flexion of the elbow
• Supination of the forearm
• Weak flexion of the shoulder
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Palpation Type of Lever
• The bicep brachii is easy to be palpated on the aterior aspect of the humerous and the elbow
• Third class leverAxis = the elbow jointForce = the bicep
insertion at the radial tuberosity
Resistance = center of gravity, or weight in the hand
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Bicep Brachii Exercises
• Bicep Curls Normal– Hold the weights with your
palms facing away from you, in the downward position.
– Aim to keep the elbows tucked into the side and avoid swinging the weights up, or arching your back.
– Move the weights in a smooth motion from your middle up towards your chin, then lower under control, and repeat.
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Biceps Brachii Exercises
• Hammer CurlsStand with soft knees, keeping
your back straight and your shoulder width apart.
Hold the weights with your palms facing towards your sides.
Aim to keep the elbows tucked into the side and avoid swinging the weights up.
Move the weights in a smooth motion from your middle up towards your chin, in a hammer like motion.
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Biceps Brachii Exercises
• Incline Bench Bicep CurlStand behind an incline bench, resting one arm
along the bench.
Hold a dumbbell in that arm, with your palm facing upwards.
Smoothly curl the weight up towards your shoulder, then lower and repeat.
This method helps isolate the biceps, and is good for beginners, as it helps you develop correct technique.
Change arms then repeat on the other side.
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Stretches for the Biceps Brachii
• Place your arm straight against a wall, with your palm facing the wall.
• With your body close to the wall, slowly turn your body away from it, keeping the arm in contact with the wall.
• This is an excellent stretch for the biceps and chest muscles.
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Additional Stretches
• The elbow must be extended maximally with the shoulder in full extension. The biceps must be stretched by beginning with full elbow extension and progressing into full horizontal abduction.
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Sporting Activities
• Rowing
• Bowling
• Tackling in Football
• Softball Pitching
• Throwing a curve ball in baseball
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Brachialis Muscle
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Brachialis Muscle
• Origin– Distal half of the anterior portion of the humerous.
• Insertion– Coronoid process of the Ulna.
• Palpation– Lateral side of the upper arm under the biceps brachii
muscle.• Innervation
– Muscolocutaneous nerve and sometimes branches from the radial and median nerves (C5,C6)
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Brachialis Muscle
• Action– The brachialis muscle is used whenever the
elbow flexes.– It pulls on the ulna and is the only pure flexor
of the elbow joint.
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Brachialis Muscle
• Third Class Lever– The axle is the elbow.– The force is the insertion point on the ulna– The resistance is the object that is being lifted.
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Brachialis Muscle
• Synergist Muscles– Biceps Brachii
– Brachioradialis
• Antagonist Muscles– Triceps Brachii
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Strengthening Exercises
• Preacher Curl (Barbell or Dumbbell)
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Strengthening Exercises
• Isolation Curls
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Strengthening Exercises
• Any other elbow curling exercises
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Stretching
• Brachialis can only be stretched by extending the elbow with the shoulder relaxed and flexed.
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Activities
• Any activity where the elbow is flexed, such as…
– Bowling
– Softball
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Brachioradialis
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Origin: Distal two-thirds of the lateral condyloid ridge of the humerus
Insertion:Lateral surface of the distal end of the radius at the styloid process
origin
insertion
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Innervation: Radial nerve (C5,6)
Palpation: On the lateral anterior side of the forearm
Third Class Lever
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Actions: - Elbow flexion
- Pronation (from supinated position to neutral)
- Supination (from pronated position to neutral)
Sports examples:- Golf swing, baseball swing, throwing, catching, rock climbing, running, shooting
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Synergists: Biceps brachii, brachialis, pronator teres, pronator quadratus, supinator
Antagonists: Triceps brachii, anconeus
Brachioradialis
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Lifting & Stretching Lifts:
- dumbbell hammer curl
- barbell reverse curl
- reverse preacher curl
- cable reverse curl
- overhead tricep extension
- wrist curls
Stretches: - extend elbow with shoulder in flexion, then
maximally pronate or supinate the forearm
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Dumbbell Hammer Curl
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Barbell Reverse Curl
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Reverse Preacher Curl
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Cable Reverse Curl
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Overhead Tricep Extension
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Wrist Curls
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TRICEPS BRACHII
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TRICEPS BRACHII
Triceps Brachii has three parts, the long head (1), the lateral head (2), and the medial head (3).
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TRICEPS BRACHII
• Innervation:– Radial Nerve C7 and C8
• Lever Class:– In elbow extension, is First Class Lever
– F: Olecranon A: Elbow R: Nonsupported forearm
– In pushups, is Second Class Lever
– F: Olecranon A: Hand R: Body weight at elbow joint
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TRICEPS BRACHII
• Origin:– Long Head: infraglenoid tubercle below
inferior lip of glenoid fossa of the scapula.– Lateral Head: upper half of the posterior
surface of the humerus.– Medial Head: distal two-thirds of the posterior
surface of the humerus.
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TRICEPS BRACHII
• Insertion:– Olecranon process of the ulna.
• Actions:– All Heads: Extension of the elbow– Long Head: Extension of the shoulder joint &
Adduction of the shoulder joint.
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TRICEPS BRACHII
• Synergist:– Anconeus muscle. Few synergists because the
three heads of the muscle do all the work.
• Antagonist:– Biceps brachii, brachialis muscle,
brachioradialis muscle.
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STRENGTHENING EXCERCISES
• Typical action of the triceps brachii is shown in push-ups when there is powerful extension of the elbow.
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STRENGTHENING EXCERCISES
• Bench pressing a barbell or a dumbbell is an excellent exercise to perform elbow extension.
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STRENGTHENING EXCERCISES
• The overhead press is also a very good way to emphasize the triceps brachii.
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STRENGTHENING EXCERCISES
Dips are also a good way to achieve elbow extension and extensively work the triceps brachii.
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STRENGTHENING EXCERCISES
• Standing elbow extensions work the triceps brachii very well.
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STRENGTHENING EXCERCISES
• Bent over elbow extensions are another form of elbow extensions that work the triceps brachii primarily.
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STRETCHING EXCERCISE
• Can be flexed with both the shoulder and the elbow in maximal flexion, as seen in those overhead elbow flexion stretch.
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SPORTING ACTIVITIES
When shooting a basketball, you use your triceps to extend your elbow on your follow through.
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SPORTING ACTIVITIES
• In golf, when you are swinging your club and pulling the club back, you are doing shoulder adduction and using your triceps.
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SPORTING ACTIVITIES
• In hockey, when pulling your stick back to hit the puck, you are doing shoulder extension and using your triceps.
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Anconeus
• Triangular muscle overlying the back of the head of the radius
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Anconeus
• Origin is posterior surface of the lateral condyle of the humerus
• Insertion is the posterior surface of the olecranon process of the ulna
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Anconeus
• Chief function – pull the synovial membrane of the elbow joint out of the way of the olecranon process
• 3rd class lever
• Actions – Weak extension of the elbow
– Abducts ulna in pronation
– Stabilizes the elbow joint
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Anconeus
• Contracts along with the triceps brachii during extension of the elbow
• ‘4th head of the triceps’
• Weakness of the anconeus results in the inability to extend the forearm against gravity
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Anconeus
• Antagonists – Biceps brachii– Brachialis– Brachioradialis
• Synergists – all three heads of the triceps– Long head– Lateral head– Medial head
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Anconeus
• Palpation can occur on the posterior lateral aspect of the olecranon process
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Anconeus
• Innervated by the radial nerve (C7 & C8)
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Anconeus - Stretch
• Maximal elbow flexion stretches the anconeus
– First reach towards the middle of the back where the scapulae meet during retraction
– Then with the opposite hand slightly push the elbow posteriorly
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Anconeus - Exercise
• Cable pull-downs
– Extend the cable to a 180 degree angle between the upper and lower arm
– Decrease the angle to no less than 90 degrees and return to the original position
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Anconeus - Exercise
• Dumbbell extension
– Begin with a 90 degree angle and contract the tricep in an attempt to raise the lower arm
– Return the weight slowly to the original position
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Anconeus - Exercise
• Overhead Barbell Extension
– Begin with maximal elbow flexion and contract the triceps to extend the lower arm
– Then return slowly from the overhead straightened-arm position
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Anconeus - Exercise
• Bench Dips
– Begin with the elbow flexed and contract the triceps to extend the lower arm and raise the body
– Return slowly
Beginning position
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Anconeus - Activities
• Extending the elbow during follow through of a basketball shot
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Anconeus - Activities
• Blocking in football maximizes usage of the anconeus as a great deal of resistance is obtained
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Pronator Teres
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Biomechanical Information
• Origin– Distal part of the medial condyloid ridge of the humerus and medial side of the ulna.
• Insertion—Middle third of the lateral surface of the radius
• Innervation— Median nerve (C6, 7)
• Palpation– Anteromedial surface of the proximal forearm [up near the elbow joint]
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Action of Pronator Teres
• Pronation of the forearm.
• Weak flexion of the elbow.
• Lever—3rd classAxis- radio-ulnar joint
Force- near origin
Resistance- radius
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Synergists and Antagonist
• Synergists– Pronator quadratus
– Flexor carpi radialis
– Anconeus
• Antagonists– Supinator
– Biceps Brachii
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Strengthening Exercises
• The best exercise to hit the pronator teres is any exercise that would add resistance to the action of forearm pronation and supination (eccentric and concentric contraction). A small dumbbell or large hammer can be held while you twist the forearm from the palm down position to the palm up position and back.
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Beginning Phase of exercise
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Mid-phase of exercise
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Stretches
• The elbow must be fully extended while taking the forearm into full supination to stretch the pronator teres.
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Sports
• Baseball swing (right handed batter)
• Tennis (forehand return)
• Golf (swing)
• Hockey (slap-shot)
• Racquetball
• Pinick-pinuck (table tennis)
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Baseball swing
Tennis
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Golf Hockey
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Racquetball Table tennis
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Pronator Quadratus Muscle
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Origin
• Distal fourth of the anterior side of the ulna
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Insertion
• Distal fourth of the anterior side of the radius
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Action
• Pronation of the forearm– the ulna is fixed, so the
pronator quadratus moves the radius over the ulna
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Innervation
• Median nerve, (palmar interosseous branch) (C6,7)
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Lever
• 3rd class
• Axis- radioulnar joint
• Force(insertion)- distal fourth of the anterior side of the radius
• Resistance- whatever you are holding
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Synergist Antagonist
• Pronation– pronator teres
– flexor carpi radialis
– anconeus
– triceps (when also extending the elbow)
• Supination– supinator
– biceps brachii
– brachioradialis
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Stretches
• Have a partner take your wrist and passively place your forearm in extreme supination (or you can do this yourself)
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Strengthening Exercises
• Pronation with a dumbell or hammer
• wringing out a towel
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Sporting Activities
• Swimming- pulling back during a stroke
• Baseball- pitching in release of a screwball
• Tennis- to put spin on a ball
• Volleyball- when hitting to put spin on the ball
• also used when turning a screwdriver to unscrew
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SUPINATOR MUSCLE
KINESIOLOGY
10/09/01
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ORIGIN
• Lateral epicondyle of the humerus
• Neighboring posterior part of the ulna
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INSERTION
• Lateral surface of the proximal radius just below the head
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CLASS LEVER• THIRD class lever
• Axis = Elbow Joint
• Force = insertion on the lateral surface of proximal radius just below the head
• Resistance = weight of hand or resistance against the supination of the hand
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ELBOW AND RADIOULNAR JOINT MUSCLES
• ANTAGONISTS• Primarilu flexion and
pronation
– Biceps brachii– Brachialis– Brachioradialis– Pronator teres– Pronator quadratus
• SYNERGISTS• Primarily extension
and supination
– Triceps brachii
– Aconeus
– Supinator
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CHARACTERISTICS
• ACTIONS• Supinates the forearm
• Extension movements
• Rotates radius to turn palm anteriorly
• INNERVATION• Deep branch of radial
nerve
• C5 and C6
• PALPATION• Cannot be palpated
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EXERCISES• Supination of forearm with dumbbells
• Holding a hammer with the head suspended from the ulnar side while the forearm is supported on a desk or table…the hammer should be hanging toward the floor with the forearm supinated to the palm-up position
• Hands grasped and forearms extended in an attempt to supinate forearm against grip of the hands
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SUPINATION WITH DUMBBELLS
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GRASPING OF HANDS
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HAMMER (with dumbbells)
This is like wrist curls; full extension for supinator.
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STRETCHING
• Supinator is stretched when the forearm us maximally pronated
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SPORTING ACTIVITIES• Baseball (throwing a curve)
• Volleyball (snapping in hitting and serving)
• Tennis (cross court swing - snap)
• Also…the motion of turning a screwdriver
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CURVE BALL PITCH
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VOLLEYBALLDIGGING
SERVING
HITTING
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TENNIS
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Flexor Carpi Radialis
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Flexor Carpi Radialis
OriginMedial Epicondyle of the
Humerus
InsertionAnterior base of the second and
third metacarpals (palmar surface)
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Flexor Carpi Radialis
• Palpation
-Anterior surface of the wrist, slightly lateral, in line with the second and third metacarpals
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Flexor Carpi Radialis
• Innervation
-Median Nerve (C6, C7)
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Flexor Carpi Radialis
• Action
-Flexion of the wrist
-Abduction of the wrist
-Weak flexion of the elbow
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Flexor Carpi Radialis
Synergists
-Flexor carpi ulnaris
-Palmaris longus
-Flexor digitorum profundus
-Flexor pollicis longus
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Flexor Carpi Radialis
• Antagonist
-Extensor carpi radialis longus
-Extensor carpi radialis brevis
-Extensor carpi ulnaris
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Flexor Carpi Radialis
• Third Class Lever-Resistance at the fingers, force at
the insertion point, and the axis at the wrist
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Flexor Carpi Radialis
Stretches-the elbow must be fully extended
with the forearm supinated while the wrist is extended and adducted.
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Praying wrist stretch
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Seated Wrist Stretch
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Single Arm Wrist Stretch
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Flexor Carpi Radialis
• Exercises
-Cable wrist curl
-Barbell wrist curl
-Rope curl
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Barbell Wrist Curl
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Cable Wrist Curl
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Rope Curl
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Flexor Carpi Radialis
• Sports
(Baseball)-movement of wrist at the end of a throw
(Baseball)-movement of wrist when
hitting a ball
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Palmaris Longus
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• Originates at the medial epicondyle of the humerus
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• Inserts at the palmar aponeurosis of the second, third, forth, and fifth metacarpals
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• Palpation– Anterior medial aspect of the forearm and the
central aspect of the anterior forearm just proximal to the wrist
• Innervation– Median nerve (C6, C7)
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• Actions– Flexion of the wrist– Weak flexion of the elbow
• Lever– 3rd class lever
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• Synergists– Flexor Digitorum Superficialis– Flexor Digitorum Profundus – Flexor Carpi Radialis – Flexor Carpi Ulnaris – Flexor Pollicis Longus
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• Antagonists– Extensor Digitorum
– Extensor Carpi Radialis Longus
– Extensor Carpi Radialis Brevis
– Extensor Carpi Ulnaris
– Extensor Indicis
– Extensor Digiti Minimi
– Entensor Pollicis Longus
– Extensor Pollicis Brevis
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• Wrist Curl– Barbell– Cable– Dumbbell
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• Praying Wrist Flexor Stretch
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• Seated wrist flexor stretch
• Kneeling wrist flexor stretch
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• Activites– Bowling– Softball– Baseball– Tennis– Gymnastics
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The Flexor Carpi Ulnaris
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Flexor Carpi Ulnaris
• Origin– Medial epicondyle of the humerus– Posterior aspect of the proximal ulna
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Flexor Carpi Ulnaris
• Insertion– Pisiform
– Hamate
– Base of the fifth metacarpals
Pisiform Hamate Base of 5th metacarpal
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Flexor Carpi Ulnaris
• Innervation– Ulnar nerve (C8, T1)
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Flexor Carpi Ulnaris
• Lever type– 3rd Class Lever
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Flexor Carpi Ulnaris
• Actions– Flexion of the wrist– Adduction of the wrist– Weak flexion of the elbow
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Flexor Carpi Ulnaris
• Palpation– Anterior medial aspect of forearm and central
aspect of the anterior forearm just proximal to the wrist
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Flexor Carpi UlnarisSynergists
• Wrist Flexion– Flexor carpi radialis– Palmaris longus– Extensor carpi ulnaris– Flexor digitorum superficialis– Flexor digitorum profundus– Flexor pollici longus muscle
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Flexor Carpi UlnarisSynergists
• Wrist adduction– Extensor carpi ulnaris
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Flexor Carpi Ulnaris
• Antagonists– Flexor carpi radialis (wrist abduction)– Extensor carpi ulnaris (wrist & elbow
extension)– Extensor carpi radialis longus & brevis (in all
actions)– Flexor digitorum superficialis (wrist and elbow
extension)
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Flexor Carpi Ulnaris
• Strengthening exercises
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Flexor Carpi Ulnaris
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Flexor Carpi Ulnaris
• Stretches
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Flexor Carpi Ulnaris
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Flexor Carpi Ulnaris
• Sporting Activities– Basketball jump shot– The javelin throw – Baseball swing
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Flexor Carpi Ulnaris
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Flexor Carpi Ulnaris
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Flexor Carpi Ulnaris
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Extensor Carpi Ulnaris
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Extensor Carpi Ulnaris
• Origin– Lateral epicondyle of the humerus– Middle two fourths of the posterior
border of the ulna
• Insertion– Base of the dorsal surface of the fifth
metacarpal
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Extensor Carpi Ulnaris
• Nerve Innervation– Radial Nerve
• Palpation– Near the base of the 5th metacarpal
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Extensor Carpi Ulnaris
• Actions– Extension of the wrist
– Adduction (ulnar deviation) of the wrist
– Weak extension of the elbow
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Extensor Carpi Ulnaris
• Synergists– Wrist exntensors
• Ext. Carpi Rad. Brev.
• Ext. Carpi. Rad. Long.
– Elbow extensors• Triceps
• Anconeus
– Wrist Adductors• Flexor Carpi Ulnaris
• Antagonists– Wrist flexors
• Fl. Carpi. Rad.
• Palmaris Longus
– Elbow Flexors • Biceps Brachi
• Brachioradialis
– Wrist Abductors• Flexor Carpi Radialis
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Wrist Extension Exercises
DUMBELL
EXTENSIONS:
• Support the forearm on a bench or table
• Hold the elbow down with the opposite hand
• Hold the dumbell and extend the wrist
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Wrist Extension Exercises
BARBELL
EXTENSIONS:
• Support the forearm on a bench or table
• Hold the elbow down with the opposite hand
• Hold the barbell and extend the wrist
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Wrist Extension Exercises
THE WRIST ROLLER:
• Grab the bar
• Extend the wrists with an alternating action
• Slowly lower the bar with an eccentric motion
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Wrist Extension Exercises
UNAR DEVIATION:
• Hold a dumbell over your head
• Adduct the wrist
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Wrist Extensor Stretches
• The elbow should be straight
• Grab the involved hand and pull it toward you
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Sports and Activities
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Extensor Carpi Radialis Brevis
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ORIGIN
*Lateral epicondyle of the humerus
INSERTION*Base of the third metacarpal (dorsal surface)
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ACTIONS~Extension of the wrist
~Abduction of the wrist
~Weak extension of the elbow
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NERVE INNERVATION*Deep branch of the radial
nerve
(C6, 7)
PALPATION*Dorsal side of the forearm,
which is difficult to palpate
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LEVER
*Third class
A-Elbow joint
F-Insertion=base of third metacarpal
R-Resistance in hand
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SYNERGISTS
Extensor Carpi Radialis Longus
Extensor Carpi Ulnaris
ANTAGONIST
Palmaris Longus
Flexor carpi ulnaris
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*With palm facing downward, pull wrist and fingers downward toward forearm.
*Extend or straighten elbow. Hold stretch for 20 seconds. Repeat with opposite arm.
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*Sit and grasp bar with narrow to shoulder width overhand grip. Rest forearms on thighs with wrists just beyond knees.
*Hyperextend wrist and return until wrist are fully flexed. Repeat.
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*Sit and grip dumbbell with overhand grip. Rest forearm on thigh with wrists just beyond knees.
*Hyperextend wrist and return until wrist is fully flexed. Repeat. Continue with opposite arm.
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Sit and grasp cable bar with narrow to shoulder width overhand grip. Rest forearms on thighs with wrists just beyond knees.
Hyperextend wrist and return until wrists are fully flexed. Repeat.
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SPORTS
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Extensor carpi radialis longus
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Origin + Insertion
• O, Lower third of the lateral supracondylar ridge of the humerus and lateral epicondyle of the humerus
• I, Base of the second metacarpal(dorsal surface).
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Actions
• Extension of the wrist
• Abduction of the wrist
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Innervation
• The extensor carpi radialis longus is innervated by the Radial nerve(C6,7).
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Lever Class
• This is an example of a first-class lever.– Axis- wrist
– Resistance- weight in hand
– Force- muscle
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Synergist muscles
• Extensor Carpi radialis brevis
• Extensor Carpi Ulnaris
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Antagonist muscles
• Primary wrist flexors– Flexor carpi radialis
– Flexor carpi ulnaris
– Palmaris longus
– Other muscles involved in flexion of the wrist
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Strengthening exercises
• Dumbell Reverse Wrist Curl
• Barbell Reverse Wrist Curl
• Rope Wrist Curl
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Exercises
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Stretches
• With the palm facing downward, pull wrist and fingers downward toward forearm.
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Sports
• Racquetball
• Tennis
• Golf
• Baseball
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Flexor Digitorum Superficialis
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Origin
• Medial epicondyle of the humerus
• Ulnar head – medial coronoid process
• Radial head – upper two-thirds of the anterior border of the radius
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Insertion
• Palmar surface of the middle phalanx of the four fingers
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Actions
• Flexion of the fingers at the proximal interphalangeal joints and at the metacarpophalangeal joints
• Flexion of the wrist
• Weak flexion of the elbow
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Levers
• Third Class - occurs when resistance is at the fingertips
• Second Class – occurs when resistance is in the palm
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Palpation
• Anterior wrist surface on the ulnar side
• Next to the flexor carpi ulnaris
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Innervation
• Median nerve (C7, C8, T1)
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Synergists
• Flexor Digitorum Profundus
• Flexor Carpi Radialis
• Flexor Carpi Ulnaris
• Palmaris Longus
• Flexor Pollicis Longus
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Antagonists
• Extensor Digitorum
• Extensor Carpi Radialis Longus
• Extensor Carpi Radialis Brevis
• Extensor Pollicis Longus
• Extensor Pollicis Brevis
• Extensor indicis
• Extensor digiti minimi
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Wrist Barbell Curl
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Wrist Dumbbell Curl
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Hand Gripper
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Praying Posture Stretch
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Seated Forearm Stretch
04/08/23 523
One Arm Forearm Stretch
04/08/23 524
Sporting Activities
• Rock Climbing – gripping the rock
• Baseball – gripping the bat
• Baseball – gripping the ball and flexing the wrist on a pitch
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Structural Kinesiology
Flexor Digitorum Profundus
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Origin
• Proximal 3/4 of the anterior and medial ulna Insertion
Base of the distal phalanxes of the four fingers
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Palpation
Anterior surfaces of the middle phalanges of the four fingers
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Innervation
Median nerve (C8,T1) to the second and third fingers
Ulnar nerve C8,T1) to the fourth and fifth fingers
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Actions
• Flexion of the four fingers at the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints
• Flexion of the wrist
04/08/23 533
Agonists
• In wrist flexion: Flexor carpi radialis, Palmaris longus, Flexor carpi ulnaris, Flexor digitorum superficialis, Flexor pollicis longus
• In flexion of the 4 fingers: Flexor digitorum superficialis
04/08/23 534
Antagonists• In wrist flexion: Extensor
carpi ulnaris, Extensor carpi radialis brevis, Extensor carpi radialis longus, Extensor digitorum, Extensor indicis, Extensor digiti minimi, Extensor pollicis longus, Extensor pollicis brevis
• In flexion of 4 fingers: Extensor digitorum, Extensor indicis (2), Extensor digiti minimi(5)
04/08/23 535
What Lever is It?
2nd in wrist flexion at the radioulnar joint:
A: radioulnar joint
R: weight in hand
F: base of distal phalanxes
1st in fist clenching, distal interphalangeal joint:
R: At fingertips
A: distal interphalangeal joint
F: base of distal phalanxes
04/08/23 536
What Lever is it?3rd in fist clenching, proximal interphalangeal joint:
R: At fingertips
F: base of distal phalanxes
A: proximal interphalangeal joint2nd in fist clenching, metacarpophalangeal joint:
F: base of the distal phalanxes
R: right above the joint, between the metacarpalphalangeal joint and the proximal interphalangeal joint
A: metacarpophalangeal joint
It is important to note that the resistance is dependant on the size of the ball
04/08/23 537
Stretching the Flexor Digitorum Profundus
• Wrist/Finger extension
• Palm press
04/08/23 538
Wrist/Finger Extension
04/08/23 539
Palm Press
04/08/23 540
Strengthening theFlexor Digitorum Profundus
√ Wrist Curls using a bar
* alternative: dumbbells
√ Wrist flexion with twisting bar
√ Fist clenching using a ball
04/08/23 541
Wrist Curls using a bar
Forearms are placed on bench to isolate the wrist movement
04/08/23 542
Wrist Flexion with twisting bar
04/08/23 543
Fist Clenching with a ball
04/08/23 544
Sporting Events that use theFlexor Digitorum Profundus
• Softball: holding the bat,throwing and catching the ball
• Baseball: holding the bat,throwing and catching the ball
• Tennis: holding the raquet
• Hockey:holding the hockey stick, punching the opponent
• Bowling: holding and releasing the ball
• Volleyball: passing, slight flexion setting and blocking
• All sports involving clenching of the fist and wrist flexion….
04/08/23 545
That’s my roommate!
04/08/23 546
Flexor Pollicis Longus
04/08/23 547
Origin
• Middle anterior surface of the radius
• Anterior medial border of the ulna just distal to the coronoid process
04/08/23 548
Insertion
• Base of the distal phalanx of the thumb (palmar surface)
04/08/23 549
Action• Flexion of the thumb carpometacarpal,
metacarpophalangeal, and interphalangeal joints
• Flexion of the wrist
04/08/23 550
Synergists and Antagonists
• Wrist Flexors– Flexor carpi radialis– Flexor carpi ulnaris– Palmaris longus– Flexor digitorum profundus– Flexor digitorum
superficialis– Flexor pollicis brevis
• Wrist and thumb extensors– Extensor pollicis brevis– Extensor pollicis longus
• Wrist extensors– Extensor carpi ulnaris– Extensor carpi radialis
brevis/longus– Extensor digitorum– Extensor indicis (weak)– Extensor digiti minimi
(weak)
04/08/23 551
Palpation
• Anterior surface of the thumb
• How to:
-Flex the interphalangeal joint
-Feel muscle along proximal phalanx of thumb
04/08/23 552
Nerve Innervation
• Median nerve, palmar interosseous branch (C8, T1)– From the 8th cervical
and 1st thoracic vertebrae
04/08/23 553
Lever
• Second Class Lever– When the carpometacarpal and metacarpophalangeal
joints are being used in gripping, the resistance is proximal to the force and distal to the axis.
• Axis- carpometacarpal/metacarpophalangeal joints of thumb
• Resistance- barbell, bat, ball, etc. on proximal phalanx
• Force- muscle insertion on the distal phalanx of thumb
04/08/23 554
Lever
• Third Class Lever– At the interphalangeal joint,
• Axis- interphalangeal joint
• Force- muscle insertion at base of distal phalanx of thumb
• Resistance- middle of distal phalanx (holding a football)
– During wrist flexion:• Axis- wrist joint
• Force- muscle insertion on distal phalanx of thumb
• Resistance- barbell, bat, ball, etc. on other 4 fingers (distal to force)
04/08/23 555
Exercises
• Gripping and grasping exercises that flex the wrist and thumb– Dumbell curls– Barbell curls– Cable curls– Stress ball squeezes
04/08/23 556
Dumbbell Curls Barbell Curls
04/08/23 557
Cable Curls and Stress Ball
04/08/23 558
•Extension of thumbPassively extend the entire thumb while simultaneously maintaining maximal wrist extension
•Extension of wrist•Praying •Seated•Single arm•Kneeling
04/08/23 559
Praying flexor stretch
Seated flexor stretch
04/08/23 560
Single arm stretch
Kneeling stretch
04/08/23 561
Sports
• Bowling
• Gymnastics
• Catching
• Throwing– Baseball/softball– Football– Javelin
04/08/23 562
04/08/23 563
04/08/23 564
Extensor Digitorum
04/08/23 565
Nerve Innervation
• The Radial Nerve (C6-8)
04/08/23 566
Origin Insertion
• Lateral epicondyle of the humerus
• Four tendons to bases of middle and distal phalanges of four fingers(dorsal)
04/08/23 567
2nd Class Lever
• Force: Insertion on the dorsal side of 2-5 phalanges.
• Resistance: Weight in the palm.
• Axis: Wrist joint.
04/08/23 568
Palpation
• Middorsal surface of the forearm
04/08/23 569
Actions
• Extension of the second, third, fourth, and fifth phalanges at the metacarpophalageal joints.
• Extension of the wrist
• Weak extension of the elbow.(biarticular)
04/08/23 570
Antagonist Synergist
• Extensor carpi radialis longus & brevis
• Extensor carpi ulnaris
• Palmaris longus
• Flexor digitorum superficialis & profundus
• Flexor pollicis longus
• Extensor carpi radialis longus & brevis
• Extensor carpi ulnaris
• Extensor indicis
• Extensor pollicis brevis & longus
04/08/23 571
Exercises
• Rope curls
• Forearm curls
• Backward curls
04/08/23 572
Stretch
• With fingers maximally flexed at all joints and the maximally flex the wrist joint.
04/08/23 573
Sports movements
• Tennis bringing racket back and back hand.
• Baseball throwing
• Discus throwing.
• Shooting a basketball.
04/08/23 574
Extensor Indicis Muscle
04/08/23 575
Extensor Inicis Muscle
• Origin– Posterior surface of ulna (distal to extensor
pollicis longus)– Middle to distal one-third
04/08/23 576
Extensor Indicis muscle
• Insertion– Base of the middle and distal phanlanxes of
second phalange (dorsal surface)
04/08/23 577
Extensor Indicis muscle
• Action– Extension of the index finger at the
metacarpophalangeal joint– Weak wrist extension
04/08/23 578
Extensor indicis
• Palpation– Posterior aspect of the distal forearm and dorsal
surface of the hand just medial to the extensor digitorum tendon of the index finger
04/08/23 579
Extensor indicis
• Innervation: Radial nerve (C6-8)
• Synergist– Extensor Digitorum
• Antagonist– Flexor digitorum superficialis muscle– Flexor digitorum profundus muscle
04/08/23 580
Extensor indicis
• Third class lever– The axis is the metacarpophanlangeal joint– The Resistance is the Insersertion at the base of
middle and distal phalanxes of second phalange.
– The force falls in the middle!
04/08/23 581
Extensor indicis
• Exercises– Rubber band extension
04/08/23 582
Extensor indicis
• How to stretch?– Passively taking the index finger into miaximal
flexion at its metacarpophanlangeal, proximal interphalangeal, and distal interphalangeal joints while fully flexing the wrist.
04/08/23 583
Extensor Indicis
• This is not a particularly main muscle in any movement. It is the muscle used in pointing with the index finger, particularly when the other fingers are flexed
• This muscle would be used “flicking” objects.
04/08/23 584
Extensor Digiti Minimi
04/08/23 585
Extensor Digiti Minimi
• Origin– Lateral Epicondyle of the Humerous
• Insertion– Base of the middle and distal phalanxes of the
fifth phalange.• Palpation
– Cannot be palpated.
• Innervation– Radial nerve (C6-8)
04/08/23 586
Extensor Digiti Minimi
• Action– Extension of the little finger at the metacarpophalangeal joint.
– Weak wrist extension
04/08/23 587
Extensor Digiti Minimi
• Third Class Lever– Axis is the Metacarpophalangeal joint– Force is the insertion point– Resistance is the tip of the finger
04/08/23 588
Extensor Digiti Minimi
• Synergist Muscles– Extensor Carpi Ulnaris
– Extensor Carpi Radialis Brevis
– Extensor Carpi Radialis Longus
– Extensor Digitorum
– Extensor Indicis
– Extensor pollicis longus
– Extensor pollicis brevis
• Antagonist Muscles– Flexor Carpi Radialis
– Flexor Carpi Ulnaris
– Flexor Digitorum Superficialis
– Flexor Digitorum Profundus
– Flexor Pollicis Longus
04/08/23 589
Strengthening Exercises
• Same exercises used for Extensor Digitorum– Reverse Curls
04/08/23 590
Strengthening Exercises
• Can also be strengthened by applying manual resistance to the dorsal aspect of fifth phalange, while flexed, and then extending it fully.
04/08/23 591
Stretching
• Same stretches used for the rest of the wrist extensors.
04/08/23 592
Activities
• Any sport that involves wrist extension– Basketball
– Baseball
04/08/23 593
Abductor Pollicis Longus
• Tendons of this muscle and those of the abductor pollicis brevis form the “anatomical snuffbox”
04/08/23 594
Abductor Pollicis Longus
• Origin is posterior aspect of the radius and midshaft of ulna
• Insertion is the base of the first metacarpal on the dorsal surface
04/08/23 595
Abductor Pollicis Longus
• Primary function – abduction of thumb
• Assists to extend and rotate 1st metacarpal
• Radially deviates wrist
• Flexes hand at wrist
04/08/23 596
Abductor Pollicis Longus
• Innervated by the posterior interosseus nerve (C7,8) and the deep branch of the radial nerve (C6,7)
• Palpated on the lateral aspect of the wrist joint just proximal to the thumb
• 3rd Class Lever
04/08/23 597
Abductor Pollicis Longus
• Antagonists– Flexor Carpi Radialis/Ulnaris
– Palmaris Longus
– Flexor Digitorum Superficialis/Profundus
– Flexor Pollicis Longus
• Syngergists– Abductor Pollicis Brevis
– Extensor Pollicis Longus
04/08/23 598
Abductor Pollicis Longus
• Stretching– Fully flexing and adducting
the entire thumb across the palm with the wrist fully adducted
• Strengthening– Abducting the thumb from
the adducted position against a manual resistance
04/08/23 599
Abductor Pollicis Longus
Volleyball
04/08/23 600
Abductor Pollicis LongusBasketball
04/08/23 601
Abductor Pollicis LongusCatching a Football
04/08/23 602
EXTENSOR POLLICIS BREVIS
04/08/23 603
EXTENSOR POLLICIS BREVIS
• Origin: Posterior surface of the lower middle radius.
• Insertion: Base of the proximal phalanx of the thumb (dorsal surface).
• Palpation: Just lateral to the extensor pollicis longus tendon most prominent on lower dorsal side of the hand.
04/08/23 604
EXTENSOR POLLICIS BREVIS
• Innervation: Radial nerve C6,7.
• Action; – Extension of the thumb at the
metacarpophalangeal joint.– Weak wrist extension.
04/08/23 605
EXTENSOR POLLICIS BREVIS
• Lever Class:3rd Class Lever:– Axis: Metacarpophalangeal joint– Force: Insertion– Resistance: Weight at end of thumb
04/08/23 606
EXTENSOR POLLICIS BREVIS
• Synergists:– Extensor pollicis
longus
– Abductor pollicis longus
• Antagonists:– Flexor pollicis longus
04/08/23 607
Strengthening Exercise
• The only real way of strengthening is by extending the flexed thumb against manual resistance, as seen in the picture.
04/08/23 608
Stretching Exercise
• It is stretched by passively taking the first carpometacarpal joint and the metacarpophalangeal joint of thumb into maximal flexion while fully flexing the wrist.
04/08/23 609
Sporting Activities
• In football, when you extend your hands to catch a ball, you are extending your thumb and using this muscle.
• Also in football, when lineman are in their stance they are extending their thumb for balance and using this muscle.
04/08/23 610
Sporting Activities
• In baseball, when you are wearing a baseball glove to catch the baseball, you are extending your thumb and using this muscle.
• When gripping a bowling ball, football, or basketball, you are extending your thumb and using this muscle.
04/08/23 611
Extensor Pollicis Longus
04/08/23 612
Actions
• Weak extension of the wrist
• Extension of the thumb
04/08/23 613
Origin & Insertion
• Origin: Posterior lateral surface of the lower middle ulna
• Insertion: Base of the distal phalanx of the thumb (dorsal surface)origin
insertion
04/08/23 614
Extensor Pollicis Longus
• 3rd class lever- axis: wrist- force: insertion of muscle- resistance: weight in hand
• Innervation: Radial nerve (C6-8)
• Palpation: Most prominent on dorsal side of thumb
04/08/23 615
Extensor Pollicis Longus
• Synergists: extensors - extensor pollicis brevis* - abductor pollicis longus* - extensor carpi ulnaris - extensor carpi radialis - extensor carpi radialis
longus - extensor digitorum - extensor indicis (weak) - extensor digiti minimi
(weak)
• Antagonists: flexors - flexor pollicis longus* - flexor carpi radialis - palmaris longus - flexor carpi ulnaris - flexor digitorum
superficialis - flexor digitorum profundus
04/08/23 616
• Stretches - kneeling
- single arm
Strengthening & Stretching
• Lifts - barbell reverse wrist curl
- cable reverse wrist curl
- dumbbell reverse wrist curl
- weighted rope twist
04/08/23 617
Barbell Reverse Wrist Curl
04/08/23 618
Cable Reverse Wrist Curl
04/08/23 619
Dumbbell Reverse Wrist Curl
04/08/23 620
More strengthening…
• This muscle can also be strengthened by extending the flexed thumb against manual resistance.
04/08/23 621
Kneeling Wrist Stretch
04/08/23 622
Single Arm Stretch
04/08/23 623
More stretching…
• This muscle can also be stretched by passively taking the entire thumb into maximal flexion while fully flexing the wrist.
04/08/23 624
Sports Applications
• Extension of wrist before shooting, throwing
• Gripping a racquet, golf club, bat
• Catching
• Other uses: hammering, shaking hands, thumb wars, knocking on a door
04/08/23 625
CHAPTER 6
Muscular Analysis of the Upper Extremity
04/08/23 626
Objectives
• Analyze movements of simple exercises
• Learn the concept of open / closed chain exercises
• Group muscles by their actions
• Learn the names of different exercises used to strengthen muscles and increase performance
04/08/23 627
Exercises
• Pull-up
• Pull-Down
• Shoulder Press
• Low/High Rows
• Upright Rows
• Supine Flys
• Lateral Flys
• Bench Press
• Millitary Press
• Arm Curl
• Tricep Extensions
• Push-Ups
• Wrist Curls
• Wrist Extensions
• Dips
04/08/23 628
CHAPTER 7
The Hip Joint and Pelvic Girdle
04/08/23 629
Bones
• Bones of the Illium
• Bones of the Ischium
• Bones of the Pubis
• Bones of the Sacrum
• Bones of the Coccyx
• Bones of the Femur
04/08/23 630
Lumbar Spine Movements
• Flexion
• Extension
• Lateral Flexion
• Lateral Rotation
04/08/23 631
Pelvic Movements
• Anterior Rotation (sagital plane)
• Posterior Rotation (sagital plane
• Lateral Rotation (frontal plane)
• Transverse Rotation (horizontal plane)
04/08/23 632
Hip Movements
• Flexion
• Extension
• Abduction
• Adduction
• Internal Rotation
• External Rotation
• Circumduction
04/08/23 633
Iliopsoas Muscle(composed of)
Iliacus and Psoas major and minor
04/08/23 634
Information
• ORIGIN—iliacus inner surface of ilium.
• ORIGIN—psoas major and minor lower borders of the transverse processes (L1-5), sides of the bodies of T12, the lumbar vertebrae (L1-5), intervertebral fibrocartilages, and base of sacrum.
• INSERTION—Iliacus and psoas major lesser trochanter of the femur and shaft just below.
04/08/23 635
Information, cont.
• INSERTION– psoas minor pectineal line and iliopectineal eminence.
• 3rd Class Lever– Axis (Hip joint)– Force (the muscle)– Resistance (the leg, in both movements)
04/08/23 636
Actions
• Flexion of the Hip
• External Rotation of the Hip
• #2 is the Psoas
• #1 is the Iliacus
04/08/23 637
Palpation
• Impossible to palpate except with almost complete relaxation of the rectus abdominis muscle.
04/08/23 638
Innervation
• Lumbar nerve and femoral nerve (L2-4) from the Lumbar Plexus
• This diagram shows the femoral nerve (in yellow with a red arrow) in relation to other muscles and veins.
04/08/23 639
Synergists
• Synergists:– Flexion: Sartorius, Rectus femoris, Tensor
fasciae latae, Pectineus– External rotation: Sartorius, six deep lateral
rotator muscles, Gluteus medius, Gluteus maximus, Biceps femoris, Adductor magnus
04/08/23 640
Antagonists
• Antagonists– Flexion (extension of the hip): Gluteus
maximus, Semitendinosus, Semimembranosus, Biceps femoris
– Ext. rotation (internal rotation of hip): Gluteus minimus, Gluteus medius, Semitendinosus, Semimembranosus, Pectineus
04/08/23 641
Strengthening Exercise and Stretches
• The iliopsoas muscle is powerful in actions such as raising the legs from the floor while in the supine position.
• The muscle may be strengthened by supporting the arms on a dip bar and then flexing the hips to lift the legs. To decrease resistance, flex the knees into a tucked position.
04/08/23 642
Stretching the Iliopsoas
• The hip must be extended so that the femur is behind the plane of the body. Full knee flexion must be avoided. Slight additional stretch may be applied by internally rotating the hip while it is extended.
04/08/23 643
Exercises
Weighted Leg RaiseVertical Leg Raise
04/08/23 644
Hanging Leg Raise
Lever Hip Flexion
04/08/23 645
StretchesPNF
Self-stretch
04/08/23 646
Sports
• Running
• Baseball (stealing a base, pitching from the “stretch”)
• Gymnastics
• Bicycling
04/08/23 647
Gymnastics
Cycling
04/08/23 648
Baseball pitcher
Running
04/08/23 649
SartoriusSartorius
Origin- anterior
superior iliac spine and
notch just below the spine
Insertion- anterior medial condyle of the tibia
04/08/23 650
• Palpation- easiest to palpate at the anterior superior spine of the ilium
• Innervation- Femoral Nerve
04/08/23 651
Synergists Antagonists• Hip flexion
– iliopsoas– pectineus– rectus femoris
• Knee flexion– semitendinosus– semimembranosus– biceps femoris– gracilis– popliteus– gastrocnemius
• External rotation of hip joint– iliopsoas– six deep lateral rotator muscles– gluteus medius & maximus– biceps femoris– adductor brevis & magnus
• Hip flexion– gluteus maximus
– biceps femoris
– semitendinosus
– semimembranosus
– six deep external rotators
• Knee flexion– rectus femoris
– vastus medialis, intermedius, & lateralis
• External rotation of hip joint– gluteus minimus
– semitendinosus
– semimembranosus
– pectineus
– gracilis
04/08/23 652
Levers• when resistance is on posterior side of ankle with
knee flexion– axis: knee joint
– force: anterior medial condyle of tibia
• 3rd Class Lever
• when resistance is at the knee or thigh with hip flexion or external rotation– axis: hip joint
– force: anterior medial condyle of tibia
• 2nd Class Lever
04/08/23 653
Actions
• Flexion of the hip
• Flexion of the knee
• External rotation of the thigh as it flexes the hip and the knee
04/08/23 654
Strengthening Exercises
• Leg lifts (either tucked or straight legs)
– support arms on parallel or dip bars and flex hips to lift the legs
• Leg Curls
– in a supine position, flex knees to lift ankles
• Knee Raises
– lift resistance placed on anterior of the knee
• Sitting Exercise
– put ankle weight on externally rotate hip while flexing knee and hip to raise ankle superior to opposite knee
04/08/23 655
Leg Lifts Leg Curls
•
04/08/23 656
Knee Raises Sitting Exercise
04/08/23 657
Stretches
04/08/23 658
Hip Extension, Adduction, and Internal Rotation
• Have a partner passively take your hip into – extreme extension
– extreme adduction
– extreme internal rotation
04/08/23 659
Sporting Activities
• Ballet- plies
• Baseball & Softball - steping of the plate to catch a ball
• Swimming- breast stroke
04/08/23 660
RECTUS FEMORIS
04/08/23 661
QUADRICEPS
1) RECTUS FEMORIS
2) VASTUS LATERALIS
3) VASTUS INTERMEDIUS
4) VASTUS MEDIALIS
04/08/23 662
ORIGINAnterior inferior iliac spine of the ilium and
groove (posterior) above the acetabulum
04/08/23 663
INSERTIONSuperior aspect of the patella and patellar
tendon to the tibial tuberosity
04/08/23 664
CLASS LEVERThird Class LeverAxis = hip joint/knee joint Force = insertion (patella)Resistance = weight at
feet (squat, leg press, etc.) or mid-shin (knee extension
Second Class Lever
Axis = hip jointForce = insertion
(patella)Resistance = mid-
thigh/quad (hip flexion)
04/08/23 665
DOES WHAT?ACTION
Flexion of the hipExtension of the knee
04/08/23 666
APPLICATIONSYNERGISTS
SartoriusTensor Fascia LataeVastus LateralisVastus MediusVastus Intermedius
ANTAGONISTSHamstringsGluteus
Maximus
04/08/23 667
PALPATIONINNERVATION
Femoral nerveL2L3L4
PALPATIONAny place on the
anterior surface of the femur
04/08/23 668
EXERCISESLeg pressLungeLeg ExtensionStep-upSquat
Front Squat Full Squat Hack Squat Safety Squat
04/08/23 669
LEG PRESS
04/08/23 670
SQUATS
04/08/23 671
LUNGE
04/08/23 672
STEP-UP
04/08/23 673
HIP FLEXION
04/08/23 674
PLYOMETRICSBOX JUMPS
04/08/23 675
STRETCHESLying quad stretchStanding quad stretchSquat quad stretchLunge stretch
04/08/23 676
KNEE BACK
04/08/23 677
04/08/23 678
SITTING SQUAT
04/08/23 679
LUNGE STRETCH
04/08/23 680
SPORTING ACTIVITIES
Volleyball (jumping and digging)Baseball/Softball Catchers (positional
stance)Basketball (jumping)Track (Running, Long and High Jump)Soccer (kicking the ball)
04/08/23 681
04/08/23 682
04/08/23 683
TensorFasciaeLatae
04/08/23 684
Tensor fasciae lataeOrigin
-Anterior iliac crest and surface
of the ilium just below the crest
04/08/23 685
Tensor fasciae lataeInsertion
-1/4th of the way down the thigh into the illotibal tract, which in turn inserts onto Gerdy’s tubercle of the anterolateral tibal condyle
04/08/23 686
Tensor fasciae lataeAction
-Abduction of the hip
-Flexion of the hip
-Tendency to rotate the hip internally as it flexes
04/08/23 687
Tensor fasciae lataeSynergists (Flexion of the Hip)
-Rectus femoris-Sartorious-Ilipsoas
Synergist (Abduction of the Hip)-Gluteus Minimus-Gluteus Medius
04/08/23 688
Tensor fasciae lataeAntagonist (Extension of the Hip)
-Gluteus Maximus
-Semitendinosus
-Semimembranosus
-Biceps Femoris
04/08/23 689
Tensor fasciae lataeAntagonist (Adduction of the hip)
-Adductor brevis
-Adductor longus
-Adductor magnus
-Pectineus
04/08/23 690
Levers (Second class lever)Axis is at the origin on the ilium
Resistance is on the thigh
Force is at the insertion point
(Third class lever)Axis is at the origin on the ilium
Force is at the insertion point
Resistance is at the feet
Tensor fasciae latae
04/08/23 691
Tensor fasciae lataePalpation
-Slightly in front of the greater trochanter
Innervation
-Superior gluteal nerve (L4-5, S1)
04/08/23 692
Tensor fasciae lataeExercises
-Abduction of the hip-Cable hip abduction-Lever standing hip abduction
-Flexion of the hip-Lever hip flexion-Cable lying leg raise
-Cable leg raise
04/08/23 693
Cable Hip Abduction
04/08/23 694
Standing Lever Hip Abduction
04/08/23 695
Lever Hip Flexion
04/08/23 696
Cable Lying Leg Raise
04/08/23 697
Cable Leg Raise
04/08/23 698
StretchesStanding Ibiotibal Stretch
04/08/23 699
StretchesWall Ibiotibal Stretch
04/08/23 700
Sports
Basketball-Defensive slide (Abduction of hip)-lay-up (Flexion of hip)
Soccer-Juggling a ball (Flexion of the hip)
Baseball-windup of a pitcher (Flexion and Abduction)
04/08/23 701
The Six Deep Lateral Rotator Muscles
• Piriformis
• Gemellus superior
• Gemellus inferior
• Obturator externus
• Obturator internus
• Quadratus femoris
04/08/23 702
Origin
• Anterior sacrum
• Posterior portions of the ischium
• Obturator foramen
04/08/23 703
Insertion
• Superior and posterior aspect of the greater trochanter
04/08/23 704
Nerve Innervation
• Piriformis– 1st or 2nd sacral nerve
• Gemellus superior– sacral nerve (L5-S2)
• Gemellus inferior– branches from sacral
plexus (L4-S2)
• Obturator exernus– obturator nerve (L3-4)
• Obturator internus– branches from sacral
plexus (L4-S2)
• Quadratus femoris– branches from sacral
plexus (L4-S1)
04/08/23 705
Palpation
04/08/23 706
Action/Lever
• External rotation of the hip
• 3rd class Lever– Axis = hip– Force = insertion– Resistance = leg
04/08/23 707
Synergists
• Iliopsoas
• Sartorius
• Gluteus medius – posterior fibers
• Gluteus maximus
• Biceps femoris
• Adductor brevis
• Adductor mangus
04/08/23 708
Antagonists
• Tensor fasciae latae
• Gluteus minimus
• Gluteus medius– anterior fibers
• Semitendinosus
• Semimembranosus
• Pectineus
• Gracilis
04/08/23 709
Exercises
• Using a theraband– keep one foot planted on the ground while
forcefully turning the body and the opposite leg away from the planted foot.
04/08/23 710
Exercises
04/08/23 711
Exercises
• Using a theraband– Attach one end of the theraband to a foot– Use theraband as resistance as you externally
rotate the hip
04/08/23 712
Exercises
04/08/23 713
Stretches
• While standing, maximally internally rotate the hip while rotating the torso in an opposite direction
• While lying on your back, bend at the knee and adduct one leg while a partner slightly raises your foot (to internally rotate the hip)
04/08/23 714
Stretches
04/08/23 715
Applications
• Baseball– batting
– pitching
• Basketball– pivoting
• Dance
• Track & Field– discus
– shotput
04/08/23 716
Applications
04/08/23 717
Applications
04/08/23 718
GLUTEUS MEDIUS
04/08/23 719
GLUTEUS MEDIUS
• ORIGIN– Lateral surface of the ilium just
below the crest.
• INSERTION– Posterior and middle surfaces of the
greater trochanter of the femur
04/08/23 720
GLUTEUS MEDIUS
• Actions– Abduction of the hip
– External Rotation of the hip as it abducts (posterior fibers)
– Internal rotation of the hip
04/08/23 721
GLUTEUS MEDIUS
• Palpation– above the greater trochanter
• Innervation– superior gluteal nerve (L4-S1)
• Lever– third class lever
04/08/23 722
GLUTEUS MEDIUS
• Synergists– Gluteus minimus (hip abduction)
– Tensor fascia latae (hip abduction)
– Gluteus maximus (hip external rotation)
– 6 deep lateral rotators (hip external rotation)
– Biceps
– Gluteus minimus (hip internal rotation)
– Semitendonosis (hip internal rotation)
– Semimembranosus (hip internal rotation)
04/08/23 723
GLUTEUS MEDIUS
• Antagonists– Adductors (adduction)– Biceps femoris (external rotation)– Gluteus Maximus (external rotation)– 6 deep lateral rotators (external rotation)– Semitendonosis (internal rotation)– Semimembranosus (internal rotation)
04/08/23 724
GLUTEUS MEDIUS
• Exercises– Hip Abduction machine– Lateral lunges– Lateral step ups– Squats etc.
04/08/23 725
External Rotation Exercise
• Externally rotate the leg against resistance.
04/08/23 726
Hip Abduction Machine
• Abduction of the hip against resistance
04/08/23 727
GLUTEUS MEDIUS
• Stretches– The hip should be placed in extreme adduction
in front of the opposite leg with the foot internally rotated (posterior fibers).
– The hip should be placed in extreme adduction behind the opposite leg with the foot
externally rotated (anterior fibers).
04/08/23 728
Gluteus Medius Stretch
• With the involved leg adducted in front or behind the opposite leg, lean the opposite direction
04/08/23 729
Application
• Trendelenburgs Test
• Push Off from a base or pitching rubber
• Gluteus medius is also a great stabilizer of the hip for proprioception (balance) of the leg during any exercise
• Slide step in baskeball
• Push off in the shot put
04/08/23 730
Application
04/08/23 731
Application
Recommended