Se ction I  

Essential Topics of Kinesiology

Chapter 1 Getting Started, 3
Chapter 2 Basic Structure and Function of Human Joints, 28
Chapter 3 Muscle: The Primary Stabilizer and Mover of the Skeletal System, 47
Chapter 4 Biomechanical Principles, 77
Appendix I Trigonometry Review and Anthropometric Data, 115

Se c t i o n I is divided into four chapters, each describing a different topic related to kinesiology.
This section provides the background for the more specific kinesiologic discussions of the various
regions of the body (Sections II to IV). Chapter 1 provides introductory terminology and biome-
chanical concepts related to kinesiology. A glossary of important kinesiologic terms with definitions
is located at the end of Chapter 1. Chapter 2 presents the basic anatomic, histologic, and functional
aspects of human joints—the pivot points for movement of the body. Chapter 3 reviews the basic
anatomic and functional aspects of skeletal muscle—the source that produces active movement and
stabilization of the skeletal system. More detailed discussion and quantitative analysis of many of
the biomechanical principles introduced in Chapter 1 are provided in Chapter 4.

ADDITIONAL CLINICAL CONNECTIONS

Additional Clinical Connections are included at the end of Chapter 4. This feature is intended to
highlight or expand on particular clinical concepts associated with the kinesiology covered in the
chapter.

STUDY QUESTIONS
Study Questions are included at the end of each chapter and within Chapter 4. These questions are
designed to challenge the reader to review or reinforce some of the main concepts contained within
the chapter. The process of answering these questions is an effective way for students to prepare for
examinations. The answers to the questions are included on the Evolve website.
 Chapter

1
Getting Started
DONALD A. NEUMANN, PT, PhD, FAPTA

C H A P T E R AT A G L A N C E

WHAT IS KINESIOLOGY? 3 Fundamental Movements between Joint Musculoskeletal Torques, 15

OVERALL PLAN OF THIS TEXTBOOK, 3 Surfaces, 8 Muscle and Joint Interaction, 17
KINEMATICS, 4 Predicting an Arthrokinematic Pattern Types of Muscle Activation, 17
Translation Compared with Rotation, 4 Based on Joint Morphology, 10 Muscle Action at a Joint, 18
Osteokinematics, 5 Close-Packed and Loose-Packed Positions Musculoskeletal Levers, 20
Planes of Motion, 5 at a Joint, 11 Three Classes of Levers, 20
Axis of Rotation, 5 KINETICS, 11 Mechanical Advantage, 21
Degrees of Freedom, 5 Musculoskeletal Forces, 11 SYNOPSIS, 23
Osteokinematics: A Matter of Impact of Forces on the Musculoskeletal GLOSSARY, 25
Perspective, 6 System: Introductory Concepts and REFERENCES, 26
Arthrokinematics, 7 Terminology, 11 STUDY QUESTIONS, 27
Typical Joint Morphology, 7 Internal and External Forces, 14

WHAT IS KINESIOLOGY? This text of kinesiology borrows heavily from three bodies of
knowledge: anatomy, biomechanics, and physiology. Anatomy is

T
he origins of the word kinesiology are from the Greek the science of the shape and structure of the human body and its
kinesis, to move, and logy, to study. Kinesiology of the parts. Biomechanics is a discipline that uses principles of physics
Musculoskeletal System: Foundations for Rehabilitation to quantitatively study how forces interact within a living body.
serves as a guide to kinesiology by focusing on the anatomic and Physiology is the biologic study of living organisms. This textbook
biomechanical interactions within the musculoskeletal system. interweaves an extensive review of musculoskeletal anatomy with
The beauty and complexity of these interactions have been cap- selected principles of biomechanics and physiology. Such an
tured by many great artists, such as Michelangelo Buonarroti approach allows the kinesiologic functions of the musculoskeletal
(1475–1564) and Leonardo da Vinci (1452–1519). Their work system to be reasoned rather than purely memorized.
likely inspired the creation of the classic text Tabulae Sceleti et
Musculorum Corporis Humani, published in 1747 by the anato-
mist Bernhard Siegfried Albinus (1697–1770). A sample of this OVERALL PLAN OF THIS TEXTBOOK
work is presented in Fig. 1.1.
The primary intent of this textbook is to provide students and This text is divided into four sections. Section I: Essential Topics of
clinicians with a firm literature-based foundation behind the prac- Kinesiology includes Chapters 1 to 4. To get the reader started,
tice of many elements of physical rehabilitation. A detailed review Chapter 1 provides many of the fundamental concepts and ter-
of the anatomy of the musculoskeletal system, including its inner- minology related to kinesiology. A glossary is provided at the end
vation, is presented as a background to the structural and func- of Chapter 1 with definitions of these fundamental concepts and
tional aspects of movement and their clinical applications. terms. Chapters 2 to 4 describe the necessary background regard-
Discussions are presented on both normal conditions and abnor- ing the mechanics of joints, physiology of muscle, and review of
mal conditions that result from disease and trauma. A sound applied biomechanics.
understanding of kinesiology allows for the development of a The material presented in Section I sets forth the kinesiologic
rational evaluation, a precise diagnosis, and an effective treatment foundation for the more anatomic- and regional-based chapters
of disorders that affect the musculoskeletal system. These abilities included in Sections II to IV. Section II (Chapters 5 to 8) describes
represent the hallmark of high quality for any health professional the kinesiology related to the upper extremity; Section III
engaged in the practice of physical rehabilitation. (Chapters 9 to 11) covers the kinesiology involving primarily the

3
4 Section I   Essential Topics of Kinesiology

5
4
5 cm 3
2
1
0

0% 10% 20% 30% 40% 50%

FIG. 1.2 A point on the top of the head is shown translating upward and
downward in a curvilinear fashion during walking. The horizontal axis
of the graph shows the percentage of completion of one entire gait
(walking) cycle.

FIG. 1.1 An illustration from the anatomy text Tabulae Sceleti et Muscu-
lorum Corporis Humani (1747) by Bernhard Siegfried Albinus.

axial skeleton and trunk; finally, Section IV (Chapters 12 to 16)

presents the kinesiology of the lower extremity, including a pair
of closing chapters that focus on walking and running.
FIG. 1.3 With a stroboscopic flash, a camera is able to capture the rota-
tion of the forearm around the elbow. If not for the anatomic constraints
KINEMATICS of the elbow, the forearm could, in theory, rotate 360 degrees around an
axis of rotation located at the elbow (open circle).
Kinematics is a branch of mechanics that describes the motion of
a body, without regard to the forces or torques that may produce the same angular direction (e.g., clockwise and counterclockwise)
the motion. In biomechanics the term body is used rather loosely across the same number of degrees.
to describe the entire body, or any of its parts or segments, such Movement of the human body as a whole is often described as
as individual bones or regions. In general, there are two types of a translation of the body’s center of mass, located generally just
motions: translation and rotation. anterior to the sacrum. Although a person’s center of mass trans-
lates through space, it is powered by muscles that rotate the limbs.
Translation Compared with Rotation The fact that limbs rotate can be appreciated by watching the path
created by a fist while the elbow is flexing (Fig. 1.3). (It is custom-
Translation describes a linear motion in which all parts of a rigid ary in kinesiology to use the phrases “rotation of a joint” and
body move parallel to and in the same direction as every other “rotation of a bone” interchangeably.)
part of the body. Translation can occur in either a straight line The pivot point for angular motion of the body or body parts
(rectilinear) or a curved line (curvilinear). During walking, for is called the axis of rotation. The axis is at the point where motion
example, a point on the head moves in a general curvilinear of the rotating body is zero. For most movements of the limbs or
manner (Fig. 1.2). trunk, the axis of rotation is located within or very near the struc-
Rotation, in contrast to translation, describes a motion in which ture of the joint.
an assumed rigid body moves in a circular path around some pivot Movement of the body, regardless of translation or rotation, can
point. As a result, all points in the body simultaneously rotate in be described as active or passive. Active movements are caused by
 Chapter 1   Getting Started 5

TABLE 1.1 Common Conversions between Units of SAGIT ONTAL PLANE

Kinematic Measurements TAL PFR
LANE
SI Units English Units

1 meter (m) = 3.28 feet (ft) 1 ft = 0.305 m

1 m = 39.37 inches (in) 1 in = 0.0254 m
1 centimeter (cm) = 0.39 in 1 in = 2.54 cm
1 m = 1.09 yards (yd) 1 yd = 0.91 m
1 kilometer (km) = 0.62 miles (mi) 1 mi = 1.61 km
1 degree = 0.0174 radians (rad) 1 rad = 57.3 degrees

HORIZONT
AL PLANE
stimulated muscle, such as when bending the elbow to drink a
glass of water. Passive movements, in contrast, are caused by sources
other than active muscle contraction, such as a push or pull from
another person, the pull of gravity, tension in stretched connective
tissues, and so forth.
The primary variables related to kinematics are position, veloc-
ity, and acceleration. Specific units of measurement are needed to
indicate the quantity of these variables. Units of meters or feet are
used for translation, and degrees or radians are used for rotation.
In most situations, Kinesiology of the Musculoskeletal System uses
the International System of Units, adopted in 1960. This system is
abbreviated SI, for Système International d’Unités, the French
name. This system of units is widely accepted in many journals
related to kinesiology and rehabilitation. The kinematic conver-
sions between the more common SI units and other measurement
units are listed in Table 1.1. Additional units of measurements are
described in Chapter 4. FIG. 1.4 The three cardinal planes of the body are shown while a person
is standing in the anatomic position.
Osteokinematics
TABLE 1.2 A Sample of Common Osteokinematic Terms*
PLANES OF MOTION
Plane Common Terms
Osteokinematics describes the motion of bones relative to the three
cardinal (principal) planes of the body: sagittal, frontal, and hori- Sagittal plane Flexion and extension
zontal. These planes of motion are depicted in the context of a Dorsiflexion and plantar flexion
Forward and backward bending
person standing in the anatomic position as in Fig. 1.4. The sagittal
plane runs parallel to the sagittal suture of the skull, dividing the Frontal plane Abduction and adduction
body into right and left sections; the frontal plane runs parallel to Lateral flexion
Ulnar and radial deviation
the coronal suture of the skull, dividing the body into front and Eversion and inversion
back sections. The horizontal (or transverse) plane courses parallel
Horizontal Internal (medial) and external (lateral) rotation
to the horizon and divides the body into upper and lower sections.
plane Axial rotation
A sample of the terms used to describe the different osteokinemat-
ics is shown in Table 1.2. More specific terms are defined in the
*Many of the terms are specific to a particular region of the body. The thumb, for example,
chapters that describe the various regions of the body.
uses different terminology.

AXIS OF ROTATION
spheres with changing surface curvatures. The issue of a migrating
Bones rotate around a joint in a plane that is perpendicular to an axis of rotation is discussed further in Chapter 2.
axis of rotation. As a rough estimation, the axis (or pivot point)
can be assumed to pass through the convex member of the joint. DEGREES OF FREEDOM
The shoulder, for example, allows movement in all three planes
and therefore has three axes of rotation (Fig. 1.5). Although the Degrees of freedom are the number of independent directions of
three orthogonal axes are depicted as stationary, in reality, as in movements allowed at a joint. A joint can have up to three degrees
all joints, each axis shifts slightly throughout the range of motion. of angular freedom, corresponding to the three cardinal planes.
The axis of rotation would remain stationary only if the convex As depicted in Fig. 1.5, for example, the shoulder has three degrees
member of a joint were a perfect sphere, articulating with a per- of angular freedom, one for each plane. The wrist allows only two
fectly reciprocally shaped concave member. The convex members degrees of freedom (rotation within sagittal and frontal planes),
of most joints, like the humeral head at the shoulder, are imperfect and the elbow allows just one (within the sagittal plane).
6 Section I   Essential Topics of Kinesiology

short, straight arrows near proximal humerus in Fig. 1.5). At

many joints, the amount of translation is used clinically to test
the health of the joint. Excessive translation of a bone relative to
the joint may indicate ligamentous injury or abnormal laxity. In
Vertical axis contrast, a significant reduction in translation (accessory move-
ments) may indicate pathologic stiffness within the surrounding
periarticular connective tissues. Abnormal translation within a
joint typically affects the quality of the active movements, poten-
tially causing increased intra-articular stress and microtrauma.

ML axis OSTEOKINEMATICS: A MATTER OF PERSPECTIVE

In general, the articulation of two or more bony or limb segments
constitutes a joint. Movement at a joint can therefore be consid-
AP axis
ered from two perspectives: (1) the proximal segment can rotate
against the relatively fixed distal segment, and (2) the distal
segment can rotate against the relatively fixed proximal segment.
(In reality, both perspectives can and often do occur simultane-
ously; although for ease of discussion and analysis, this situation
is often omitted within this text.) The two kinematic perspectives
are shown for knee flexion in Fig. 1.6. A term such as knee flexion,
for example, describes only the relative motion between the thigh
and leg. It does not describe which of the two segments is actually
rotating. Often, to be clear, it is necessary to state the bone that
is considered the rotating segment. As in Fig. 1.6, for example,
the terms tibial-on-femoral movement and femoral-on-tibial move-
ment adequately describe the osteokinematics.
Most routine movements performed by the upper extremities
involve distal-on-proximal segment kinematics. This reflects the
need to bring objects held by the hand either toward or away from
the body. The proximal segment of a joint in the upper extremity
is usually stabilized by muscles, gravity, or its inertia, whereas the
distal, relatively unconstrained, segment rotates.
Feeding oneself and throwing a ball are common examples of
distal-on-proximal segment kinematics employed by the upper
extremities. The upper extremities are certainly capable of per-
FIG. 1.5 The right glenohumeral (shoulder) joint highlights three orthog-
forming proximal-on-distal segment kinematics, such as flexing
onal axes of rotation and associated planes of angular motion: flexion and and extending the elbows while one performs a pull-up.
extension (green curved arrows) occur around a medial-lateral (ML) axis The lower extremities routinely perform both proximal-on-
of rotation; abduction and adduction (purple curved arrows) occur around distal and distal-on-proximal segment kinematics. These kinemat-
an anterior-posterior (AP) axis of rotation; and internal rotation and ics reflect, in part, the two primary phases of walking: the stance
external rotation (blue curved arrows) occur around a vertical axis of rota- phase, when the limb is planted on the ground under the load of
tion. Each axis of rotation is color-coded with its associated plane of body weight, and the swing phase, when the limb is advancing
movement. The short, straight arrows shown parallel to each axis repre- forward. Many other activities, in addition to walking, use both
sent the slight translation potential of the humerus relative to the scapula. kinematic strategies. Flexing the knee in preparation to kick a ball,
This illustration shows both angular and translational degrees of freedom. for example, is a type of distal-on-proximal segment kinematics
(See text for further description.)
(see Fig. 1.6A). Descending into a squat position, in contrast, is
an example of proximal-on-distal segment kinematics (see Fig.
Unless specified differently throughout this text, the term 1.6B). In the latter example, a relatively large demand is placed
degrees of freedom indicates the number of permitted planes of on the quadriceps muscle of the knee to control the gradual
angular motion at a joint. From a strict engineering perspective, descent of the body.
however, degrees of freedom apply to translational (linear) as well The terms open and closed kinematic chains are frequently used
as angular movements. All synovial joints in the body possess in the physical rehabilitation literature and clinics to describe the
at least some translation, driven actively by muscle or passively concept of relative segment kinematics. A kinematic chain refers
because of the natural laxity within the structure of the joint. The to a series of articulated segmented links, such as the connected
slight passive translations that occur in most joints are referred to pelvis, thigh, leg, and foot of the lower extremity. The terms
as accessory movements (or joint “play”) and are commonly defined “open” and “closed” are typically used to indicate whether the
in three linear directions. From the anatomic position, the spatial distal end of an extremity is fixed to the earth or some other
orientation and direction of accessory movements can be described immovable object. An open kinematic chain describes a situation
relative to the three axes of rotation. In the relaxed glenohumeral in which the distal segment of a kinematic chain, such as the foot
joint, for example, the humerus can be passively translated slightly: in the lower limb, is not fixed to the earth or another immovable
anterior-posteriorly, medial-laterally, and superior-inferiorly (see object. The distal segment therefore is free to move (see Fig. 1.6A).
 Chapter 1   Getting Started 7

Knee flexion Proximal segment free

Proximal segment fixed Distal segment free

Distal segment fixed

A Tibial-on-femoral perspective B Femoral-on-tibial perspective

FIG. 1.6 Sagittal plane osteokinematics at the knee show an example of (A) distal-on-proximal segment kinematics
and (B) proximal-on-distal segment kinematics. The axis of rotation is shown as a circle at the knee.
rus
Hume

FIG. 1.7 The humero-ulnar joint at the elbow is an

example of a convex-concave relationship between two
articular surfaces. The trochlea of the humerus is convex,
and the trochlear notch of the ulna is concave.
Articular capsule
Trochlea
(convex)
Trochlear notch (concave)

Ulna

A closed kinematic chain describes a situation in which the distal partial squat, for example, is often referred to clinically as the
segment of the kinematic chain is fixed to the earth or another movement of a closed kinematic chain. It could be argued,
immovable object. In this case the proximal segment is free to however, that this is a movement of an open kinematic chain
move (see Fig. 1.6B). These terms are employed extensively to because the contralateral leg is not fixed to ground (i.e., the circuit
describe methods of applying resistive exercise to muscles, espe- formed by the total body is open). To avoid confusion, this text
cially to the joints of the lower limb. uses the terms open and closed kinematic chains sparingly, and the
Although very convenient terminology, the terms open and preference is to explicitly state which segment (proximal or distal)
closed kinematic chains are often ambiguous. From a strict engi- is considered fixed and which is considered free.
neering perspective, the terms apply more to the kinematic inter-
dependence of a series of connected rigid links, which is not exactly Arthrokinematics
the same as the previous definitions given here. From this engi-
neering perspective, the chain is “closed” if both ends are fixed to TYPICAL JOINT MORPHOLOGY
a common object, much like a closed circuit. In this case, move-
ment of any one link requires a kinematic adjustment of one or Arthrokinematics describes the motion that occurs between the
more of the other links within the chain. articular surfaces of joints. As described further in Chapter 2, the
“Opening” the chain by disconnecting one end from its fixed shapes of the articular surfaces of joints range from flat to curved.
attachment interrupts this kinematic interdependence. This more Most joint surfaces, however, are at least slightly curved, with one
precise terminology does not apply universally across all health- surface being relatively convex and one relatively concave (Fig.
related and engineering disciplines. Performing a one-legged 1.7). The convex-concave relationship of most articulations
8 Section I   Essential Topics of Kinesiology

improves their congruency (fit), increases the surface area for dis- surface moves on a concave surface, and vice versa (Fig. 1.8).
sipating contact forces, and helps guide the motion between the Although other terms are used, these are useful for visualizing the
bones. relative movements that occur within a joint. The terms are for-
mally defined in Table 1.3.
FUNDAMENTAL MOVEMENTS BETWEEN JOINT SURFACES
Roll-and-Slide Movements
Three fundamental movements exist between curved joint sur- One primary way that a bone rotates through space is by a rolling
faces: roll, slide, and, spin. These movements occur as a convex of its articular surface against another bone’s articular surface. The

Convex-on-concave arthrokinematics

ROLL

SLIDE
SPIN

Concave-on-convex arthrokinematics

SPIN
E
ID
SL

ROLL

FIG. 1.8 Three fundamental arthrokinematics that occur between curved joint surfaces: roll, slide, and spin.
A, Convex-on-concave movement. B, Concave-on-convex movement.
 Chapter 1   Getting Started 9

TABLE 1.3 Three Fundamental Arthrokinematics: Roll, Slide, and Spin

Movement Definition Analogy

Roll* Multiple points along one rotating articular surface contact multiple points A tire rotating across a stretch of pavement
on another articular surface.
Slide† A single point on one articular surface contacts multiple points on another A nonrotating tire skidding across a stretch
articular surface. of icy pavement
Spin A single point on one articular surface rotates on a single point on another A toy top rotating on one spot on the floor
articular surface.

*Also termed rock.

†
Also termed glide.

Subacromial bursa
Subacromial bursa Supraspinatus pull
N
TIO
ABDUC

ROLL

R O LL
S
L
I
D
E
Supraspinatus
Supraspinatus
pull
pull

A B
FIG. 1.9 Arthrokinematics at the glenohumeral joint during abduction. The glenoid fossa is concave, and the humeral
head is convex. A, Roll-and-slide arthrokinematics typical of a convex articular surface moving on a relatively station-
ary concave articular surface. B, Consequences of a roll occurring without a sufficient offsetting slide.

motion is shown for a convex-on-concave surface movement at articular surface area of the convex member exceeds that of the
the glenohumeral joint in Fig. 1.9A. The contracting supraspina- concave member.
tus muscle rolls the convex humeral head against the slight con-
cavity of the glenoid fossa. In essence, the roll directs the Spin
osteokinematic path of the abducting shaft of the humerus. Another primary way that a bone rotates is by a spinning of its
A rolling convex surface typically involves a concurrent, oppo- articular surface against the articular surface of another bone. This
sitely directed slide. As shown in Fig. 1.9A the inferior-directed occurs as the radius of the forearm spins against the capitulum of
slide of the humeral head offsets most of the potential superior the humerus during pronation of the forearm (Fig. 1.10). Other
migration of the rolling humeral head. The offsetting roll-and- examples include internal and external rotation of the 90-degree
slide kinematics are analogous to a tire on a car that is spinning abducted glenohumeral joint, and flexion and extension of the
on a sheet of ice. The potential for the tire to rotate forward on hip. Spinning is the primary mechanism for joint rotation when
the icy pavement is offset by a continuous sliding of the tire in the longitudinal axis of the moving bone intersects the surface of
the opposite direction to the intended rotation. A classic patho- its articular mate at right angles.
logic example of a convex surface rolling without an offsetting
slide is shown in Fig. 1.9B. The humeral head translates upward Motions That Combine Roll-and-Slide and Spin Arthrokinematics
and impinges on the delicate tissues in the subacromial space. The Several joints throughout the body combine roll-and-slide with
migration alters the relative location of the axis of rotation, which spin arthrokinematics. A classic example of this combination
may alter the effectiveness of the muscles that cross the glenohu- occurs during flexion and extension of the knee. As shown during
meral joint. femoral-on-tibial knee extension (Fig. 1.11A), the femur spins
As shown in Fig. 1.9A the concurrent roll-and-slide motion internally slightly as the femoral condyle rolls and slides relative
maximizes the angular displacement of the abducting humerus to the fixed (stationary) tibia. These arthrokinematics are also
and minimizes the net translation between joint surfaces. This shown as the tibia extends relative to the fixed femur in Fig.
mechanism is particularly important in joints in which the 1.11B. In the knee the spinning motion that occurs with flexion
10 Section I   Essential Topics of Kinesiology

and extension occurs automatically and is mechanically linked to PREDICTING AN ARTHROKINEMATIC PATTERN BASED ON
the primary motion of extension. As described in Chapter 13, the JOINT MORPHOLOGY
obligatory spinning rotation is based on the shape of the articular
surfaces at the knee. The conjunct rotation helps to securely lock As previously stated, most articular surfaces of bones are either
the knee joint when fully extended. convex or concave. Depending on which bone is moving, a convex
surface may rotate on a concave surface or vice versa (compare
Fig. 1.11A with Fig. 1.11B). Each scenario presents a different
roll-and-slide arthrokinematic pattern. As depicted in Figs. 1.11A
and 1.9A for the shoulder, during a convex-on-concave movement,
the convex surface rolls and slides in opposite directions. As previ-
Humerus
ously described, the contradirectional slide offsets much of the
translation tendency inherent to the rolling convex surface.
During a concave-on-convex movement, as depicted in Fig. 1.11B,
the concave surface rolls and slides in similar directions. These two
Medial
principles are very useful for visualizing the arthrokinematics
Capitulum during a movement. In addition, the principles serve as a basis for
epicondyle
some manual therapy techniques.18 External forces may be applied
by the clinician that assist or guide the natural arthrokinematics
SPIN Pronator teres
at the joint. For example, in certain circumstances, glenohumeral
na

abduction can be facilitated by applying an inferior-directed force

Ul

at the proximal humerus, simultaneously with an active-abduction

effort. The arthrokinematic principles are based on the knowledge
Radius

of the joint surface morphology.

P RO
NATION
Arthrokinematic Principles of Movement
• For a convex-on-concave surface movement, the convex member
FIG. 1.10 Pronation of the forearm shows an example of a spinning rolls and slides in opposite directions.
motion between the head of the radius and the capitulum of the humerus. • For a concave-on-convex surface movement, the concave
The pair of opposed short black arrows indicates compression forces member rolls and slides in similar directions.
between the head of the radius and the capitulum.

Spin rotation
Quadriceps fe

S ION
Femur

EN
T
EX

moris

ROLL

S L ID E
Patellar ten

ROLL
don

S L ID E

EXT
ENSION
Tibia

Spin rotation

A B
FIG. 1.11 Extension of the knee demonstrates a combination of roll-and-slide with spin arthrokinematics. The femoral
condyle is convex, and the tibial plateau is slightly concave. A, Femoral-on-tibial (knee) extension. B, Tibial-on-femoral
(knee) extension.
 Chapter 1   Getting Started 11

CLOSE-PACKED AND LOOSE-PACKED POSITIONS

AT A JOINT
The pair of articular surfaces within most joints “fits” best in only
one position, usually in or near the very end range of a motion.
This position of maximal congruency is referred to as the joint’s
close-packed position.21 In this position, most ligaments and parts
of the capsule are pulled taut, providing an element of natural
stability to the joint. Accessory movements are typically minimal
in a joint’s close-packed position.
For many joints in the lower extremity, the close-packed posi- Unloaded Tension Compression Bending
tion is associated with a habitual function. At the knee, for
example, the close-packed position includes full extension—a
position that is typically approached while standing. The com-
bined effect of the maximal joint congruity and stretched liga-
ments helps to provide transarticular stability to the knee.
All positions other than a joint’s close-packed position are
referred to as the joint’s loose-packed positions. In these positions,
the ligaments and capsule are relatively slackened, allowing an
increase in accessory movements. The joint is generally least con-
gruent near its midrange. In the lower extremity, the loose-packed Shear Torsion Combined
positions of the major joints are biased toward flexion. These loading
positions are generally not used during prolonged standing, but FIG. 1.12 The manner by which forces or loads are most frequently
frequently are preferred by the patient during long periods of applied to the musculoskeletal system is shown. The combined loading
immobilization, such as extended bed rest. of torsion and compression is also illustrated.

KINETICS S PE C I A L F O C U S 1 . 1
Kinetics is a branch of the study of mechanics that describes the
effect of forces on the body. The topic of kinetics is introduced
Body Weight Compared with Body Mass
here as it applies to the musculoskeletal system. A more detailed
and mathematic approach to this subject matter is provided in
Chapter 4.
From a kinesiologic perspective, a force can be considered as a
A kilogram (kg) is a unit of mass that indicates the relative
number of particles within an object. Strictly speaking,
therefore, a kilogram is a measure of mass, not weight. Under
push or pull that can produce, arrest, or modify movement. Forces the influence of gravity, however, a 1-kg mass weighs about
therefore provide the ultimate impetus for movement and stabi- 9.8 N (2.2 lb). This is the result of gravity acting to accelerate
lization of the body. As described by Newton’s second law, the the 1-kg mass toward the center of earth at a rate of about
quantity of a force (F) can be measured by the product of the 9.8 m/sec2. Very often, however, the weight of a body is expressed
mass (m) that receives the push or pull, multiplied by the accelera- in kilograms. The assumption is that the acceleration resulting
tion (a) of the mass. The formula F = ma shows that, given a from gravity acting on the body is constant and, for practical
constant mass, a force is directly proportional to the acceleration purposes, ignored. Technically, however, the weight of a person
of the mass: measuring the force yields the acceleration of the varies inversely with the square of the distance between the
body, and vice versa. A net force is zero when the acceleration of mass of the person and the center of the earth. A person on the
the mass is zero. summit of Mt. Everest at 29,035 ft (8852 m), for example, weighs
The standard international unit of force is the newton (N): slightly less than a person with identical mass at sea level.
1 N = 1 kg × 1 m/sec2. The English equivalent of the newton is The acceleration resulting from gravity on Mt. Everest is
the pound (lb): 1 lb = 1 slug × 1 ft/sec2 (4.448 N = 1 lb). 9.782 m/sec2 compared with 9.806 m/sec2 at sea level.

Musculoskeletal Forces
IMPACT OF FORCES ON THE MUSCULOSKELETAL SYSTEM: tension generated within the elongated (stretched) tissue. Any
INTRODUCTORY CONCEPTS AND TERMINOLOGY tissue weakened by disease, trauma, or prolonged disuse may not
be able to adequately resist the application of the loads depicted
A force that acts on the body is often referred to generically as a in Fig. 1.12. The proximal femur weakened by osteoporosis, for
load. Forces or loads that move, fixate, or otherwise stabilize the example, may fracture from the impact of a fall secondary to
body also have the potential to deform and injure the body. The compression or torsion (twisting), shearing, or bending of the neck
loads most frequently applied to the musculoskeletal system are of the femur. Fracture may also occur in a severely osteoporotic
illustrated in Fig. 1.12. (See the glossary at the end of this chapter hip after a very strong muscle contraction.
for formal definitions.) Healthy tissues are typically able to par- The ability of periarticular connective tissues to accept and
tially resist changes in their structure and shape. The force that disperse loads is an important topic of research within physical
stretches a healthy ligament, for example, is met by an intrinsic rehabilitation, manual therapy, and orthopedic medicine.9,14
12 Section I   Essential Topics of Kinesiology

Ultimate
Yield point failure point

Stress (N/mm2)
on
e gi Y
rr
n ea
Li
X
Y/X = stiffness

Nonlinear
Elastic region Plastic region
(toe) region

Physiologic range
Strain (%)
FIG. 1.13 The stress-strain relationship of an excised ligament that has been stretched to a point of mechanical failure
(disruption).

Clinicians and scientists are very interested in how variables such climbing stairs, pedaling a stationary bicycle, or squatting.6,7,11 It
as aging, trauma, altered activity or weight-bearing levels, or pro- is important to note that a healthy and relatively young ligament
longed immobilization affect the load-accepting functions of peri- that is strained within the elastic zone returns to its original length
articular connective tissues. One laboratory-based method of (or shape) once the deforming force is removed. The area under
measuring the ability of a connective tissue to tolerate a load is to the curve (in darker blue) represents elastic deformation energy.
plot the force required to deform an excised tissue.5 This type of Most of the energy used to deform the tissue is released when the
experiment is typically performed using animal or human cadaver force is removed. Even in a static sense, elastic energy has an
specimens. Fig. 1.13 shows a theoretical graph of the tension important function within joints. When stretched even a moder-
generated by a generic ligament (or tendon) that has been stretched ate amount into the elastic zone, ligaments and other connective
to a point of mechanical failure. The vertical (Y) axis of the graph tissues perform important joint stabilization functions.
is labeled stress, a term that denotes the internal resistance gener- A tissue that is elongated beyond its physiologic range eventu-
ated as the ligament resists deformation, divided by its cross- ally reaches its yield point. At this point, increased strain results
sectional area. (The units of stress are similar to pressure: N/mm2.) in only marginal increased stress (tension). This physical behavior
The horizontal (X) axis is labeled strain, which in this case is the of an overstretched (or overcompressed) tissue is known as plas-
percent increase in a tissue’s stretched length relative to its original, ticity. The overstrained tissue has experienced plastic deformation.
preexperimental length.20 (A similar procedure may be performed At this point microscopic failure has occurred and the tissue
by compressing rather than stretching an excised slice of cartilage remains permanently deformed. The area under this region of
or bone, for example, and then plotting the amount of stress the curve (in lighter blue) represents plastic deformation energy.
produced within the tissue.) Note in Fig. 1.13 that under a rela- Unlike elastic deformation energy, plastic energy is not recover-
tively slight strain (stretch), the ligament produces only a small able in its entirety even when the deforming force is removed.
amount of stress (tension). This nonlinear or “toe” region of the As elongation continues, the ligament eventually reaches its ulti-
graph reflects the fact that the collagen fibers within the tissue are mate failure point, the point when the tissue partially or com-
initially wavy or crimped and must be drawn taut before signifi- pletely separates and loses its ability to hold any level of tension.
cant tension is measured.14 Further elongation, however, shows a Most healthy tendons fail at about 8–13% beyond their pre-
linear relationship between stress and strain. The ratio of the stress stretched length.24
(Y) caused by an applied strain (X) in the ligament is a measure The graph in Fig. 1.13 does not indicate the variable of time of
of its stiffness (often referred to as Young’s modulus). All normal load application. Tissues in which the physical properties associ-
connective tissues within the musculoskeletal system exhibit some ated with the stress-strain curve change as a function of time are
degree of stiffness. The clinical term “tightness” usually implies a considered viscoelastic. Most tissues within the musculoskeletal
pathologic condition of abnormally high stiffness. system demonstrate at least some degree of viscoelasticity. One
The initial nonlinear and subsequent linear regions of the curve phenomenon of a viscoelastic material is creep. As demonstrated
shown in Fig. 1.13 are often referred to as the elastic region. Liga- by the tree branch in Fig. 1.14, creep describes a progressive strain
ments, for example, are routinely strained within the lower limits of a material when exposed to a constant load over time. The
of their elastic region. The anterior cruciate ligament, for example, phenomenon of creep helps to explain why a person is taller in
is strained about 3–4% during common activities such as a the morning than at night. The constant compression caused by
 Chapter 1   Getting Started 13

body weight on the spine throughout the day literally squeezes a

small amount of fluid out of the intervertebral discs. The fluid is
reabsorbed at night while the sleeping person is in a non–weight-
bearing position.
The stress-strain curve of a viscoelastic material is also sensitive
to the rate of loading of the tissue. In general, the slope of a stress-
strain relationship when placed under tension or compression
8 am increases throughout its elastic range as the rate of the loading
increases.20 The rate-sensitivity nature of viscoelastic connective
6 pm
tissues may protect surrounding structures within the musculo-
skeletal system. Articular cartilage in the knee, for example,
FIG. 1.14 The branch of the tree is demonstrating a time-dependent becomes stiffer as the rate of compression increases,19 such as
property of creep associated with a viscoelastic material. Hanging a load during running. The increased stiffness affords greater protection
on the branch at 8 am creates an immediate deformation. By 6 pm, the to the underlying bone at a time when forces acting on the joint
load has caused additional deformation in the branch. (From Panjabi are greatest.
MM, White AA: Biomechanics in the musculoskeletal system, New York, In summary, similar to building materials such as steel, con-
2001, Churchill Livingstone.) crete, and fiberglass, the periarticular connective tissues within the

S PE C I A L F O C U S 1 . 2

Productive Antagonism: The Body’s Ability to Convert Passive Tension into Useful Work

A stretched or elongated tissue within the body generally pro-

duces tension (i.e., a resistance force that opposes the
stretch). In pathologic cases this tension may be abnormally large,
illustration). Part of the contractile energy produced by muscle B
is used to stretch muscle A, and the cycle is repeated.
This transfer and storage of energy between opposing muscles
thereby interfering with functional mobility. This textbook presents is useful in terms of overall metabolic efficiency. This phenomenon
several examples, however, illustrating how relatively low levels is often expressed in different ways by multi-articular muscles
of tension produced by stretched connective tissues (including (i.e., muscles that cross several joints). Consider the rectus
muscle) perform useful functions. This phenomenon is called pro- femoris, a muscle that flexes the hip and extends the knee. During
ductive antagonism and is demonstrated for a pair of muscles in the upward phase of jumping, for example, the rectus femoris
the simplified model in Fig. 1.15. As shown by the figure on the contracts to extend the knee. At the same time, the extending hip
left, part of the energy produced by active contraction of muscle stretches the active rectus femoris across the front of the hip. As
A is transferred and stored as elastic energy in the stretched con- a consequence, the overall shortening of the rectus femoris is
nective tissues within muscle B. The elastic energy is released as minimized, which helps preserve useful passive tension within the
muscle B actively contracts to drive the nail into the board (right muscle.

A
A

B
B

FIG. 1.15 A simplified model showing a pair of opposed muscles surrounding a joint. In the left illustration,
muscle A is contracting to provide the force needed to lift the hammer in preparation to strike the nail. In the
right illustration, muscle B is contracting, driving the hammer against the nail while simultaneously stretching
muscle A. (Redrawn from Brand PW: Clinical biomechanics of the hand, St Louis, 1985, Mosby.)
14 Section I   Essential Topics of Kinesiology

Internal force Internal force

FIG. 1.16 A sagittal plane view of the elbow joint and associ- Joint
ated bones. A, Internal (muscle) and external (gravitational) reaction
forces are shown both acting vertically, but each in a different force
direction. The two vectors have different magnitudes and
different points of attachment to the forearm. B, Joint reac-
tion force is added to prevent the forearm from accelerating
upward. (Vectors are drawn to relative scale.)

A External force B External force

human body possess unique physical properties when loaded or by an arrow that represents a vector. By definition, a vector is a
strained. In engineering terms, these physical properties are for- quantity that is completely specified by its magnitude and its
mally referred to as material properties. The topic of material direction. (Quantities such as mass and speed are scalars, not
properties of periarticular connective tissues (such as stress, strain, vectors. A scalar is a quantity that is completely specified by its
stiffness, plastic deformation, ultimate failure load, and creep) has magnitude and has no direction.)
a well-established literature base.* Although much of the data on In order to completely describe a vector in a biomechanical
this topic are from animal or cadaver research, they do provide analysis, its magnitude, spatial orientation, direction, and point
insight into many aspects of patient care, including understanding of application must be known. The forces depicted in Fig. 1.16
mechanisms of injury, improving the design of orthopedic surgery, indicate these four factors.
and judging the potential effectiveness of certain forms of physical 1. The magnitude of the force vectors is indicated by the length
therapy, such as prolonged stretching or application of heat to of the shaft of the arrow.
induce greater tissue extensibility.† 2. The spatial orientation of the force vectors is indicated by the
position of the shaft of the arrows. Both forces are oriented
INTERNAL AND EXTERNAL FORCES vertically, often referred to as the Y axis (further described in
Chapter 4). The orientation of a force can also be described
As a matter of convenience, the forces that act on the musculo- by the angle formed between the shaft of the arrow and a refer-
skeletal system can be divided into two sets: internal and external. ence coordinate system.
Internal forces are produced from structures located within the 3. The direction of the force vectors is indicated by the arrowhead.
body. These forces may be “active” or “passive.” Active forces are In the example depicted in Fig. 1.16A, the internal force acts
generated by stimulated muscle, generally but not necessarily upward, typically described in a positive Y sense; the external
under volitional control. Passive forces, in contrast, are typically force acts downward in a negative Y sense. Throughout this
generated by tension in stretched periarticular connective tissues, text, the direction and spatial orientation of a muscle force and
including the intramuscular connective tissues, ligaments, and gravity are referred to as their line of force and line of gravity,
joint capsules. Active forces produced by muscles are typically the respectively.
largest of all internal forces. 4. The point of application of the vectors is where the base of
External forces are produced by forces acting from outside the the vector arrow contacts the part of the body. The point of
body. These forces usually originate from either gravity pulling on application of the muscle force is where the muscle inserts
the mass of a body segment or an external load, such as that of into the bone. The angle-of-insertion describes the angle
luggage, “free” weights, or physical contact, such as that applied by formed between a tendon of a muscle and the long axis of
a therapist against the limb of a patient. Fig. 1.16A shows an the bone into which it inserts. In Fig. 1.16A, the angle-of-
opposing pair of internal and external forces: an internal force insertion is 90 degrees. The angle-of-insertion changes as the
(muscle) pulling the forearm, and an external (gravitational) force elbow rotates into flexion or extension. The point of applica-
pulling on the center of mass of the forearm. Each force is depicted tion of the external force depends on whether the force is
the result of gravity or the result of a resistance applied by
physical contact. Gravity acts on the center of mass of the
body segment (see Fig. 1.16A, dot at the forearm). The point
*References 8, 12, 13, 15, 17, 22, 25 of application of a resistance generated from physical contact
†
References 1, 4, 9, 10, 14, 16, 23 can occur anywhere on the body.
 Chapter 1   Getting Started 15

Internal force (IF)

Factors Required to Completely Describe a Vector in
Most Simple Biomechanical Analyses Internal torque = External torque
• Magnitude
• Spatial orientation
• Direction
• Point of application IF × D = EF × D1

D1
As a push or a pull, all forces acting on the body cause a poten-
tial translation of the segment. The direction of the translation
External force (EF)
depends on the net effect of all the applied forces. In Fig. 1.16A,
because the muscle force is three times greater than the weight of FIG. 1.17 The balance of internal and external torques acting in the sagit-
the forearm, the net effect of both forces would accelerate the tal plane around the axis of rotation at the elbow (small circle) is shown.
The internal torque is the product of the internal force multiplied by the
forearm vertically upward. In reality, however, the forearm is typi-
internal moment arm (D). The internal torque has the potential to rotate
cally prevented from accelerating upward by a joint reaction force the forearm in a counterclockwise direction. The external torque is the
produced between the surfaces of the joint. As depicted in Fig. product of the external force (gravity) and the external moment arm (D1).
1.16B, the distal end of the humerus is pushing down with a The external torque has the potential to rotate the forearm in a clockwise
reaction force (shown in blue) against the proximal end of the direction. The internal and external torques are equal, demonstrating a
forearm. The magnitude of the joint reaction force is equal to the condition of static rotary equilibrium. (Vectors are drawn to relative
difference between the muscle force and external force. As a result, scale.)
the sum of all vertical forces acting on the forearm is balanced,
and net acceleration of the forearm in the vertical direction is zero.
The system is therefore in static linear equilibrium.

Musculoskeletal Torques The human body typically produces or receives torques repeat-
edly in one form or another. Muscles generate internal torques
Forces exerted on the body can have two outcomes. First, as constantly throughout the day, to unscrew a cap from a jar, turn
depicted in Fig. 1.16A, forces can potentially translate a body a wrench, or swing a baseball bat. Manual contact forces received
segment. Second, the forces, if applied at some distance perpen- from the environment in addition to gravity are constantly con-
dicular to the axis of rotation, can also produce a potential rotation verted to external torques across joints. Internal and external
of the joint. The perpendicular distance between the axis of rota- torques are constantly “competing” for dominance across joints—
tion of the joint and the force is called a moment (or lever) arm. the more dominant torque is reflected by the direction of move-
The product of a force and its moment arm produces a torque or ment or position of the joints at any given time throughout the
a moment. A torque can be considered as a rotatory equivalent to body.
a force. A force acting without a moment arm can push and pull Torques are involved in most therapeutic situations with
an object generally in a linear fashion, whereas a torque rotates patients, especially when physical exercise or strength assessment
an object around an axis of rotation. This distinction is a funda- is involved. A person’s “strength” is the product of their muscles’
mental concept in the study of kinesiology. force and, equally important, the internal moment arm: the per-
A torque is described as occurring around a joint in a plane pendicular distance between the muscle’s line of force and the
perpendicular to a given axis of rotation. Fig. 1.17 shows the axis of rotation. Leverage describes the relative moment arm
torques produced within the sagittal plane by the internal and length possessed by a particular force. As explained further in
external forces introduced in Fig. 1.16. The internal torque is Chapter 4, the length of a muscle’s moment arm, and hence lever-
defined as the product of the internal force (muscle) and the age, changes constantly throughout a range of motion. This par-
internal moment arm. The internal moment arm (see D in Fig. tially explains why a person is naturally stronger in certain parts
1.17) is the perpendicular distance between the axis of rotation of a joint’s range of motion.
and the internal force. As depicted in Fig. 1.17, the internal torque Clinicians frequently apply manual resistance against their
has the potential to rotate the forearm around the elbow joint in patients or clients as a means to assess, facilitate, and challenge a
a counterclockwise, or flexion, direction. (Other conventions for particular muscle activity. The force applied against a patient’s
describing rotation direction are explored in Chapter 4.) extremity is often performed with the intent of producing an
The external torque is defined as the product of the external external torque against the patient’s musculoskeletal system. A
force (such as gravity) and the external moment arm. The external clinician can challenge a particular muscle group by applying an
moment arm (see D1 in Fig. 1.17) is the perpendicular distance external torque by way of a small manual force exerted a great
between the axis of rotation and the external force. The external distance from the joint, or a large manual force exerted close to
torque has the potential to rotate the forearm around the elbow the joint. Because torque is the product of a resistance force and
joint in a clockwise, or extension, direction. Because the magni- its moment arm, either means can produce the same external
tudes of the opposing internal and external torques are assumed torque against the patient. Modifying the force and external
to be equal in Fig. 1.17, no rotation occurs around the joint. This moment arm variables allows different strategies to be employed
condition is referred to as static rotary equilibrium. based on the strength and skill of the clinician.
16 Section I   Essential Topics of Kinesiology

S PE C I A L F O C U S 1 . 3

Muscle-Produced Torques across a Joint: An Essential Concept in Kinesiology

H ow muscles produce torques across joints is one of the most

important (and often difficult) concepts to understand in
kinesiology. An understanding of this concept can be helped
attempting to swing open a door. The essential mechanics in both
scenarios are surprisingly similar. This analogy is described with
the assistance of Fig. 1.18A–B.
by considering a simple analogy between a muscle’s potential Fig. 1.18A shows top and side views of a door mounted on a
to produce a torque (i.e., rotation) and the action of a force vertical hinge (depicted in blue). Horizontally applied forces

G H

Side view

Top view

A
E F

Side view
Top view

Piriformis

Obturator
externus
Gluteus medius
(middle fibers)

FIG. 1.18 Mechanical analogy depicting the fundamental mechanics of how a force can be converted into a
torque. A, Six manually applied forces are indicated (colored arrows), each attempting to rotate the door in the
horizontal plane. The vertical hinge of the door is shown in blue. The moment arms available to two of the
forces (on the left) are indicated by dark black lines, originating at the hinge. B, Three muscle-produced forces
are depicted (colored arrows), each attempting to rotate the femur (hip) in the horizontal plane. The axes of
rotation are shown in blue, and the moment arm as a dark black line. As described in the text, for similar
reasons, only a selected number of forces is actually capable of generating a torque that can rotate either the
door or the hip. For the sake of this analogy, the magnitude of all forces is assumed to be the same.
 Chapter 1   Getting Started 17

S PE C I A L F O C U S 1 . 3

Muscle-Produced Torques across a Joint: An Essential Concept in Kinesiology—cont’d

(C to F) represent different attempts at manually pulling open the The force vectors illustrated on the left side of Fig. 1.18B rep-
door. Although all forces are assumed equal, only forces C and E resent the lines of force of two predominantly horizontally aligned
(applied at the doorknob) are actually capable of rotating the door. muscles at the hip (the piriformis and obturator externus). The
This holds true because only these forces meet the basic require- piriformis is capable of producing an external rotation torque
ments of producing a torque: (1) each force is applied in a plane within the horizontal plane for the same reasons given for the
perpendicular to the given axis of rotation (hinge in this case), and analogous force C applied to the door (Fig. 1.18A). Both forces are
(2) each force is associated with a moment arm distance (dark applied in a plane perpendicular to the axis of rotation, and each
black line originating at the hinge). In this example the torque is possesses an associated moment arm distance (depicted as the
the product of the pulling force times its moment arm. Force E dark line). In sharp contrast, however, the obturator externus
will produce a greater torque than force C because it has the muscle cannot produce a torque in the horizontal plane. This
longer moment arm (or greater leverage). Nevertheless, forces C muscle force (as with the analogous force D acting on the door)
and E both satisfy the requirement to produce a torque in the passes directly through the vertical axis of rotation. Although the
horizontal plane. muscle force will compress the joint surfaces, it will not rotate the
Forces D and F, however, cannot produce a torque within the joint, at least not in the horizontal plane. As will be described in
horizontal plane and therefore are not able to rotate the door, Chapter 12, which studies the hip, changing the rotational position
regardless of their magnitude. Although this may seem intuitively of the joint often creates a moment arm distance for a muscle. In
obvious based on everyone’s experience closing or opening doors, this case the obturator externus may generate external rotation
the actual mechanical reasoning may not be so clear. Forces D torque at the hip, although relatively small.
and F are directed through the axis of rotation (the hinge in this The final component of this analogy is illustrated on the right of
case) and therefore have a zero moment arm distance. Any force Fig. 1.18B. The middle fibers of the gluteus medius are shown
multiplied by a zero moment arm produces zero torque, or zero attempting to rotate the femur in the horizontal plane around a
rotation. Although these forces may compress or distract the vertical axis of rotation (depicted as a blue pin). Because the
hinge, they will not rotate the door. muscle force acts essentially parallel with the vertical axis of rota-
Forces G and H, shown at the right in Fig. 1.18A, also cannot tion (like forces G and H acting on the door), it is incapable of
rotate the door. Any force that runs parallel with an axis of rotation generating a torque in the horizontal plane. This same muscle,
cannot produce an associated torque. A torque can be generated however, is very capable of generating torque in other planes,
only by a force that is applied perpendicular to a given axis of especially the frontal.
rotation. Forces G and H therefore possess no ability to produce To summarize, a muscle is capable of producing a torque (or
a torque in the horizontal plane. rotation) at a joint only provided it (1) produces a force in a plane
To complete this analogy, Fig. 1.18B shows two views of the perpendicular to the axis of rotation of interest, and (2) acts with
hip joint along with three selected muscles. In this example the an associated moment arm distance greater than zero. Stated
muscles are depicted as producing forces in attempt to rotate from a different perspective, an active muscle is incapable of
the femur within the horizontal plane. (The muscle forces in these producing a torque if the force either pierces or parallels the
illustrations are analogous to the manually applied forces applied associated axis of rotation. This applies to all axes of rotation that
to the door.) The axis of rotation at the hip, like the hinge on the may exist at a joint: vertical, anterior-posterior (AP), or medial-
door, is in a vertical direction (shown in blue). As will be explained, lateral (ML). These principles will be revisited many times through-
even though all the muscles are assumed to produce an identical out this textbook
force, only one is capable of actually rotating the femur (i.e.,
producing a torque).

Muscle and Joint Interaction force in one of three ways: isometric, concentric, and eccentric.
The physiology of the three types of muscle activation is
The term muscle and joint interaction refers to the overall effect described in greater detail in Chapter 3 and briefly summarized
that a muscle force may have on a joint. A force produced by a subsequently.
muscle that has a moment arm causes a torque, and a potential Isometric activation occurs when a muscle is producing a pulling
to rotate the joint. A force produced by a muscle that lacks a force while maintaining a constant length. This type of activation
moment arm will not cause a torque or a rotation. The muscle is apparent by the origin of the word isometric (from the Greek
force is still important, however, because it usually provides a isos, equal, and metron, measure or length). During an isometric
source of stability and sensory information to the joint. activation, the internal torque produced within a given plane at
a joint is equal to the external torque; hence, there is no muscle
TYPES OF MUSCLE ACTIVATION shortening or rotation at the joint (Fig. 1.19A).
Concentric activation occurs as a muscle produces a pulling force
A muscle is considered activated when it is stimulated by the as it contracts (shortens) (see Fig. 1.19B). Literally, concentric
nervous system. Once activated, a healthy muscle produces a means “coming to the center.” During a concentric activation, the
18 Section I   Essential Topics of Kinesiology

Three types of muscle activation

A B C
Isometric Concentric Eccentric
FIG. 1.19 Three types of muscle activation are shown as the pectoralis major produces a maximal effort force to
internally rotate the shoulder (glenohumeral) joint. In each of the three illustrations, the internal torque is assumed
to be the same: the product of the muscle force (red) times its internal moment arm. The external torque is the product
of the external force applied throughout the arm (gray) and its external moment arm. Note that the external moment
arm, and therefore the external torque, is different in each illustration. A, Isometric activation is shown as the internal
torque matches the external torque. B, Concentric activation is shown as the internal torque exceeds the external
torque. C, Eccentric activation is shown as the external torque exceeds the internal torque. The axis of rotation is
vertical and depicted in blue through the humeral head. All moment arms are shown as thick black lines, originating
at the axis of rotation piercing the glenohumeral joint. (Vectors are not drawn to scale.)

internal torque at the joint exceeds the opposing external torque. segment kinematics, or vice versa, depending on which of the
This is evident as the contracting muscle creates a rotation of the segments comprising the joint is least constrained.
joint in the direction of the pull of the activated muscle. The study of kinesiology can allow one to determine the action
Eccentric activation, in contrast, occurs as a muscle produces a of a muscle without relying purely on memory. Suppose the
pulling force as it is being elongated by another more dominant student desires to determine the actions of the posterior deltoid at
force. The word eccentric literally means “away from the center.” the glenohumeral (shoulder) joint. In this particular analysis, two
During an eccentric activation, the external torque around the assumptions are made. First, it is assumed that the humerus is the
joint exceeds the internal torque. In this case the joint rotates in freest segment of the joint, and that the scapula is fixed, although
the direction dictated by the relatively larger external torque, such the reverse assumption could have been made. Second, it is
as that produced by the hand-held external force in Fig. 1.19C. assumed that the body is in the anatomic position at the time of
Many common activities employ eccentric activations of muscle. the muscle activation.
Slowly lowering a cup of water to a table, for example, is caused The first step in the analysis is to determine the planes of rotary
by the pull of gravity on the forearm and water. The activated motion (degrees of freedom) allowed at the joint. In this case the
biceps slowly elongates in order to control the descent. The triceps glenohumeral joint allows rotation in all three planes (see Fig.
muscle, although considered as an elbow “extensor,” is most likely 1.5). It is therefore theoretically possible that any muscle crossing
inactive during this particular process. the shoulder can express an action in up to three planes. Fig.
The term contraction is often used synonymously with activa- 1.20A shows the potential for the posterior deltoid to rotate the
tion, regardless of whether the muscle is actually shortening, humerus in the frontal plane. The axis of rotation passes in an
lengthening, or remaining at a constant length. The term contract anterior-posterior direction through the humeral head. In the
literally means to be drawn together; this term, however, can be anatomic position, the line of force of the posterior deltoid passes
confusing when describing either an isometric or an eccentric inferior to the axis of rotation. By assuming that the scapula is
activation. Technically, contraction of a muscle occurs during a stable, a contracting posterior deltoid would rotate the humerus
concentric activation only. toward adduction, with strength equal to the product of the
muscle force multiplied by its internal moment arm (shown as
MUSCLE ACTION AT A JOINT the dark line from the axis). This same logic is next applied to
determine the muscle’s action in the horizontal and sagittal planes.
A muscle action at a joint is defined as the potential for a muscle As depicted in Fig. 1.20B–C, it is apparent that the muscle is also
to cause a torque in a particular rotation direction and plane. The an external (lateral) rotator and an extensor of the glenohumeral
actual naming of a muscle’s action is based on an established joint. As will be described throughout this text, it is common for
nomenclature, such as flexion or extension in the sagittal plane, a muscle that crosses a joint with at least two degrees of freedom
abduction or adduction in the frontal plane, and so forth. The to express multiple actions. A particular action may not be pos-
terms muscle action and joint action are used interchangeably sible, however, if the muscle either lacks a moment arm or does
throughout this text, depending on the context of the discussion. not produce a force in the associated plane.
If the action is associated with a nonisometric muscle activation, Determining the potential action (or actions) of a muscle is a
the resulting osteokinematics may involve distal-on-proximal central theme in the study of kinesiology. This skill is the basis
 Chapter 1   Getting Started 19

Frontal plane Horizontal plane Sagittal plane

EXTER
NA
L

RO
TA
NTIO
ADDUCTION EXTENSION
A B C
Posterior view Superior view Lateral view
FIG. 1.20 The multiple actions of the posterior deltoid are shown at the glenohumeral joint. A, Adduction in the
frontal plane. B, External rotation in the horizontal plane. C, Extension in the sagittal plane. The internal moment
arm is shown extending from the axis of rotation (small circle through humeral head) to a perpendicular intersection
with the muscle’s line of force.

for a clinician being able to evaluate a specific muscle for weak- arm is lifted (abducted) well overhead, however, the line of
ness, tightness, guarding, or source of pain, and responding by an force of the muscle shifts just to the superior side of the axis of
appropriate intervention. rotation. As a consequence the posterior deltoid actively abducts
The logic presented within the context of Fig. 1.20 can be the shoulder. The example shows how one muscle can have
used to determine the action of any muscle in the body, at any opposite actions, depending on the position of the joint at the
joint. If available, an articulated skeleton model and a piece of time of muscle activation. It is important, therefore, to establish
string that mimics the line of force of a muscle are helpful in a reference position for the joint when analyzing the actions of
applying this logic. This exercise is particularly helpful when a muscle. One common reference position is the anatomic posi-
analyzing a muscle whose action switches depending on the posi- tion (see Fig. 1.4). Unless otherwise specified, the actions of
tion of the joint. One such muscle is the posterior deltoid. From muscles described throughout Sections II to IV in this text are
the anatomic position the posterior deltoid is an adductor of the based on the assumption that the joint is in the anatomic
glenohumeral joint (previously depicted in Fig. 1.20A). If the position.

S PE C I A L F O C U S 1 . 4

A Simple but Useful Axiom of Kinesiology

T ypically, a contracting muscle with adequate leverage will

cause a rotation of the bones around a joint. The expected
direction of the rotation, or “muscle action,” is traditionally defined
to the scapula) without adequate stabilization provided by an axial-
scapular muscle. With weakness of a muscle such as the serratus
anterior, for example, contraction of the deltoid causes the scapula
by the anticipated movement of the distal bony segment of the to be the freest segment of the glenohumeral joint (shoulder
joint relative to the proximal segment. Consider, for example, the segment), not the humerus. Using the traditional assumption that
contracting biceps brachii as it flexes the elbow to bring the hand a contracting middle deltoid only abducts the arm (i.e., moves the
to the mouth. This standard definition of muscle action assumes distal segment of the joint), the diagnosis of axial-scapular muscle
that the distal segment is less constrained, or less fixed, than the weakness may have been overlooked. Although a distal-on-prox-
proximal segment. imal segment movement is typically the desired outcome of deltoid
Perhaps a more inclusive way to consider the effect of a muscle activation, this scenario only occurs when the scapula is restrained
contraction is to use the axiom that a contracting muscle moves from moving by activation of other muscles, leaving the humerus
the freest segment of the joint. Factors that determine the freest as the “freest” segment.
segment include some combination of inertia, external resistance, Although this axiom may appear overly simplistic, it can provide
passive tension, or activation of other muscles. Using this axiom useful clinical clues for understanding the pathomechanic origin
can be very enlightening when evaluating human movement, of certain abnormal movements or postures. Furthermore, the
especially when it appears abnormal. Assume that, for example, axiom allows the student of kinesiology to understand the large
you observe a person performing active shoulder abduction, and possibilities of actions available to muscles even in the healthy
you note an accompanying and obviously abnormal and distorted state; either segment of a joint is equally likely to move following
movement of the scapula. The abnormal scapular movement may a muscle contraction.
be caused by a contraction of the middle deltoid (which attaches
20 Section I   Essential Topics of Kinesiology

Terminology Related to the Actions of Muscles Musculoskeletal Levers

The following terms are often used when the actions of muscles
are described: THREE CLASSES OF LEVERS
• The agonist is the muscle or muscle group that is most directly
related to the initiation and execution of a particular move- Within the body, internal and external forces produce torques
ment. For example, the tibialis anterior is the agonist for the through a system of bony levers. Generically speaking, a lever is
motion of dorsiflexion of the ankle. a simple machine consisting of a rigid rod suspended across a
• The antagonist is the muscle or muscle group that is considered pivot point. The seesaw is a classic example of a first-class lever
to have the opposite action of a particular agonist. For example, (Fig. 1.22). One function of a lever is to convert a linear force
the gastrocnemius and soleus muscles are considered the antag- into a rotary torque. As shown in the seesaw in Fig. 1.22, a 672-N
onists to the tibialis anterior. (about 150-lb) man sitting 0.91 m (about 3 ft) from the pivot
• Muscles are considered synergists when they cooperate during point produces a torque that balances a boy weighing half his
the execution of a particular movement. Actually, most mean- weight who is sitting twice the distance from the pivot point. In
ingful movements of the body involve multiple muscles acting Fig. 1.22, the opposing torques are equal (BWm × D = BWb ×
as synergists. Consider, for example, the flexor carpi ulnaris D1): the lever system therefore is balanced and in equilibrium. As
and flexor carpi radialis muscles during flexion of the wrist. indicated, the boy has the greatest leverage (D1 > D). An impor-
The muscles act synergistically because they cooperate to flex tant underlying concept of the lever is that with unequal moment
the wrist. Each muscle, however, must neutralize the other’s arm lengths, the opposing torques can balance each other only if
tendency to move the wrist in a side-to-side (radial and ulnar the opposing forces (or body weights in the preceding figure) are
deviation) fashion. Paralysis of one of the muscles significantly of different magnitudes.
affects the overall action of the other. The most dominant forces involved with musculoskeletal levers
Another example of muscle synergy is described as a muscular are those produced by muscle, gravity, and physical contact within
force-couple. A muscular force-couple is formed when two or more the environment. The pivot point, or fulcrum, is located at the
muscles simultaneously produce forces in different linear direc- joint. As with the seesaw, the internal and external torques within
tions, although the resulting torques act in the same rotary direc- the musculoskeletal system may be equal, such as during an iso-
tion. A familiar analogy of a force-couple occurs between the two metric activation; or, more often, when one of the two opposing
hands while turning a steering wheel of a car. Rotating the steering torques dominates, resulting in movement at the joint.
wheel to the right, for example, occurs by the action of the right Levers are classified as either first, second, or third class (see inset
hand pulling down and the left hand pulling up on the wheel. in Fig. 1.22).
Although the hands are producing forces in different linear direc-
tions, they cause a torque on the steering wheel in the same rotary First-Class Lever
direction. The hip flexor and low back extensor muscles, for As depicted in Fig. 1.22, the first-class lever has its axis of rotation
example, form a force-couple to rotate the pelvis in the sagittal positioned between the opposing forces. An example of a first-class
plane around the hip joints (Fig. 1.21). lever in the human body is the head-and-neck extensor muscles
that control the posture of the head in the sagittal plane (Fig.
1.23A). As in the seesaw example, the head is held in equilibrium
when the product of the muscle force (MF) multiplied by the
internal moment arm (IMA) equals the product of head weight
(HW) multiplied by its external moment arm (EMA). In first-
class levers, the internal and external forces typically act in similar
linear directions, although they produce torques in opposing
rotary directions.
e
Second-Class Lever
a
in
sp

A second-class lever always has two features. First, its axis of rota-
r
cto

Anterior ti tion is located at one end of a bone. Second, the muscle, or

Iliopsoas

lt
Ere

internal force, possesses greater leverage than the external force.

Second-class levers are very rare in the musculoskeletal system.
The classic example is the calf muscles producing the torque
needed to stand on tiptoes (see Fig. 1.23B). The axis of rotation
for this action is assumed to act through the metatarsophalangeal
joints. Based on this assumption, the internal moment arm used
by the calf muscles greatly exceeds the external moment arm used
Sartorius by body weight.

Third-Class Lever
As in the second-class lever, the third-class lever has its axis of
FIG. 1.21 Side view of the force-couple formed between two representa- rotation located at one end of a bone. The elbow flexor muscles
tive hip flexor muscles (sartorius and iliopsoas) and back extensor muscles use a third-class lever to produce the flexion torque required to
(erector spinae) as they contract to tilt the pelvis in an anterior direction. support a weight in the hand (see Fig. 1.23C). Unlike with the
The internal moment arms used by the muscles are indicated by the black second-class lever, the external weight supported by a third-class
lines. The axis of rotation runs through both hip joints. lever always has greater leverage than the muscle force. The
 Chapter 1   Getting Started 21

First-class lever

D1 D

BWb 3 classes of levers

1st class

3rd class

2nd class

BWm

FIG. 1.22 A seesaw is shown as a typical first-class lever. The body weight of the man (BWm) is 672 N (about 150 lb).
He is sitting 0.91 m (about 3 ft) from the pivot point (man’s moment arm = D). The body weight of
the boy (BWb) is only 336 N (about 75 lb). He is sitting 1.82 m (about 6 ft) from the pivot point (boy’s moment
arm = D1). The seesaw is balanced because the clockwise torque produced by the man is equal in magnitude to the
counterclockwise torque produced by the boy: 672 N × 0.91 m = 336 N × 1.82 m. The inset compares the three
classes of levers. In each lever the opposing forces may be considered as an internal force (such as a muscle pull
depicted in red) and an external force or load (depicted in gray). The axis of rotation or pivot point is indicated as a
wedge. (Force vectors are drawn to scale.)

third-class lever is the most common lever used by the musculoskeletal to bone relatively close to the joint’s axis of rotation. The external
system. forces that oppose the action of the muscles typically exert their
influence considerably distal to the joint, such as at the hand or
MECHANICAL ADVANTAGE the foot. Consider the force demands placed on the supraspinatus
and deltoid muscles to maintain the shoulder abducted to 90
The mechanical advantage (MA) of a musculoskeletal lever can be degrees while an external weight of 35.6 N (8 lb) is held in the
defined as the ratio of the internal moment arm to the external hand. For the sake of this example, assume that the muscles have
moment arm. Depending on the location of the axis of rotation, an internal moment arm of 2.5 cm (about 1 inch) and that the
the first-class lever can have an MA equal to, less than, or greater center of mass of the external weight has an external moment arm
than 1. Second-class levers always have an MA greater than 1. As of 50 cm (about 20 inches). (For simplicity, the weight of the limb
depicted in the boxes associated with Fig. 1.23A–B, lever systems is ignored.) In theory, the 1/20 MA requires that the muscle would
with an MA greater than 1 are able to balance the torque equi- have to produce 711.7 N (160 lb) of force, or 20 times the weight
librium equation by an internal (muscle) force that is less than the of the external load! (Mathematically stated, the relationship
external force. Third-class levers always have an MA less than 1. between the muscle force and external load is based on the inverse
As depicted in Fig. 1.23C, in order to balance the torque equilib- of the MA.) As a general principle, most skeletal muscles produce
rium equation, the muscle must produce a force much greater than forces several times larger than the external loads that oppose them.
the opposing external force. Depending on the shape of the muscle and configuration of the
The majority of muscles throughout the musculoskeletal system joint, a typically large percentage of the muscle force produces
function with an MA of much less than 1. Consider, for example, large compression or shear forces across the joint surfaces. These
the biceps at the elbow, the quadriceps at the knee, and the supra- myogenic (muscular-produced) forces are most responsible for the
spinatus and deltoid at the shoulder. Each of these muscles attaches amount and direction of the joint reaction force.
22 Section I   Essential Topics of Kinesiology

First-class lever

Data for first-class lever:

Muscle force (MF) = unknown
Head weight (HW) = 46.7 N (10.5 lbs)
Internal moment arm (IMA) = 4 cm
External moment arm (EMA) = 3.2 cm
Mechanical advantage = 1.25

MF  IMA = HW  EMA
IMA EMA MF = HW  EMA
IMA
MF = 46.7 N  3.2 cm
MF 4 cm
MF = 37.4 N (8.4 lbs)

A HW

Second-class lever

Data for second-class lever:

MF Muscle force (MF) = unknown
Body weight (BW) = 667 N (150 lbs)
Internal moment arm (IMA) = 12 cm
External moment arm (EMA) = 3 cm
Mechanical advantage = 4

MF  IMA = BW  EMA
MF = BW  EMA
IMA
MF = 667 N  3 cm
12 cm
MF = 166.8 N (37.5 lbs)

IMA
B
EMA
BW

Third-class lever
Data for third-class lever:
Muscle force (MF) = unknown
MF External weight (EW) = 66.7 N (15 lbs)
Internal moment arm (IMA) = 5 cm
External moment arm (EMA) = 35 cm
Mechanical advantage = 0.143
IMA
MF  IMA = EW  EMA
EMA MF = EW  EMA
IMA
MF = 66.7 N  35 cm
5 cm
C MF = 467 N (105 lbs)
EW

FIG. 1.23 Anatomic examples are shown of first-class (A), second-class (B), and third-class (C) levers. (The vectors are
not drawn to scale.) The data contained in the boxes to the right show how to calculate the muscle force required to
maintain static rotary equilibrium. Note that the mechanical advantage is indicated in each box. The muscle activation
(depicted in red) is isometric in each case, with no movement occurring at the joint.
 Chapter 1   Getting Started 23

abduction action. A very short contraction distance (excursion)

S PE C I A L F O C U S 1 . 5 of the muscles produces a much larger vertical displacement of
the load. When considering the element of time in this example,
the muscles produce a relatively large force at a relatively slow
Mechanical Advantage: A Closer Look at the Torque contraction velocity. The mechanical benefit, however, is that a
Equilibrium Equation relatively light external load is lifted at a much faster velocity.
In summary, most muscle and joint systems in the body func-

A s stated, the mechanical advantage (MA) of a musculoskel-

etal lever can be defined as the ratio of its internal and
external moment arms.
tion with an MA of much less than 1. This being the case, the
distance and velocity of the load displacement will always exceed
that of the muscle contraction. (This arrangement is functionally
• First-class levers may have an MA less than 1, equal to 1, advantageous because muscles are only physiologically capable of
or greater than 1. generating useful forces over a short distance.) Obtaining a high
• Second-class levers always have an MA greater than 1. linear velocity of the distal end of the extremities is a necessity for
• Third-class levers always have an MA less than 1. generating large contact forces against the environment. These
The mathematic expression of MA is derived from the balance high forces can be used to rapidly accelerate objects held in the
of torque equation: hand, such as a tennis racket, or to accelerate the limbs purely as
MF × IMA = EF × EMA (Eq. 1.1) an expression of art and athleticism, such as dance. Regardless of
where the nature of the movement, muscle-and-joint systems that
MF = Muscle force operate with an MA of less than 1 must pay a force “penalty” by
EF = External force generating relative large internal forces, even for seemingly low-
IMA = Internal moment arm load activities. Periarticular tissues, such as articular cartilage, fat
EMA = External moment arm pads, and bursa, must partially absorb or dissipate these large
Eq. 1.1 can be rearranged as follows: myogenic forces. In the absence of such protection, joints may
partially degenerate and become painful and chronically inflamed.
IMA EMA = EF MF (Eq. 1.2)
This presentation is often the hallmark of osteoarthritis.
• In some first-class levers, IMA/EMA = 1; the torque equation
is balanced only when MF = EF.
• In some first-class and all second-class levers, IMA/EMA SYNOPSIS
> 1; the torque equation is balanced only when MF is less
than EF. The human body moves primarily through rotations of its limbs
• In some first-class and all third-class levers, IMA/EMA < 1; and trunk. Two useful terms that describe these movements are
the torque equation is balanced only when MF is greater osteokinematics and arthrokinematics. Osteokinematics describes
than EF. movement of the limbs or trunk in one of the three cardinal
As indicated by Eq. 1.2, MA can also be expressed by the planes, each occurring around an associated axis of rotation.
ratio of external force to muscle force (EF/MF). Although this is Osteokinematic descriptors, such as internal rotation or exten-
correct, this text uses the convention of defining a muscle-and- sion, facilitate the study of these movements. Arthrokinematics
joint’s MA as the ratio of its internal-to-external moment arms are the movements that occur between the articular surfaces of
(IMA/EMA). joints. The wide acceptance of arthrokinematic descriptors such
as roll, slide, and spin, for instance, has improved the ability of
clinicians and students to conceptualize movements that occur
at joints. This terminology is used extensively in manual-based
Dictating the Trade-Off between Force and Distance therapy—treatment based largely on the specific movements that
As previously described, most muscles are obligated to produce a occur between joint surfaces. The strong association between
force much greater than the resistance applied by the external arthrokinematics and articular morphology has stimulated the
load. At first thought, this design may appear biomechanically growth of the topic of arthrology: the study of the structure and
flawed. The design is absolutely necessary, however, when consid- function of joints and their surrounding connective tissues.
ering the many functional movements that require large displace- Whereas kinematics refers to the motion of bones and joints,
ment and velocity of the more distal points of the extremities. kinetics refers to the forces that cause or arrest the motion. Muscles
Work is the product of force times the distance through which produce the forces that propel the body into motion. A funda-
it is applied. In addition to converting a force to a torque, a mental concept presented in Chapter 1 is an appreciation of how
musculoskeletal lever converts the work of a contracting muscle a muscle force acting in a linear direction produces a torque
to the work of a rotating bone and external load. The MA of a around a joint. An internal torque is the angular expression of a
particular musculoskeletal lever dictates how the work is to be muscle force, with a magnitude that equals the product of the
performed. Because work is the product of force and distance, it muscle force times its moment arm; both variables are equally
can be performed through either a relatively large force exerted important when one considers the strength of a muscle action.
over a short distance or a small force exerted over a large distance. Also important to the study of kinesiology is the understanding
Consider the small mechanical advantage of 1/20 described earlier of how an external torque affects a joint. An external torque is
for the supraspinatus and deltoid muscles. This MA implies that defined as the product of an external force (such as gravity or
the muscle must produce a force 20 times greater than the weight physical contact) times its associated moment arm. Ultimately,
of the external load. What must also be considered, however, is movement and posture are based on the instantaneous interaction
that the muscles need to contract only 5% (1/20) the distance between internal and external torques—the prevailing direction
that the center of mass of the load would be raised by the and extent of which are determined by the more dominant torque.
24 Section I   Essential Topics of Kinesiology

S PE C I A L F O C U S 1 . 6

Surgically Altering a Muscle’s Mechanical Advantage

A surgeon may perform a muscle-tendon transfer operation as

a means to partially restore the loss of internal torque at a
joint.2 Consider, for example, complete paralysis of the elbow
flexor muscles after poliomyelitis. Such a paralysis can have pro-
found functional consequences, especially if it occurs bilaterally.
One approach to restoring elbow flexion is to surgically reroute
the fully innervated triceps tendon to the anterior side of the elbow
(Fig. 1.24). The triceps, now passing anteriorly to the medial-
lateral axis of rotation at the elbow, becomes a flexor instead of
an extensor. The length of the internal moment arm for the flexion
action can be exaggerated, if desired, by increasing the perpen-
dicular distance between the transferred tendon and the axis of
rotation. By increasing the muscle’s mechanical advantage (MA),
the activated muscle produces a greater torque per level of muscle
force. This may be a beneficial outcome, depending on the specific
circumstances of the patient.
An important mechanical trade-off exists whenever a muscle’s
MA is surgically increased. Although a greater torque is produced
per level of muscle force, a given amount of muscle shortening
results in a reduced angular displacement of the joint. As a result,
a full muscle contraction may produce an ample torque, but the
joint may not complete its full range of motion.3 In essence, the
active range of motion “lags” behind the muscle contraction.
The reduced displacement and velocity of the distal segment of the FIG. 1.24 An anterior transfer of the triceps tendon after paralysis of
joint may have negative functional consequences. This mechanical the elbow flexor muscles. The triceps tendon is elongated by a graft of
trade-off needs to be considered before the muscle’s internal fascia. (From Bunnell S: Restoring flexion to the paralytic elbow, J
moment arm is surgically enhanced. Often, the greater torque Bone Joint Surg Am 33:566, 1951.)
potential gained by increasing the moment arm functionally “out-
weighs” the loss of the speed and distance of the movement.

Most muscles in the body act through a skeletal lever system sites, neutralize unwanted secondary or tertiary actions, or simply
with a mechanical advantage of much less than 1. This design augment the power, strength, or control of a particular movement.
favors a relative high speed and displacement of the distal end of When muscle function is disrupted by disease or injury, the lack
the extremities. This so-called biomechanical “advantage” is at the of such synergy is often responsible for the pathomechanics of a
expense of a muscle force that is usually much larger than the movement. Consider, for example, the consequences of paralysis
combined weight of the limb and supported external load. The or weakness of a selected few muscles within a functional muscle
obligatory large muscle forces are usually directed across the group. Even the healthy unaffected muscles (when acting in rela-
surfaces of joints and on to bone and are most often described tive isolation) have a dominant role in an abnormal movement
in terms of compression and shear. In order for these forces to pattern. The resulting kinetic imbalance across the region can lead
be physiologically tolerated over a lifetime, the articular ends of to certain compensatory movements or postures, possibly causing
most bones are relatively large, thereby increasing their surface deformity and reduced function. Understanding how muscles
area as a means to reduce peak contact pressure. Additional interact normally is a prerequisite to comprehending the overall
protection is provided through the presence of a spongelike, rela- pathomechanics of the region. Such an understanding serves as
tively absorbent subchondral bone located just deep to articular the foundation for designing effective therapeutic interventions,
cartilage. These features are essential for the dissipation of forces aimed at restoring or maximizing function.
that would otherwise cause degeneration, possibly leading to Kinesiology is the study of human motion, studied both in
osteoarthritis. healthy, ideal conditions and in those conditions affected by
The study of kinesiology pays strict attention to the actions of trauma, disease, or disuse. To facilitate this study, this textbook
individual muscles and their unique lines of force relative to the focuses heavily on the structure and function of the musculo­
joints’ axes of rotation. Once this is understood, the focus of study skeletal system. A strong emphasis is placed on the interaction
typically shifts to understanding how multiple muscles cooperate among the forces and tensions created by muscles, gravity, and
to control complex movements, often across multiple joints. connective tissues that surround the joints. This chapter has
Muscles act synergistically with one another for many reasons. helped to establish a foundation of many of the basic concepts
Muscular interactions may serve to stabilize proximal attachment and terminology used throughout this textbook.
 Chapter 1   Getting Started 25

GLOSSARY Elasticity: property of a material demonstrated by its ability to

return to its original length after the removal of a deforming
Acceleration: change in velocity of a body over time, expressed force.
in linear (m/sec2) and angular (degrees/sec2) terms. External Force: push or pull produced by sources located outside
Accessory Movements: slight, passive, nonvolitional movements the body. These typically include gravity and physical contact
allowed in most joints (also called joint play). applied against the body.
Active Force: push or pull generated by stimulated muscle. External Moment Arm: perpendicular distance between an axis
Active Movement: motion caused by stimulated muscle. of rotation and the external force.
Agonist Muscle: muscle or muscle group that is most directly External Torque: product of an external force and its external
related to the initiation and execution of a particular moment arm (also called external moment).
movement. Force: a push or a pull that produces, arrests, or modifies a
Anatomic Position: the generally agreed upon reference position motion.
of the body used to describe the location and movement of its Force-Couple: two or more muscles acting in different linear
parts. In this position, a person is standing fully upright and directions, but producing a torque in the same rotary
looking forward, with arms resting by the side, forearms fully direction.
supinated, and fingers extended. Force of Gravity: potential acceleration of a body toward the
Angle-of-Insertion: angle formed between a tendon of a muscle center of the earth as a result of gravity.
and the long axis of the bone into which it inserts. Friction: resistance to movement between two contacting
Antagonist Muscle: muscle or muscle group that has the action surfaces.
opposite to a particular agonist muscle. Internal Force: push or pull produced by a structure located
Arthrokinematics: motions of roll, slide, and spin that occur within the body. Most often, internal force refers to the force
between curved articular surfaces of joints. produced by an active muscle.
Axial Rotation: angular motion of an object in a direction per- Internal Moment Arm: perpendicular distance between the axis
pendicular to its longitudinal axis; often used to describe a of rotation and the internal (muscle) force.
motion in the horizontal plane. Internal Torque: product of an internal force and its internal
Axis of Rotation: an imaginary line extending through a joint moment arm.
around which rotation occurs (also called the pivot point or the Isometric Activation: activated muscle that maintains a constant
center of rotation). length as it produces a pulling force.
Bending: effect of a force that deforms a material at right angles Joint Reaction Force: force that exists at a joint, developed in
to its long axis. A bent tissue is compressed on its concave side reaction to the net effect of internal and external forces. The
and placed under tension on its convex side. A bending joint reaction force includes contact forces between joint sur-
moment is a quantitative measure of a bend. Similar to a faces, as well as forces from any periarticular structure.
torque, a bending moment is the product of the bending force Kinematics: branch of mechanics that describes the motion of a
and the perpendicular distance between the force and the axis body, without regard to the forces or torques that may produce
of rotation of the bend. the motion.
Center of Mass: point at the exact center of an object’s mass (also Kinematic Chain: series of articulated segmented links, such as
referred to as center of gravity when considering the weight of the connected pelvis, thigh, leg, and foot of the lower
the mass). extremity.
Close-Packed Position: unique position of most joints of the Kinetics: branch of mechanics that describes the effect of forces
body where the articular surfaces are most congruent and the and torques on the body.
ligaments are maximally taut. Leverage: relative moment arm length possessed by a particular
Compliance: the inverse of stiffness. force.
Compression: a force, applied perpendicularly to the contact Line of Force: direction and orientation of a muscle’s force.
surface that pushes or pulls one object directly against another. Line of Gravity: direction and orientation of the gravitational
Concentric Activation: activated muscle that shortens as it pro- pull on a body.
duces a pulling force. Load: general term that describes the application of a force to a
Creep: a progressive strain of a material when exposed to a con- body.
stant load over time. Longitudinal Axis: axis that extends within and parallel to a long
Degrees of Freedom: number of independent directions of move- bone or body segment.
ments allowed at a joint. A joint can have up to three degrees Loose-Packed Positions: positions of most synovial joints of the
of translation and three degrees of rotation. body in which the articular surfaces are least congruent and
Displacement: change in the linear or angular position of an the ligaments are slackened.
object. Mass: quantity of matter in an object.
Distal-on-Proximal Segment Kinematics: type of movement in Mechanical Advantage: ratio of the internal moment arm to the
which the distal segment of a joint rotates relative to a fixed external moment arm.
proximal segment (also called an open kinematic chain). Moment Arm: perpendicular distance between an axis of rotation
Distraction: a force, applied perpendicularly to the contact and the line of force.
surface that pushes or pulls one object directly away from Muscle Action: potential of a muscle to produce a torque within
another. a particular plane of motion and rotation direction (also called
Eccentric Activation: activated muscle that is producing a pulling joint action when referring specifically to a muscle’s potential
force while being elongated by another more dominant to rotate a joint). Terms that describe a muscle action are
force. flexion, extension, pronation, supination, and so forth.
26 Section I   Essential Topics of Kinesiology

Osteokinematics: motion of bones relative to the three cardinal, Static Linear Equilibrium: state of a body at rest in which the
or principal, planes. sum of all forces is equal to zero.
Passive Force: push or pull generated by sources other than Static Rotary Equilibrium: state of a body at rest in which the
stimulated muscle, such as tension in stretched periarticular sum of all torques is equal to zero.
connective tissues, physical contact, and so forth. Stiffness: ratio of stress (force) to strain (elongation) within an
Passive Movement: motion produced by a source other than elastic material, or N/m (also referred to as Young’s modulus or
activated muscle. modulus of elasticity).
Plasticity: property of a material demonstrated by remaining Strain: ratio of a tissue’s deformed length to its original length.
permanently deformed after the removal of a force. May also be expressed in units of distance (m).
Pressure: force divided by a surface area (also called stress). Stress: force generated as a tissue resists deformation, divided by
Productive Antagonism: phenomenon in which relatively low- its cross-sectional area (also called pressure).
level tension within stretched connective tissues performs a Synergists: two or more muscles that cooperate to execute a partic-
useful function. ular movement.
Proximal-on-Distal Segment Kinematics: type of movement in Tension: application of one or more forces that pulls apart or
which the proximal segment of a joint rotates relative to a fixed separates a material (also called a distraction force). Used to
distal segment (also referred to as a closed kinematic chain). denote the internal stress within a tissue as it resists being
Roll: arthrokinematic term that describes when multiple points stretched.
on one rotating articular surface contact multiple points on Torque: a force multiplied by its moment arm; tends to rotate a
another articular surface. body or segment around an axis of rotation.
Rotation: angular motion in which a rigid body moves in a cir- Torsion: application of a force that twists a material around its
cular path around a pivot point or an axis of rotation. longitudinal axis.
Scalar: quantity, such as speed or temperature that is completely Translation: linear motion in which all parts of a rigid body move
specified by its magnitude and has no direction. parallel to and in the same direction as every other point in
Segment: any part of a body or limb. the body.
Shear: a force produced as two compressed objects slide past each Ultimate Failure Point: length at which a tissue structurally fails
other in opposite directions (like the action of two blades on and loses its ability to hold a load.
a pair of scissors). Vector: quantity, such as velocity or force that is completely speci-
Shock Absorption: the act of dissipating a force. fied by its magnitude and direction.
Slide: arthrokinematic term describing when a single point on Velocity: change in position of a body over time, expressed in
one articular surface contacts multiple points on another artic- linear (m/sec) and angular (degrees/sec) terms.
ular surface (also called glide). Viscoelasticity: property of a material expressed by a changing
Spin: arthrokinematic term describing when a single point on one stress-strain relationship over time.
articular surface rotates on a single point on another articular Weight: gravitational force acting on a mass.
surface (like a top).

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