Dennis-Upper Extremity Kinesiology

Structural Kinesiology
Prepared by
DENNIS N. MUÑOZ, RN, RM, PTRP,MAN
12/6/2012 1
Anatomical Review
• Skeletal System
• Muscular System
• Nervous System
• Human Movement
• Basic Biomechanics
• Application of Kinesiology to Physical
Activity
12/6/2012 2
CHAPTER 1
FOUNDATIONS OF
STRUCTURAL KINESIOLOGY
• Understand the skeletal system
• Understand directional terminology
• Understand planes of motion
• Understand joint movements
12/6/2012 3
Skeletal Systems
• 206 bones make up the skeletal system
• Functions of the skeletal system
– Provides support
– Provides protection
– Provides a structure for muscles to attach
– Provides levers (joints) for human movement
– Provides a place for mineral storage
– Provides a place for blood cell formation
12/6/2012 4
Skeletal Systems
• Appendicular skeleton
– Upper extremity & shoulder girdle
– Lower extremity & pelvic girdle
• Axial skeleton
– Skull
– Vertebral column
– Ribs
– Sternum
12/6/2012 5
Bones
• Skull scapula
• Frontal bone • Axillary border
• Zygomatic bone • Vertebral border
• Parietal bone • Spine of the scapula
• Temporal bone • Acromion process
• Occipital bone • Coracoid process
• Maxilla • Inferior angle
• Mandible
12/6/2012 6
Bones
• Pelvic girdle • Femur
• Iliac crest • Greater trochanter
• Ilium • Lesser trochanter
• Ischium • Medial femoral
• Ischial tuberosity condyle
• pubis • Lateral femoral
• Sacrum condyle
• coccyx • Patella
12/6/2012 7
Bones
• Thoracic cage • Arm
• Manubrium • Humerus
• Sternum • Greater tubercle
• Xiphoid process • Lesser tubercle
• Ribs • Radius
• Thoracic Vertebrae • Ulna
• Carpal bones
• Metatarsals
• phalanges
12/6/2012 8
Bones
• Lower leg • Ankle and foot
• Tibia • Calcaneus
• Tibial tuberosity • Talus
• Medial malleolus • Tarsal bones
• Fibula • Metatarsal
• Fibular head • phalanges
• Lateral malleolus
12/6/2012 9
Anatomical Directional
Terminology
• Anterior: in front of
• Anteroinferior: in front and below
• Anterolateral: in front and to the side
• Anteromedial: in front and toward the
midline
• Anteroposterior: relating to both front and
rear
• Anterosuperior: in front and above
12/6/2012 10
Terminology
• Contralateral: opposite side
• Ipsilateral: same side
• Deep: below the surface
• Distal: away from the midline
• Dorsal: relating to the backside
• Inferior: below another structure
• Lateral: away from the median
• Medial: nearer to the median
12/6/2012 11
Terminology
• Posterior: in the rear
• Posteroinferior: behind and below
• Posterolateral: behind and to one side
• Posteromedial: behind and to the inner side
• Posterosuperior: behind at the upper part
12/6/2012 12
Terminology
• Prone: the body facing downward
• Supine: the body facing upward
• Proximal: nearest the trunk or point of origin
• Superficial: near the surface
• Superior: above in relation to another structure
• Volar: relating to the palm of the hand or the sole
of the foot
12/6/2012 13
Planes of Motion
• Sagittal Plane: divides the body into right
and left halves.
• Frontal Plane: divides the body into front
and back halves.
• Horizontal Plane: divides the body into
superior and inferior halves.
• Diagonal Plane: is a combination of more
than one plane.
12/6/2012 14
Types of Bones
• Long Bones
• Short Bones
• Flat Bones
• Irregular Bones
• Sesamoid Bones
12/6/2012 15
Bony Features
• Bone growth
– Epiphyseal plates
– Osteoblasts, Osteoclasts
– Osteocytes
• Bone properties
– Made of calcium, collagen, and water
– Size and shape are influenced by outside forces
• Bone markings
– Processes
– Cavities
12/6/2012 16
Types of Joints
• Synarthrodial: immovable
• Ampiarthrodial: slightly movable
• Diarthrodial: freely movable
12/6/2012 17
Diarthrodial Joints
• Arthrodial (gliding) joint: usually two flat
bones make up this joint and they permit
limited gliding movement:
– intercarpal joint
– scapular-thoracic joint
12/6/2012 18
Diarthrodial Joints
• Condyloidal (biaxial ball-and-socket) joint:
bones with a concave and convex surface
which allow movement in two planes
without rotation.
– Radial-carpal joint
– Metacarpophalangeal joints
12/6/2012 19
Diarthrodial Joints
• Enarthrodial (multiaxial ball-and-socket)
joint: concave and convex bones which
allow movements in all planes
– Glenohumeral joint
– Illiofemoral joint
12/6/2012 20
Diarthrodial Joints
• Ginglimus (hinge) joint: usually concave
and convex surfaces which allow movement
in only one plane
– Radioulnar joint (elbow)

– Tibiotalar joint (ankle)
– Tibiofemoral joint (knee)
12/6/2012 21
Diarthrodial Joints
• Sellar (saddle) joint: two concave surfaces
which permit ball-and-socket movement
without rotation.
– Carpometacarpal joint (thumb)
12/6/2012 22
Diarthrodial Joints
• Trochoidal (pivot) joint: a concave and
convex joint which allows for rotation
around a long axis.
– Radioulnar joint
12/6/2012 23
Movements in Joints
• Measured by a goniometer
• Limited by:
– Skeletal structue
– Muscular structure
– Ligamentous structure
– Fat
– Cartilage
12/6/2012 24
Movements in Joints
• General
– Abduction: away from the midline
– Adduction: toward the midline
– Flexion: decreased angle of a joint
– Extension: increased angle of a joint
– Circumduction: circular movement
12/6/2012 25
Movements in Joints
• General
– Diagonal abduction: away from the
midline in a diagonal plane.
– Diagonal adduction: toward the

midline in a diagonal plane.
12/6/2012 26
Movement in Joints
• General
– External Rotation: rotary movement around a
longitudinal axis of a bone away from the
midline.
– Internal Rotation: rotary movement around the

longitudinal axis of a bone toward the midline.
12/6/2012 27
Movement in Joints
• Ankle
– Eversion
– Inversion
– Dorsiflexion
– Plantarflexion
12/6/2012 28
Movement in Joints
• Radioulnar
– Pronation
– Supination
12/6/2012 29
Movement in Joints
• Shoulder Girdle and Joint
– Depression
– Elevation
– Horizontal abduction
– Horizontal adduction
– Protraction (abduction)
– Retraction (adduction)
– Downward rotation
– Upward rotation
12/6/2012 30
Movement in Joints
• Spine
– Lateral flexion (side bending)
– Reduction (return to anatomical position)
– Slight flexion & Extension
12/6/2012 31
Movement in Joints
• Wrist and Hand
– Palmar flexion
– Radial deviation
– Ulnar deviation
– Opposition of the thumb
12/6/2012 32
CHAPTER 2
NEUROMUSCULAR
FUNDAMENTALS
• Review basic anatomy
• To learn and understand terminology
• To learn and understand muscle contraction
• To learn and understand basic
neuromuscular concepts
• To understand neural mechanisms for
movement
12/6/2012 33
INTRODUCTION
• Over 600 muscles
• Muscle contraction causes joint (body)
movement
• Muscle provide protection for bones and
organs of the body
• Muscles contribute to posture and support
• Muscles create body heat
12/6/2012 34
MUSCLE NOMENCLATURE
• Muscles are usually named and grouped for
their characteristics.
• Visual appearance
• Anatomical location
• Function
• (see pages 22 & 23)
12/6/2012 35
MUSCLES
• Sternocleidomastoid
• Trapezius
• Deltoid
• Pectoralis Major
• Supraspinatus
• Infraspinatus
• Teres minor / major
12/6/2012 36
MUSCLES
• Triceps brachi
• Biceps brachi
• Brachioradialis
• Extensor carpi radialis longus
• Extensor carpi radialis brevis
• Extensor carpi ulnaris
• Flexor carpi ulnaris
• Anconeus
12/6/2012 37
MUSCLES
• Extensor digitorum communis
• Abductor pollicis longus
• Extensor pollicus brevis
• Pronator teres
• Brachialis
• Coracobrachialis
• Brachioradialis
• Flexor carpi radialis
12/6/2012 38
MUSCLES
• Extensor carpis radialis longus
• Extensor digitorum communus
• Palmaris longus
• Abductor pollicus longus
• Extensor pollicus brevis
12/6/2012 39
MUSCLES
• Latissimus dorsi
• Serratus anterior
• Recuts sheath
• External oblique
• Interanl oblique
12/6/2012 40
MUSCLES
• Tensor fasciae latae
• Sartorius
• Iliopsoas
• Pectineus
• Gluteus maximus
• Iliotibial band
• Adductor longus
• Adductor Magnus
• Gracilis
12/6/2012 41
MUSCLES
• Biceps femoris
• Semitendinosus
• Semimembranosus
12/6/2012 42
MUSCLES
• Rectus femoris
• Vastus lateralis
• Vastus medialis
• Vastus intermedius
12/6/2012 43
MUSCLES
• Tibialis anterior • Gastrocnemius
• Tibialis posterior • Soleus
• Peroneus longus • Plantaris
• Peroneus brevis • Achilles tendon
• Extensor digitorum
longus
• Extensor hallucis
longus
12/6/2012 44
MUSCLES SHAPE AND
ARRANGEMENT
• Force Generating Capacity is Effected By:
– Cross sectional diameter
– Pennation of muscles
• Range of Motion is Effected By:
– Ability of a muscle to shorten and lengthen
– Parallel muscles
12/6/2012 45
MUSCLES SHAPE AND
ARRANGEMENT
• Flat: thin and broad (external oblique)
• Fusiform: spindle-shaped (brachialis)
• Strap Muscles: long parallel manner
(sartorius)
• Radiate: fan shaped (pectoralis major)
• Sphincter: circular muscles which close
openings upon contraction (anal sphincter)
12/6/2012 46
MUSCLES SHAPE AND
ARRANGEMENT
• Pennate muscles have shorter fibers that are
arranged obliquely to their tendons.
– Unipennate: muscle fibers run obliquely from
one side of the tendon (biceps femoris).
– Bipennate: muscle fibers run obliquely from
both sides of the tendon (rectus femoris).
– Multipennate: muscles have several tendons
with fibers running obliquely between them
(deltoid).
– (see page 26)
12/6/2012 47
MUSCLE TISSUE PROPERTIES
• Irritability: sensitive to chemical, electrical,
and mechanical stimuli.
• Contractility: ability to contact and develop
force against resistance.
• Extensibility: ability of a muscle to return to
its original length after contraction.
• Elasticity: ability of a muscle to return to its
orginal length following stretching.
12/6/2012 48
Muscle Terminology
• Intrinsic: internal
• Extrinsic: external
• Action: the joint movement that occurs from a
muscle contraction
• Innervation: a segment of the nervous system
that causes a muscle to contract
• Amplitude: the range of muscle fiber length
between maximal and minimal lengthening.
• Origin: proximal attachment
•
12/6/2012 Insertion: distal attachment 49
Types of Muscle Contractions
• Isometric Contraction: a maximum static
contraction that is equal to the resistance and
therefore no joint movement occurs.
• Isotonic Contraction: a shortening or lengthening
of the muscle to develop tension.
– Concentric Contraction: muscle shortening under
tension to create joint movement.
– Eccentric Contraction: muscle lengthening under
tension to allow joint movement.
12/6/2012 50
The Role of Muscles
• Agonist: the prime mover of a joint.
• Antagonist: the opposing muscle of a joint
• Stabilizers: contract to stabilize a joint.
• Synergist: muscles that assist in the action of
the agonist.
• Neutralizers: contract to resist specific actions
of other muscles.
12/6/2012 51
The Role of Muscles
• Several factors decide the action of a
muscle:
– Motor units activated
– Joint position
– Muscle length
– Contraction vs Relaxation
– The action of all muscles involved.
12/6/2012 52
The Role of Muscles
• Determination of Muscle Action
– Lines of pull
• Palpation: feeling a muscle contract
• Use of a rubber band: simulation of a muscle
contraction using origin and insertion.
• Electromyography: detects neural impulses when a
muscle contracts.
• Electrical muscle stimulation: causes muscle
contraction which can then determine the action of
the muscle.
12/6/2012 53
The Role of Muscles
• Determination of Muscle Action
– Line of Pull
• Rotary component: when the line of muscular force
is at 90 degrees to the bone of which it attaches, all
of the force is rotary in nature
• Stabilizing component: if the angle of pull is less
than 90 degrees it has a % of stabilizing force.
• Dislocating component: if the angle of pull is greater
than 90 degrees it has a % of dislocating force.
12/6/2012 54
Neural Control of Voluntary
Movement
• All voluntary movement is a result of both
the muscular and nervous systems working
together.
– Every muscle fiber is innervated by a somatic
(efferent) motor neuron.
– Senses create communication to the CNS
through (afferent) neurons
12/6/2012 55
Movement
• Levels of the Central
Nervous System
– 1: Cerebral cortex:
creates voluntary
gross motor
movements and
interprets senses.
12/6/2012 56
Movement
– 2: Basal Ganglia:
white matter below
the cerebral cortex
that controls the
maintenance of
posture and
equilibrium, and
learned motor
movements.
12/6/2012 57
Movement
– 3: Cerebellum: located
behind the brain stem and
is the major integrator of
sensory information and
provides feedback relative
to motion. It also controls
the timing and intensity of
muscle activity to assist in
the refinement of motor
movements
12/6/2012 58
Movement
• Levels of the Central Nervous
System
– 4: Brain Stem: integrates all CNS
activity through excitation and
inhibition of desired muscle
activity
– 5: Spinal Cord: the common
pathway between the CNS and
the peripheral nervous system.
Specific control and integrates
spinal reflexes.
12/6/2012 59
Movement
– 6: Peripheral Nervous
System: sends the
impulse to the specific
muscle for contraction
or relaxation. (afferent
vs efferent, see pg. 34)
• Nerve roots: 12 cranial,
8cervical, 12 thoracic,
5 lumbar, 5 sacral, 1
coccygeal
12/6/2012 60
Movement
• The Cell Body (nucleus)
• The Dendrites
– the receivers
• The Axon
– the transmitter
– contains the axon
terminals
– contains the synaptic knobs that
release chemicals known as
neurotransmitters.
– The axon hillock decides if the
impulse is a graded potential or an
action potential.
12/6/2012 61
Movement
• Dermatomes
• Myotomes
• Proprioception: internal receptors located in the
skin, joints, muscles and tendons which provide
feedback to muscle length, tension, and
contraction state of muscle.
– Muscle spindles are sensitive to stretch (contract)
– Golgi tendon organs are sensitive to tension (relax)
• Kinesthesis: awareness of the position and
movement of the body in space.
– Kinesthetic receptors provide joint feedback
12/6/2012 62
Neuromuscular Concepts
• All or None Principle: muscle fibers within a
given motor unit will either fire and contract
maximally or not at all.
• Muscle Length-Tension Relationship: the
greatest amount of tension can be developed
when a muscle is stretched between 100% and
130% (stretch reflex) of its resting length
12/6/2012 63
• Biarticular and Multiarticular
Muscles
– Cross over two joints
– Can move two joints
– Can control length tension relationship
– Examples
• Biceps
• Rectus femorus
• Gastrocnemius
• Hamstrings
12/6/2012 64
• Autogenic Inhibition: relaxation of the
agonist muscle after contraction
• Reciprocal Inhibition: relaxation of the
antagonist muscles when the agonist muscles
contract.
– Example: PNF stretching
• Contract – relax
• Contract – hold - relax
12/6/2012 65
• Active Insufficiency: when the muscle becomes

shortened to the point that it can not generate or
maintain active tension.
– Rectus femorus: in hip flexion can not extend the knee with
as much force.
• Passive Insufficiency: when an opposing muscle
becomes stretched to the point where it can no longer
lengthen and allow movement.
– Rectus femorus: hamstrings won‘t allow hip flexion
12/6/2012 66
Types of Training
• Isometric
• Isotonic
• Isokinetic
• Plyometrics
12/6/2012 67
Modes of Training
• Free weights
• Nautilus
• Hydraulics
• Friction
• Rubber tubing
• Cybex
• Bow-flex
• Box-jumps
• Hydrotherapy
• Etc.
12/6/2012 68
Web Sites
• MUSCLES
www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/diss
ector/mml/
• PROPRIOCEPTION
http://sportsmedicine.about.com/library/weekly/aa062200.
htm
• MUSCLES CONTRACTING
http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/M/Muscles.ht
ml
• MUSCLES CONTRACTING
www.ebsa.org/npbsn41/intro_muscle.html
12/6/2012 69
Chapter 3
Basic Biomechanical Factors and Concepts
• Biomechanics: the study of the mechanics as it

relates to the functional and anatomical analysis
of the human body.
– Statics: involves all forces acting on the body being
in balance, resulting in the body being in
equilibrium.
– Dynamics: involves the study of systems in motion
while unbalanced due to unequal forces acting on
the body.
12/6/2012 70
Chapter 12
Basic Biomechanical Factors and Concepts
– Kinematics: the description of motion.

• Time
• Displacement
• Velocity etc.
– Kinetics: is the study of forces associated
with the motion of a body.
• Force
• Resistance
12/6/2012 71
Levers
• Lever: a rigid bar that
turns about an axis.
– Force
– Axis
– Resistance
• The ―Dog Principle‖
– ―A‖ in the middle
– ―R‖ in the middle
– ―F‖ in the middle
12/6/2012 72
First Class Levers
• Axis is in the middle
• Produces balanced movements
when the axis is centered in the
middle.
• When the axis is close to the force
it provides speed and range of
motion.
• When the axis is close to the
resistance it provides greater
force.
• Examples: elbow, ankle
12/6/2012 73
Second Class Levers
• Resistance is in the middle
• Designed to produce forceful
movements.
• There are relatively few
occurrences of second class
levers in the body.
• Examples:
– Plantar flexion
– Scapular rotation
12/6/2012 74
Third Class Levers
• Force is in the middle
• Designed to produce speed and range
of motion movements.
• Most of the levers in the human body
are third class.
• Examples:
– Elbow (bicep)
– Elbow (brachialis)
– Knee (hamstrings)
– Many others…
12/6/2012 75
Factors In Use of Anatomical Levers
• Torque: force which causes a turning effect.
– Force X Force Arm = Torque
12/6/2012 76
• Eccentric Force: force that is applied in a
direction not in line with the center of rotation.
12/6/2012 77
• Force Arm: the distance between the axis and

the point of force.
• Resistance Arm: The distance between the axis
and the point of resistance.
12/6/2012 78
• The longer the force arm, the less force
required to move the lever.
• A greater resistance may be moved by
shortening the resistance arm.
12/6/2012 79
Factors In Use of Anatomical
Levers
F X FA = R X RA
Lbs. inches lbs. inches
12/6/2012 80
Factors in Use of Anatomical
Levers
Force =
Force Arm = 3 inches
Resistance Arm = 5 inches
Resistance = 20 lbs
What is the force required?

How much force is required if the
FA equals 2 inches?
12/6/2012 81
• The system of leverage in the human body is
built for speed and range of motion at the
expense of force.
– Short force arms
– Long resistance arms
• The human body is a system of levers that have
to work together to create athletic movement.
12/6/2012 82
• Sports also use the advantage of longer levers
– Longer golf clubs
– Longer tennis racquets
– Long arms for pitching
• What limitations are there with longer levers?
12/6/2012 83
• Angle of Pull: the angle between the line of pull
of the muscles and the bone on which it
inserts.
– With every degree of joint motion, the angle of pull
changes.
– The angle of pull decreases as the bone moves away
from its anatomical position.
– The range of motion depends on the type of joint,
the bony structure, and other considerations.
12/6/2012 84
• 3 Components of Muscular Force
– Rotary component: muscular force that acts
perpendicular to the long axis of the bone.
– Stabilizing component: the muscular force pulls the
bone toward the joint at less than 90 degrees.
– Dislocating component: the muscular force pulls the
bone away from the joint at greater than 90 degrees.
12/6/2012 85
Laws Of Motion and Physical
Activities
• Two Types of Motion
– Linear motion: motion along a line
• Rectilinear: motion along a straight line
• Curvilinear: motion along a curved line
– Angular (rotary) motion: motion around an axis
• Example: motion around a joint axis
12/6/2012 86
Activities
• Displacement: refers to a change in location of
an object from its original position.
– Angular displacement: change in location of a
rotating body.
– Linear displacement: change in location of a body
moving in a straight line.
• Distance: length of measurement the body travels.
• Speed: how fast a body is moving per distance.
• Velocity: the rate of displacement.
12/6/2012 87
Activities
• Law of Inertia: A body in motion tends to
remain in motion at the same speed in a
straight line unless acted on by a force; a
body at rest tends to remain at rest unless
acted on by a force.
12/6/2012 88
Activities
• Law of Acceleration: A change in the acceleration of a
body occurs in the same direction as the force that
caused it. The change in acceleration is directly
proportional to the force causing it and inversely
proportional to the mass of the body (A = F / M)
– Mass: the amount of matter in a body which affects the
speed and acceleration in physical movements.
– baseball vs shot put
– Lineman vs runningback
12/6/2012 89
Activities
12/6/2012 90
Activities
• Law of Reaction: for every action there is an
opposite and equal reaction.
12/6/2012 91
Activities
• Centripetal Force: a force which pulls an object
toward the center of motion in a circular path
(axis).
• Centrifugal Force: the equal and opposite
reaction to centripetal force, causing the object
to pull away from the center of motion
(eccentric force).
12/6/2012 92
Balance, Equilibrium, and Stability
• Balance: is the ability to control equilibrium.

– Equilibrium: the state of zero acceleration or change
in direction.
• Static equilibrium: a state of complete motionlessness
• Dynamic equilibrium: when forces of motion are acting
on a moving body to keep it balanced
• Center of Gravity: the point at which the body‘s mass and
weight is equally balanced.
12/6/2012 93
• Balance is Enhanced by:
– Wide base of support
– Low center of gravity
– Increased weight
– Relationship of center of gravity to base of support
– Increased friction of supporting structures
– Rotation about an axis aids balance
– Kinesthetics sense
• Inner ear, touch, vision, practice etc.
12/6/2012 94
• Force: a strength or energy exerted to cause
motion or change.
– Force = Mass X Acceleration
– Baseball vs shot put
12/6/2012 95
• Momentum: the quantity of motion
– Momentum = Mass X Velocity
– Running back vs Lineman
– The greater the momentum the
greater the resistance to change in
inertia.
12/6/2012 96
• Summation of Forces: the forces accumulated
from each muscle to a joint and each joint to an
activity.
– Throwing a baseball
– Swinging a golf club
• Skillful performance requires
– The regulation (speed) of force
– The control (direction) of force
12/6/2012 97
A Kinesiological Analysis is a
Summary of all Components of A
Movement
• Anatomy used for the activity
• Directional terminology
• Planes of motion
• Types of bones and joints
– Types of levers
– Mechanical advantages
• Types of muscle contractions
• Laws of motion
• Balance, Equilibrium, and Stability
12/6/2012 98
Chapter 2
The Shoulder Girdle
• Objectives
– Identify bones and landmarks
– Identify shoulder girdle muscles
– Identify shoulder girdle movements
• Planes
• Axis of rotation
– Palpate the muscles of the shoulder girdle
– Palpate the joints of the shoulder girdle
12/6/2012 99
Bones
• Scapula
• Acromion process
• Glenoid cavity
• Infraspinatus fossa
• Lateral border
• Posterior surface
• Inferior angle
• Medial border
• Spine of the scapula
• Supraspinatus fossa
• Superior angle
• Coracoid process
• Subscapular fossa
12/6/2012 100
Bones
• Clavicle
• Manubrium
• Sternum
12/6/2012 101
Movements
• Abduction (protraction)
• Adduction (retraction)
• Elevation
• Depression
• Upward Rotation
• Downward Rotation
12/6/2012 102
Muscles
12/6/2012 103
LEVATOR SCAPULAE
MUSCLE
12/6/2012 104
LEVATOR SCAPULAE
MUSCLE
• Innervation:
– Dorsal scapula nerve C5 and
branches of C3 and C4.
• First Class Lever
12/6/2012 105
LEVATOR SCAPULAE
MUSCLE
• Origin:
– Transverse processes of the upper four
cervical vertebrae.
• Insertion:
– Medial border of the scapula above the
base of the scapular spine.
12/6/2012 106
LEVATOR SCAPULAE
MUSCLE
• Action:
– Elevates the medial margin of the scapula, as
seen in shoulder elevation.
• Synergist:
– Trapezius, Rhomboid Muscles
• Antagonist:
– Part 3 of the Trapezius, Pectoralis Minor
12/6/2012 107
LEVATOR SCAPULAE
MUSCLE
• Strengthening Exercises:
– Shoulder shrugs are the major strengthening exercise for
the Levator Scapulae Muscle.
– Four-way neck machine can also be used to do neck
extensions and lateral flexion to strengthen the Levator
Scapulae Muscle.
• Stretching:
– Best stretched by rotating the head approximately 45
degrees to the opposite side and flexing the cervical spine
actively while maintaining the scapula in a relaxed,
depressed position.
12/6/2012 108
NECK EXTENSION
12/6/2012 109
CERVICAL LATERAL FLEXION
12/6/2012 110
SHOULDER SHRUGS
12/6/2012 111
STRETCHING
12/6/2012 112
LEVATOR SCAPULAE
MUSCLE
• Sporting Activities Where Muscle is Used:
– When in stance waiting to hit a baseball, you
must elevate your shoulders using this muscle
along with the Trapezius , and the Rhomboid
Major and Minor.
– During Football, whenever you brace your neck
to initiate or withstand impact, you are using
your Levator Scapulae Muscle.
12/6/2012 113
SPORTING ACTIVITIES
12/6/2012 114
RHOMBOIDS
Major and
Minor
12/6/2012 115
Physiological Information
• Innervation- Dorsal scapula nerve (C5)
• Lever- 3rd Class
• Origin: Spinous process of the last cervical
and the first five thorasic vertebrae.
• Insertion: Medial border of the scapula,
below the spine.
• Relation to other muscles: Deep to the
trapezius muscle
12/6/2012 116
Actions
• Both major and minor work together.
• Adduction: draw the scapula toward the
spinal column.
• Rotation downward: from the upward
rotated position; they draw the scapula into
downward rotation.
• Elevation: slight upward movement,
accompanying adduction.
12/6/2012 117
Actions, cont.
• Elevation, cont.: elevates the medial border
of the scapula.
• Stabilizes the scapula.
12/6/2012 118
Other Helpful Muscles
• SYNERGISTS • ANTAGONISTS
• Trapezius • Pectoralis major
• Posterior Deltoid • Latissimus dorsi
• Levator scapulae • Anterior Deltoid
• SITS
12/6/2012 119
WORKOUTS
• Chin ups
• Dips
• Seated rows
• Low rows
• Push-ups
• Theraband activity
12/6/2012 120
Chin ups
12/6/2012 121
Dips
12/6/2012 122
Seated Rows
12/6/2012 123
Incline Rows
12/6/2012 124
Push-ups
12/6/2012 125
Theraband
12/6/2012 126
SPORTS
• Rowing
• Hockey (slap shot
wind up)
• Pitching (wind-up)
• Javelin (preparatory)
• Pretty much any sport
where the scapula
adduct!
12/6/2012 127
Rowing
12/6/2012 128
Hockey
12/6/2012 129
Pitching
12/6/2012 130
Quarterback
12/6/2012 131
Javelin
12/6/2012 132
STRETCHES
12/6/2012 133
STRETCHES cont.
12/6/2012 134
STRETCHES cont.
12/6/2012 135
Muscle Analysis
of the
Serratus Anterior
12/6/2012 136
Overview
of the
Serratus Anterior
• Anterior shoulder girdle muscles are the serratus
anterior, pectoralis minor, and subclavius and
function primarily in abduction and depression.
• Provides dynamic stability of the scapula so that it

can serve as a relative base of support for the
shoulder joint while holding the scapula against the
thoracic wall.
• An example of a 1st class lever

12/6/2012 137
Nerve Innervation
• Innervated by the long
thoracic nerves C5 – C7
C5 slips from ribs 1 & 2

C6 slips from ribs 3 & 4
C7 slips from ribs 5 – 8
A winged scapula condition

indicates a weakness of the muscle
resulting from injury to the long
thoracic nerves.
12/6/2012 138
Origin & Insertion
• Origin is located on the surface of the upper
nine ribs at the side of the chest and
intercostal membranes from the
midclavicular line.
• Insertion is near the anterior aspect of the

whole length of the medial border of the
scapula.
12/6/2012 139
Actions
• Primarily abduction and depression

• Abduction (protraction) draws the medial border
of the scapula away from vertebrae.
• Rotation upwards is present with the longer, lower
fibers drawing the inferior angle of the scapula
farther away from the vertebrae,
thus rotating the scapula slightly upward.
12/6/2012 140
Role of Other Muscles
• Synergists include the other anterior
shoulder girdle muscles of the subclavius
and pectoralis minor and major.
• Antagonists primarily include the trapezius,

rhomboid, and often the levator scapula.
12/6/2012 141
Strengthening Exercises
Bench Press Overhead
Press
12/6/2012 142
Seated Upright Rows Dumbbell Rows
12/6/2012 143
Push-ups
12/6/2012 144
Stretching Exercises
Wall Push Sit and Reach
(Scapular Adduction)
12/6/2012 145
Applications
• The serratus anterior is used commonly in
movements drawing the scapula forward
with slight upward rotation.
• It works with the pectoralis major

(synergist) in typical action such as
throwing a baseball.
12/6/2012 146
Relevant Athletic Activities
Swinging a Bat Throwing a Baseball
12/6/2012 147
Relevant Athletic Activities
Tackling in Football Shooting a Basketball
12/6/2012 148
Pectoralis Minor
Innervated by the
Medial Pectoral Nerve (C8-T1)
1st Class Lever (force- ribs,

axis- shoulder joint,
resistance- weight on scapula)
12/6/2012 149
Pectoralis Minor
12/6/2012 150
Origins Insertions
• Medial & upper
• Anterior surface of coracoid
surfaces of
process of scapula
the 3rd, 4th, &
5th ribs
(outer surface
& upper
margin)
12/6/2012 151
Actions of the Muscle
• Abduction (protraction): draws the
scapula forward and tends to tilt the
lower border away from the ribs
• Downward rotation: as it abducts, it
draws the scapula downward
• Depression: when the scapula is
rotated upward, it assists in
depression
12/6/2012 152
Synergist Antagonist
• Rhomboid muscles
• Serratus (depression and
anterior abduction)
(abduction)
• Levator scapulae
• Rhomboid muscle (depression)
muscles
• Serratus anterior
(downward
(downward rotation)
rotation)
12/6/2012 153
12/6/2012 154
Bench Press
12/6/2012 155
Chin-Ups
12/6/2012 156
Dips
12/6/2012 157
Push-Ups
12/6/2012 158
Standing Fly
12/6/2012 159
Stretches
12/6/2012 160
Wall Pectoralis Minor
Stretch
• Keep back
against the wall
with a step away
• Arms at 90º
against the wall
• Push arms and
shoulders into
the wall while
raising and
lowering as far
as possible
12/6/2012 161
Doorway Modified Chest Stretch
• Arm at 90º
against wall
• Stand a step
away
• Lean into the
wall while
turning your
body away
from the wall
12/6/2012 162
Wall Push-Up Stretch
• Push your
shoulders toward
the corner
• Hold for 15
seconds
12/6/2012 163
Sporting Activities that use
the Pectoralis Minor
• Gymnastics
• Softball
• Bowling
• Tennis
• Golf
12/6/2012 164
KINESIOLOGY
TRAPEZIUS
Muscle
12/6/2012 165
CHARACTERISTICS
* INNERVATION*
– Dorsal scapula nerve C5
– Branches of C3 and C4
* CLASS LEVER*
– THIRD
12/6/2012 166
ORIGIN
• Upper fibers: base of skull, occipital
protuberance, and posterior ligaments of
neck
• Middle fibers: spinous processes of seventh
cervical and upper three thoracic vertebrae
• Lower fibers: spinous processes of fourth
through twelfth thoracic vertebrae
12/6/2012 167
INSERTION
• Upper fibers: posterior aspect of the lateral
third of the clavicle
• Middle fibers: medial border of the
acromion process and upper border of the
scapular spine
• Lower fibers: triangular space at the base
of the scapular spine
12/6/2012 168
ACTIONS
• Upper fibers: elevation of the scapula,
extension of the head at the neck
• Middle fibers: elevation, upward rotation,
and adduction of the scapula
• Lower fibers: depression, adduction, and
upward rotation of the scapula
12/6/2012 169
SHOULDER GIRDLE MUSCLE
* SYNERGIST * ANTAGONIST
· Primarily adduction · Primarily abduction
and elevation and depression
· Rhomboid · Pectoralis Minor
· Levator Scapula
· Serratus Anterior
· Subclavius
12/6/2012 170
STRENGTHENING
EXERCISES
• Shoulder-shrugging exercises
• Bent rowing from a prone
position
• Side arm shoulder joint abduction
• Lawn mowers
• Upright row
• Sitting row
12/6/2012 171
Seated Row
12/6/2012 172
Lawn Mowers
(Low Row)
12/6/2012 173
Lateral Flys
12/6/2012 174
Upright Row
12/6/2012 175
STRETCHES
• Use one hand to pull the head and
neck forward into flexion or slight
ipsilateral flexion to the opposite side
while the ipsilateral hand is hooked
under a table edge to maintain the
scapula in depression
• Use a partner to pull the scapula into
protraction
• Move the scapula into max elevation
and protraction
12/6/2012 176
12/6/2012 177
12/6/2012 178
12/6/2012 179
SPORTING
ACTIVITIES
• THROWING
• ROWING
• X-C SKIING
• REBOUNDING
• TACKLING
• BATTING
• BLOCKING
12/6/2012 180
Subclavius Muscle
12/6/2012 181
Origin
• Superior aspect of first rib at its

junction with its costal cartilage
12/6/2012 182
Insertion
• Inferior groove in the mid-portion of
the of the clavicle
12/6/2012 183
Action
• Stabilizes and protects the
sternoclavicular joint during upper
extremity movements
• Assists the depression of the clavicle
12/6/2012 184
Lever
• Third-class lever system
-force(subclavius) is being applied
between the axis (origin) and the resistance
(insertion)
12/6/2012 185
Role of Subclavius
• Synergist
Assists in the depression of the
clavicle
• Stabilizer
Protects and stabilizes the
sternoclavicle joint
12/6/2012 186
List of Sporting Activities
• Baseball
- the motion of throwing a ball
• Shot Put
- tossing a shot
• Basketball
-the motion of shooting
12/6/2012 187
Exercises
Dips, Lat Pulldowns
12/6/2012 188
Dips
12/6/2012 189
Lat Pulldown
12/6/2012 190
Stretches
• Extreme elevation of the shoulder girdle
12/6/2012 191
12/6/2012 192
Sporting Activities
• THROWING
• ROWING
• X-C SKIING
• REBOUNDING
• TACKLING
• BATTING
• BLOCKING
12/6/2012 193
The Deltoid Muscle
• The deltoid muscle overlies most of the
anterior shoulder to the middle of the lateral
humorous.
– The Deltoid is used in virtually any lifting
movement
– Innervated by the Axillary nerve (C5, C6)
12/6/2012 194
Origin/Insertion
• There are three points of origin for the deltoid
muscle.
– Anterior Fibers:
• Anterior lateral third of the clavical
– Middle Fibers:
• Lateral aspect of the acromion
– Posterior Fibers:
• Inferior edge of the spine of the scapula
• The insertion of the deltoid is the deltoid
tuberosity on the lateral humerus.
12/6/2012 195
Actions of the Deltoid
• Actions of the deltoid are separated into
actions produced by three categorized fibers
of the muscle.
– Anterior fibers
– Middle fibers
– Posterior fibers
12/6/2012 196
Anterior Fibers
• Abduction, flexion,
horizontal adduction,
and internal rotation of
the glenohumeral joint
12/6/2012 197
Middle Fibers
• Abduction of the
glenohumeral joint
12/6/2012 198
Posterior Fibers
• Abduction, extension,
horizontal abduction,
and external rotation
of the glenohumeral
joint
12/6/2012 199
Levers
• Because the insertion of the deltoid muscle
lies at the deltoid tuberosity of the lateral
humerus, this is a 3rd class lever.
– In all cases, the force (muscle insertion) is in
the middle, between the axis (shoulder joint)
and the resistance (anything being lifted).
12/6/2012 200
Synergists/Antagonists
• Depending on the task being performed by
the deltoid muscle, various other muscles
play a role in the action.
12/6/2012 201
• Anterior Deltoid
• Dumbbell front raise
– Grasp the dumbbells in both hands
– Raise one dumbbell with elbows fixed in a 10°
to 30° angle throughout until upper arm is
parallel to the floor.
– Continue with alternate arm.
12/6/2012 202
Dumbbell Front Raise
12/6/2012 203
Dumbbell Front Raise
• Synergists
– Pectoralis major, middle and lower trapezius,
serratus anterior
• Antagonist
– Latissimus dorsi
12/6/2012 204
• Lever Shoulder Press
– Sit at machine, and grasp the bar with an
overhand grip.
– Press lever until arms are extended overhead.
– Lower and repeat.
12/6/2012 205
Lever Shoulder Press
12/6/2012 206
Lever Shoulder Press
• Synergists
– Pectoralis major, triceps brachii, middle and
lower trapezius, serratus anterior
• Antogonist
– Latissimus dorsi, biceps brachii
12/6/2012 207
• Lateral Deltiod
• Barbell upright row
– Grasp bar with shoulder width or slightly
narrower overhand grip.
– Pull bar to neck with elbows leading. Allow
wrists to flex as bar rises.
– Lower and repeat.
12/6/2012 208
Barbell Upright Row
• Synergists
– Anterior deltoid, supraspinatus, brachialis,
briachioradialis, biceps brachii, middle and
lower trapezius, serratus anterior, infraspinatus,
teres minor
• Antagonists
– Lattisimus dorsi
12/6/2012 209
• Posterior Deltoid
• Row
– Sit on platform with knees slightly bent.
– Grasp cable attachment.
– Pull cable attachment with upper arm
perpendicular to trunk until upper arms is just
beyond parallel to one another.
– Return and repeat.
12/6/2012 210
Seated Row
12/6/2012 211
Row
• Synergists
– Infraspinatis, teres minor, lateral deltoid,
middle and lower trapezius, rhomboids,
brachialis, brachioradialis
• Antagonists
– Triceps brachii, latissimus dorsi
12/6/2012 212
Anterior Deltoid Stretch
• Doorway front deltoid stretch
– Stand at end of wall or in doorway facing
perpendicular to wall.
– Position palm on surface of wall slightly lower
than shoulder.
– Bend elbow slightly.
– Turn body away from positioned arm. Hold
stretch for 20 seconds.
12/6/2012 213
Doorway Front Deltoid
Stretch
12/6/2012 214
Lateral Deltoid Stretch
• Position arm across chest. Place opposite
hand on elbow.
• Push elbow toward chest. Hold stretch for

20 seconds.
• Repeat with opposite arm.
12/6/2012 215
Lateral Deltoid Stretch
12/6/2012 216
Posterior Deltoid Stretch
• Position arm across neck. Place opposite
hand on elbow.
• Push elbow toward neck. Hold stretch for

20 seconds.
• Repeat with opposite arm.
12/6/2012 217
Posterior Deltoid Stretch
12/6/2012 218
Sports Using Deltoids
• Baseball
• Football
• Track and Field
• Gymnastics
12/6/2012 219
Structural Kinesiology:
Supraspinatus Muscle
12/6/2012 220
Supraspinatus Muscle
• (sú pra-spi-ná tus)
• Origin: Medial two thirds of the
Supraspinatus fossa
• Insertion: Superiorly on the greater tubercle
of the humerus
12/6/2012 221
Palpation
• The Supraspinatus cannot be palpated

• This muscle lies:
• under the deltoid muscle distally
– Distal: situated away from the center or midline of the
body, or away from the point of origin
• under the trapezius proximally

– Proximal: nearest the trunk or the point of origin
12/6/2012 222
Innervation
• Suprascapular nerve (C5)
12/6/2012 223
3rd Class Lever
• Axis - shoulder joint
• Force - the muscle inserts at the greater
tubercle of the humerus
• Resistance - is the weight held in the hand
12/6/2012 224
• ―empty can exercise‖
• shoulder abduction with the use of
Theraband
• lateral dumbbell raises
12/6/2012 225
―Empty can exercise‖
12/6/2012 226
Start Finish
Shoulder Abduction with
Theraband
12/6/2012 227
Lateral dumbbell raise
12/6/2012
Finish 228
Start
Stretches
• Adducting the arm behind the back with the
shoulder internally rotated and extended
stretches the supraspinatus
• Lying supine with elbow at ninety degree
angle with hand pronated (partner applies
pressure to the dorsal side of hand)
12/6/2012 229
Athletics Utilizing Supraspinatus
• Baseball - throwing, batting
• Basketball - shooting, passing
• Football - throwing, blocking
• Golf - full motion of swing
• Softball - throwing, batting
• Volleyball - hitting, digging
12/6/2012 230
Synergists
• Deltoid
• Infraspinatus
• Teres minor
12/6/2012 231
Antagonists
• Coracobrachialis
• Subscapularis
• Teres major
12/6/2012 232
Infraspinatus
12/6/2012 233
Nerve Innervation
Suprascapular Nerve (C5,6)
12/6/2012 234
Actions
*External rotation of the
glenohumeral joint
*Horizontal abduction of the
glenohumeral joint
*Extension of the glenohumeral
joint
*Stabilization of the humeral head in
12/6/2012
the glenoid fossa 235
Origin/Insertion
*Origin: Medial aspect of the
infraspinatus fossa just
below the spine of the
scapula
*Insertion: Posteriorly on the
greater tubercle of the
humerus
12/6/2012 236
Synergists
Teres Minor, Subscapularis, Deltoid
Antagonists
Deltoid, Pectoralis Major
12/6/2012 237
Palpation
*Immediately below the spine of
the scapula and the posterior
fibers of the deltoid muscle
12/6/2012 238
3rd Class Lever
Axis- glenohumeral joint
Force-is at the insertion:
posteriorly on the greater
tubercle of the humerus
Resistance-in the hand
12/6/2012 239
Stretching
12/6/2012 240
12/6/2012 241
12/6/2012 242
Exercises
12/6/2012 243
12/6/2012 244
12/6/2012 245
12/6/2012 246
Sports
Baseball
Tennis
Rowing
12/6/2012 247
12/6/2012 248
12/6/2012 249
Teres Minor Muscle
12/6/2012 By Chris Laz 250

Innervation
• The axillary nerve innervates the teres
minor as well as the deltoid and the skin
over the deltoid tuberosity of the humerous.
12/6/2012 251
Lever Class
• If the scapula is stabilized this muscle becomes a
first class lever with the axis being the insertion
point, the force being applied to contract the
muscle and the resistance being applied on the
humerous.
12/6/2012 252
Origin/Insertion
• Origin: Posteriorly on the upper and middle aspect of the
lateral border of the scapula.
• Insertion: Posteriorly on the greater tubercle of the

humerous.
12/6/2012 253
Actions of the teres minor
• External rotation of the glenohumeral joint: Rotary
movement around the longitudinal axis of the bone away
from the center of the body; turning the upper arm
outward.
• Horizontal abduction of the glenohumeral joint: moving

the upper arm away from the chest with the elbows facing
down.
• Extension of the glenohumeral joint
• Stabilization of the humeral head in the glenoid fossa

12/6/2012 254
Synergist Muscles
• The infraspinatus helps the teres minor in stabilizing the
glenohumeral joint posteriorly.
• The supraspinatus and the subscapularis muscles also are
involved in the rotator cuff in order to make sure the
humeral head stays in its proper location within the glenoid
cavity.
12/6/2012 255
Antagonist Muscles
• Anterior Deltoid
• Latissimus Dorsi
• Subscapularis
12/6/2012 256
• Chin-Ups
• Rope Climbing
• Dips on a parallel bar
• Rotating the arm against resistance in the 0-
degree and the 90-degree abducted
12/6/2012 257
Chin-Ups
12/6/2012 258
Climbing Rope
12/6/2012 259
Dips
12/6/2012 260
Stretches
• Internally rotating the shoulder while moving into extreme
horizontal adduction.
• Externally rotating the shoulder in a 90-degree abducted
position.
12/6/2012 261
Broomstick
12/6/2012 262
Bent-Over Stretch
12/6/2012 263
Seated Bent-Over
12/6/2012 264
Sporting Activities
• Several sporting exercises use the rotator
cuff. The teres minor is involved in
swimming, tennis, volleyball, golf, and
throwing any object.
-Kick serve to the backhand
-Hitting a hook
-Throwing a slider
-Swimming butterfly
12/6/2012 265
Subscapularis
12/6/2012 266
Origin
• Entire anterior surface of the subscapular
fossa
12/6/2012 267
Insertion
• Lesser tubercle of the humerus
12/6/2012 268
12/6/2012 269
Innervation
• Upper and lower supscapular nerve (C5-C6)
12/6/2012 270
Action
• Glenohumeral head depressor
• (Medial) Internal rotation of glenohumeral
joint
• Adduction of the glenohumeral joint
• Stabilization of the humeral head in the
glenoid fossa
12/6/2012 271
Third Class Lever
• During stabilization of the scapula
• Force – insertion at humeral head
• Axis – glenohumeral joint
• Resistance – weight of arm or dumbell
12/6/2012 272
First Class Lever
• Stabilization of the glenohumeral joint
• Force – supscapularis
• Axis – scapular rotation
• Resistance – weight of scapula
12/6/2012 273
Supscapular Exercises
• Synergists – Pectoralis Major, Latissimus
Dorsi, Teres Major, Deltoid – anterior
• Stabilizers – Pectoralis minor, Rhomboids,
Levator scapulae, Wrist Flexors
• Antagonists – Teres minor, Infraspinatus,
Deltoid - posterior
12/6/2012 274
Cable Internal Rotation
12/6/2012 275
Dumbbell Internal Rotation
12/6/2012 276
Broom Stick Subscapularis
Stretch
12/6/2012 277
Doorway Subscapularis Stretch
12/6/2012 278
Sporting Activities
• Baseball – throwing a pitch
• Swimming – freestyle, butterfly
• Tennis – forehand swing
12/6/2012 279
Tennis
12/6/2012 280
Swimming
12/6/2012 281
Baseball
12/6/2012 282
TERES MAJOR
12/6/2012 283
Teres Major
12/6/2012 284
Origin
• Posteriorly on the inferior third of the lateral
border of the scapula and just superior to the
inferior angle
12/6/2012 285
Insertion
• Medial lip of the intertubercular groove of
the humerus
12/6/2012 286
Actions
• Extension of the glenohumeral joint,
particularly from the flexed position to the
posteriorly extended position
• Internal rotation of the glenohumeral joint
• Adduction of the glenohumeral joint,
particularly from the abducted position
down to the side and toward the midline of
the body
12/6/2012 287
Palpation Innervation
• Posterior scapular • Lower subscapular
surface, moving nerve, C5,6
diagonally upward
from the inferior angle
of the scapula
12/6/2012 288
Synergists Antagonists
• Latissimus dorsi, • Deltoid, Teres Minor,
Pectoralis major, and the Supraspinatus and
Subscapularis in all three Infraspinatus in adduction
major actions of Teres
Major • Coracobrachialis in
• Teres minor and extension
Infraspinatus in extension • Teres Minor and
of glenohumeral joint Infraspinatus in internal
• Coracobrachialis in rotation
adduction of glenohumeral
joint
12/6/2012 289
Third Class Lever
A: The glenohumeral joint of the

shoulder
F: Muscle attaches at medial lip of
intertubercular groove of the humerus
R: Resistance in your hand
12/6/2012 290
How to stretch the
Teres Major
12/6/2012 291
How to strengthen the
Teres Major
Lat Pulldowns
Rope Climbing
Internal Rotation using Theraband
Adduction using Theraband
Extension using Theraband
12/6/2012 292
Lat Pull-Down
12/6/2012 293
Rope Climbing
12/6/2012 294
Internal Rotation
12/6/2012 295
Adduction with Theraband
12/6/2012 296
Extension using Theraband
12/6/2012 297
Sports that use the
Teres Major
Internal rotation in Extension

the follow through while pulling
of the swing
12/6/2012 yourself 298
upwards
Sports that use the
Teres Major
Left: Extension
following serve
Below:
Extension in the
free style
Extension in the row
12/6/2012 299
Sports that use the Teres Major
From
abduction
(left) to
adduction
(right) in the
rings
12/6/2012 300
Latissimus Dorsi
Posterior shoulder
joint muscle
12/6/2012 301
Origin
• Posterior crest of the ilium
• Back of sacrum
• Spinous processes of the
lumbar vertebrae (L1-5)
and lower 6 thoracic
vertebrae (T7-12)
• Slips from the lower 3 ribs
12/6/2012 302
Insertion
• Medial side of the
intertubercular groove
of the humerus
12/6/2012 303
Palpation Innervation
Posterolateral aspect of the Thoracodorsal nerve (C6-

trunk below the armpit 8) from brachial plexus
(Don‘t tickle your partner)
12/6/2012 304
• Rhomboids • Pectorals
• Pectoralis major • Deltoids
• Teres major • Rotator cuff muscles
Supraspinatus
Infraspinatus
Stabilizers Subscapularus
• Triceps
• Biceps
12/6/2012 305
Lever Type
• Third class lever
force- insertion on humerus
axis- shoulder joint
resistance- varies depending on
movement
12/6/2012 306
Actions
• Adduction of the glenohumeral joint
• Internal rotation of the glenohumeral joint
• Horizontal abduction of the glenohumeral
joint
(Accompanied by depression, downward

rotation, and adduction of the scapula)
12/6/2012 307
• Chin-ups (assisted or weighted)
• Pull-ups (over or underhand)
• Dips
• Lat pull downs (front and rear)
• Lat pullovers (Lat pulls)
• Seated rows (keep elbows close to body)
12/6/2012 308
Pull-up
12/6/2012 309
Dips
12/6/2012 310
Pulldowns
(can be done in front or back)
12/6/2012 311
Pullovers (Lat Pulls)
12/6/2012 312
Seated Rows
(should be done with elbows kept close to body)
12/6/2012 313
Stretches
• Bent-over lat stretch
• Overhead lat stretch
• Wall lat stretch
• Side-to-side bends
12/6/2012 314
Bent-over Lat Stretch
12/6/2012 315
Overhead Lat Stretch
12/6/2012 316
Wall Lat Stretch
12/6/2012 317
Side-to-side Bends
12/6/2012 318
Sports
• Baseball
*throwing, hitting
• Running
• Soccer throw-ins
• Rope/rock climbing
• Gymnastics
• Volleyball
*serve, block
12/6/2012 319
12/6/2012 320
12/6/2012 321
12/6/2012 322
Biceps Brachii
Muscle
• The bicep is known as
a two-joint muscle.
Although it should be
a three joint muscle—
the shoulder, elbow,
and radioulnar.
12/6/2012 323
Origin
• Two Heads
– Long Head: supraglenoid tubercle above the
superior lip of the glenoid fossa
– Short head: coracoid process of the scapula and
upper lip of the glenoid fossa
12/6/2012 324
Insertion
• Tuberosity of the radius and bicipital

aponeurosis
12/6/2012 325
Innervation
• Musculocutaneous nerve (C5, C6)
12/6/2012 326
• Synergists • Antagonists
Elbow Flexion: Elbow Fexion:
Brachialis Triceps Brachii
Brachioradialis Aconeus
Pronator teres Supination of the forearm:
Supination of the forearm: Pronator quadratus
brachioradialis Pronator teres muscle
Supinator muscle Flexion of the Shoulder joint:
Flexion of the Shoulder joint: Triceps brachii
Coracobrachialis
12/6/2012 327
Action
• Flexion of the elbow
• Supination of the forearm
• Weak flexion of the shoulder
12/6/2012 328
Palpation Type of Lever
• The bicep brachii is • Third class lever
easy to be palpated on Axis = the elbow joint
the aterior aspect of Force = the bicep
the humerous and the insertion at the radial
elbow tuberosity
Resistance = center of
gravity, or weight in
the hand
12/6/2012 329
Bicep Brachii Exercises
• Bicep Curls Normal
– Hold the weights with your
palms facing away from you,
in the downward position.
– Aim to keep the elbows tucked
into the side and avoid
swinging the weights up, or
arching your back.
– Move the weights in a smooth
motion from your middle up
towards your chin, then lower
under control, and repeat.
12/6/2012 330
Biceps Brachii Exercises
• Hammer Curls
Stand with soft knees, keeping
your back straight and your
shoulder width apart.
Hold the weights with your palms
facing towards your sides.
Aim to keep the elbows tucked into
the side and avoid swinging the
weights up.
Move the weights in a smooth
motion from your middle up
towards your chin, in a hammer
like motion.
12/6/2012 331
Biceps Brachii Exercises
• Incline Bench Bicep Curl
Stand behind an incline bench, resting one arm
along the bench.
Hold a dumbbell in that arm, with your palm
facing upwards.
Smoothly curl the weight up towards your
shoulder, then lower and repeat.
This method helps isolate the biceps, and is good
for beginners, as it helps you develop correct
technique.
Change arms then repeat on the other side.
12/6/2012 332
Stretches for the Biceps Brachii
• Place your arm straight
against a wall, with your
palm facing the wall.
• With your body close to
the wall, slowly turn your
body away from it,
keeping the arm in contact
with the wall.
• This is an excellent stretch
for the biceps and chest
muscles.
12/6/2012 333
Additional Stretches
• The elbow must be extended maximally
with the shoulder in full extension. The
biceps must be stretched by beginning with
full elbow extension and progressing into
full horizontal abduction.
12/6/2012 334
Sporting Activities
• Rowing
• Bowling
• Tackling in Football
• Softball Pitching
• Throwing a curve ball in baseball
12/6/2012 335
Brachialis Muscle
12/6/2012 336
Brachialis Muscle
• Origin
– Distal half of the anterior portion of the humerous.
• Insertion
– Coronoid process of the Ulna.
• Palpation
– Lateral side of the upper arm under the biceps brachii
muscle.
• Innervation
– Muscolocutaneous nerve and sometimes branches from the
radial and median nerves (C5,C6)
12/6/2012 337
Brachialis Muscle
• Action
– The brachialis muscle is used whenever the
elbow flexes.
– It pulls on the ulna and is the only pure flexor
of the elbow joint.
12/6/2012 338
Brachialis Muscle
• Third Class Lever
– The axle is the elbow.
– The force is the insertion point on the ulna
– The resistance is the object that is being lifted.
12/6/2012 339
Brachialis Muscle
• Synergist Muscles • Antagonist Muscles
– Biceps Brachii – Triceps Brachii
– Brachioradialis
12/6/2012 340
• Preacher Curl (Barbell
or Dumbbell)
12/6/2012 341
• Isolation Curls
12/6/2012 342
• Any other elbow
curling exercises
12/6/2012 343
Stretching
• Brachialis can only be stretched by
extending the elbow with the shoulder
relaxed and flexed.
12/6/2012 344
Activities
• Any activity where the
elbow is flexed, such as…
– Bowling
– Softball
12/6/2012 345
Brachioradialis
12/6/2012 346
Origin:
Distal two-thirds of the lateral condyloid
ridge of the humerus
origin
Insertion:
Lateral surface of the distal end of the
radius at the styloid process
insertion
12/6/2012 347
Innervation: Radial nerve (C5,6)
Palpation:
On the lateral anterior side of the forearm
Third Class Lever
12/6/2012 348
Actions:
- Elbow flexion
- Pronation (from supinated position to neutral)
- Supination (from pronated position to neutral)
Sports examples:
- Golf swing, baseball swing, throwing,
catching, rock climbing, running, shooting
12/6/2012 349
Brachioradialis
Synergists: Biceps brachii, brachialis,

pronator teres, pronator quadratus, supinator
Antagonists: Triceps brachii, anconeus
12/6/2012 350
Lifting & Stretching
Lifts:
- dumbbell hammer curl
- barbell reverse curl
- reverse preacher curl
- cable reverse curl
- overhead tricep extension
- wrist curls
Stretches:
- extend elbow with shoulder in flexion, then
12/6/2012 351
maximally pronate or supinate the forearm
Dumbbell Hammer Curl
12/6/2012 352
Barbell Reverse Curl
12/6/2012 353
Reverse Preacher Curl
12/6/2012 354
Cable Reverse Curl
12/6/2012 355
Overhead Tricep Extension
12/6/2012 356
Wrist Curls
12/6/2012 357
TRICEPS BRACHII
12/6/2012 358
TRICEPS BRACHII
Triceps Brachii has three parts, the

long head (1), the lateral head (2),
and the medial head (3).
12/6/2012 359
TRICEPS BRACHII
• Innervation:
– Radial Nerve C7 and C8
• Lever Class:
– In elbow extension, is First Class Lever
– F: Olecranon A: Elbow R: Nonsupported forearm
– In pushups, is Second Class Lever
– F: Olecranon A: Hand R: Body weight at elbow joint
12/6/2012 360
TRICEPS BRACHII
• Origin:
– Long Head: infraglenoid tubercle below
inferior lip of glenoid fossa of the scapula.
– Lateral Head: upper half of the posterior
surface of the humerus.
– Medial Head: distal two-thirds of the posterior
surface of the humerus.
12/6/2012 361
TRICEPS BRACHII
• Insertion:
– Olecranon process of the ulna.
• Actions:
– All Heads: Extension of the elbow
– Long Head: Extension of the shoulder joint &
Adduction of the shoulder joint.
12/6/2012 362
TRICEPS BRACHII
• Synergist:
– Anconeus muscle. Few synergists because the
three heads of the muscle do all the work.
• Antagonist:
– Biceps brachii, brachialis muscle,
brachioradialis muscle.
12/6/2012 363
STRENGTHENING EXCERCISES
• Typical action of the
triceps brachii is
shown in push-ups
when there is powerful
extension of the
elbow.
12/6/2012 364
• Bench pressing a
barbell or a dumbbell
is an excellent exercise
to perform elbow
extension.
12/6/2012 365
• The overhead press is
also a very good way
to emphasize the
triceps brachii.
12/6/2012 366
Dips are also a good

way to achieve
elbow extension and
extensively work the
triceps brachii.
12/6/2012 367
• Standing elbow
extensions work the
triceps brachii very
well.
12/6/2012 368
• Bent over elbow
extensions are another
form of elbow
extensions that work
the triceps brachii
primarily.
12/6/2012 369
STRETCHING EXCERCISE
• Can be flexed with
both the shoulder and
the elbow in maximal
flexion, as seen in
those overhead elbow
flexion stretch.
12/6/2012 370
SPORTING ACTIVITIES
When shooting a
basketball, you use
your triceps to extend
your elbow on your
follow through.
12/6/2012 371
SPORTING ACTIVITIES
• In golf, when you are
swinging your club
and pulling the club
back, you are doing
shoulder adduction
and using your triceps.
12/6/2012 372
SPORTING ACTIVITIES
• In hockey, when
pulling your stick back
to hit the puck, you are
doing shoulder
extension and using
your triceps.
12/6/2012 373
Anconeus
• Triangular muscle
overlying the back of
the head of the radius
12/6/2012 374
Anconeus
• Origin is posterior surface
of the lateral condyle of
the humerus
• Insertion is the posterior

surface of the olecranon
process of the ulna
12/6/2012 375
Anconeus
• Chief function – pull the synovial membrane of the
elbow joint out of the way of the olecranon process
• 3rd class lever
• Actions
– Weak extension of the elbow
– Abducts ulna in pronation
– Stabilizes the elbow joint
12/6/2012 376
Anconeus
• Contracts along with the triceps brachii during
extension of the elbow
• ‗4th head of the triceps‘
• Weakness of the anconeus results in the inability

to extend the forearm against gravity
12/6/2012 377
Anconeus
• Antagonists
– Biceps brachii
– Brachialis
– Brachioradialis
• Synergists – all three

heads of the triceps
– Long head
– Lateral head
– Medial head
12/6/2012 378
Anconeus
• Palpation can occur on
the posterior lateral aspect
of the olecranon process
12/6/2012 379
Anconeus
• Innervated by the radial
nerve (C7 & C8)
12/6/2012 380
Anconeus - Stretch
• Maximal elbow flexion
stretches the anconeus
– First reach towards the

middle of the back where
the scapulae meet during
retraction
– Then with the opposite

hand slightly push the
elbow posteriorly
12/6/2012 381
Anconeus - Exercise
• Cable pull-downs
– Extend the cable to a 180

degree angle between the
upper and lower arm
– Decrease the angle to no

less than 90 degrees and
return to the original
position
12/6/2012 382
Anconeus - Exercise
• Dumbbell extension
– Begin with a 90 degree

angle and contract the tricep
in an attempt to raise the
lower arm
– Return the weight slowly to

the original position
12/6/2012 383
Anconeus - Exercise
• Overhead Barbell
Extension
– Begin with maximal elbow

flexion and contract the
triceps to extend the lower
arm
– Then return slowly from the

overhead straightened-arm
position
12/6/2012 384
Anconeus - Exercise
• Bench Dips
Beginning position
– Begin with the elbow
flexed and contract the
triceps to extend the
lower arm and raise the
body
– Return slowly
12/6/2012 385
Anconeus - Activities
• Extending the
elbow during
follow through of a
basketball shot
12/6/2012 386
Anconeus - Activities
• Blocking in football
maximizes usage of
the anconeus as a
great deal of
resistance is
obtained
12/6/2012 387
Pronator Teres
12/6/2012 388
Biomechanical Information
• Origin– Distal part of • Innervation— Median
the medial condyloid nerve (C6, 7)
ridge of the humerus • Palpation–
and medial side of the Anteromedial surface
ulna. of the proximal
• Insertion—Middle forearm [up near the
third of the lateral elbow joint]
surface of the radius
12/6/2012 389
Action of Pronator Teres
• Pronation of the
forearm.
• Weak flexion of the
elbow.
• Lever—3rd class
Axis- radio-ulnar joint
Force- near origin
Resistance- radius
12/6/2012 390
Synergists and Antagonist
– Pronator quadratus – Supinator
– Flexor carpi radialis – Biceps Brachii
– Anconeus
12/6/2012 391
• The best exercise to hit the pronator teres is
any exercise that would add resistance to
the action of forearm pronation and
supination (eccentric and concentric
contraction). A small dumbbell or large
hammer can be held while you twist the
forearm from the palm down position to the
palm up position and back.
12/6/2012 392
Beginning Phase of exercise
12/6/2012 393
Mid-phase of exercise
12/6/2012 394
Stretches

• The elbow must be
fully extended while
taking the forearm into
full supination to
stretch the pronator
teres.
12/6/2012 395
Sports
• Baseball swing (right handed batter)
• Tennis (forehand return)
• Golf (swing)
• Hockey (slap-shot)
• Racquetball
• Pinick-pinuck (table tennis)
12/6/2012 396
Baseball Tennis
swing
12/6/2012 397
Golf Hockey
12/6/2012 398
Racquetball Table tennis
12/6/2012 399
Pronator Quadratus Muscle
12/6/2012 400
Origin
• Distal fourth of the anterior side of the ulna
12/6/2012 401
Insertion
• Distal fourth of the anterior side of the
radius
12/6/2012 402
Action
• Pronation of the
forearm
– the ulna is fixed, so the
pronator quadratus
moves the radius over
the ulna
12/6/2012 403
Innervation
• Median nerve, (palmar interosseous branch)
(C6,7)
12/6/2012 404
Lever
• 3rd class
• Axis- radioulnar joint
• Force(insertion)- distal fourth of the
anterior side of the radius
• Resistance- whatever you are holding
12/6/2012 405
Synergist Antagonist
• Pronation • Supination
– pronator teres – supinator
– flexor carpi radialis – biceps brachii
– anconeus – brachioradialis
– triceps (when also
extending the elbow)
12/6/2012 406
Stretches
• Have a partner take
your wrist and
passively place your
forearm in extreme
supination (or you can
do this yourself)
12/6/2012 407
• Pronation with a
dumbell or hammer
• wringing out a towel
12/6/2012 408
Sporting Activities
• Swimming- pulling back
during a stroke
• Baseball- pitching in
release of a screwball
• Tennis- to put spin on a
ball
• Volleyball- when hitting
to put spin on the ball
• also used when turning a
screwdriver to unscrew
12/6/2012 409
SUPINATOR MUSCLE
KINESIOLOGY
10/09/01
12/6/2012 410
ORIGIN
• Lateral epicondyle of
the humerus
• Neighboring posterior
part of the ulna
12/6/2012 411
INSERTION
• Lateral surface of the
proximal radius just
below the head
12/6/2012 412
CLASS LEVER
• THIRD class lever
• Axis = Elbow Joint
• Force = insertion on the lateral surface of
proximal radius just below the head
• Resistance = weight of hand or resistance
against the supination of the hand
12/6/2012 413
ELBOW AND RADIOULNAR
JOINT MUSCLES
• ANTAGONISTS
• SYNERGISTS • Primarilu flexion and
• Primarily extension pronation
and supination – Biceps brachii
– Triceps brachii – Brachialis
– Aconeus – Brachioradialis
– Pronator teres
– Supinator
– Pronator quadratus
12/6/2012 414
CHARACTERISTICS
• INNERVATION
• ACTIONS • Deep branch of radial
• Supinates the forearm nerve
• Extension movements • C5 and C6
• Rotates radius to turn
palm anteriorly
• PALPATION
• Cannot be palpated
12/6/2012 415
EXERCISES
• Supination of forearm with dumbbells
• Holding a hammer with the head suspended from
the ulnar side while the forearm is supported on a
desk or table…the hammer should be hanging
toward the floor with the forearm supinated to the
palm-up position
• Hands grasped and forearms extended in an
attempt to supinate forearm against grip of the
hands
12/6/2012 416
SUPINATION WITH
DUMBBELLS
12/6/2012 417
GRASPING OF
HANDS
12/6/2012 418
HAMMER (with dumbbells)
12/6/2012 419
This is like wrist curls; full extension for supinator.
STRETCHING
• Supinator is stretched
when the forearm us
maximally pronated
12/6/2012 420
SPORTING ACTIVITIES
• Baseball (throwing a curve)
• Volleyball (snapping in hitting and serving)
• Tennis (cross court swing - snap)
• Also…the motion of turning a screwdriver
12/6/2012 421
CURVE BALL PITCH
12/6/2012 422
VOLLEYBALL
DIGGING
HITTING
SERVING
12/6/2012 423
TENNIS
12/6/2012 424
Flexor Carpi Radialis
12/6/2012 425
Origin
Medial Epicondyle of the
Humerus
Insertion
Anterior base of the second and
third metacarpals (palmar surface)
12/6/2012 426
• Palpation
-Anterior surface of the wrist,
slightly lateral, in line with the
second and third metacarpals
12/6/2012 427
• Innervation
-Median Nerve (C6, C7)
12/6/2012 428
• Action
-Flexion of the wrist
-Abduction of the wrist
-Weak flexion of the elbow
12/6/2012 429
Synergists
-Flexor carpi ulnaris
-Palmaris longus
-Flexor digitorum profundus
-Flexor pollicis longus
12/6/2012 430
• Antagonist
-Extensor carpi radialis longus
-Extensor carpi radialis brevis
-Extensor carpi ulnaris
12/6/2012 431
-Resistance at the fingers, force at
the insertion point, and the axis at the
wrist
12/6/2012 432
Stretches
-the elbow must be fully extended
with the forearm supinated while the
wrist is extended and adducted.
12/6/2012 433
Praying wrist stretch
12/6/2012 434
Seated Wrist Stretch
12/6/2012 435
Single Arm Wrist Stretch
12/6/2012 436
• Exercises
-Cable wrist curl
-Barbell wrist curl
-Rope curl
12/6/2012 437
Barbell Wrist Curl
12/6/2012 438
Cable Wrist Curl
12/6/2012 439
Rope Curl
12/6/2012 440
• Sports
(Baseball)-movement of wrist at the
end of a throw
(Baseball)-movement of wrist when
hitting a ball
12/6/2012 441
Palmaris Longus
12/6/2012 442
• Originates at the
medial epicondyle
of the humerus
12/6/2012 443
• Inserts at the palmar
aponeurosis of the
second, third, forth,
and fifth metacarpals
12/6/2012 444
• Palpation
– Anterior medial aspect of the forearm and the
central aspect of the anterior forearm just
proximal to the wrist
• Innervation
– Median nerve (C6, C7)
12/6/2012 445
• Actions
– Flexion of the wrist
– Weak flexion of the elbow
• Lever
– 3rd class lever
12/6/2012 446
• Synergists
– Flexor Digitorum Superficialis
– Flexor Digitorum Profundus
– Flexor Carpi Radialis
– Flexor Carpi Ulnaris
– Flexor Pollicis Longus
12/6/2012 447
• Antagonists
– Extensor Digitorum – Extensor Indicis
– Extensor Carpi – Extensor Digiti Minimi
Radialis Longus – Entensor Pollicis
– Extensor Carpi Longus
Radialis Brevis – Extensor Pollicis
– Extensor Carpi Ulnaris Brevis
12/6/2012 448
• Wrist Curl
– Barbell
– Cable
– Dumbbell
12/6/2012 449
12/6/2012 450
• Praying Wrist
Flexor Stretch
12/6/2012 451
• Seated wrist flexor • Kneeling wrist flexor
stretch stretch
12/6/2012 452
• Activites
– Bowling
– Softball
– Baseball
– Tennis
– Gymnastics
12/6/2012 453
The Flexor Carpi Ulnaris
12/6/2012 454
Flexor Carpi Ulnaris
• Origin
– Medial epicondyle of the humerus
– Posterior aspect of the proximal ulna
12/6/2012 455
• Insertion
– Pisiform
– Hamate
– Base of the fifth
metacarpals
12/6/2012 456
• Innervation
– Ulnar nerve (C8, T1)
12/6/2012 457
• Lever type
– 3rd Class Lever
12/6/2012 458
• Actions
– Flexion of the wrist
– Adduction of the wrist
– Weak flexion of the elbow
12/6/2012 459
• Palpation
– Anterior medial aspect of forearm and central
aspect of the anterior forearm just proximal to
the wrist
12/6/2012 460
Synergists
• Wrist Flexion
– Flexor carpi radialis
– Palmaris longus
– Extensor carpi ulnaris
– Flexor digitorum superficialis
– Flexor digitorum profundus
– Flexor pollici longus muscle
12/6/2012 461
Synergists
• Wrist adduction
– Extensor carpi ulnaris
12/6/2012 462
• Antagonists
– Flexor carpi radialis (wrist abduction)
– Extensor carpi ulnaris (wrist & elbow
extension)
– Extensor carpi radialis longus & brevis (in all
actions)
– Flexor digitorum superficialis (wrist and elbow
extension)
12/6/2012 463
• Strengthening
exercises
12/6/2012 464
12/6/2012 465
• Stretches
12/6/2012 466
12/6/2012 467
• Sporting Activities
– Basketball jump shot
– The javelin throw
– Baseball swing
12/6/2012 468
12/6/2012 469
12/6/2012 470
12/6/2012 471
Extensor Carpi Ulnaris
12/6/2012 472
• Origin
– Lateral epicondyle of the humerus
– Middle two fourths of the posterior
border of the ulna
• Insertion
– Base of the dorsal surface of the fifth
metacarpal
12/6/2012 473
• Nerve Innervation
– Radial Nerve
• Palpation
– Near the base of the 5th metacarpal
12/6/2012 474
• Actions
– Extension of the wrist
– Adduction (ulnar deviation) of the
wrist
– Weak extension of the elbow
12/6/2012 475
– Wrist exntensors – Wrist flexors
• Ext. Carpi Rad. Brev. • Fl. Carpi. Rad.
• Ext. Carpi. Rad. Long. • Palmaris Longus
– Elbow extensors – Elbow Flexors
• Triceps • Biceps Brachi
• Anconeus • Brachioradialis
– Wrist Adductors – Wrist Abductors
• Flexor Carpi Ulnaris • Flexor Carpi Radialis
12/6/2012 476
Wrist Extension Exercises
DUMBELL
EXTENSIONS:
• Support the forearm
on a bench or table
• Hold the elbow down
with the opposite hand
• Hold the dumbell and
extend the wrist
12/6/2012 477
BARBELL
EXTENSIONS:
• Support the forearm
on a bench or table
• Hold the elbow down
with the opposite hand
• Hold the barbell and
extend the wrist
12/6/2012 478
THE WRIST ROLLER:
• Grab the bar
• Extend the wrists with
an alternating action
• Slowly lower the bar
with an eccentric
motion
12/6/2012 479
UNAR DEVIATION:
• Hold a dumbell over
your head
• Adduct the wrist
12/6/2012 480
Wrist Extensor Stretches
• The elbow should be
straight
• Grab the involved
hand and pull it
toward you
12/6/2012 481
Sports and Activities
12/6/2012 482
Extensor Carpi Radialis
Brevis
12/6/2012 483
ORIGIN
*Lateral epicondyle of the humerus
INSERTION
*Base of the third metacarpal (dorsal surface)
12/6/2012 484
ACTIONS
~Extension of the wrist
~Abduction of the wrist
~Weak extension of the elbow
12/6/2012 485
NERVE INNERVATION
*Deep branch of the radial nerve
(C6, 7)
PALPATION
*Dorsal side of the forearm,
which is difficult to palpate
12/6/2012 486
LEVER
*Third class
A-Elbow joint
F-Insertion=base of third
metacarpal
R-Resistance in hand
12/6/2012 487
SYNERGISTS
Extensor Carpi Radialis Longus
ANTAGONIST
Palmaris Longus
Flexor carpi ulnaris
12/6/2012 488
*With palm facing
downward, pull wrist
and fingers downward
toward forearm.
*Extend or straighten
elbow. Hold stretch
for 20 seconds.
Repeat with opposite
arm.
12/6/2012 489
*Sit and grasp bar with
narrow to shoulder width
overhand grip. Rest
forearms on thighs with
wrists just beyond knees.
*Hyperextend wrist and
return until wrist are fully
flexed. Repeat.
12/6/2012 490
*Sit and grip dumbbell
with overhand grip.
Rest forearm on thigh
with wrists just beyond
knees.
*Hyperextend wrist
and return until wrist
is fully flexed. Repeat.
Continue with
opposite arm.
12/6/2012 491
Sit and grasp cable bar
with narrow to
shoulder width
overhand grip. Rest
forearms on thighs
with wrists just beyond
knees.
Hyperextend wrist and

return until wrists are
fully flexed. Repeat.
12/6/2012 492
SPORTS
12/6/2012 493
12/6/2012 494
Extensor carpi radialis longus
12/6/2012 495
Origin + Insertion
• O, Lower third of the lateral supracondylar
ridge of the humerus and lateral epicondyle
of the humerus
• I, Base of the second metacarpal(dorsal
surface).
12/6/2012 496
Actions
• Extension of the wrist
• Abduction of the wrist
12/6/2012 497
Innervation
• The extensor carpi radialis longus is
innervated by the Radial nerve(C6,7).
12/6/2012 498
Lever Class
• This is an example of a first-class lever.
– Axis- wrist
– Resistance- weight in hand
– Force- muscle
12/6/2012 499
Synergist muscles
• Extensor Carpi radialis brevis
• Extensor Carpi Ulnaris
12/6/2012 500
Antagonist muscles
• Primary wrist flexors
– Flexor carpi radialis
– Flexor carpi ulnaris
– Palmaris longus
– Other muscles involved in flexion of the wrist
12/6/2012 501
Strengthening exercises
• Dumbell Reverse Wrist Curl
• Barbell Reverse Wrist Curl
• Rope Wrist Curl
12/6/2012 502
Exercises
12/6/2012 503
12/6/2012 504
12/6/2012 505
Stretches
• With the palm facing downward, pull wrist and fingers downward
toward forearm.
12/6/2012 506
Sports
• Racquetball
• Tennis
• Golf
• Baseball
12/6/2012 507
12/6/2012 508
Flexor Digitorum Superficialis
12/6/2012 509
Origin
• Medial epicondyle of the humerus
• Ulnar head – medial coronoid process
• Radial head – upper two-thirds of the
anterior border of the radius
12/6/2012 510
Insertion
• Palmar surface of the middle phalanx of the
four fingers
12/6/2012 511
Actions
• Flexion of the fingers at the proximal
interphalangeal joints and at the
metacarpophalangeal joints
• Flexion of the wrist
• Weak flexion of the elbow
12/6/2012 512
Levers
• Third Class - occurs when resistance is at
the fingertips
• Second Class – occurs when resistance is in
the palm
12/6/2012 513
Palpation
• Anterior wrist surface on the ulnar side
• Next to the flexor carpi ulnaris
12/6/2012 514
Innervation
• Median nerve (C7, C8, T1)
12/6/2012 515
Synergists
• Flexor Digitorum Profundus
• Flexor Carpi Radialis
• Flexor Carpi Ulnaris
• Palmaris Longus
• Flexor Pollicis Longus
12/6/2012 516
Antagonists
• Extensor Digitorum
• Extensor Carpi Radialis Longus
• Extensor Carpi Radialis Brevis
• Extensor Pollicis Longus
• Extensor Pollicis Brevis
• Extensor indicis
• Extensor digiti minimi
12/6/2012 517
Wrist Barbell Curl
12/6/2012 518
Wrist Dumbbell Curl
12/6/2012 519
Hand Gripper
12/6/2012 520
Praying Posture Stretch
12/6/2012 521
Seated Forearm Stretch
12/6/2012 522
One Arm Forearm Stretch
12/6/2012 523
Sporting Activities
• Rock Climbing – gripping the rock
• Baseball – gripping the bat
• Baseball – gripping the ball and flexing the
wrist on a pitch
12/6/2012 524
12/6/2012 525
12/6/2012 526
12/6/2012 527
Flexor Digitorum Profundus
12/6/2012 528
Origin
• Proximal 3/4
of the anterior
and medial
ulna Insertion
Base of the
distal phalanxes
of the four
fingers
12/6/2012 529
Palpation
Anterior surfaces of the middle
phalanges of the four fingers
12/6/2012 530
Innervation
Median nerve (C8,T1) to the Ulnar nerve C8,T1) to
second and third fingers the fourth and fifth
fingers
12/6/2012 531
Actions
• Flexion of the four fingers at the
metacarpophalangeal, proximal
interphalangeal and distal interphalangeal
joints
12/6/2012 532
Agonists
• In wrist flexion:
Flexor carpi radialis, • In flexion of the 4 fingers:
Palmaris longus, Flexor digitorum
Flexor carpi ulnaris, superficialis
Flexor digitorum
superficialis, Flexor
pollicis longus
12/6/2012 533
Antagonists
• In wrist flexion: Extensor • In flexion of 4 fingers:
carpi ulnaris, Extensor
Extensor digitorum,
carpi radialis brevis,
Extensor carpi radialis Extensor indicis (2),
longus, Extensor Extensor digiti
digitorum, Extensor minimi(5)
indicis, Extensor digiti
minimi, Extensor pollicis
longus, Extensor pollicis
brevis
12/6/2012 534
What Lever is It?
2nd in wrist flexion at the radioulnar joint:
A: radioulnar joint
R: weight in hand
F: base of distal phalanxes
1st in fist clenching, distal interphalangeal joint:

R: At fingertips
A: distal interphalangeal joint
12/6/2012 535
What Lever is it?
3rd in fist clenching, proximal interphalangeal joint:
R: At fingertips
A: proximal interphalangeal joint
2nd in fist clenching, metacarpophalangeal joint:
F: base of the distal phalanxes
R: right above the joint, between the metacarpalphalangeal joint and the
proximal interphalangeal joint
A: metacarpophalangeal joint
It is
12/6/2012 important to note that the resistance is dependant on the 536
size of the ball
Stretching the
• Wrist/Finger extension
• Palm press
12/6/2012 537
Wrist/Finger Extension
12/6/2012 538
Palm Press
12/6/2012 539
Strengthening the
√ Wrist Curls using a bar

* alternative: dumbbells
√ Wrist flexion with twisting bar
√ Fist clenching using a ball
12/6/2012 540
Wrist Curls using a bar
Forearms are placed on bench

12/6/2012
to isolate the wrist movement 541
Wrist Flexion with twisting bar
12/6/2012 542
Fist Clenching with a ball
12/6/2012 543
Sporting Events that use the
• Softball: holding the bat,throwing and catching the ball
• Baseball: holding the bat,throwing and catching the ball
• Tennis: holding the raquet
• Hockey:holding the hockey stick, punching the opponent
• Bowling: holding and releasing the ball
• Volleyball: passing, slight flexion setting and blocking
• All sports involving clenching of the fist
and wrist flexion….
12/6/2012 544
That’s my
roommate!
12/6/2012 545
Flexor Pollicis Longus
12/6/2012 546
Origin
• Middle anterior
surface of the radius
• Anterior medial border
of the ulna just distal
to the coronoid
process
12/6/2012 547
Insertion
• Base of the distal
phalanx of the thumb
(palmar surface)
12/6/2012 548
Action
• Flexion of the thumb carpometacarpal,
metacarpophalangeal, and interphalangeal
joints
12/6/2012 549
Synergists and Antagonists
• Wrist Flexors • Wrist and thumb extensors
– Flexor carpi radialis – Extensor pollicis brevis
– Flexor carpi ulnaris – Extensor pollicis longus
– Palmaris longus • Wrist extensors
– Flexor digitorum profundus – Extensor carpi ulnaris
– Flexor digitorum – Extensor carpi radialis
superficialis brevis/longus
– Flexor pollicis brevis – Extensor digitorum
– Extensor indicis (weak)
– Extensor digiti minimi
(weak)
12/6/2012 550
Palpation
• Anterior surface of the thumb
• How to:
-Flex the interphalangeal joint
-Feel muscle along proximal phalanx of
thumb
12/6/2012 551
Nerve Innervation
• Median nerve, palmar
interosseous branch
(C8, T1)
– From the 8th cervical
and 1st thoracic
vertebrae
12/6/2012 552
Lever
• Second Class Lever
– When the carpometacarpal and metacarpophalangeal
joints are being used in gripping, the resistance is
proximal to the force and distal to the axis.
• Axis- carpometacarpal/metacarpophalangeal joints of thumb
• Resistance- barbell, bat, ball, etc. on proximal phalanx
• Force- muscle insertion on the distal phalanx of thumb
12/6/2012 553
Lever
– At the interphalangeal joint,
• Axis- interphalangeal joint
• Force- muscle insertion at base of distal phalanx of thumb
• Resistance- middle of distal phalanx (holding a football)
– During wrist flexion:
• Axis- wrist joint
• Force- muscle insertion on distal phalanx of thumb
• Resistance- barbell, bat, ball, etc. on other 4 fingers (distal to
force)
12/6/2012 554
Exercises
• Gripping and grasping exercises that flex
the wrist and thumb
– Dumbell curls
– Barbell curls
– Cable curls
– Stress ball squeezes
12/6/2012 555
Dumbbell Curls Barbell Curls
12/6/2012 556
Cable Curls and Stress Ball
12/6/2012 557
•Extension of thumb
Passively extend the entire thumb while
simultaneously maintaining maximal
wrist extension
•Extension of wrist
•Praying
•Seated
•Single arm
•Kneeling
12/6/2012 558
Seated flexor stretch
Praying flexor stretch
12/6/2012 559
Kneeling stretch
Single arm stretch
12/6/2012 560
Sports
• Bowling
• Gymnastics
• Catching
• Throwing
– Baseball/softball
– Football
– Javelin
12/6/2012 561
12/6/2012 562
12/6/2012 563
Extensor Digitorum
12/6/2012 564
Nerve Innervation
• The Radial Nerve (C6-8)
12/6/2012 565
Origin Insertion
• Lateral epicondyle of • Four tendons to bases
the humerus of middle and distal
phalanges of four
fingers(dorsal)
12/6/2012 566
2nd Class Lever
• Force: Insertion on the dorsal side of 2-5

phalanges.
• Resistance: Weight in the palm.
• Axis: Wrist joint.
12/6/2012 567
Palpation
• Middorsal surface of the forearm
12/6/2012 568
Actions
• Extension of the second, third, fourth, and
fifth phalanges at the metacarpophalageal
joints.
• Extension of the wrist
• Weak extension of the elbow.(biarticular)
12/6/2012 569
Antagonist Synergist
• Extensor carpi radialis • Extensor carpi radialis
longus & brevis longus & brevis
• Extensor carpi ulnaris • Extensor carpi ulnaris
• Palmaris longus • Extensor indicis
• Flexor digitorum • Extensor pollicis
superficialis & brevis & longus
profundus
• Flexor pollicis longus
12/6/2012 570
Exercises
• Rope curls
• Forearm curls
• Backward curls
12/6/2012 571
Stretch
• With fingers maximally flexed at all joints

and the maximally flex the wrist joint.
12/6/2012 572
Sports movements
• Tennis bringing racket back and back hand.
• Baseball throwing
• Discus throwing.
• Shooting a basketball.
12/6/2012 573
Extensor Indicis Muscle
12/6/2012 574
Extensor Inicis Muscle
• Origin
– Posterior surface of ulna (distal to extensor
pollicis longus)
– Middle to distal one-third
12/6/2012 575
Extensor Indicis muscle
• Insertion
– Base of the middle and distal phanlanxes of
second phalange (dorsal surface)
12/6/2012 576
Extensor Indicis muscle
• Action
– Extension of the index finger at the
metacarpophalangeal joint
– Weak wrist extension
12/6/2012 577
Extensor indicis
• Palpation
– Posterior aspect of the distal forearm and dorsal
surface of the hand just medial to the extensor
digitorum tendon of the index finger
12/6/2012 578
Extensor indicis
• Innervation: Radial nerve (C6-8)
• Synergist
– Extensor Digitorum
• Antagonist
– Flexor digitorum superficialis muscle
– Flexor digitorum profundus muscle
12/6/2012 579
Extensor indicis
• Third class lever
– The axis is the metacarpophanlangeal joint
– The Resistance is the Insersertion at the base of
middle and distal phalanxes of second
phalange.
– The force falls in the middle!
12/6/2012 580
Extensor indicis
• Exercises
– Rubber band extension
12/6/2012 581
Extensor indicis
• How to stretch?
– Passively taking the index finger into miaximal
flexion at its metacarpophanlangeal, proximal
interphalangeal, and distal interphalangeal
joints while fully flexing the wrist.
12/6/2012 582
Extensor Indicis
• This is not a particularly main muscle in any
movement. It is the muscle used in pointing
with the index finger, particularly when the
other fingers are flexed
• This muscle would be used ―flicking‖
objects.
12/6/2012 583
Extensor Digiti Minimi
12/6/2012 584
• Origin
– Lateral Epicondyle of the Humerous
• Insertion
– Base of the middle and distal phalanxes of the
fifth phalange.
• Palpation
– Cannot be palpated.
• Innervation
– Radial nerve (C6-8)
12/6/2012 585
• Action
– Extension of the little finger at the metacarpophalangeal joint.
– Weak wrist extension
12/6/2012 586
– Axis is the Metacarpophalangeal joint
– Force is the insertion point
– Resistance is the tip of the finger
12/6/2012 587
• Synergist Muscles • Antagonist Muscles
– Extensor Carpi Ulnaris – Flexor Carpi Radialis
– Extensor Carpi Radialis – Flexor Carpi Ulnaris
Brevis
– Flexor Digitorum
– Extensor Carpi Radialis Superficialis
Longus
– Flexor Digitorum
– Extensor Digitorum Profundus
– Extensor Indicis – Flexor Pollicis Longus
– Extensor pollicis longus
– Extensor pollicis brevis
12/6/2012 588
• Same exercises used
for Extensor
Digitorum
– Reverse Curls
12/6/2012 589
• Can also be strengthened by applying
manual resistance to the dorsal aspect of
fifth phalange, while flexed, and then
extending it fully.
12/6/2012 590
Stretching
• Same stretches used
for the rest of the wrist
extensors.
12/6/2012 591
Activities
• Any sport that
involves wrist
extension
– Basketball
– Baseball
12/6/2012 592
Abductor Pollicis Longus
• Tendons of this
muscle and those of
the abductor pollicis
brevis form the
―anatomical snuffbox‖
12/6/2012 593
• Origin is posterior
aspect of the radius
and midshaft of ulna
• Insertion is the base

of the first metacarpal
on the dorsal surface
12/6/2012 594
• Primary function – abduction of thumb
• Assists to extend and rotate 1st metacarpal
• Radially deviates wrist
• Flexes hand at wrist
12/6/2012 595
• Innervated by the
posterior interosseus nerve
(C7,8) and the deep
branch of the radial nerve
(C6,7)
• Palpated on the lateral

aspect of the wrist joint
just proximal to the thumb
• 3rd Class Lever
12/6/2012 596
• Antagonists
– Flexor Carpi Radialis/Ulnaris
– Palmaris Longus
– Flexor Digitorum Superficialis/Profundus
– Flexor Pollicis Longus
• Syngergists
– Abductor Pollicis Brevis
– Extensor Pollicis Longus
12/6/2012 597
• Stretching
– Fully flexing and adducting
the entire thumb across the
palm with the wrist fully
adducted
• Strengthening
– Abducting the thumb from
the adducted position
against a manual resistance
12/6/2012 598
Volleyball
12/6/2012 599
Basketball
12/6/2012 600
Catching a Football
12/6/2012 601
EXTENSOR POLLICIS
BREVIS
12/6/2012 602
EXTENSOR POLLICIS BREVIS
• Origin: Posterior surface of the lower

middle radius.
• Insertion: Base of the proximal phalanx of
the thumb (dorsal surface).
• Palpation: Just lateral to the extensor
pollicis longus tendon most prominent on
lower dorsal side of the hand.
12/6/2012 603
• Innervation: Radial nerve C6,7.

• Action;
– Extension of the thumb at the
metacarpophalangeal joint.
– Weak wrist extension.
12/6/2012 604
• Lever Class:
3rd Class Lever:
– Axis: Metacarpophalangeal joint
– Force: Insertion
– Resistance: Weight at end of thumb
12/6/2012 605
• Synergists: • Antagonists:
– Extensor pollicis – Flexor pollicis longus
longus
– Abductor pollicis
longus
12/6/2012 606
Strengthening Exercise
• The only real way of
strengthening is by
extending the flexed
thumb against manual
resistance, as seen in
the picture.
12/6/2012 607
Stretching Exercise
• It is stretched by
passively taking the first
carpometacarpal joint
and the
metacarpophalangeal
joint of thumb into
maximal flexion while
fully flexing the wrist.
12/6/2012 608
Sporting Activities
• In football, when you • Also in football, when
extend your hands to lineman are in their
catch a ball, you are stance they are
extending your thumb extending their thumb
and using this muscle. for balance and using
this muscle.
12/6/2012 609
Sporting Activities
• In baseball, when you are wearing a
baseball glove to catch the baseball, you are
extending your thumb and using this
muscle.
• When gripping a bowling ball, football, or
basketball, you are extending your thumb
and using this muscle.
12/6/2012 610
Extensor Pollicis Longus
12/6/2012 611
Actions
• Weak extension of the wrist
• Extension of the thumb
12/6/2012 612
Origin & Insertion
• Origin: Posterior
insertion lateral surface of the
lower middle ulna
• Insertion: Base of the

distal phalanx of the
origin thumb (dorsal surface)
12/6/2012 613
• 3rd class lever
- axis: wrist
- force: insertion of muscle
- resistance: weight in hand
• Innervation: Radial nerve (C6-8)
• Palpation: Most prominent on dorsal side of

thumb
12/6/2012 614
• Synergists: extensors • Antagonists: flexors
- extensor pollicis brevis* - flexor pollicis longus*
- abductor pollicis longus* - flexor carpi radialis
- extensor carpi ulnaris - palmaris longus
- extensor carpi radialis - flexor carpi ulnaris
- extensor carpi radialis - flexor digitorum
longus superficialis
- extensor digitorum - flexor digitorum profundus
- extensor indicis (weak)
- extensor digiti minimi
(weak)
12/6/2012 615
Strengthening & Stretching
• Lifts • Stretches
- barbell reverse wrist curl - kneeling
- cable reverse wrist curl - single arm
- dumbbell reverse wrist curl
- weighted rope twist
12/6/2012 616
Barbell Reverse Wrist Curl
12/6/2012 617
Cable Reverse Wrist Curl
12/6/2012 618
Dumbbell Reverse Wrist Curl
12/6/2012 619
More strengthening…
• This muscle can also be strengthened by

extending the flexed thumb against manual
resistance.
12/6/2012 620
Kneeling Wrist Stretch
12/6/2012 621
Single Arm Stretch
12/6/2012 622
More stretching…
• This muscle can also be stretched by

passively taking the entire thumb into
maximal flexion while fully flexing the
wrist.
12/6/2012 623
Sports Applications
• Extension of wrist before shooting,
throwing
• Gripping a racquet, golf club, bat
• Catching
• Other uses: hammering, shaking hands,
thumb wars, knocking on a door
12/6/2012 624
CHAPTER 6
Muscular Analysis of the Upper

Extremity
12/6/2012 625
Objectives
• Analyze movements of simple exercises
• Learn the concept of open / closed chain
exercises
• Group muscles by their actions
• Learn the names of different exercises used
to strengthen muscles and increase
performance
12/6/2012 626
Exercises
• Pull-up • Bench Press
• Pull-Down • Millitary Press
• Shoulder Press • Arm Curl
• Low/High Rows • Tricep Extensions
• Upright Rows • Push-Ups
• Supine Flys • Wrist Curls
• Lateral Flys • Wrist Extensions
• Dips
12/6/2012 627
CHAPTER 7
The Hip Joint and Pelvic Girdle
12/6/2012 628
Bones
• Bones of the Illium
• Bones of the Ischium
• Bones of the Pubis
• Bones of the Sacrum
• Bones of the Coccyx
• Bones of the Femur
12/6/2012 629
Lumbar Spine Movements
• Flexion
• Extension
• Lateral Flexion
• Lateral Rotation
12/6/2012 630
Pelvic Movements
• Anterior Rotation (sagital plane)
• Posterior Rotation (sagital plane
• Lateral Rotation (frontal plane)
• Transverse Rotation (horizontal plane)
12/6/2012 631
Hip Movements
• Flexion
• Extension
• Abduction
• Adduction
• Internal Rotation
• External Rotation
• Circumduction
12/6/2012 632
Iliopsoas Muscle
(composed of)
Iliacus and Psoas major and minor
12/6/2012 633
Information
• ORIGIN—iliacus inner surface of ilium.
• ORIGIN—psoas major and minor lower
borders of the transverse processes (L1-5), sides of
the bodies of T12, the lumbar vertebrae (L1-5),
intervertebral fibrocartilages, and base of sacrum.
• INSERTION—Iliacus and psoas major lesser
trochanter of the femur and shaft just below.
12/6/2012 634
Information, cont.
• INSERTION– psoas minor pectineal line
and iliopectineal eminence.
• 3rd Class Lever

– Axis (Hip joint)
– Force (the muscle)
– Resistance (the leg, in both movements)
12/6/2012 635
Actions
• Flexion of the Hip
• External Rotation of
the Hip
• #2 is the Psoas
• #1 is the Iliacus
12/6/2012 636
Palpation
• Impossible to palpate
except with almost
complete relaxation of
the rectus abdominis
muscle.
12/6/2012 637
Innervation
• Lumbar nerve and femoral
nerve (L2-4) from the 
Lumbar Plexus
• This diagram shows the

femoral nerve (in yellow
with a red arrow) in
relation to other muscles
and veins.
12/6/2012 638
Synergists
• Synergists:
– Flexion: Sartorius, Rectus femoris, Tensor
fasciae latae, Pectineus
– External rotation: Sartorius, six deep lateral
rotator muscles, Gluteus medius, Gluteus
maximus, Biceps femoris, Adductor magnus
12/6/2012 639
Antagonists
• Antagonists
– Flexion (extension of the hip): Gluteus
maximus, Semitendinosus, Semimembranosus,
Biceps femoris
– Ext. rotation (internal rotation of hip): Gluteus
minimus, Gluteus medius, Semitendinosus,
Semimembranosus, Pectineus
12/6/2012 640
Strengthening Exercise and Stretches
• The iliopsoas muscle is powerful in actions
such as raising the legs from the floor while
in the supine position.
• The muscle may be strengthened by
supporting the arms on a dip bar and then
flexing the hips to lift the legs. To decrease
resistance, flex the knees into a tucked
position.
12/6/2012 641
Stretching the Iliopsoas
• The hip must be extended so that the femur
is behind the plane of the body. Full knee
flexion must be avoided. Slight additional
stretch may be applied by internally rotating
the hip while it is extended.
12/6/2012 642
Exercises
Vertical Leg Raise Weighted Leg Raise
12/6/2012 643
Lever Hip Flexion
Hanging Leg Raise
12/6/2012 644
Stretches
PNF
Self-stretch
12/6/2012 645
Sports
• Running
• Baseball (stealing a base, pitching from the
―stretch‖)
• Gymnastics
• Bicycling
12/6/2012 646
Gymnastics
12/6/2012 Cycling 647

Baseball pitcher
Running
12/6/2012 648
Sartorius
Origin- anterior
superior iliac spine and
notch just below the spine
Insertion- anterior
medial condyle of
the tibia
12/6/2012 649
• Palpation- easiest to palpate at the anterior
superior spine of the ilium
• Innervation- Femoral Nerve
12/6/2012 650
• Hip flexion • Hip flexion
– iliopsoas – gluteus maximus
– pectineus – biceps femoris
– rectus femoris – semitendinosus
• Knee flexion – semimembranosus
– semitendinosus
– six deep external rotators
– semimembranosus
– biceps femoris • Knee flexion
– gracilis – rectus femoris
– popliteus – vastus medialis, intermedius,
– gastrocnemius & lateralis
• External rotation of hip joint
– iliopsoas • External rotation of hip joint
– six deep lateral rotator muscles – gluteus minimus
– gluteus medius & maximus – semitendinosus
– biceps femoris – semimembranosus
– adductor brevis & magnus – pectineus
12/6/2012 651
– gracilis
Levers
• when resistance is on posterior side of ankle with
knee flexion
– axis: knee joint
– force: anterior medial condyle of tibia
• 3rd Class Lever
• when resistance is at the knee or thigh with hip

flexion or external rotation
– axis: hip joint
– force: anterior medial condyle of tibia
12/6/2012
• 2nd Class Lever 652
Actions
• Flexion of the hip
• Flexion of the knee
• External rotation of the thigh as it flexes the
hip and the knee
12/6/2012 653
• Leg lifts (either tucked or straight legs)

– support arms on parallel or dip bars and flex hips to lift
the legs
• Leg Curls
– in a supine position, flex knees to lift ankles
• Knee Raises
– lift resistance placed on anterior of the knee
• Sitting Exercise
– put ankle weight on externally rotate hip while flexing
knee and hip to raise ankle superior to opposite knee
12/6/2012 654
Leg Lifts Leg Curls
•
12/6/2012 655
Knee Raises Sitting Exercise
12/6/2012 656
Stretches
12/6/2012 657
Hip Extension, Adduction, and
Internal Rotation
• Have a partner passively
take your hip into
– extreme extension
– extreme adduction
– extreme internal rotation
12/6/2012 658
Sporting Activities
• Ballet- plies
• Baseball & Softball - steping of the plate to
catch a ball
• Swimming- breast stroke
12/6/2012 659
RECTUS FEMORIS
12/6/2012 660
QUADRICEPS
1) RECTUS FEMORIS
2) VASTUS LATERALIS
3) VASTUS INTERMEDIUS
4) VASTUS MEDIALIS
12/6/2012 661
ORIGIN
Anterior inferior iliac spine of the ilium
and groove (posterior) above the
acetabulum
12/6/2012 662
INSERTION
Superior aspect of the patella and patellar
tendon to the tibial tuberosity
12/6/2012 663
CLASS LEVER
Third Class Lever Second Class
Axis = hip joint/knee joint Lever
Force = insertion (patella)
Axis = hip joint
Resistance = weight at
feet (squat, leg press, etc.) Force = insertion
or mid-shin (knee (patella)
extension Resistance = mid-
thigh/quad (hip
flexion)
12/6/2012 664
DOES WHAT?
ACTION
Flexion of the hip
Extension of the knee
12/6/2012 665
APPLICATION
SYNERGISTS ANTAGONIST
Sartorius S
Tensor Fascia Hamstrings
Latae
Vastus Lateralis
Gluteus
Maximus
Vastus Medius
Vastus Intermedius
12/6/2012 666
PALPATION
INNERVATIO PALPATION
N Any place on
Femoral nerve the anterior
L2 surface of the
L3 femur
L4
12/6/2012 667
EXERCISES
Leg press
Lunge
Leg Extension
Step-up
Squat
Front Squat
Full Squat
Hack Squat
Safety Squat
12/6/2012 668
LEG PRESS
12/6/2012 669
SQUATS
12/6/2012 670
LUNGE
12/6/2012 671
STEP-UP
12/6/2012 672
HIP FLEXION
12/6/2012 673
PLYOMETRICS
BOX JUMPS
12/6/2012 674
STRETCHES
Lying quad stretch
Standing quad stretch
Squat quad stretch
Lunge stretch
12/6/2012 675
KNEE BACK
12/6/2012 676
12/6/2012 677
SITTING SQUAT
12/6/2012 678
LUNGE STRETCH
12/6/2012 679
SPORTING
ACTIVITIES
Volleyball (jumping and digging)
Baseball/Softball Catchers (positional
stance)
Basketball (jumping)
Track (Running, Long and High Jump)
Soccer (kicking the ball)
12/6/2012 680
12/6/2012 681
12/6/2012 682
Tensor
Fasciae
Latae
12/6/2012 683
Tensor fasciae latae
Origin
-Anterior iliac crest and surface
of the ilium just below the crest
12/6/2012 684
Insertion
-1/4th of the way down the thigh
into the illotibal tract, which in turn
inserts onto Gerdy‘s tubercle of the
anterolateral tibal condyle
12/6/2012 685
Action
-Abduction of the hip
-Flexion of the hip
-Tendency to rotate the hip
internally as it flexes
12/6/2012 686
Synergists (Flexion of the Hip)
-Rectus femoris
-Sartorious
-Ilipsoas
Synergist (Abduction of the Hip)
-Gluteus Minimus
-Gluteus Medius
12/6/2012 687
Antagonist (Extension of the Hip)
-Gluteus Maximus
-Semitendinosus
-Semimembranosus
-Biceps Femoris
12/6/2012 688
Antagonist (Adduction of the hip)
-Adductor brevis
-Adductor longus
-Adductor magnus
-Pectineus
12/6/2012 689
Levers (Second class lever)
Axis is at the origin on the ilium
Resistance is on the thigh
Force is at the insertion point
(Third class lever)
Axis is at the origin on the ilium
Force is at the insertion point
Resistance is at the feet
12/6/2012 690
Palpation
-Slightly in front of the greater
trochanter
Innervation
-Superior gluteal nerve (L4-5, S1)
12/6/2012 691
Exercises
-Abduction of the hip
-Cable hip abduction
-Lever standing hip abduction
-Flexion of the hip

-Lever hip flexion
-Cable lying leg raise
-Cable leg raise
12/6/2012 692
Cable Hip Abduction
12/6/2012 693
Standing Lever Hip Abduction
12/6/2012 694
Lever Hip Flexion
12/6/2012 695
Cable Lying Leg Raise
12/6/2012 696
Cable Leg Raise
12/6/2012 697
Stretches
Standing Ibiotibal Stretch
12/6/2012 698
Stretches
Wall Ibiotibal Stretch
12/6/2012 699
Sports
Basketball
-Defensive slide (Abduction of hip)
-lay-up (Flexion of hip)
Soccer
-Juggling a ball (Flexion of the hip)
Baseball
-windup of a pitcher (Flexion and
Abduction)
12/6/2012 700
The Six Deep Lateral Rotator
Muscles
• Piriformis
• Gemellus superior
• Gemellus inferior
• Obturator externus
• Obturator internus
• Quadratus femoris
12/6/2012 701
Origin
• Anterior sacrum
• Posterior portions of
the ischium
• Obturator foramen
12/6/2012 702
Insertion
• Superior and posterior
aspect of the greater
trochanter
12/6/2012 703
Nerve Innervation
• Piriformis • Obturator exernus
– 1st or 2nd sacral nerve – obturator nerve (L3-4)
• Gemellus superior • Obturator internus
– sacral nerve (L5-S2) – branches from sacral
• Gemellus inferior plexus (L4-S2)
– branches from sacral • Quadratus femoris
plexus (L4-S2) – branches from sacral
plexus (L4-S1)
12/6/2012 704
Palpation
12/6/2012 705
Action/Lever
• External rotation of the hip
• 3rd class Lever

– Axis = hip
– Force = insertion
– Resistance = leg
12/6/2012 706
Synergists
• Iliopsoas • Biceps femoris
• Sartorius • Adductor brevis
• Gluteus medius • Adductor mangus

– posterior fibers
• Gluteus maximus
12/6/2012 707
Antagonists
• Tensor fasciae latae • Semimembranosus
• Gluteus minimus • Pectineus
• Gluteus medius • Gracilis

– anterior fibers
• Semitendinosus
12/6/2012 708
Exercises
• Using a theraband
– keep one foot planted on the ground while
forcefully turning the body and the opposite leg
away from the planted foot.
12/6/2012 709
Exercises
12/6/2012 710
Exercises
• Using a theraband
– Attach one end of the theraband to a foot
– Use theraband as resistance as you externally
rotate the hip
12/6/2012 711
Exercises
12/6/2012 712
Stretches
• While standing, maximally internally rotate
the hip while rotating the torso in an
opposite direction
• While lying on your back, bend at the knee

and adduct one leg while a partner slightly
raises your foot (to internally rotate the hip)
12/6/2012 713
Stretches
12/6/2012 714
Applications
• Baseball • Dance
– batting
– pitching • Track & Field
– discus
• Basketball – shotput
– pivoting
12/6/2012 715
Applications
12/6/2012 716
Applications
12/6/2012 717
GLUTEUS MEDIUS
12/6/2012 718
GLUTEUS MEDIUS
• ORIGIN
– Lateral surface of the ilium just
below the crest.
• INSERTION
– Posterior and middle surfaces of the
greater trochanter of the femur
12/6/2012 719
GLUTEUS MEDIUS
• Actions
– Abduction of the hip
– External Rotation of the hip as it
abducts (posterior fibers)
– Internal rotation of the hip
12/6/2012 720
GLUTEUS MEDIUS
• Palpation
– above the greater trochanter
• Innervation
– superior gluteal nerve (L4-S1)
• Lever
– third class lever
12/6/2012 721
GLUTEUS MEDIUS
• Synergists
– Gluteus minimus (hip abduction)
– Tensor fascia latae (hip abduction)
– Gluteus maximus (hip external rotation)
– 6 deep lateral rotators (hip external rotation)
– Biceps
– Gluteus minimus (hip internal rotation)
– Semitendonosis (hip internal rotation)
– Semimembranosus (hip internal rotation)
12/6/2012 722
GLUTEUS MEDIUS
• Antagonists
– Adductors (adduction)
– Biceps femoris (external rotation)
– Gluteus Maximus (external rotation)
– 6 deep lateral rotators (external rotation)
– Semitendonosis (internal rotation)
– Semimembranosus (internal rotation)
12/6/2012 723
GLUTEUS MEDIUS
• Exercises
– Hip Abduction machine
– Lateral lunges
– Lateral step ups
– Squats etc.
12/6/2012 724
External Rotation Exercise
• Externally rotate the
leg against resistance.
12/6/2012 725
Hip Abduction Machine
• Abduction of the hip
against resistance
12/6/2012 726
GLUTEUS MEDIUS
• Stretches
– The hip should be placed in extreme adduction
in front of the opposite leg with the foot
internally rotated (posterior fibers).
– The hip should be placed in extreme adduction
behind the opposite leg with the foot
externally rotated (anterior fibers).
12/6/2012 727
Gluteus Medius Stretch
• With the involved leg
adducted in front or
behind the opposite
leg, lean the opposite
direction
12/6/2012 728
Application
• Trendelenburgs Test
• Push Off from a base or pitching rubber
• Gluteus medius is also a great stabilizer of
the hip for proprioception (balance) of the
leg during any exercise
• Slide step in baskeball
• Push off in the shot put
12/6/2012 729
Application
12/6/2012 730
Application
12/6/2012 731

Dennis-Upper Extremity Kinesiology

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Dennis-Upper Extremity Kinesiology

Hochgeladen von

Copyright:

Verfügbare Formate

Structural Kinesiology

– Radioulnar joint (elbow)

– Carpometacarpal joint (thumb)

– Diagonal adduction: toward the

– Internal Rotation: rotary movement around the

• Active Insufficiency: when the muscle becomes

• Biomechanics: the study of the mechanics as it

– Kinematics: the description of motion.

• Force Arm: the distance between the axis and

What is the force required?

• Balance: is the ability to control equilibrium.

• Provides dynamic stability of the scapula so that it

• An example of a 1st class lever

C5 slips from ribs 1 & 2

A winged scapula condition

• Insertion is near the anterior aspect of the

• Primarily abduction and depression

• Antagonists primarily include the trapezius,

• It works with the pectoralis major

1st Class Lever (force- ribs,

• Superior aspect of first rib at its

Dips, Lat Pulldowns

• Extreme elevation of the shoulder girdle

• Push elbow toward chest. Hold stretch for

• Repeat with opposite arm.

• Push elbow toward neck. Hold stretch for

• Repeat with opposite arm.

• The Supraspinatus cannot be palpated

• under the trapezius proximally

12/6/2012 By Chris Laz 250

• Insertion: Posteriorly on the greater tubercle of the

• Horizontal abduction of the glenohumeral joint: moving

• Extension of the glenohumeral joint

• Stabilization of the humeral head in the glenoid fossa

A: The glenohumeral joint of the

Internal rotation in Extension

Posterolateral aspect of the Thoracodorsal nerve (C6-

(Don‘t tickle your partner)

(Accompanied by depression, downward

• Tuberosity of the radius and bicipital

Third Class Lever

Synergists: Biceps brachii, brachialis,

Antagonists: Triceps brachii, anconeus

Triceps Brachii has three parts, the

Dips are also a good

• Insertion is the posterior

• 3rd class lever

• ‗4th head of the triceps‘

• Weakness of the anconeus results in the inability

• Synergists – all three

– First reach towards the

– Then with the opposite

– Extend the cable to a 180

– Decrease the angle to no

– Begin with a 90 degree

– Return the weight slowly to

– Begin with maximal elbow

– Then return slowly from the

• Also…the motion of turning a screwdriver

Hyperextend wrist and

Flexor Digitorum Profundus

1st in fist clenching, distal interphalangeal joint: