The document discusses various aspects of shoulder biomechanics during pulling movements. It considers whether pulling is better characterized as a translational or rotational movement, and what factors influence this. Some key points discussed include:
- Pulling involves elements of both translation and rotation, and the contribution of each depends on variables like grip width and bar height.
- The scapula and trunk play an important role in distributing forces. Proper scapular stability is important for injury prevention.
- Slow, heavy pulls with the elbow passing the trunk line can overload small rotator cuff muscles if other joints don't move together. Lighter loads or explosive movements may reduce this.
- Push-pull strength ratios
Goniometry is the measuring of angles created by the bones of the body at the joints.1, 2, 3
The term goniometry is derived from two Greek words, gonia meaning angle and metron, meaning measure. 1, 2, 3, 4, 5,
System to measure the joint ranges in each plane of the joint is termed goniometry. 4
These measurements are done with instrument such as goniometer, a tape measure, inclinometers or by visual estimate.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
Goniometry is the measuring of angles created by the bones of the body at the joints.1, 2, 3
The term goniometry is derived from two Greek words, gonia meaning angle and metron, meaning measure. 1, 2, 3, 4, 5,
System to measure the joint ranges in each plane of the joint is termed goniometry. 4
These measurements are done with instrument such as goniometer, a tape measure, inclinometers or by visual estimate.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
Elbow complex is designed to serve hand.
They provide MOBILITY for Hand in space by apparent shortening and Lengthening of upper extremity.
They provide Stability for skillful and forceful movements
The manual muscle testing procedure was described in this power point, indications, contraindications, limitations of MMT was included. the MMT grading system (scale) was explained well in this PPT.
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
Elbow complex is designed to serve hand.
They provide MOBILITY for Hand in space by apparent shortening and Lengthening of upper extremity.
They provide Stability for skillful and forceful movements
The manual muscle testing procedure was described in this power point, indications, contraindications, limitations of MMT was included. the MMT grading system (scale) was explained well in this PPT.
Kinesiology is the study of human and nonhuman animal-body movements, performance, and function by applying the sciences of biomechanics, anatomy, physiology, psychology, and neuroscience.
Posture - a perquisite for functional abilities in daily life. Posture is a combination of anatomy and physiology with inherent application of bio-mechanics and kinematics. Sitting, standing, walking are all functional activities depending on the ability of the body to support that posture to carry out each activity. Injuries and pathologies either postural or structural can massively change the bio-mechanics of posture and thus affect functional abilities.
Femoral Head (Superiorly, Medially, Anteriorly).
Acetabulum (Inferiorly, Laterally, Anteriorly).
Horseshoe-shaped (Acetabular Notch).
The deepest portion (Acetabular Fossa).
Labrum Acetabular:
Is a wedged fibrocartilaginous ring inserted into the acetabular rim to increase the acetabular concavity.
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2. Scapula positioning andsetting
Scapula plane or coronalplane
Should pulling movement be taught as two
actions orone?
What should the range of movementshould
the pullinvolve?
Shoulderstability
Push - pullRatios?
Structural balance of theshoulder?
4. Trapezius and serratus anterior most
important stabilisers acting on scapula
thoracicjoint
(Mottram)
Deltoids generate significant shear forceand
compressive force in support of anterior
shoulderinstability.
The deltoid provides dynamic stability with
the arm in the scapular plane and only
decreased the stability of the shoulder with
the arm inthe coronal plane. (Lee &An)
5.
◦ Scapula stability exercises and thoracic curve
correction should be done before rotatorcuff
exercises(Kibler)
◦ Ideal scapula position yet to bedetermined but it is
not in its inner range of lower traps, and “down and
back” is not an appropriatecommand(Mottram)
6.
7.
8.
9. ◦ Suggested ratio of external to internalstrength is
approx2/3.
◦ Weight training more likely to cause imbalances
(Kobler)
◦ Rugby players – bench press to pull ups 1:1(Baker)
◦ Kayak paddlers – bench press to pull ups1:1.47
(McKean - unpublished)
◦ Relative height of the handle influences strength of
push pull outcome and ratio (Badi & Boushaala)
10. ◦ Deltoid : External Rotators : Lower Traps
3 : 1.5 : 1 ratio of strength
◦Compared to 1RM Pull up
(kayakers -Mckean unpublished data)
Deltoid –18%
External rotators –9%
Lower Traps –6%
11. ◦ Internal rotator strength similar for both planes but
external rotator strength better in scapula plane
(Greenfield etal)
◦ Horizontal muscle force was decreased16.2% in the
slouched thoracic position for abduction to
horizontal in scapula plane.
(Kebaetse et al)
12. ◦ The scapulo-humeral rhythm (2.2–2.5)and scapular
tilting (2–4°) remained relatively constant during
elevation (Graichen etal)
◦ Mean ratio of gleno-humeral to scapulo-thoracic
motion was1.7:1
◦ Normal scapular motion consists of substantial
rotations around 3axes
◦ Significant relationship in scapula-thoracic-
humeral-clavicle movement (McClure et al)
◦ Clavicular and scapular angles were significantly
related to the arm elevation (de groot)
13. ◦ Although movement analysis is considered an
integral part of a physiotherapist's skill, research
has shown that a sample of experienced
manipulative physiotherapists had difficulty in
determining the symptomatic status of patients
with clinically diagnosed shoulder complaints by
movement analysis alone. 58% accuracy achieved
(Hickey etal)
◦ Push pull movements/stabilising showed postural
adjustments were initiated shortly before all focal
movements (Cordo&Nashner)
14. ◦ Scapula neutral position requires muscular support
and correct thoraciccurve
◦ Shoulder strength ratios exist but maybe sport or
activity specific
◦ All rotator cuff strength most balance din scapula
plane
◦ Scapula, thoracic spine and humerus all move in an
associated manner not yet defined clearly
◦ Movement analysis not an exact science
15.
16. ◦ Throwing – force summation where forces
overlap in sequence (involves rotational
components)
◦ Pushing – all joint move simultaneously
(translation)
◦ Squatting – all joints move together (translation)
◦ Pulling – is it rotational or translation?
17. ◦ If a body is moved from one position to another,
and if the lines joining the initial and final points
of each of the points of the body are a set of
parallel straight lines of lengthℓ, so that the
orientation of the body in space is
unaltered, the displacement is called a
translation parallel to the direction of the
lines, through a distance ℓ.
– E.T. Whittaker: A Treatise on the Analytical
Dynamics of Particles and
Rigid Bodies,
18. ◦ A rotation is a movement of an object in a
circular motion. A two-dimensional object rotates
around a center (or point) of rotation. A three-
dimensional object rotates around a line called an
axis. If the axis of rotation is within the body, the
body is said to rotate upon itself,
◦ Mathematically, a rotation is a rigid body
movement which, unlike a translation, keeps a
point fixed
19. ◦ Aaberg suggests–
Start position of scapula in neutral
Move both scapula and arms together
Continue to retract scapula
Pull arms till humerus parallel with body or
aligned with shoulders
(if all joints move together -translational)
20. ◦ Fees et al suggests
Shrug with elbows locked and scapula fully
retracted
Partial ROM
Full ROM
(If scapula becomes set and arms move
afterwards -rotational)
Shrug with elbows locked and scapula fully
retracted
Partial ROM
Full ROM
(If scapula becomes set and arms move
afterwards -rotational)
21. Is pulling a translational movement of
rotational movement?
22. ◦ Compound movements like throwing, or kicking,
Bigger slower muscles initiate action
Smaller faster muscles build on the action super imposing
their forces on top of momentum already developed
◦ Isolated movements like leg extension, leg curls,
bicep curls
Single joint rotation via action of muscle above the joint
Rotation occurs about the axis of thejoint
23. ◦ Compound movements like Bench press,squat,
All joints start moving and complete the
movement at or about the same time utilising
different muscles in an optimal way to achieve
the fullest movement possible
Multiple joints and muscles contribute within
their ability to the whole movement
24. ◦ Bent over row
◦ DB Row
◦ Chin up
◦ Standing cable pull
25.
26.
27. a. Shoulder below b.Shoulder stopped
c. Shoulder rotates
Once elbow passes trunk line and shoulder
ceases to move to rear, movement becomes
rotation
28.
29. Ashoulder below - translation
Shoulder above and stopped
Shoulder still but arm passed trunk line now
rotation
w
30.
31. Shoulder remains centrally positioned in all 3
shots but elbow never passes the trunk line,
hence little rotation
32.
33. Axis of rotation now involves the trunk
The shoulder and elbow has passed trunk line
but has the movement become rotation at the
shoulder?
34.
35. Thoracic position andcurve
Scapulastabilisers
Large muscles of theback
Rotatorcuff
Trunk rotation “core”muscles
Re-patterning
Combination of all
36. Should the scapula setfirst?
Should the elbow bend with thesetting?
Should the elbow cease moving at thetrunk
line?
Should the trunkrotate?
37. Some cases require retraining of the scapula
positioning
Setting back and down, or in and down isnot
justified by research – find Neutral??????
The need to engage the scapula stabilisers is
important and may require initial strength
training prior to full pulling movements.
Scapula stabilising automatically occurs prior
to humerus movement
Injury prevention through scapula stability
training is an important factor
38.
39.
40. Wide to narrowgrips
◦ Wide grips tend to allow moretranslational
movements
High to lowbars
◦ Low bar pulls to lower chest tend to allow more
rotationalmovements
Supinated, pronated and neutralgrips
◦ Supinated grips tend to allow morerotational
movements
41. Slow strength moves under high intensity
transfer great force to small muscles of rotation
if the elbow passes trunk line
Small muscles cannot complete the movement so
enlist aid of other muscles causing postural
adjustments to shoulder girdle
Are these scapula positional adjustments
supporting the true function of the movement or
a form of cheating
Under explosive or high speed movements the
force summation reduces this stress and less
adjustment of shoulder girdle occur.
42. In slow strength training, movements should
occur together unless retraining or rehabilitating
a shoulder
If movement is slow or load is high take care with
how far past the trunk line you allow clients to
pull elbow
If this is a desired movement then be sure to
account for postural adjustments of the shoulder
girdle and trunk in this action and ensure light
enough load that rotator cuff can manage
Aim to achieve push-pull ratios and ext-
introtation ratios appropriate to sport or activity.
