Movement Science

One full gait cycle

starts with heel contact of one foot (0%) and ends with another heel contact of the same/ipsilateral foot (100%)

50% of gait cycle

heel contact of opposite/contralateral foot

Stance phase

60%

foot is on floor (early, middle, late subphases)

Swing phase

40%

leg is swinging forwards

Major determinants of gait result from

minimizing COM movement and minimizing overall energy expenditure

MD of Gait - Stance phase knee flexion

normal = 20 degrees

minimizes vertical movement of COM by keeping body low

MD of Gait - Pelvis list (hip drop)

normal = <1 inch of lateral translation

as foot impacts w/ground - pelvis drops downward on opposite side

minimizes vertical movement of COM

MD of Gait - Posterior pelvic rotation

rotation of pelvis posteriorly helps reduce energy expenditure by minimizing the movement of COM

reduces the “braking phase” of gait

MD of Gait - Pronation of the

subtalar joint

MD of Gait - 1st ray dorsiflexion (big toe/1st MTP)

normal = >60 degrees during walking

crucial during toe-off phase of gait

crucial for windlass effect of plantar fascia and subsequent support of foot during weight-bearing activities

MD of Gait - Ankle dorsiflexion

normal = 40 degrees

only need 10-20 degrees during normal gait

What does the talus function as in ankle dorsiflexion during gait

as a frictionless ball bearing (b/c 70% of it is covered with cartilage)

MD of Gait - Gluteal friction

essential for controlling motion at the knee and further down the kinetic chain

• upper fibers - lever arm controlling frontal plane motion

• lower fibers - control sagittal and transverse plane motions

Gait cycle of running

contact, midstance, propulsion

**Extra phase = double float phase

People w/low arches

pronate more rapidly through larger ranges of motion

exhibit more SOFT TISSUE injuries

People w/high arches

hit the ground harder and pronate through very small ranges

exhibit more BONY injuries

Three primary mechanical functions that the NS must successfully execute to move normally

withstand tension

slide in its container

be compressible

Effects of tension on intraneural blood flow

8% elongation - flow of venous BF from nerves starts to diminish

15% elongation - all circulation in/out of nerve is obstructed

Effects of compression on intraneural blood flow

nerves that have been previously compromised by compression may be more sensitive to smaller pressure producing neuropathic symptoms

What does overuse or underuse of muscles lead to

overuse - shortening/tightening of tonic muscles

underuse - weakening/inhibition of phasic muscles

Global vs local stabilizers

Global - large, long superficial muscles that span two or more joints

Local - small, short deep muscles that span two or more joints

Global and Local stabilizer roles

stabilize and static proprioceptive feedback

**contraction creates tension to introduce stability

Global vs Local movers

Global - large, long superficial muscles that span two or more joints

Local - small, short deep superficial muscles that span two or more joints

Global and Local mover roles

movement and dynamic proprioceptive feedback

**contraction creates movement within a specific pattern

Three types of neuromuscular phenomena that can lead to muscle imbalances

reciprocal inhibition

synergistic dominance

arthrokinetic inhibition

Reciprocal inhibition

occurs when a tight muscle decreases the neural drive to its functional antagonist

**leads to predictable injury patterns

Synergistic dominance

occurs when synergists and stabilizers take over for a weak or inhibited prime mover

Arthrokinetic inhibition

occurs when a muscle is inhibited by joint dysfunction or the capsule that crosses the joint

Upper Crossed Syndrome - Tight/Overactive

upper traps and levator scapulae

pec major/minor

Upper Crossed Syndrome - Weak/Underactive

deep cervical neck flexors

middle and lower traps

Postural imbalances in Upper Crossed Syndrome

forward head posture

increased cervical lordosis and thoracic kyphosis

elevated and protracted (rounded) shoulder

rotation/abduction and winging of scapulae

Lower Crossed Syndrome - Tight/Overactive

thoracolumbar extensors

hip flexors

Lower Crossed Syndrome - Weak/Underactive

abdominals

gluteal muscles (maximus)

Postural imbalances in Lower Crossed Syndrome

thoracic hyperkyphosis

lumbar hyperlordosis

anterior pelvic tilt

slight hip and knee flexion

Progression of forces (least to most)

pt generated forces

pt overpressure

clinician overpressure

clinician mobilization techniques

manipulation

Derangement syndrome

variable symptoms

possible distal pain, obstructed range

potential for rapid change with the correct direction

Lumbar spine MC directional preference

extension

Cervical spine MC directional preference

retraction with extension

What is crucial for truly learning motor skills

intrinsic feedback

The more feedback you give

the least amount of learning that occurs

Stability/motor control dysfunctions (SMCD) is what type of issue

brain issue

What is the general rule to determine a true SMCD

decreased active ROM with functional passive ROM

Definition of SMCD

underlying mobility to complete the desired movement, but b/c of an input or processing problem, the coordination of the movement isn’t demonstrated

Examples of SMCD

mechanical breathing dysfunction, poor static stabilization, postural control

Mobility dysfunctions (MD) are what type of issues

tissue issue

What is the general rule to determine a true MD

decreased active and passive ROM

Definition of MD

a decrease or limitation in full range of motion

Examples of MD

neural tension, fusion, osteoarthritis

Mobility dysfunction will ________ no matter what accommodation you make

stay consistent

What are three things that impact our movements

motor control and NS tone

mental health

morphology of body tissues

ACSM guidelines for aerobic training

moderate intensity - 150min/week

vigorous intensity - 75min/week

ACSM guidelines for resistance training

2x a week

What is the predictor of all-cause mortality

ability to sit and rise from the floor

Hierarchy of Movement - Movement evaluation (order of 3)

1 - functional patterning

2 - motor control

3 - mobility

Hierarchy of Movement - Management (order of 3)

1 - mobility

2 - motor control

3 - functional patterning

What are other predictors of mortality (3)

push-ups, grip strength, toe strength

What is the single best predictor of senior citizen falling

toe strength

What is the second best predictor of senior citizen falling

leg strength

What is functionally the only tissue that can mediate the kinetic chain responsiveness

connective tissue

Regional interdependence

unrelated impairments in a remote anatomical region may contribute to the patient’s primary complaint

Motor control

necessary input, sufficiently processed, with an acceptable output

What is the average musculoskeletal tissue healing time

4-8 weeks

When do we have justification to look at parts

when a pattern is dysfunctional