atrhrokinetics UE 3/19

Definitions:
- Arthrokinematics: Refers to the movements at the joint surfaces during joint motion. It is generally involuntary and happens without conscious thought.
- Osteokinematics: Involves the movement of bones around a joint and is usually under voluntary control.

Movements:
- Flexion
- Extension
- Abduction
- Adduction
- Internal Rotation
- External Rotation
- Scaption: A movement occurring in the scapular plane (30 degrees to the frontal plane), which is a diagonal alignment.
Importance of Scaption:
- Reduces stress on the shoulder joint during exercises.
- Useful in early therapy and rehabilitation practices.
End Feel:
- Ligamentous stretch has a firm feel, while bony lock is a hard end feel.

Open Packed Position:
- Defined as 55 degrees of abduction and 30 degrees of horizontal adduction. This position allows for maximum joint movement and looseness in ligaments and capsules.
- Therapeutical Importance: Useful for joint mobilizations as it allows mobility.
Closed Packed Position:
- Represents a position of great stability, like the knee in full extension where bones lock together.
- In the elbow, the closed packed position for the ulnohumeral joint is stable during extension and the radiohumeral joint is at 90 degrees of flexion.
Practical Application:
- Knowledge of open and closed packed positions aids therapists in determining appropriate positions for stretching and mobilization.

For shoulder abduction:
- Roll: Superior
- Glide: Inferior
For shoulder flexion:
- Roll: Anterior
- Glide: Posterior
Hip Movement Impact:
- Common complaints include difficulty with reaching overhead resulting from inadequate mobility in abduction and flexion. Mobilizing inferiorly or posteriorly can alleviate this issue.

Muscles Involved:
- Supraspinatus
- Infraspinatus
- Teres Minor
- Subscapularis
Stability Role: The rotator cuff muscles primarily provide stability to the humeral head during active movement.
Other Contributing Muscles:
- Deltoid: Assists in stabilization and movement.
- Scapular Upward Rotators:
  - Upper Trapezius
  - Lower Trapezius
  - Serratus Anterior

Key Joints: Ulnar (ulnohumeral) and Radiohumeral joints.
Open and Closed Packed Positions:
- Ulnar joint closed packed during extension.
- Radiohumeral closed packed at 90 degrees of flexion.
Arthrokinematics of Elbow:
- For elbow flexion:
  - Roll: Anterior
  - Glide: Posterior
- For elbow extension:
  - Roll: Posterior
  - Glide: Anterior
Muscular Actions:
- Supination Muscles: Biceps Brachii, Supinator, Pronator Teres, Pronator Quadratus.
- Flexion: Biceps, Brachialis, Brachioradialis.
- Extension: Triceps Brachii, Anconeus.

Key Movements: Flexion, Extension, Ulnar Deviation, Radial Deviation.
Joint Type: Radiocarpal joint is classified as a condyloid (or ellipsoid) joint.
End Feel:
- All motions except for radial deviation are characterized by a firm end feel.
Arthrokinematics:
- For wrist flexion:
  - Roll: Anterior
  - Glide: Posterior
- For ulnar deviation:
  - Roll: Medial
  - Glide: Lateral

Joint Type: Saddle joint, with one direction being concave and the other convex.
Arthrokinematics for flexion/extension:
- Flexion:
  - Roll: Medial (Same direction due to concave on convex relationship).
- Abduction/Adduction:
  - Roll: Opposite due to the switch in concave/convex relationship.

Movements: Flexion/Extension and Abduction/Adduction.
Arthrokinematics:
- For flexion:
  - Roll: Anterior
  - Glide: Anterior (both same direction).
- Mobilization should always be in the direction of the glide.

Mobilizations: Therapists should understand joint mechanics to apply appropriate mobilization techniques.
Positioning for Treatment: Open-packed positions are ideal for mobility work, while closed packed provides stability for strengthening exercises.

Understanding the complex interactions of arthrokinematics and osteokinematics aids in predicting joint behavior and informs effective treatment strategies for rehabilitation practices.