Muscles and Movement

Presentation Transcript

Muscles and Movement Dan Foster, PhD, ATC January 7, 2010 Rothbart B, May 2009

Athletic Training Assessment Skilled Movement Deficiency Rule-out life & appendage undermining wounds or Rule-out referral issues or Functional status Philosophy of approach for insufficiencies and practical status: minor modifications in exactness of development prompt to damage and torment, created by changes in muscle length, quality, firmness, and development designs

Key Elements Assessment of arrangement Indicates conceivable muscle length changes and joint arrangement Interfere with ideal development Movement designs Specific muscle length and quality testing Borstad J, Phys Ther , 2006 Whyte E, Gait & Post , 2010 Garner B, BioMed Engineer , 2004

Scapular & Humeral Alignment Vertebral fringe parallel to spine ~ 3 in. away Between T2 – T7 Flat on trunk divider Rotated 30 o anteriorly Less than 1/3 distending Cubital fossa forward Humerus vertical Garner B, BioMed Engineer , 2004 Kibler W, AJSM, 1998

Alignment Issues Downwardly pivoted

Scapular Motions Scapula variable amid initial 30 o abd or 60 o flex Remaining 120 o Humeral and 60 o Scapular Timing frequently 140 o Humeral flex when scapula stops Inman V, JBJS, 1944

Muscle Physiology and Control Strength Length Stiffness Timing

Muscle Strength Capacity Fiber number Contractile components Hypertrophy/Atrophy Arrangement Series/Parallel Length of strands Configuration Overlapped, stretched, disturbed Tipton C, Am J Physiol , 1970 Wilkie D, Br. Med Bull , 1956

Muscle Length Prolonged extension Strain harm and constant pressure Sustained extending Kendall F, 1993

Muscle Stiffness Change in pressure per unit change long Contributes to development designs Active and aloof firmness A figure compensatory movement in touching joints Sahrmann S, 2002

Movement Timing Altered enrollment designs Upper trapezius predominance Learned Preferred example because of agony Delayed or lacking activity Stabilizing muscle causes development

Case 16 YO ♀ swimmer with B bear torment R>L Cumul torment happens in flex & abd at ~100 o Swimmer since 6, positioned high at one time Works hard, weight preparing & swim in spite of 5'7" 127# Slight thoracic kyphosis, frail abs B bear support rise, arms abd

B scapular abd Humerus coasts sup, at 120 o flex humerus med turns/pop, float sup on come back to unbiased Trunk ext on shoulder flex to offset If trunk is balanced out, flex is constrained Trapezius & Rhomboids are short (hard to decide) Deltoid & Supraspinatus are short Lat rotators are solid Lower & mid Trapezius are powerless Deltoid gets to be distinctly prevailing on ER – Humeral ext, winging, and humeral head skim sup On IR & ER quickly starts scapular movement Serratus is feeble and wings in quadruped position

Diagnosis? Impingement Supraspinatus tendinopathy Subacromial or subdeltoid bursitis Bicepital tendinopathy Humeral predominant skim – essential During shoulder flexion with elbow flexion sx ↓ Scapular snatching - optional

Treatment Primary accentuation Stretch deltoid and decline strength Improve control of trapezius and serratus subterranean insect Learn how to control IR/ER without different movements (recumbent) Target infraspinatus and teres minor (inclined & standing) Control scapula and sup float on IR (inclined)

Exercises

Outcome Within 4 weeks (no swimming) Arms at side amid rest Arms flex without torment to 180 and w/o moving trunk No average pivot with popping Tolerates 4 pounds of load Ready to venture up her action and resume swimming when she can experience her stroke without popping

Summary Minor modifications in exactness of development prompt to damage and torment, created by changes in muscle length, quality, firmness, and development designs The impact of various muscle associations following up on numerous joints in practically arranged errands is the place we may run with insufficiency screening and recovery recuperation