Principles of

Biomechanics and
its Application in
Joint Function

How do sports injuries and

fractures occur?

Dr Jon Chua
3 March 2021

Image from Katsuhira J, Matsudaira K, Yasui T, Iijima S, Ito A. Efficacy of a trunk orthosis with joints providing
resistive force on low-back load in elderly persons during static standing. Clinical interventions in aging. 2015;10:1413.
Learning Explain an injury using a basic biomechanical
•

model

Outcomes • Appreciate how mechanical forces lead to

sports injuries
• Describe various causes of fractures
• Identify fracture patterns based on
mechanical loading forces
• Clinical application of biomechanics
Distinct modulus of human tissues suggesting tissue-specific stiffness. Different tissues with their
specific elastic modulus in the body are correlated with their functions (adapted from Cox et al., 2011)
Load: force acting on
body

Stress: intensity of an
internal force

Stress = force / area

[Pa or N/m2]

Strain: relative measure

of deformation of object

Strain = change in
length / original length
Two scenarios Mechanical load in excess of that tolerated
•

under normal circumstances

of injuries •

• Reduction of tolerance levels to a point at

which normal mechanical load cannot be
tolerated
Tendon
Stress-Strain
Curve
• Mechanical load > normal
Abnormal Tendon

Abnormal architecture
in tendinopathy
•

• collagen fibres in
disarray
• reduces tolerance
levels of tendon
Sports Injury
Loss or abnormality of bodily
structure or functioning
resulting from an isolated
exposure to physical energy
during sports training or
competition that following
examination is diagnosed by a
clinical professional as a
medically recognized injury
Timpka et al. (2014)
Types of Sports Direct
•

• Indirect
Injuries • Overuse
Direct Injuries

• Injury sustained at site of

external force
•

• Examples: bruises, fractures,

dislocations, abrasions, blisters
•

• Mechanism of injury: hit by a

ball, bat, person etc.
Indirect Injuries

• Injury sustained from an

internal force generated by
muscles or transferred from
outside
•

• Examples: pulled (strained)

hamstring, sprained ankle,
shoulder dislocation
Overuse Injuries

• Due to repetitive use causing

damage to the structures
involved
•

• Examples: tennis elbow,

golfer’s elbow, swimmer’s
shoulder etc.
Common Physeal injuries and growth disturbance in
•

developing or growing children

Regions of •

•
Spine problems
Knee injury and osteoarthritis
Sports Injuries • Ankle ligament injury and osteoarthritis
• Residual upper limb symptoms in the
‘overhead’ athlete
Physeal Injuries
Spine Injuries
Knee Injuries
Meniscus

• Biomechanics
•

• Transmits 50% - 70% of load across

joint
•

• Total menisectomy increases contact

stress 2x - 3x normal

Image adapted from:

https://commons.wikimedia.org/wiki/File:Meniscus_of_the_Knee_Unlabeled.jpg
Ankle Injuries
Upper Limb Injuries
Break in the structural continuity of bone
Apley’s System of Orthopaedics & Fractures 10e (2018)
FRACTURE

Injury
Fracture due to Injury

• Sudden and excessive forces

•

• Direct
Indirect
Mechanism of Injury

TENSION
COMPRESSIO
N
TORSION
BENDING
Fatigue or Stress Fractures

• Normal bone
• Abnormal stresses – repeated heavy loading
Fragility Abnormal bone (weakened bone)
•

• Low energy trauma

Fractures •

• Individuals on medication that alters bone

resorption and replacement
•

• Patients with chronic inflammatory diseases

who are on treatment with steroids or
methotrexate
•

• Patients with osteoporosis

Pathological Fractures

• Abnormal bone
• Normal stresses
•

• Examples:
•

• Osteoporosis
• Osteogenesis imperfecta
• Paget’s disease
• Lytic lesion – bone cyst or metastasis
Osteogenesis Imperfecta
Osteogenesis Imperfecta
Application of
Biomechanics

Image from:
https://www.mayo.edu/research/labs/motion-analysis/motion-analysis-patient-care/tests-procedures
Application of
Biomechanics Human motion
analysis is the
systematic study
It aims to gather
quantitative data
about the
Gait analysis is a
special branch of
human motion

in Motion of human motion

by careful
observation,
mechanics of the
musculoskeletal
system a motor
analysis specific to
the study of
human walking.

Analysis
augmented by task.
instrumentation
for measuring
body movements,
body mechanics
and the activity of
the muscles.

Gait analysis is
used to assess,
plan and treat
individuals with
conditions
affecting their
ability to walk.
 Motion Analysis

Understanding the biomechanics

and loading of each element
during movement using motion
analysis is helpful for:
•

• studying disease etiology

• making decisions about
treatment
• evaluating treatment
effects
Image from:
https://www.mayo.edu/research/labs/motion-analysis/motion-analysis-
patient-care/tests-procedures
Clinical Surgical planning in certain patient groups,
•

such as those with cerebral palsy

Applications of • Accurate evaluation of critical joint motion

characteristics, which is necessary during
Motion
the development of prostheses and orthoses
• Improve performance and identify
Analysis mechanisms of injuries and/or posture-
related or movement-related problems in
athletes
Summary Injury results from transfer of energy to tissue
•

• Various mechanical forces lead to sports injuries

• Different causes of fractures – balance between
bone and forces acting on it
• How fracture patterns develop based on forces
acting on bone
• Motion analysis is a useful application of
biomechanics in clinical practice
•
References Bahr, R., & Krosshaug, T. (2005). Understanding injury
•

mechanisms: a key component of preventing injuries

in sport. British journal of sports medicine, 39(6),
324-329.
• Mallick, A., & Prem, H. (2017). Physeal injuries in
children. Surgery (Oxford), 35(1), 10-17.
• Solomon, L., Warwick, D., & Nayagam, S. (Eds.).
(2010). Apley's system of orthopaedics and fractures.
CRC press.
• Timpka, T., Jacobsson, J., Bickenbach, J., Finch, C. F.,
Ekberg, J., & Nordenfelt, L. (2014). What is a sports
injury? Sports medicine, 44(4), 423-428.
• Lu TW, Chang CF. (2012). Biomechanics of human
movement and its clinical applications. The
Kaohsiung journal of medical sciences. 28:S13-25.
Any questions?
Thank You