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2362_FM_i-xxii.qxd 2/3/11 4:24 PM Page vii
The fifth edition of Joint Structure and Function is made
possible only by the continued and combined efforts of
many people and groups. We are, first and foremost,
grateful for the time, effort, and expertise of our esteemed
contributors with whom it has been a pleasure to work.
Our thanks, therefore, to Drs. Sam Ward, Sandra Curwin,
Gary Chleboun, Diane Dalton, Julie Starr, Pam Ritzline,
Paula Ludewig, John Borstad, RobRoy Martin, Lynn
Snyder-Mackler, Michael Lewek, Erin Hartigan, Janice
Eng, and Sandra Olney, as well as to Ms. Noelle Austin
and Mr. Benjamin Kivlan. Additionally, we want to express
our appreciation to the individuals who helped develop the
ancillary materials that support the fifth edition, including
the Instructor’s Resources developed by Ms. Christine
Conroy and the videos developed by Dr. Lee Marinko and
Center City Film & Video. We would also like to acknowl-
edge and thank the individuals who contributed their
comments and suggestions as reviewers (listed on page xi),
as well as those who passed along their unsolicited sugges-
tions through the years, including our students.
ACKNOWLEDGMENTS
We extend our continuing gratitude to F. A. Davis for
their investment in the future of Joint Structure and Function
and its ancillary materials. Particular thanks go to Margaret
Biblis (Publisher), Melissa Duffield (Acquisitions Editor),
Karen Carter (Developmental Editor), Yvonne Gillam
(Developmental Editor), George Lang (Manager of Content
Development), David Orzechowski (Managing Editor),
Robert Butler (Production Manager), Carolyn O’Brien
(Manager of Art and Design), Katherine Margeson (Illustra-
tion Coordinator), and Stephanie Rukowicz (Assistant De-
velopmental Editor) who provided great support. As always
we must thank the artists who, through the years, provided
the images that are so valuable to the readers. These include
artists of past editions, Joe Farnum, Timothy Malone, and
Anne Raines. New to the fifth edition is Dartmouth Publish-
ing, Inc., adding both new figures and enhanced color to
the text.
Finally, we acknowledge and thank our colleagues and
families, without whose support this work could not have
been done and to whom we are eternally indebted.
vii
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2362_FM_i-xxii.qxd 2/3/11 4:24 PM Page ix
Noelle M. Austin, PT, MS, CHT
CJ Education and Consulting, LLC
Woodbridge, Connecticut
www.cj-education.com
The Orthopaedic Group
Hamden, Connecticut
John D. Borstad, PT, PhD
Assistant Professor
Physical Therapy Division
Ohio State University
Columbus, Ohio
Gary Chleboun, PT, PhD
Professor
School of Physical Therapy
Ohio University
Athens, Ohio
Sandra Curwin, PT, PhD
Associate Professor
School of Physiotherapy
Dalhousie University
Halifax, Nova Scotia, Canada
Diane Dalton, PT, DPT, OCS
Clinical Assistant Professor
Physical Therapy Program
Boston University
Boston, Massachusetts
Janice J. Eng, PT, OT, PhD
Professor
Department of Physical Therapy
University of British Columbia
Vancouver, British Columbia, Canada
Erin Hartigan, PT, PhD, DPT, OCS, ATC
Assistant Professor
Physical Therapy Department
University of New England
Portland, Maine
Benjamin Kivlan, PT, SCS, OCS, CSCS
Doctoral Student
Duquesne University
Pittsburgh, Pennsylvania
CONTRIBUTORS
Michael Lewek, PT, PhD
Assistant Professor
Division of Physical Therapy
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Paula M. Ludewig, PT, PhD
Associate Professor
Program in Physical Therapy
University of Minnesota
Minneapolis, Minnesota
RobRoy L. Martin, PT, PhD, CSCS
Associate Professor
Duquesne University
Pittsburgh, Pennsylvania
Sandra J. Olney, PT, OT, PhD
Professor Emeritus
School of Rehabilitation Therapy
Queens University
Kingston, Ontario, Canada
Pamela Ritzline, PT, EdD
Associate Professor
Department of Physical Therapy
University of Tennessee Health Science Center
Memphis, Tennessee
Lynn Snyder-Mackler, PT, ScD, SCS, ATC,
FAPTA
Alumni Distinguished Professor
Department of Physical Therapy
University of Delaware
Newark, Delaware
Julie Ann Starr, PT, DPT, CCS
Clinical Associate Professor
Physical Therapy Program
Boston University
Boston, Massachusetts
Sam Ward, PT, PhD
Departments of Radiology, Orthopaedic Surgery, and
Bioengineering
University of California San Diego
La Jolla, California
ix
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2362_FM_i-xxii.qxd 2/3/11 4:24 PM Page xi

REVIEWERS

John H. Hollman, PT, PhD Nancy R. Talbott, PhD, MS, PT

Director and Assistant Professor, Program in Physical Associate Professor
Therapy Rehabilitation Sciences
Department of Physical Medicine and Rehabilitation University of Cincinnati
Mayo Clinic College of Medicine Cincinnati, Ohio
Rochester, Minnesota
David P. Village, MS, PT, DHSc
Chris Hughes, PT, PhD, OCS, CSCS Associate Professor
Professor Department of Physical Therapy
Graduate School of Physical Therapy Andrews University
Slippery Rock University Berrien Springs, Michigan
Slippery Rock, Pennsylvania
Krista M. Wolfe, DPT, ATC
Leigh K. Murray, PT, PhD Director, Physical Therapy Assistant Program
Assistant Professor Allied Health Department
Physical Therapy Department Central Pennsylvania College
Walsh University Summerdale, Pennsylvania
North Canton, Ohio
Linda L. Wright, PhD, PT
William K. Ogard, PT, PhD Professor, Department of Physical Therapy
Assistant Professor Director, Educational Technology
Physical Therapy Department College of Health Professions
University of Alabama at Birmingham Armstrong Atlantic State University
Birmingham, Alabama Savannah, Georgia

Suzanne Reese, PT, MS

Associate Professor
Physical Therapist Assistant Program
Tulsa Community College
Tulsa, Oklahoma

xi
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CONTENTS IN
BRIEF
SECTION 1. Chapter 9. The Wrist and Hand
Joint Structure and Function: Complex 305
Foundational Concepts 2 Noelle M. Austin, PT, MS, CHT

Chapter 1. Biomechanical Applications SECTION 4.

to Joint Structure and Hip Joint 354
Function 3 Chapter 10. The Hip Complex 355
Samuel R. Ward, PT, PhD
RobRoy L. Martin, PT, PhD,
Chapter 2. Joint Structure and Function 64 CSCS, and Benjamin Kivlan,
Sandra Curwin, PT, PhD PT, SCS, OCS, CSCS

Chapter 3. Muscle Structure and Chapter 11. The Knee 395

Function 108 Erin Hartigan, PT, PhD,
Gary Chleboun, PT, PhD DPT, OCS, ATC; Michael
Lewek, PT, PhD; and Lynn
SECTION 2.
Snyder-Mackler, PT, ScD,
Axial Skeletal Joint Complexes 138 SCS, ATC, FAPTA

Chapter 4. The Vertebral Column 139 Chapter 12. The Ankle and Foot
Diane Dalton, PT, DPT, OCS Complex 440
RobRoy L. Martin, PT, PhD,
Chapter 5. The Thorax and Chest Wall 192
CSCS
Julie Starr, PT, MS, CCS, and Diane
Dalton, PT, DPT, OCS SECTION 5.
Chapter 6. The Temporomandibular Integrated Function 482
Joint 212
Pamela D. Ritzline, PT, EdD Chapter 13. Posture 483
SECTION 3. Cynthia C. Norkin, PT, EdD

Upper Extremity Joint Chapter 14. Gait 524

Complexes 230 Sandra J. Olney, PT, OT, PhD,
and Janice Eng, PT, OT, PhD
Chapter 7. The Shoulder Complex 231 Index 569
Paula M. Ludewig, PT, PhD,
and John D. Borstad, PT, PhD
Chapter 8. The Elbow Complex 271
Cynthia C. Norkin, PT, EdD

xiii
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CONTENTS

SECTION 1. ADDITIONAL LINEAR

Joint Structure and Function: FORCE CONSIDERATIONS 23
Foundational Concepts 2 Tensile Forces 23

Chapter 1. Biomechanical Applications Joint Distraction 25

to Joint Structure and Revisiting Newton’s Law of Inertia 29
Function 3 Shear and Friction Forces 30
Samuel R. Ward, PT, PhD
Considering Vertical and
INTRODUCTION 4 Horizontal Linear Equilibrium 32
PART 1: KINEMATICS AND PART 2: KINETICS—CONSIDERING
INTRODUCTION TO KINETICS 6 ROTARY AND TRANSLATORY
DESCRIPTIONS OF MOTION 6 FORCES AND MOTIONS 33
Types of Displacement 6 TORQUE, OR MOMENT
OF FORCE 33
Location of Displacement in Space 7
Angular Acceleration
Direction of Displacement 9 and Angular Equilibrium 34
Magnitude of Displacement 9 Parallel Force Systems 35
Rate of Displacement 10 Meeting the Three Conditions
INTRODUCTION TO FORCES 11 for Equilibrium 38
Definition of Forces 11 MUSCLE FORCES 39
Force Vectors 12 Total Muscle Force Vector 39
Force of Gravity 14 TORQUE REVISITED 41
INTRODUCTION TO STATICS Changes to Moment Arm
AND DYNAMICS 18 of a Force 42
Newton’s Law of Inertia 18 Angular Acceleration With
Changing Torques 43
Newton’s Law of Acceleration 18
Moment Arm and Angle
TRANSLATORY MOTION
of Application of a Force 44
IN LINEAR AND CONCURRENT
FORCE SYSTEMS 19 LEVER SYSTEMS,
OR CLASSES OF LEVERS 46
Linear Force Systems 19
Muscles in Third-Class Lever Systems 46
Concurrent Force Systems 21
Muscles in Second-Class Lever Systems 47
Newton’s Law of Reaction 22
Muscles in First-Class Lever Systems 48

xv
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xvi Contents

Mechanical Advantage 48 GENERAL CHANGES WITH

DISEASE, INJURY,
Limitations of Analysis of Forces
IMMOBILIZATION,
by Lever Systems 50
EXERCISE, AND OVERUSE 98
FORCE COMPONENTS 50
Disease 98
Resolving Forces Into Perpendicular
Injury 99
and Parallel Components 51
Immobilization (Stress Deprivation) 99
Perpendicular and Parallel
Force Effects 51 Exercise 101
Translatory Effects of Force Overuse 102
Components 56 Summary 103
Rotary Effects of Force Components 57 Study Questions 104
References 104
MULTISEGMENT (CLOSED-
CHAIN) FORCE ANALYSIS 58 Chapter 3. Muscle Structure
Summary 61 and Function 108
Study Questions 61 Gary Chleboun, PT, PhD
References 63 INTRODUCTION 109
Chapter 2. Joint Structure and Function 64 ELEMENTS OF MUSCLE
Sandra Curwin, PT, PhD STRUCTURE 109
INTRODUCTION 65 Composition of a Muscle Fiber 109
Joint Design 65 The Contractile Unit 110
MATERIALS FOUND IN HUMAN The Motor Unit 112
JOINTS 67
Muscle Structure 114
Structure of Connective Tissue 67
Muscle Architecture: Size,
Specific Connective Tissue Structures 73 Arrangement, and Length 115
GENERAL PROPERTIES OF Muscular Connective Tissue 117
CONNECTIVE TISSUE 80
MUSCLE FUNCTION 119
Mechanical Behavior 80
Muscle Tension 119
Viscoelasticity 84
Classification of Muscles 126
Time-Dependent and
Factors Affecting Muscle Function 128
Rate-Dependent Properties 84
EFFECTS OF IMMOBILIZATION,
Properties of Specific Tissues 85
INJURY, AND AGING 132
COMPLEXITY OF HUMAN
Immobilization 132
JOINT DESIGN 87
Injury 133
Synarthroses 88
Aging 133
Diarthroses 89
Summary 133
JOINT FUNCTION 94 Study Questions 134
Kinematic Chains 94 Refereces 134
Joint Motion 95
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Contents xvii

SECTION 2. Muscles Associated With the

Axial Skeletal Joint Rib Cage 199
Complexes 138 Coordination and Integration
of Ventilatory Motions 206
Chapter 4. The Vertebral Column 139
Diane Dalton, PT, DPT, OCS
DEVELOPMENTAL ASPECTS OF
STRUCTURE AND FUNCTION 207
INTRODUCTION 140
Differences Associated
GENERAL STRUCTURE With the Neonate 207
AND FUNCTION 140
Differences Associated With
Structure 140 the Elderly 207
Function 150 PATHOLOGICAL CHANGES IN
REGIONAL STRUCTURE STRUCTURE AND FUNCTION 208
AND FUNCTION 154 Chronic Obstructive Pulmonary
Structure of the Cervical Region 154 Disease (COPD) 208
Summary 210
Function of the Cervical Region 159
Study Questions 210
Structure of the Thoracic Region 162 References 210
Function of the Thoracic Region 163 Chapter 6. The Temporomandibular
Structure of the Lumbar Region 164 Joint 212
Function of the Lumbar Region 169 Pamela D. Ritzline, PT, EdD

Structure of the Sacral Region 171 INTRODUCTION 213

Function of the Sacral Region 174 JOINT STRUCTURE 214
MUSCLES OF THE VERTEBRAL Articular Structures 214
COLUMN 176
Accessory Joint Structures 215
The Craniocervical/Upper
Capsule and Ligaments 216
Thoracic Regions 176
JOINT FUNCTION 217
Lower Thoracic/Lumbopelvic Regions 180
Joint Kinematics 217
Muscles of the Pelvic Floor 186
Muscles 220
EFFECTS OF AGING 187
Nerves 222
Age-Related Changes 187
Summary 188 Relationship to the Cervical
Study Questions 188 Spine and Posture 222
References 188 Dentition 223
Chapter 5. The Thorax and Chest Wall 192 COMMON IMPAIRMENTS
Julie Starr, PT, MS, CCS, and AND PATHOLOGIES 224
Diane Dalton, PT, DPT, OCS Age-Related Changes in the
INTRODUCTION 193 TM Joint 224
GENERAL STRUCTURE Inflammatory Conditions 225
AND FUNCTION 193 Capsular Fibrosis 225
Rib Cage 193
2362_FM_i-xxii.qxd 2/3/11 4:24 PM Page xviii

xviii Contents

Osseous Mobility Conditions 225 Teres Major and Rhomboid

Muscle Function 265
Articular Disc Displacement 226
Summary 266
Degenerative Conditions 226 Study Questions 267
Summary 227 References 267
Study Questions 227
References 228 Chapter 8. The Elbow Complex 271
Cynthia C. Norkin, PT, EdD
SECTION 3. INTRODUCTION 272
Upper Extremity Joint STRUCTURE: ELBOW JOINT
Complexes 230 (HUMEROULNAR AND
HUMERORADIAL
Chapter 7. The Shoulder Complex 231 ARTICULATIONS) 272
Paula M. Ludewig, PT, PhD,
and John D. Borstad, PT, PhD Articulating Surfaces on
the Humerus 272
INTRODUCTION 232
Articulating Surfaces on
COMPONENTS OF THE
the Radius and Ulna 272
SHOULDER COMPLEX 232
Articulation 273
Sternoclavicular Joint 232
Joint Capsule 276
Acromioclavicular Joint 236
Ligaments 277
Scapulothoracic Joint 240
Muscles 279
Glenohumeral Joint 245
FUNCTION: ELBOW JOINT
INTEGRATED FUNCTION
(HUMEROULNAR AND
OF THE SHOULDER COMPLEX 257
HUMERORADIAL
Scapulothoracic and Glenohumeral ARTICULATIONS) 281
Contributions 258
Axis of Motion 281
Sternoclavicular and
Mobility and Stability 284
Acromioclavicular Contributions 259
Muscle Action 285
Structural Dysfunction 261
STRUCTURE: PROXIMAL
MUSCLES OF ELEVATION 262
AND DISTAL ARTICULATIONS 288
Deltoid Muscle Function 262
Proximal (Superior) Radioulnar Joint 288
Supraspinatus Muscle Function 263
Distal (Inferior) Radioulnar Joint 288
Infraspinatus, Teres Minor,
Articulations 290
and Subscapularis Muscle Function 263
Ligaments 290
Upper and Lower Trapezius
and Serratus Anterior Muscle Muscles 291
Function 263 FUNCTION: RADIOULNAR
Rhomboid Muscle Function 265 JOINTS 292
MUSCLES OF DEPRESSION 265 Axis of Motion 292
Latissimus Dorsi and Pectoral Range of Motion 292
Muscle Function 265
2362_FM_i-xxii.qxd 2/3/11 4:24 PM Page xix

Contents xix

Muscle Action 292 Summary 349

Stability 293 Study Questions 349
References 350
MOBILITY AND STABILITY:
ELBOW COMPLEX 295 SECTION 4.
Functional Activities 295 Hip Joint 354
Relationship to the Hand and Wrist 295 Chapter 10. The Hip Complex 355
EFFECTS OF AGE, GENDER, RobRoy L. Martin, PT, PhD,
AND INJURY 297 CSCS, and Benjamin Kivlan, PT,
SCS, OCS, CSCS
Age and Gender 297
Injury 298 INTRODUCTION 356
Summary 301 STRUCTURE OF THE HIP JOINT 356
Study Questions 301 Proximal Articular Surface 356
References 301
Distal Articular Surface 358
Chapter 9. The Wrist and Hand
Articular Congruence 362
Complex 305
Noelle M. Austin, PT, MS, CHT Hip Joint Capsule and Ligaments 363
INTRODUCTION 306 Structural Adaptations to
Weight-Bearing 366
THE WRIST COMPLEX 306
FUNCTION OF THE HIP JOINT 368
Radiocarpal Joint Structure 307
Motion of the Femur on
Midcarpal Joint Structure 310 the Acetabulum 368
Function of the Wrist Complex 312 Motion of the Pelvis on the Femur 369
THE HAND COMPLEX 319 Coordinated Motions of the
Carpometacarpal Joints of the Fingers 319 Femur, Pelvis, and Lumbar Spine 372
Metacarpophalangeal Joints Hip Joint Musculature 374
of the Fingers 322 HIP JOINT FORCES AND
Interphalangeal Joints of the Fingers 324 MUSCLE FUNCTION
IN STANCE 379
Extrinsic Finger Flexors 326
Bilateral Stance 379
Extrinsic Finger Extensors 329
Unilateral Stance 380
Extensor Mechanism 330
HIP JOINT PATHOLOGY 385
Intrinsic Finger Musculature 335
Femoroacetabular Impingement 385
Structure of the Thumb 339
Labral Pathology 387
Thumb Musculature 341
Arthrosis 387
PREHENSION 343
Fracture 388
Power Grip 344
Summary 390
Precision Handling 346 Study Questions 390
FUNCTIONAL POSITION References 391
OF THE WRIST AND HAND 348
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xx Contents

Chapter 11. The Knee 395 Chapter 12. The

Ankle and Foot
Erin Hartigan, PT, PhD, DPT, OCS, Complex 440
ATC; Michael Lewek, PT, PhD; and RobRoy L. Martin PT, PhD, CSCS
Lynn Snyder-Mackler, PT, ScD, SCS,
INTRODUCTION 441
ATC, FAPTA
DEFINITIONS OF MOTIONS 441
INTRODUCTION 396
ANKLE JOINT 443
TIBIOFEMORAL JOINT
Ankle Joint Structure 443
STRUCTURE 396
Ankle Joint Function 447
Femur 396
THE SUBTALAR JOINT 448
Tibia 397
Subtalar Joint Structure 448
Tibiofemoral Alignment and
Weight-Bearing Forces 398 Subtalar Joint Function 449
Menisci 399 TRANSVERSE TARSAL JOINT 455
Joint Capsule 401 Transverse Tarsal Joint Structure 455
Ligaments 404 Transverse Tarsal Joint Function 458
Iliotibial Band 411 TARSOMETATARSAL JOINTS 460
Bursae 411 Tarsometatarsal Joint Structure 460
TIBIOFEMORAL JOINT Tarsometatarsal Joint Function 462
FUNCTION 412 METATARSOPHALANGEAL
Joint Kinematics 412 JOINTS 463
Muscles 417 Metatarsophalangeal Joint
Structure 463
Stabilizers of the Knee 422
Metatarsophalangeal Joint
PATELLOFEMORAL JOINT 424
Function 464
Patellofemoral Articular
INTERPHALANGEAL JOINTS 467
Surfaces and Joint Congruence 425
PLANTAR ARCHES 467
Motions of the Patella 426
Structure of the Arches 467
Patellofemoral Joint Stress 427
Function of the Arches 468
Frontal Plane Patellofemoral
Joint Stability 428 Muscular Contribution to the Arches 471
Weight-Bearing Versus MUSCLES OF THE ANKLE
Non-Weightbearing Exercises AND FOOT 471
With Patellofemoral Pain 432 Extrinsic Musculature 471
EFFECTS OF INJURY Intrinsic Musculature 474
AND DISEASE 432
DEVIATIONS FROM NORMAL
Tibiofemoral Joint Injury 433 STRUCTURE AND FUNCTION 475
Patellofemoral Joint Injury 434 Summary 476
Summary 435 Study Questions 477
Study Questions 435 Referneces 478
References 435
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Contents xxi

SECTION 5. EFFECTS OF AGE, AGE

Integrated Function 482 AND GENDER, PREGNANCY,
OCCUPATION, AND
Chapter 13. Posture 483 RECREATION ON POSTURE 515
Cynthia C. Norkin, PT, EdD
Age 515
INTRODUCTION 484
Age and Gender 516
STATIC AND DYNAMIC
Pregnancy 518
POSTURES 484
Occupation and Recreation 518
Postural Control 485
Summary 519
Major Goals and Basic Study Questions 519
Elements of Control 485
References 520
KINETICS AND KINEMATICS
Chapter 14. Gait 524
OF POSTURE 489
Sandra J. Olney, PT, OT, PhD,
Inertial and Gravitational Forces 489 and Janice Eng, PT, OT, PhD
Ground Reaction Forces 489 INTRODUCTION 525
Coincident Action Lines 490 Gait Analysis 525
External and Internal Moments 490 Major Tasks of Gait 525
OPTIMAL POSTURE 491 Phases of the Gait Cycle 525
ANALYSIS OF STANDING GAIT TERMINOLOGY 527
POSTURE: VIEWED FROM
Time and Distance Terms 527
THE SIDE 492
Kinematic Terms 528
Alignment and Analysis:
Lateral View 492 Kinetic Terms 529
Deviations From Optimal Electromyography 531
Alignment Viewed From the Side 497 CHARACTERISTICS
Optimal Alignment and Analysis: OF NORMAL GAIT 532
Anterior and Posterior Views 502 Time and Distance Characteristics 532
Deviations From Optimal Sagittal Plane Joint Angles 532
Alignment 503
Frontal Plane Joint Angles 534
ANALYSIS OF SITTING
POSTURES 509 Ground Reaction Force
and Center of Pressure 534
Muscle Activity 509
Sagittal Plane Moments 535
Interdiscal Pressures and Compressive
Loads on the Spine 511 Frontal Plane Moments 537
Seat Interface Pressures 512 Sagittal Plane Powers 540
ANALYSIS OF LYING Frontal Plane Powers 542
POSTURES 514 Mechanical Energy of Walking 542
Interdiscal Pressures 514 Muscle Activity 545
Surface Interface Pressures 515 Gait Initiation and Termination 550
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xxii Contents

TRUNK AND UPPER Assistive Devices 561

EXTREMITIES 552 Orthoses 561
Trunk 552 ABNORMAL GAIT 561
Upper Extremities 553 Structural Impairment 562
TREADMILL, STAIR, Functional Impairment 562
AND RUNNING GAITS 553
Summary 564
Treadmill Gait 553 Study Questions 564
Stair Gait 553 References 564
Running Gait 555
Index 569
Summary 558
EFFECTS OF AGE,
GENDER, ASSISTIVE
DEVICES, AND ORTHOSES 559
Age 559
Gender 560
2362_Ch01-001-063.qxd 1/29/11 4:40 PM Page 1

Joint Structure
and Function FIF TH
EDITION
A Comprehensive Analysis
2362_Ch01-001-063.qxd 1/29/11 4:40 PM Page 2

Section

1
Joint Structure
and Function:
Foundational
Concepts

Chapter 1 Biomechanical Applications to Joint Structure

and Function
Chapter 2 Joint Structure and Function
Chapter 3 Muscle Structure and Function

2
2362_Ch01-001-063.qxd 1/29/11 4:40 PM Page 3

Chapter
1
Biomechanical Applications to
Joint Structure and Function
Samuel R. Ward, PT, PhD

“Humans have the capacity to produce a nearly infinite

variety of postures and movements that require the tissues
of the body to both generate and respond to forces that
produce and control movement.”

Introduction Introduction to Statics and Dynamics

Newton’s Law of Inertia
PART 1: KINEMATICS AND INTRODUCTION Newton’s Law of Acceleration
TO KINETICS
Translatory Motion in Linear and Concurrent Force
Descriptions of Motion Systems
Types of Displacement Linear Force Systems
Translatory Motion Determining Resultant Forces in a Linear Force System
Rotary Motion Concurrent Force Systems
General Motion Determining Resultant Forces in a Concurrent Force System
Location of Displacement in Space Newton’s Law of Reaction
Direction of Displacement Gravitational and Contact Forces
Magnitude of Displacement
Rate of Displacement Additional Linear Force Considerations
Tensile Forces
Introduction to Forces Tensile Forces and Their Reaction Forces
Definition of Forces Joint Distraction
Force Vectors Distraction Forces
Force of Gravity Joint Compression and Joint Reaction Forces
Segmental Centers of Mass and Composition Revisiting Newton’s Law of Inertia
of Gravitational Forces Vertical and Horizontal Linear Force Systems
Center of Mass of the Human Body Shear and Friction Forces
Center of Mass, Line of Gravity, and Stability Static Friction and Kinetic Friction
Alterations in Mass of an Object or Segment Considering Vertical and Horizontal Linear Equilibrium
Continued

3
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4 SECTION 1 ■ Joint Structure and Function: Foundational Concepts
PART 2: KINETICS—CONSIDERING ROTARY AND
TRANSLATORY FORCES AND MOTION
Torque, or Moment of Force
Angular Acceleration and Angular Equilibrium
Parallel Force Systems
Determining Resultant Forces in a Parallel Force System
Bending Moments and Torsional Moments
Identifying the Joint Axis About Which Body Segments
Rotate
Meeting the Three Conditions for Equilibrium
Muscle Forces
Total Muscle Force Vector
Anatomic Pulleys
Anatomic Pulleys, Action Lines, and Moment Arms
Torque Revisited
Changes to Moment Arm of a Force
Angular Acceleration With Changing Torques
Moment Arm and Angle of Application of a Force
INTRODUCTION
Humans have the capacity to produce a nearly infinite vari-
ety of postures and movements that require the structures
of the human body to both generate and respond to forces
that produce and control movement at the body’s joints.
Although it is impossible to capture all the kinesiologic
elements that contribute to human musculoskeletal func-
tion at a given point in time, knowledge of at least some of
the physical principles that govern the body’s response to
active and passive stresses is prerequisite to an understand-
ing of both human function and dysfunction.
We will examine some of the complexities related to
human musculoskeletal function by examining the roles of
the bony segments, joint-related connective tissue struc-
ture, and muscles, as well as the external forces applied to
those structures. We will develop a conceptual framework
that provides a basis for understanding the stresses on
the body’s major joint complexes and the responses to
those stresses. Case examples and clinical scenarios will be
used to ground the reader’s understanding in relevant
applications of the presented principles. The objective is
to cover the key biomechanical principles necessary to
understand individual joints and their interdependent
functions in posture and locomotion. Although we ac-
knowledge the role of the neurological system in motor
control, we leave it to others to develop an understanding
of the theories that govern the roles of the controller and
feedback mechanisms.
This chapter will explore the biomechanical principles
that must be considered to examine the internal and exter-
nal forces that produce or control movement. The focus
will be largely on rigid body analysis; the next two chapters
explore how forces affect deformable connective tissues
(Chapter 2) and how muscles create and are affected by
Lever Systems, or Classes of Levers
Muscles in Third-Class Lever Systems
Muscles in Second-Class Lever Systems
Muscles in First-Class Lever Systems
Mechanical Advantage
Trade-Offs of Mechanical Advantage
Limitations of Analysis of Forces by Lever Systems
Force Components
Resolving Forces Into Perpendicular and Parallel
Components
Perpendicular and Parallel Force Effects
Determining Magnitudes of Component Forces
Force Components and the Angle of Application of the
Force
Translatory Effects of Force Components
Rotary Effects of Force Components
Rotation Produced by Perpendicular (Fy) Force Components
Rotation Produced by Parallel (Fx) Force Components
Multisegment (Closed-Chain) Force Analysis
forces (Chapter 3). Subsequent chapters then examine the
interactive nature of force, stress, tissue behaviors, and func-
tion through a regional exploration of the joint complexes of
the body. The final two chapters integrate the function of
the joint complexes into the comprehensive tasks of posture
(Chapter 13) and gait (Chapter 14).
In order to maintain our focus on clinically relevant
applications of the biomechanical principles presented in
this chapter, the following case example will provide a
framework within which to explore the relevant principles
of biomechanics.
1-1 Patient Case
case
John Alexander is 20 years old, is 5 feet 9 inches (1.75 m)
in height, and weighs 165 pounds (~75 kg or 734 N).
John is a member of the university’s lacrosse team. He
sustained an injury when another player fell onto the
posterior-lateral aspect of his right knee. Physical exami-
nation and magnetic resonance imaging (MRI) resulted
in a diagnosis of a tear of the medial collateral ligament,
a partial tear of the anterior cruciate ligament (ACL),
and a partial tear of the medial meniscus. John agreed
with the orthopedist’s recommendation that a program
of knee muscle strengthening was in order before moving
to more aggressive options. The initial focus will be on
strengthening the quadriceps muscle. The fitness center
at the university has a leg-press machine (Fig. 1–1A) and
a free weight boot (see Fig. 1–1B) that John can use.
As we move through this chapter, we will consider
the biomechanics of each of these rehabilitative options in
relation to John’s injury and strengthening goals.
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CHAPTER 1 ■ Biomechanical Applications to Joint Structure and Function 5

Figure 1–1 A. Leg-press exer-

cise apparatus for strengthening
hip and knee extensor muscles.
B. Free weight boot for strength-
B
ening knee extensor muscles.

Side-bar: The case in this chapter provides a background

for the presentation of biomechanical principles. The
values and angles chosen for the forces in the various
examples used in this case are representative but are not
intended to correspond to values derived from sophisti-
A
cated instrumentation and mathematical modeling; dif-
ferent experimental conditions, instrumentation, and
modeling can provide substantially different and often
contradictory findings.
Human motion is inherently complex, involving multi-
ple segments (bony levers) and forces that are most often
applied to two or more segments simultaneously. In order
to develop a conceptual model that can be understood
and applied clinically, the common strategy is to focus
on one segment at a time. For the purposes of analyzing
John Alexander’s issues, the focus will be on the leg-foot
segment, treated as if it were one rigid unit acting at the
knee joint. Figure 1–2A and 1–2B is a schematic represen- B
tation of the leg-foot segment in the leg-press and free
weight boot situations. The leg-foot segment is the focus
of the figure, although the contiguous components (distal
femur, footplate of the leg-press machine, and weight
boot) are maintained to give context. In some subsequent
figures, the femur, footplate, and weight boot are omitted
for clarity, although the forces produced by these seg-
ments and objects will be shown. This limited visualiza-
tion of a segment (or a selected few segments) is referred
to as a free body diagram or a space diagram. If propor-
tional representation of all forces is maintained as the
forces are added to the segment under consideration, it is
known as a “free body diagram.” If the forces are shown
but a simplified understanding rather than graphic accu-
racy is the goal, then the figure is referred to as a “space
diagram.”1 We will use space diagrams in this chapter and
text because the forces are generally not drawn in propor-
tion to their magnitudes.
As we begin to examine the leg-foot segment in either Figure 1–2 A. Schematic representation of the leg-foot seg-
the weight boot or leg-press exercise situation, the first ment in the leg-press exercise, with the leg-foot segment high-
step is to describe the motion of the segment that is or will lighted for emphasis. B. Schematic representation of the leg-foot
be occurring. This involves the area of biomechanics known segment in the weight boot exercise, with the leg-foot segment
as kinematics. highlighted for emphasis.
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6 SECTION 1 ■ Joint Structure and Function: Foundational Concepts

human movement, pure translatory movements are rare.

Part 1: Kinematics and
Introduction to Kinetics
DESCRIPTIONS OF MOTION
Kinematics includes the set of concepts that allows us to
describe the displacement (the change in position over
time) or motion of a segment without regard to the forces
that cause that movement. The human skeleton is, quite
literally, a system of segments or levers. Although bones
are not truly rigid, we will assume that bones behave as
rigid levers. There are five kinematic variables that fully
describe the motion, or the displacement, of a segment:
(1) the type of displacement (motion), (2) the location
in space of the displacement, (3) the direction of the
displacement of the segment, (4) the magnitude of the
displacement, and (5) the rate of change in displacement
(velocity) or the rate of change of velocity (acceleration).
Types of Displacement
Translatory and rotary motions are the two basic types
of movement that can be attributed to any rigid segment.
General motions are achieved by combining translatory and
rotary motions.
Translatory Motion
Translatory motion (linear displacement) is the move-
ment of a segment in a straight line. In true translatory
motion, each point on the segment moves through the
same distance, at the same time, in parallel paths. In
However, a clinical example of attempted translatory
motion is joint mobilization, in which a clinician attempts
to impose the linear motion of one bony segment on
another, allowing joint surfaces to slide past one another.
A specific example of such imposed motion is the anterior
drawer test for anterior cruciate ligament (ACL) integrity
at the knee (Fig. 1–3). This example of translatory motion
assumes, however, that the leg segment is free and uncon-
strained—that is, that the leg segment is not linked to the
femur by soft tissues. Although it is best to describe pure
translatory motion by using an example of an isolated and
unconstrained segment, segments of the body are neither
isolated nor unconstrained. Every segment is linked to at
least one other segment, and most human motion occurs
as movement of more than one segment at a time. The
translation of the leg segment in Figure 1–3 is actually
produced by the near-linear motion of the proximal tibia.
In fact, translation of a body segment rarely occurs in
human motion without some concomitant rotation (rotary
motion) of that segment (even if the rotation is barely
visible).
Rotary Motion
Rotary motion (angular displacement) is movement of a
segment around a fixed axis (center of rotation [CoR]) in
a curved path. In true rotary motion, each point on the seg-
ment moves through the same angle, at the same time, at a
constant distance from the center of rotation. True rotary
motion can occur only if the segment is prevented from
translating and is forced to rotate about a fixed axis. This
does not often happen in human movement. In the example
in Figure 1–4, all points on the leg-foot segment appear to
move through the same distance at the same time around

A B

Figure 1–3 An example of translatory motion is the anterior drawer test for ACL integrity. Ideally, the tibial plateau translates anteri-
orly from the starting position (A) to the ending position (B) as the examiner exerts a linear load on the proximal tibia. Under ideal
conditions, each point on the tibia moves through the same distance, at the same time, in parallel paths.
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CHAPTER 1 ■ Biomechanical Applications to Joint Structure and Function 7

other bony forces acting on it to produce pure rotary

motion. Instead, there is typically at least a small amount
of translation (and often a secondary rotation) that accom-
A
panies the primary rotary motion of a segment at a joint.
Most joint rotations, therefore, take place around a series
of instantaneous center of rotations. The “axis” that is gen-
erally ascribed to a given joint motion (e.g., knee flexion) is
typically a midpoint among these instantaneous centers of
rotation rather than the true center of rotation. Because
most body segments actually follow a curvilinear path, the
true center of rotation is the point around which true
rotary motion of the segment would occur and is generally
quite distant from the joint.3,4

Location of Displacement in Space

The rotary or translatory displacement of a segment is com-
monly located in space by using the three-dimensional
Cartesian coordinate system, borrowed from mathematics,
Figure 1–4 Rotary motion. Each point in the tibia segment as a useful frame of reference. The origin of the x-axis,
moves through the same angle, at the same time, at a constant y-axis, and z-axis of the coordinate system is traditionally
distance from the center of rotation or axis (A). located at the center of mass (CoM) of the human body,
assuming that the body is in anatomic position (standing
facing forward, with palms forward) (Fig. 1–5). According
what appears to be a fixed axis. In actuality, none of the body to the common system described by Panjabi and White,
segments move around truly fixed axes; all joint axes shift at the x-axis runs side-to-side in the body and is labeled in the
least slightly during motion because segments are not suffi- body as the coronal axis; the y-axis runs up and down in
ciently constrained to produce pure rotation. the body and is labeled in the body as the vertical axis; the
z-axis runs front to back in the body and is labeled in the
General Motion body as the anteroposterior (A-P) axis.3 Motion of a
When nonsegmented objects are moved, combinations of segment can occur either around an axis (rotation) or along
rotation and translation (general motion) are common. an axis (translation). An unconstrained segment can either
If someone were to attempt to push a treatment table with rotate or translate around each of the three axes, which
swivel casters across the room by using one hand, it would results in six potential options for motion of that segment.
be difficult to get the table to go straight (translatory
motion); it would be more likely to both translate and ro-
y-axis
tate. When rotary and translatory motions are combined,
a number of terms can be used to describe the result.
Curvilinear (plane or planar) motion designates a
combination of translation and rotation of a segment in
two dimensions (parallel to a plane with a maximum of
three degrees of freedom).2–4 When this type of motion
occurs, the axis about which the segment moves is not
fixed but, rather, shifts in space as the object moves. The
axis around which the segment appears to move in any
part of its path is referred to as the instantaneous center x-axis
of rotation (ICoR), or instantaneous axis of rotation
(IaR). An object or segment that travels in a curvilinear z-axis
path may be considered to be undergoing rotary motion
around a fixed but quite distant CoR3,4; that is, the curvi-
linear path can be considered a segment of a much larger
circle with a distant axis.
Three-dimensional motion is a general motion in
which the segment moves across all three dimensions. Just
as curvilinear motion can be considered to occur around a
single distant center of rotation, three-dimensional motion
can be considered to be occurring around a helical axis of
motion (HaM), or screw axis of motion.3 Figure 1–5 Body in anatomic position showing the x-axis,
As already noted, motion of a body segment is rarely y-axis, and z-axis of the Cartesian coordinate system (the coronal,
sufficiently constrained by the ligamentous, muscular, or vertical, and anteroposterior axes, respectively).
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8 SECTION 1 ■ Joint Structure and Function: Foundational Concepts

The options for movement of a segment are also referred

to as degrees of freedom. A completely unconstrained
segment, therefore, always has six degrees of freedom.
Segments of the body, of course, are not unconstrained. A
segment may appear to be limited to only one degree of
freedom (although, as already pointed out, this rarely
is strictly true), or all six degrees of freedom may be avail-
able to it.
Rotation of a body segment is described not only as
occurring around one of three possible axes but also as x
moving in or parallel to one of three possible cardinal
planes. As a segment rotates around a particular axis, the
segment also moves in a plane that is both perpendicular to
that axis of rotation and parallel to another axis. Rotation of
a body segment around the x-axis or coronal axis occurs in
the sagittal plane (Fig. 1–6). Sagittal plane motions are
most easily visualized as front-to-back motions of a seg-
ment (e.g., flexion/extension of the upper extremity at the
glenohumeral joint).
Rotation of a body segment around the y-axis or
vertical axis occurs in the transverse plane (Fig. 1–7).
Transverse plane motions are most easily visualized as Figure 1–7 The transverse plane.
motions of a segment parallel to the ground (e.g.,
medial/lateral rotation of the lower extremity at the hip
joint). Transverse plane motions often occur around axes Y
that pass through the length of long bones that are not
truly vertically oriented. Consequently, the term longitu-
dinal (or long) axis is often used instead of “vertical axis.”
Rotation of a body segment around the z-axis or A-P
axis occurs in the frontal plane (Fig. 1–8). Frontal plane
motions are most easily visualized as side-to-side motions
of the segment (e.g., abduction/adduction of the upper
extremity at the glenohumeral joint).
Rotation and translation of body segments are not
limited to motion along or around cardinal axes or within
cardinal planes. In fact, cardinal plane motions are the

Figure 1–8 The frontal plane.

z exception rather than the rule and, although useful, are

an oversimplification of human motion. If a motion
(whether in or around a cardinal axis or plane) is limited
to rotation around a single axis or translatory motion
along a single axis, the motion is considered to have one
degree of freedom. Much more commonly, a segment
moves in three dimensions with two or more degrees of
freedom. The following example demonstrates a way in
which rotary and translatory motions along or around one
or more axes can combine in human movement to produce
Figure 1–6 The sagittal plane. two- and three-dimensional segmental motion.
2362_Ch01-001-063.qxd 1/29/11 4:40 PM Page 9
CHAPTER 1 ■ Biomechanical Applications to Joint Structure and Function
Example 1-1
When the forearm-hand segment and a glass (all consid-
ered as one rigid segment) are brought to the mouth
(Fig. 1–9), rotation of the segment around an axis and
translation of that segment through space occur simulta-
neously. As the forearm-hand segment and glass rotate
around a coronal axis at the elbow joint (one degree of
freedom), the shoulder joint also rotates to translate
the forearm-hand segment forward in space along the
forearm-hand segment’s A-P axis (one degree of freedom).
By combining the two degrees of freedom, the elbow joint
axis (the instantaneous center of rotation for flexion of the
forearm-hand segment) does not remain fixed but moves
in space; the glass attached to the forearm-hand segment
moves through a curvilinear path.
Figure 1–9 The forearm-hand segment rotates around a coro-
nal axis at the elbow joint and along A-P axis (through rotation at
the shoulder joint), using two degrees of freedom that result in a
moving axis of rotation and produce curvilinear motion of the
forearm-hand segment.
Direction of Displacement
Even if displacement of a segment is confined to a single
axis, the rotary or translatory motion of a segment around
or along that axis can occur in two different directions. For
rotary motions, the direction of movement of a segment
around an axis can be described as occurring in a clockwise
or counterclockwise direction. Clockwise and counterclock-
wise rotations are generally assigned negative and positive
signs, respectively.5 However, these terms are dependent on
the perspective of the viewer (viewed from the left side, flex-
ing the forearm is a clockwise movement; if the subject
turns around and faces the opposite direction, the same
movement is now seen by the viewer as a counterclockwise
movement). Anatomic terms describing human movement
are independent of viewer perspective and, therefore, more
useful clinically. Because there are two directions of rotation
(positive and negative) around each of the three cardinal
9
axes, we can describe three pairs of (or six different)
anatomic rotations available to body segments.
Flexion and extension are motions of a segment occur-
ring around the same axis and in the same plane (uniaxial or
uniplanar) but in opposite directions. Flexion and extension
generally occur in the sagittal plane around a coronal axis,
although exceptions exist (e.g., carpometacarpal flexion and
extension of the thumb). Anatomically, flexion is the direc-
tion of segmental rotation that brings ventral surfaces of ad-
jacent segments closer together, whereas extension is the di-
rection of segmental rotation that brings dorsal surfaces
closer together.
Side-bar: Defining flexion and extension by ventral
and dorsal surfaces makes use of the true embryologic
origin of the words ventral and dorsal, rather than using
these terms as synonymous with anterior and posterior,
respectively.
Abduction and adduction of a segment occur around
the A-P axis and in the frontal plane but in opposite direc-
tions (although carpometacarpal abduction and adduction
of the thumb again serve as exceptions). Anatomically, ab-
duction brings the segment away from the midline of the
body, whereas adduction brings the segment toward the
midline of the body. When the moving segment is part of
the midline of the body (e.g., the trunk or the head), the ro-
tary movement is commonly termed lateral flexion (to the
right or to the left).
Medial (or internal) rotation and lateral (or external)
rotation are opposite motions of a segment that generally
occur around a vertical (or longitudinal) axis in the trans-
verse plane. Anatomically, medial rotation occurs as the
segment moves parallel to the ground and toward the mid-
line, whereas lateral rotation occurs opposite to that.
When the segment is part of the midline (e.g., the head or
trunk), rotation in the transverse plane is simply called
rotation to the right or rotation to the left. The exceptions
to the general rules for naming motions must be learned
on a joint-by-joint basis.
As is true for rotary motions, translatory motions of a
segment can occur in one of two directions along any of
the three axes. Again by convention, linear displacement
of a segment along the x-axis is considered positive when
displacement is to the right and negative when it is to the
left. Linear displacement of a segment up along the y-axis
is considered positive, and such displacement down along
the y-axis is negative. Linear displacement of a segment
forward (anterior) along the z-axis is positive, and such
displacement backward (posterior) is negative.1
Magnitude of Displacement
The magnitude of rotary motion (or angular displacement)
of a segment can be given either in degrees (United States
[US] units) or in radians (International System of Units
[SI units]). If an object rotates through a complete circle, it
has moved through 360°, or 6.28 radians. A radian is liter-
ally the ratio of an arc to the radius of its circle (Fig. 1–10).
One radian is equal to 57.3°; 1° is equal to 0.01745 radian.
The magnitude of rotary motion that a body segment moves
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10 SECTION 1 ■ Joint Structure and Function: Foundational Concepts

squared (ft/sec2). Angular velocity (velocity of a rotating

segment) is expressed as degrees per second (deg/sec),
whereas angular acceleration is given as degrees per second
squared (deg/sec2).
An electrogoniometer or a three-dimensional motion
analysis system allows documentation of the changes in
displacement over time. The outputs of such systems are
increasingly encountered when summaries of displace-
ment information are presented. A computer-generated
time-series plot, such as that in Figure 1–11, graphically
portrays not only the angle between two bony segments
(or the rotation of one segment in space) at each point
in time but also the direction of motion. The steepness
of the slope of the graphed line represents the angular
Figure 1–10 An angle of 57.3° describes an arc of 1 radian. velocity. Figure 1–12 plots the variation in linear acceler-
ation of a body segment (or a point on the body segment)
over time without regard to changes in joint angle.

through or can move through is known as its range of

motion (ROM). The most widely used standardized clinical
method of measuring available joint ROM is goniometry, with
units given in degrees. Consequently, we typically will use
degrees in this text to identify angular displacements (rotary
motions). ROM may be measured and stored on computer
for analysis by an electrogoniometer or a three-dimensional
motion analysis system, but these are available predomi-
nantly in research environments. Although we will not be
addressing instruments, procedures, technological capabili-
ties, or limitations of these systems, data collected by these
sophisticated instrumentation systems are often the basis of
research cited through the text.
Translatory motion or displacement of a segment is
quantified by the linear distance through which the object Figure 1–11 When a joint’s range of motion is plotted on the
or segment is displaced. The units for describing transla- y-axis (vertical axis) and time is plotted on the x-axis (horizontal
tory motions are the same as those for length. The SI axis), the resulting time-series plot portrays the change in joint
system’s unit is the meter (or millimeter or centimeter); position over time. The slope of the plotted line reflects the
the corresponding unit in the US system is the foot velocity of the joint change.
(or inch). This text will use the SI system but includes a
US conversion when this appears to facilitate understand-
ing (1 inch = 2.54 cm). Linear displacements of the entire 6000
body are often measured clinically. For example, the 4000
6-minute walk6 (a test of functional status in individuals 2000
Acceleration ( mm/sec2)

with cardiorespiratory problems) measures the distance

0
(in feet or meters) someone walks in 6 minutes. Smaller
full-body or segment displacements can also be measured -2000
by three-dimensional motion analysis systems. -4000
-6000
Rate of Displacement -8000
Although the magnitude of displacement is important, the -10000
rate of change in position of the segment (the displacement -12000
per unit time) is equally important. Displacement per unit
time regardless of direction is known as speed, whereas -14000
0 10 20 30 40 50 60 70 80
displacement per unit time in a given direction is known as
velocity. If the velocity is changing over time, the change Time (100 frames = 1 sec)
in velocity per unit time is acceleration. Linear velocity Figure 1–12 Movement of a point on a segment can be dis-
(velocity of a translating segment) is expressed as meters per played by plotting the acceleration of the segment (y-axis) over
second (m/sec) in SI units or feet per second (ft/sec) in time (x-axis). The slope and trend of the line represent increases
US units; the corresponding units for acceleration are or decreases in magnitude of acceleration as the movement
meters per second squared (m/sec2) and feet per second continues. (Courtesy of Fetters, L: Boston University, 2003.)
2362_Ch01-001-063.qxd 1/29/11 4:40 PM Page 11
CHAPTER 1 ■ Biomechanical Applications to Joint Structure and Function
INTRODUCTION TO FORCES
Definition of Forces
Kinematic descriptions of human movement permit us
to visualize motion but do not give us an understanding of
why the motion is occurring. This requires a study of
forces. Whether a body or body segment is in motion or
at rest depends on the forces exerted on that body. A
force, simplistically speaking, is a push or a pull exerted by
one object or substance on another. Any time two objects
make contact, they will either push on each other or pull
on each other with some magnitude of force (although the
magnitude may be small enough to be disregarded). The
unit for a force (a push or a pull) in the SI system is
the newton (N); the unit in the US system is the pound (lb).
The concept of a force as a push or pull can readily be used
to describe the forces encountered in evaluating human
motion.
Continuing Exploration 1-1:
A Force
Although a force is most simply described as a push or a
pull, it is also described as a “theoretical concept” because
only its effects (acceleration) can be measured.4 Conse-
quently, a force (F) is described by the acceleration (a) of
the object to which the force is applied, with the acceler-
ation being directly proportional to the mass (m) of that
object; that is,
force = (mass)(acceleration)
or F = (m)(a)
Because mass is measured in kilograms (kg) and acceler-
ation in m/sec2, the unit for force is actually kg-m/sec2 or,
more simply, the newton (N). A newton is the force required
to accelerate 1 kg at 1 m/sec2 (the pound is correspondingly
the amount of force required to accelerate a mass of 1 slug
[to be described] at 1 ft/sec2).
External forces are pushes or pulls on the body that
arise from sources outside the body. Gravity (g), the at-
traction of the earth’s mass to another mass, is an external
force that under normal conditions constantly affects all
objects. The weight (W) of an object is the pull of grav-
ity on the object’s mass with an acceleration of 9.8 m/sec2
(or 32.2 ft/sec2) in the absence of any resistance:
weight = (mass)(gravity)
or W = (m)(g)
Because weight is a force, the appropriate unit is the
newton (or pound). However, it is not uncommon to see
weight given in kilograms (kg), although the kilogram
is more correctly a unit of mass. In the US system, the
pound is commonly used to designate mass when it is
appropriately a force unit (1 kg = 2.2 lb). The correct unit
for mass in the US system is the infrequently used slug
(1 slug = 14.59 kg).
11
Continuing Exploration 1-2:
Force and Mass Unit Terminology
Force and mass units are often used incorrectly in the
vernacular. The average person using the metric system
expects a produce scale to show weight in kilograms,
rather than in newtons. In the United States, the average
person appropriately thinks of weight in pounds but also
considers the pound to be a unit of mass. Because people
commonly tend to think of mass in terms of weight (the
force of gravity acting on the mass of an object) and
because the slug is an unfamiliar unit to most people, the
pound is often used to represent the mass of an object in
the US system.
One attempt to maintain common usage while clearly
differentiating force units from mass units for scientific
purposes is to designate lb and kg as mass units and to
designate the corresponding force units as lbf (pound-
force) and kgf (kilogram-force).3,4 When the kilogram is
used as a force unit:
1 kgf = 9.8 N
When the pound is used as a mass unit:
1 pound = 0.031 slugs
These conversions assume an unresisted acceleration
of gravity of 9.8 m/sec2 or 32.2 ft/sec2, respectively.
The distinction between a measure of mass and a meas-
ure of force is important because mass is a scalar quantity
(without action line or direction), whereas the newton and
pound are measures of force and have vector characteristics.
In this text, we will consistently use the terms newton and
pound as force units and the terms kilogram and slug as the
corresponding mass units.
Because gravity is the most consistent of the forces en-
countered by the body, gravity should be the first force to
be considered when the potential forces acting on a body
segment are identified. However, gravity is only one of an
infinite number of external forces that can affect the body
and its segments. Examples of other external forces that
may exert a push or pull on the human body or its seg-
ments are wind (the push of air on the body), water (the
push of water on the body), other people (the push or pull
of an examiner on John Alexander’s leg), and other objects
(the push of floor on the feet, the pull of a weight boot on
the leg). A critical point is that the forces on the body or
any one segment must come from something that is touch-
ing the body or segment. The major exception to this rule
is the force of gravity. However, if permitted, the conceit
that gravity (the pull of the earth) “contacts” all objects on
earth, we can circumvent this exception and make it a
standing rule that all forces on a segment must come from
something that is contacting that segment (including gravity).
The obverse also holds true: that anything that contacts a
segment must create a force on that segment, although the
magnitude may be small enough to disregard.
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12 SECTION 1 ■ Joint Structure and Function: Foundational Concepts

Concept Cornerstone 1-1
Primary Rules of Forces
• All forces on a segment must come from something
that is contacting that segment.
• Anything that contacts a segment must create a force on
that segment (although the magnitude may be small
enough to disregard).
• Gravity can be considered to be “touching” all objects.
Internal forces are forces that act on structures of the body
and arise from the body’s own structures (i.e., the contact of
two structures within the body). A few common examples are
the forces produced by the muscles (the pull of the biceps
brachii on the radius), the ligaments (the pull of a ligament on
a bone), and the bones (the push of one bone on another bone
at a joint). Some forces, such as atmospheric pressure (the
push of air pressure), work both inside and outside the body,
but—in our definition—these are considered external forces
because the source is not a body structure.
External forces can either facilitate or restrict move-
ment. Internal forces are most readily recognized as
essential for initiation of movement. However, it should be
apparent that internal forces also control or counteract
movement produced by external forces, as well as coun-
teracting other internal forces. Much of the presentation
and discussion in subsequent chapters of this text relate to
the interactive role of internal forces, not just in causing
movement but also in maintaining the integrity of joint
structures against the effects of external forces and other
internal forces.
weight boot is not part of the body, although it contacts
the body. Figure 1–14 shows the force of a muscle (e.g.,
the brachialis) pulling on the forearm-hand segment. The
point of application is at the attachment of the muscle,
and the orientation and direction are toward the muscle
(pulls are toward the source of the force). The force is
called muscle-on-forearmhand (represented by the vector
MFh). Although the designation of a force as “external” or
“internal” may be useful in some contexts, the rules for
drawing (or visualizing) forces are the same for external
forces, such as the weight boot, and internal forces, such as
the muscle.
The length of a vector is usually drawn proportional to
the magnitude of the force according to a given scale. For
example, if the scale is specified as 5 mm = 20 N of force, an
arrow of 10 mm would represent 40 N of force. The length
of a vector, however, does not necessarily need to be drawn
to scale (unless a graphic solution is desired) as long as its
magnitude is labeled (as is done in Fig. 1–13). Graphically, the
action line of any vector can be considered infinitely long;
that is, any vector can be extended in either direction (at the
base or at the arrowhead) if this is useful in determining the

Force Vectors
All forces, regardless of the source or the object acted on,
are vector quantities. A force is represented by an arrow
(vector) that (1) has its base on the object being acted
on (the point of application), (2) has a shaft and arrowhead
in the direction of the force being exerted (direction/
orientation), and (3) has a length drawn to represent the
amount of force being exerted (magnitude). As we begin
WbLf (40 N)
to examine force vectors (and at least throughout this
chapter), the point of application (base) of each vector in Figure 1–13 Vector representation of the pull of the weight
each figure will be placed on the segment or object to boot on the leg-foot segment (weightboot-on-legfoot [WbLf]),
which the force is applied—which is generally also the with a magnitude proportional to the mass and equivalent to the
object under discussion. weight of the apparatus.
Figure 1–13 shows John Alexander’s leg-foot segment.
The weight boot is shaded-in lightly for context but is MFh
not really part of the space diagram. Because the weight
boot makes contact with the leg-foot segment, the weight
boot must exert a force (in this case, a pull) on the seg-
ment. The force, called weightboot-on-legfoot (WbLf), is
represented by a vector. The point of application is on the
leg (closest to where the weight boot exerts its pull); the
action line and direction indicate the direction of the pull
and the angle of pull in relation to the leg; and the length
is drawn to represent the magnitude of the pull. The force Figure 1–14 Vector MFh represents the pull of a muscle on the
weightboot-on-legfoot is an external force because the forearm-hand segment.
Another random document with
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 CROCHET INSERTION.

WORKED THE SHORT WAY.

Materials.—Cotton, No. 80. Crochet hook, No. 22.
Make 32 chain.
1st.—Miss 3, 2 dc., † 2 ch., miss 2, 1 dc., †, twice, 2 ch., miss 2, 7
dc., * 2 ch., miss 2, 1 dc. * 3 times, 2 dc.
2nd.—Turn the work; and, in this and the other alternate rows,
take up the side of the stitch nearest to you, whilst in the
intermediate you take up the side farthest from you. 3 ch., twist
them, miss 1, 2 dc., * 2 ch., miss 2, 1 dc. * 5 times, 3 dc., 2 ch., miss 2,
1 dc., 2 ch., miss 2, 3 dc.
3rd.—(Turn the work.) 3 ch., twist, miss 1, 2 dc. on dc., 2 ch., miss
2, 4 dc., 2 ch., miss 2, 1 dc., 2 ch., miss 2, 7 dc., 2 ch., miss 2, 1 dc., 2
ch., miss 2, 3 dc.
4th.—(Turn.) 3 ch., twist, miss 1, 2 dc., 2 ch., miss 2, 4 dc., 2 ch.,
miss 2, 1 dc., + 2 ch., miss 2, 4 dc., + twice, 2 ch., miss 2, 3 dc.
5th.—(Turn.) 3 ch., twist, miss 1, 2 dc., 2 ch., miss 2, 4 dc., 2 ch.,
miss 2, 1 dc. +, 2 ch. miss 2, 4 dc., + twice, 2 ch., miss 2, 3 dc.
6th.—(Turn.) 3 ch., twist, miss 1, 2 dc., 2 ch., miss 2, 4 dc., 2 ch.,
miss 2, 1 dc., 2 ch., miss 2, 7 dc., 2 ch., miss 2, 1 dc., 2 ch., miss 2, 3
dc.
7th.—(Turn.) 3 ch., twist, miss 1, 2 dc., ✕ 2 ch., miss 2, 1 dc. ✕ 6
times, 3 dc., 2 ch., miss 2, 3 dc.
8th.—(Turn.) 3 ch., twist, miss 1, 1 dc., ✕ 2 ch., miss 2, 1 dc., ✕
twice, 3 dc., * 2 ch., miss 2, 1 dc. * 4 times, 2 ch., miss 2, 3 dc.
 Repeat until sufficient is done for the purpose required.
It may be necessary to explain the meaning of the word twist. In
working a crochet pattern backwards and forwards, or in carrying the
thread from one round to another, without joining, in a round
crochet pattern, the neatest way is to make three chain, and then
twist them, letting the loop drop off the needle for the purpose and
resuming it; this looks quite sufficiently like a dc. stitch for all
ordinary purposes.
 NETTED SCARF.

Materials.—6 oz. light blue filoselle, 1 oz. each of white and of

claret ditto. When winding the skeins, split them in half and the
threads will then be quite sufficiently thick. Begin with the border.
Take a round mesh, No. 4, [the size of a common pen-holder,] make
1 stitch.
2nd.—Net 2 in 1.
3rd and succeeding rows.—Add one stitch at the end of every row
until you have thirty one stitches in the row, when you will net two as
one. The next row, you will increase one at the end; the following one
you will diminish until you have done fifty rows in this manner, then
decrease at the end of every row until one stitch only remains.
This being done in white filoselle, may be darned in a handsome
pattern with the claret. A second piece must be done in the same
way. Then two bands, each half the width of this, must be made in
light blue, to one side of which a handsome fringe must be sewed,
and to the other the white netting. The body of the scarf must also be
done in the blue filoselle.
Any handsome scroll or pattern for square crochet, which is not
more than thirty squares wide, may be used for darning the border of
the scarf.
NIGHT CAP IN CROCHET.
 Materials.—Cotton, No. 12; crochet hook, No. 16; eagle card-
board gauge; 184 chain. This pattern is worked principally in close
and open squares.
1st.—4 o., + 1 c., 1 o., 1 c., 7 o., + 5 times, 1 c., 1 o., 1 c., 4 o., 1 dc.
2nd.—3 o., + 2 c., 1 o., 2 c., 5 o., + 5 times, 2 c., 1 o., 2 c., 3 o., 1 dc.
3rd.—5 o., + 1 c., 9 o., + 5 times. 1 c., 5 o., 1 dc.
4th.—1 slip, 3 ch., miss 2, 2 o., + 2 c., 1 o., 2 c., 5 o., + 5 times, 2 c.,
1 o., 2 c., 2 o., 3 ch., miss 2, 1 slip.
5th.—1 slip, 3 ch., miss 2 to 2 o., 1 c., 1 o., 1 c., 7 o., 5 times, 1 c., 1 o.,
1 c., 2 o., 3 ch., 1 slip on the dc. of last row.
6th.—1 slip on the first dc. of the last row, 3 ch., miss 2, open
squares to the last; then 3 ch., miss 2, slip 1 on the last dc.
7th.—1 dc. on the last of the 3 ch. of the preceding row, 1 dc. on the
dc. of the last row, 6 o., + 1 c., 1 o., 1 c., 7 o., + 4 times, 1 c., 1 o., 1 c.,
6 o., 2 dc.
8th.—2 dc., + 5 o., 2 c., 1 o., 2 c., + 5 times, 5 o. 2 dc.
9th.—2 dc., 7 o., + 1 c., 9 o., + 4 times, 1 c., 7 o., 2 dc.
10th.—2 dc., + 5 o., 2 c., 1 o., 2 c., + 5 times, 5 o., 2 dc.
11th.—2 dc., 6 o., + 1 c., 1 o., 1 c., 7 o., + 4 times, 1 c., 1 o., 1 c., 6 o.,
2 dc.
12th.—dc.; open squares to the two last stitches, 2 dc.
13th.—2 dc., 1 o., + 1 c., 1 o., 1 c., 7 o., + 5 times, 1 c., 1 o., 1 c., 1 o.,
2 dc.
14th.—1 dc., + 2 c., 1 o., 2 c., 5 o., + 5 times, 2 c., 1 o., 2 c., 1 dc.
15th.—2 dc., 2 o., + 1 c., 9 o., + 5 times, 1 c. 2 o., 2 dc.
16th—Like 14th.
17th.—Like 13th.
18th.—Like 12th.
 19th.—2 dc., 6 o., + 1 c., 1 o., 1 c., 7 o., + 5 times, 1 c., 1 o., 1 c., 6 o.,
2 dc.
20th.—Like 19th.
21st.—Like 9th.
22nd.—Like 10th.
23rd —Like 11th.
24th and 25th.—Like 12th.
26th.—Forms half the band at the back. + 2 dc., 5 o., (a) turn; 5
ch., miss 2, 4 o., 2 dc., + 4 times between the crosses, and then to (a)
once,. Slip down the upper side to the top of the last dc. stitch, in the
twentieth row; so the first row of the follow point is merely a
continuation of the twenty-sixth row.
1st.—Triangular Point: 2 ch., miss 2, 8 o., 1 dc., turn, 3 ch., miss
2, 8 o., (taking care that the dc. stitches come over those of the
previous row), 1 dc., turn, 3 ch., miss 2, 7 o., 1 dc. on dc., turn, 3 ch.,
miss 2, 6 o., 1 dc. on dc., turn, 3 ch., miss 2, 5 o., 1 dc. on dc., turn, 3
dc., miss 2, 4 o., 1 dc, on dc., turn, 3 ch., miss 2, 3 o., 1 dc. on dc.,
turn, 3 ch., miss 2, 2 o., 1 dc., on dc., turn, 3 ch., miss 2, 1 o., 1 dc. on
dc., turn, 5 ch., miss 3 dc, on dc.; slip stitch up the side of this point
to the twenty-sixth row again, which is thus entirely formed by the
first rows of the points. Work five points and you will have stitches
enough left for five open squares at the end, which are to be worked
to correspond with the other half of the band at the back of the neck.
Sew the ends of the bands together, leaving the Vandyke loose.
Work round the inside of the band and round the Vandyke, thus:—
1st round.—5 ch., miss 2, 1 sc.
2nd.—1 sc. under the chain, 6 ch.; repeat.
It will then be necessary to put a border to the cap itself; and either
any pretty one may be worked on that is already given in this work,
or, if a narrow one be preferred, the following may be adopted:—
1st.—✕ 1 dc., 2 ch., miss 2, ✕; repeat all round except that at the
corners you will work, * 1 dc., 2 ch., miss none, * three consecutive
times.
2nd.—1 sc., 5 ch., miss 3 all round.
 3rd.—✕ 1 sc., 3 dc., 1 sc., under the loop made by one chain of five
of the last round, 3 ch., 1 sc. under the next loop of 5, 3 ch. ✕; repeat.
Plait a cord of narrow braid, and make tassels of the same; run
them through the top of the band at the back, when the ends are
sewed together, and through the point of each Vandyke, and draw it
up when on the head.
 CROCHET EDGING.
[WORKED THE SHORT WAY.]

Materials.—Cotton, No. 20. Chain of 20 stitches; form into a

loop.
1st.—5 ch., + miss 1, 1 dc., 2 ch., + 5 times, 1 dc.
2nd.—9 ch., 1 dc. into loop, + 2 ch., 1 dc. in next, + three times, 7
ch., 1 dc. in last.
3rd.—5 ch., 1 dc. in large loop, + 1 ch., 1 dc. in same, + 6 times, 2
ch., 1 dc. in next loop, 2 ch., 1 dc. in next.
Turn the work, and repeat the 2nd and 3rd rows until sufficient is
done.
TRANSCRIBER’S NOTES
Page Changed from Changed to
10th.—All White: cast 10th.—All White: cast
30
of 2, k. 2, p. 9, k. 4. off 2, k. 2, p. 9, k. 4.
come to the last 9 tc. come to the last 9 tc.
45 stitches, when repeat stitches, then repeat
backwards backwards
11th.—+ 1 tc., on tc. 11th.—+ 1 tc., on tc. of
of last round, 4 ch.
last round, 4 ch. +;
48 ✕; repeat. 12th.—+
Dc. on 4 ch. of last repeat. 12th.—+ Dc. on
4 ch. of last round, 1 ch.
round, 1 ch. ✕;
repeat. +; repeat.
bolland, trimmed holland, trimmed with
80 with worsted braid. worsted braid. There
There are are
12th.—✕ 3 tc. under 12th.—✕ 3 tc. under 6
83 6 ch., 3 tc. under next ch., 3 tc. under next 6
6 ch., 12 ch., + ch., 12 ch., ✕

4 times, ✕. Then
83 4 times, +. Then repeat
repeat from the
from the beginning.
beginning.
5 ch. of last row, * 4
5 ch. of last row, * 4
times, +. Repeat to
times, ✕. Repeat to the
83
the
miss 2, 7 dc., 2 ch. miss 2, 7 dc., 2 ch. miss
85
miss 2, 1 do. 2, 1 dc.
under next loop, * 6
under next loop, * 6
95 times, 5 ch., +. times, 5 ch., ✕. Repeat
Repeat

106
5th.—Knit 2, ✕ m. 1, 5th.—Knit 2, ✕ m. 1, k.
k. 2 t., + twice, k. 2 2 t., ✕ twice, k. 2

19th.—Knit 2, + m. 1, 19th.—Knit 2, + m. 1,
107
k. 2 t., ✕ twice, k. 2 k. 2 t., + twice, k. 2
 108 next loop, 5 ch., slip
through sc. stitch, ✕
3
11th.—17 os. w., 2 dc.
d. b., 3 dc. 1 l. b 2, 2
110
dc. w., dc. l. b., 17 os.
w.
b., (to form the eye),
110
dc. w., 4 dc. l. b., 17
l. b., 15 dc. w., 5 do. l.
111
b; finish as before
twist them, miss 1, 2
113 dc., * 2 ch., miss 2, 1
dc. +
ch., miss 2, 1 dc. + 6
114 times, 3 dc., 2 ch.,
miss 2, 3 dc.
115 1 c., 1 o., 1 c., 7 o., + 5
times, 1 c., 1
116
19th.—2 dc., 6 o., +1
c., 1 o., 1 c., 7 o., ✕ 5
1. Silently corrected palpable typographical
retained non-standard spellings and dialect.
2. Reindexed footnotes using numbers.
next loop, 5 ch., slip
through sc. stitch, + 3
11th.—17 os. w., 2 dc. d.
b., 3 dc. l. b 2, dc. w., ?
dc. l. b., 17 os. w.
b., (to form the eye), ?
dc. w., 4 dc. l. b., 17
l. b., 15 dc. w., 5 dc. l. b;
finish as before
twist them, miss 1, 2
dc., * 2 ch., miss 2, 1 dc.
*
ch., miss 2, 1 dc. ✕ 6
times, 3 dc., 2 ch., miss
2, 3 dc.
1 c., 1 o., 1 c., 7 o., 5
times, 1 c., 1
19th.—2 dc., 6 o., + 1
c., 1 o., 1 c., 7 o., + 5
errors;
*** END OF THE PROJECT GUTENBERG EBOOK THE LADIES'
COMPLETE GUIDE TO CROCHET, FANCY KNITTING, AND
NEEDLEWORK ***

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