Biomechanics of gait (4)

AFTAB AHMED MIRZA BAIG

Senior physiotherapist
Institute of Physical Medicine & Rehabilitation
Dow University of Health Sciences
DATE: 12-06-19
 Electromyography (EMG)
 An assessment tool used to determine electrical
activity in muscle during contraction
 The most accurate means to determine the roles of
muscles in movement patterns
 2. Needle Electrodes Method:
For deeper muscles Activity

1.Surface Electrodes Method: For

superficial muscles Activity
 Electromyography (EMG)
 EMG can determine …..
 which muscle is contracted during the movement pattern
 when and how strongly each of the muscles contracted
during the movement pattern
 which one of a number of possible muscles that have a
particular joint action, is recruited by the nervous system
to contract during specific movement patterns
 Muscular Activity During The
Gait Cycle
• The entire body is involved in the gait cycle

• Improper mechanics during the gait cycle often

lead to functional problems throughout the body

• Assessment and appropriate treatment of the

improper mechanics of gait is important
 Hip Joint Flexor Muscles
 Hip joint flexors have two roles during the gait cycle …
1. Contract concentrically to create the forward swing of the
lower extremity during the 1st half of the swing phase
2. Act eccentrically to decelerate the extension of hip joint
that is occurring before toe-off of the stance phase
 Swing phase is characterized by flexion of the hip joint
 Contraction of the hip flexors is necessary only during the
1st half of the swing phase. The 2nd half of the swing
phase is completed by momentum of the limb (i.e., swing
phase is a ballistic motion)
 Major hip joint flexors:
 Iliopsoas, Sartorius & Rectus Femoris
 Hip Joint Extensor Muscles
 Hip joint extensors have Two roles during the gait
cycle ...
1. Contract eccentrically to decelerate the forward-swinging
limb at the swing phase (i.e. their force of extension on
the hip joint slows down flexion of the thigh at the hip
joint during the swing phase)
2. Contract isometrically on heel-strike of the stance phase to
stabilize the pelvis from anteriorly tilting at the hip joint.
This contraction is necessary to prevent the pelvis and
upper body from being thrown forward because of
momentum when the lower extremity's forward
movement is stopped by striking the ground
 Major hip joint extensors:
 Hamstrings & Gluteus maximus
 Hip Joint Abductor Muscles
 Hip abductors have Two important Roles ….
1. Primary Role …. Depression of the pelvis on stance side
(particularly during the 1st half of stance
phase)
2. Secondary Role …. Stabilization of the pelvis on swing
side

 Depression of Pelvis on stance side …..

 The reverse action of abduction of the hip joint
 By creating a force of depression on stance side, they
stabilize the pelvis (and upper body) on swing side to stop it
from dropping
 Hip Joint Abductor Muscles
 Stabilization of the pelvis on swing side ….
 The hip abductors usually contract isometrically
 Actually, the pelvis is permitted to drop slightly toward the
swing side; therefore the hip abductors contraction is
slightly eccentric
 Without this stabilization, the pelvis would fall toward the
swing side, because when the body is in single-limb
support, the center of weight of the body is not balanced
over the support limb but rather located toward the swing
side
 Major hip joint abductors ……
 Gluteus medius & Gluteus minims
 Tensor fasciae latae & Sartorius
 Hip Joint Adductor Muscles
 Hip joint adductors have Two roles during the gait cycle
1. Contract at heel-strike to aid in extension of the hip joint
as the force of hitting the ground travels up through the
lower extremity
2. Contract again just after toe-off to aid in flexion of the
hip joint
 This muscle group has the ability to extend the thigh when
it is flexed and flex the thigh when it is extended
 Major hip joint adductors ……
 Adductor Longus, Brevis & Magnus
 Pectineus and Gracilis
 Hip Joint Medial Rotator Muscles
 These muscles are active during the stance phase of gait
 During stance phase ……
 The thigh is relatively fixed and the pelvis is mobile
 Therefore, ipsilateral rotation of the pelvis at the hip joint
occurs (reverse action of med. Rotators on pelvis), pulling
the entire pelvis forward
 Ipsilateral rotation of the pelvis helps to advance the swing-
limb forward
 Major hip joint medial rotators ……
 Tensor fasciae latae
 Anterior fibers of the Gluteus Medius & Minimus
 Hip Joint Lateral Rotator Muscles
 Primarily active during the stance phase of gait
 During stance phase ……
 Contralateral rotation of the pelvis at hip joint occurs (i.e.
the Reverse action of lateral rotator on pelvis)
 This action controls the reverse action of medial rotator
muscles on pelvis at hip joint
 Contralateral rotation of the pelvis is extremely important
when planting and cutting in sports
 Major hip joint lateral rotators …….
 Gluteus maximus, Posterior fibers of Gluteus medius &
minimus
 Piriformis, Sup. & Inf. Gemelli, Obturators Internus &
Externus, and Quadratus femoris
Contralateral Rotation of the Pelvis
 Knee Joint Extensor Muscles
 Knee joint extensors have two roles during the gait cycle
1. Contract concentrically at the end of swing phase to
extend the leg at the knee joint to prepare the leg for heel-
strike
2. Contract eccentrically to decelerate the knee joint flexion
in the early stage of stance phase just after heel-strike and
then contract concentrically to create extension of the
knee joint as we approach midstance
• Major knee joint extensors …..
 Quadriceps Femoris (Vastus Lateralis, Vastus Medialis,
Vastus Intermedius and the Rectus Femoris)
 Knee Joint Flexor Muscles
 Knee joint flexors have three roles during the gait cycle ….
1. Contract eccentrically to decelerate knee joint extension just
before heel-strike
2. Contract concentrically just after heel-strike to stabilize the
knee joint in the early stage of the stance phase
3. Contract concentrically during the swing phase to keep the
foot from dragging on the ground
 Major knee joint flexors ……
 Hamstring muscles (Biceps Femoris, Semitendinosus &
Semimembranosus)
 Gastrocnemius muscle
 Interpretation of the role of knee flexors in gait cycle can
be difficult because the hamstrings are also hip joint
extensors
 Ankle Joint Dorsiflexors Muscles
 Ankle joint Dorsiflexors have two roles during the gait cycle …..
1. Contract eccentrically during stance phase (between heel-strike and
foot-flat) to decelerate plantarflexion of the ankle joint.
This allows the foot to be lowered to the ground in a controlled
manner as the body weight transfers over the stance limb
2. Contract concentrically during the swing phase of the gait cycle to
create dorsiflexion of the ankle joint and to keep the toes from
scraping on the ground
 Foot Slap …. When the foot is not brought to the ground in a
controlled manner at the beginning of the stance phase, it makes a
slapping noise due to impact with ground. It is usually caused by
nerve compression of the deep fibular nerve
 Major ankle joint Dorsiflexors …..
 Tibialis Anterior, Extensor Digitorum Longus, Extensor Hallucis
Longus, Fibularis Tertius
 Ankle Joint Plantarflexor Muscles
 Ankle joint Plantarflexors have two roles during the gait
cycle …..
1. Contract eccentrically during most of the stance phase to
decelerate dorsiflexion of the ankle joint.
During stance phase the foot is fixed to the floor and the
plantarflexion is necessary to decelerate the reverse action
(i.e. anterior translation of the shank on foot at ankle joint).
Without this plantarflexion force, the shank would collapse
anteriorly at the ankle joint.
2. Contract more forcefully in a concentric manner at heel-off
during the late stage of the stance phase to help push the
foot off the floor
 Major ankle joint Plantarflexor …..
 Gastrocnemius, Soleus
 Subtalar Joint Supinator Muscles
• They have two roles during gait cycle …..
1. Contract eccentrically during heel-strike to foot-flat to
decelerate pronation of the foot. During this point,
pronation of foot is a passive process caused by the body
weight moving over the arch of the foot
2. Contract concentrically during foot-flat and toe-off to
supinate the foot at the subtalar joint
 Shin Splints …In excessively pronation of the foot, the
supinators will often overwork trying to counter the
pronation during weight bearing. It causes pain and
soreness in the supinator muscles (esp. the Tibialis Post.
and/or Tibialis Ant.). This condition is called shin splints
 Major Subtalar Joint Supinators ……
 Tibialis Post., Tibialis Ant., Flex. Dig. Longus, Flex.
Hall. Longus and the foot’s intrinsic muscles
 Intrinsic Muscles of the Foot
 They are believed to give support to the arches of the
foot
 Because excessive pronation is a collapse of the medial
longitudinal arch of the foot, they are considered to be
supinators and prevent excessive pronation of the foot

 When shoes are worn all day, much of the need for
intrinsic muscles to contract is lost and become weak

 Weakness of these muscles may lead to develop

Excessive Pronation
 Subtalar Joint Pronator Muscles
 They are active during foot-flat to toe-off
 They contract eccentrically during this point along with
supinators to stabilize the foot and make it more rigid to
assist in pushing the ground off for propulsion
 During heel-strike to foot-flat, pronation of the foot is a
passive process caused by the body weight moving over
the arch of the foot
 Major subtalar joint Pronators ……
 Fibularis Longus and Brevis
 ‘Weak person makes excuse for bad
circumstances whereas brave makes those
circumstances a reason to dream big’.