lower limb kinesiology amir h. bakhtiary ph.d., pt associate professor physiotherapy department...

Lower Limb KinesiologyLower Limb Kinesiology

Amir H. BakhtiaryAmir H. Bakhtiary

Ph.D., PTPh.D., PT

Associate ProfessorAssociate Professor

Physiotherapy DepartmentPhysiotherapy Department

Rehabilitation facultyRehabilitation faculty

Semnan Medical Sciences Semnan Medical Sciences UniversityUniversity

PelvisPelvisA ring of bone providing articulation for the lower limbs with the trunk.A ring of bone providing articulation for the lower limbs with the trunk.

Questions and SubjectsQuestions and Subjects What is the structure of the Sacroiliac Joint?What is the structure of the Sacroiliac Joint? What is the Mechanical Role of Pelvis?What is the Mechanical Role of Pelvis? What is the factors of Sacroiliac Joint What is the factors of Sacroiliac Joint

Stability?Stability? What is the Movement of Sacroiliac Joints?What is the Movement of Sacroiliac Joints? What is the Clinical Importance of Sacroiliac What is the Clinical Importance of Sacroiliac

Joint?Joint? How to we may test the accessory Movement How to we may test the accessory Movement

of Sacroiliac Joints?of Sacroiliac Joints? What is the Biomechanics role of Sacroiliac What is the Biomechanics role of Sacroiliac

Joints?Joints? What is the Symphysis Pubis?What is the Symphysis Pubis? What is the Pelvic Motions?What is the Pelvic Motions?

What is the Mechanical Role of What is the Mechanical Role of Pelvis?Pelvis?

Pelvis Is Designed to Transfer of Weight from the Trunk

Lower Limbs Ischial Tuberosities

By Loosing of Mobility

Sacroiliac Joints Symphysis Pubis

Additional Roles to Transfer of Weight

Muscle AttachmentSupport the Vicers Support Birth Canal

What is the structure of the What is the structure of the Sacroiliac Joint?Sacroiliac Joint?

Synovial Joint between Illium and Sacrum.Synovial Joint between Illium and Sacrum. Due to the powerful ligaments in posteriorDue to the powerful ligaments in posterior

Anteriorly

SinovialPosteriorly

Fibrous

The SIJs are unique in that both the structure and function of these joints change significantly from birth through adulthood

Sacroiliac JointSacroiliac Joint

It is a C shape jointIt is a C shape joint In first decade of life is smooth and In first decade of life is smooth and

flatflat After puberty, a central ridge in Iliac After puberty, a central ridge in Iliac

and groove on the sacral will appearand groove on the sacral will appear

What is the factors of Sacroiliac What is the factors of Sacroiliac Joint Stability? Joint Stability?

Line of Weight Pass Anterior to the Sacroiliac JointLine of Weight Pass Anterior to the Sacroiliac Joint

Causes

Sacral Move Downward into the Pelvis

Lower PartsTilt Upward

The Bony Surface does Not Bear the

Weight

The Weight is Suspended by the Ligaments

Slight Wedging of the Auricular Surface Resist Rotation and Gliding Movement of

Sacrum

What is the Movement of What is the Movement of Sacroiliac Joints?Sacroiliac Joints?

A little Movement is Allowed by Joint Surface and A little Movement is Allowed by Joint Surface and LigamentsLigaments

There is Slight Gliding and Rotational MovementThere is Slight Gliding and Rotational Movement

Sacroiliac Joint movement During Sacroiliac Joint movement During ChildbirthChildbirth

Nutation and Counternutation Nutation and Counternutation MovementMovement

What is the Clinical Importance of What is the Clinical Importance of Sacroiliac Joint?Sacroiliac Joint?

Sudden Bending ForwardSudden Bending Forward

Tear the Tear the Posterior Posterior LigamentLigament

Dislocate Dislocate the the

Joint Joint surfacesurface

Painful Painful Trunk Trunk

FlexionFlexionManipulation often Produce a Manipulation often Produce a

Successful ResultSuccessful Result

How How do do we may test the accessory we may test the accessory Movement of Sacroiliac Joints?Movement of Sacroiliac Joints?

These Movements are Limited by the Powerful Ligaments.These Movements are Limited by the Powerful Ligaments.

To Test These To Test These MovementsMovements

Prone PositionProne Position

Pressure by the Heel of Pressure by the Heel of the Handthe Hand

On the Apex of Sacrum On the Apex of Sacrum DownwardDownward

Small Rotation of the Small Rotation of the SacrumSacrum

What is the Biomechanics role of What is the Biomechanics role of Sacroiliac Joints?Sacroiliac Joints?

Two Trabecular Systems From Sacrum to PelvisTwo Trabecular Systems From Sacrum to Pelvisand Then to the head of Femurand Then to the head of Femur

Trabecular Trabecular sysemsysem

نحوه انتقال وزن در ساکروایلیاک و مفصل

ران چگونه است؟

What is the Symphysis What is the Symphysis Pubis?Pubis?

Secondary Cartilaginous Joint.Secondary Cartilaginous Joint. A Thin Layer of Hyaline Cartilage Cover the Bone.A Thin Layer of Hyaline Cartilage Cover the Bone. This Cartilage is Joined to the Opposite Cartilage by a This Cartilage is Joined to the Opposite Cartilage by a

Fibrocartilage Interpubic Disc.Fibrocartilage Interpubic Disc. Two Ligaments Support the Joint:Two Ligaments Support the Joint:

1) Superior Pubic Ligament1) Superior Pubic Ligament

2) Arcuate Pubic Ligament2) Arcuate Pubic Ligament The anterior portion of the joint is reinforced by The anterior portion of the joint is reinforced by

aponeurotic expansions from a number of muscles that aponeurotic expansions from a number of muscles that cross the jointcross the joint

No Normally MovementNo Normally Movement Pathology:Pathology:

Slipping of one pubic Slipping of one pubic to other (Osteitis Pubis)to other (Osteitis Pubis)

The aponeurotic extensions of the muscles crossing the anterior aspect of the symphysis pubis

What is the Pelvic Motions?•open kinematic chain motions

•anterior tilt ： ASIS moves anteriorly and inferiorly •posterior tilt ： ASIS moves posteriorly and superiorly •lateral tilt to the left/right ： one ASIS is higher than the other (Pelvic list during Gait)•Lateral forward and Backward displacement

www.pt.ntu.edu.tw-hmchai-Kines04-KINspine-PelvicGirdle.files-PelvisWBline.png.url

The pelvis lists downward (obliquity) to increase the effective leg length at toe-off and heel-strike

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http://rds.sem-ums.ac.ir/fs/files/http://rds.sem-ums.ac.ir/fs/files/drbakhtiary/sacroilliac and pubis joints drbakhtiary/sacroilliac and pubis joints kinesiology.pptkinesiology.ppt