Anatomical Terminology
Superior - Higher
Inferior - Lower
Proximal - Closer to the body
Distal - Further away from the body
Supra - Above
Infra - Below
Anterior - In front
Posterior - Behind
Medial - Close to the midline
Lateral - Away from the midline
Hypertonic - Short over-active muscle
Hypotonic - Long weak muscle
Flexion - Decrease in an angle at a joint
Extension - Increase in an angle at a joint
Adduction - Movement towards the body
Abduction - Movement away from the body
Plantar Flexion - Ankle extension
Dorsi Flexion - Ankle flexion
Medial rotation - Rotation inwards
Lateral rotation - Rotation outwards
Supination - Lateral rotation of arm
Pronation - Medial rotation of arm
Protraction - Prolonging a body part
Retraction - Drawing back a body part
Sunday, 16 November 2014
Thursday, 13 November 2014
Maintaining Anatomical Structural Integrity
By now you are probably familiar with the phrase structural integrity as it's a phrase I use a lot and some of you probably aren't familiar with the phrase nor understand what I mean when I use it, so let me explain it in more depth.
We have learned that there are many joints in the body and by now you should understand the structure, functions and importance of these joints. However let me touch more on the importance of maintaining the structural integrity of these joints. What do I mean by structural integrity? Well our body is a complex and intricate structure as you know by now... Therefore when I mention structural integrity I am referring our anatomical shape. During the evolution of the human race our anatomy evolved to adapt to its environment. Therefore this meant obtaining an upright spine enabling us to walk upright on two legs. It also meant obtaining the use of our thumbs to use tools, etc... Therefore we have essentially self designed our anatomical shape through evolving to meet the means of our environment. That's structural integrity! The hard job is maintaining it.
Over time, as we get older and grow, our body shapes can change based on our environment or the tasks we undergo on a daily basis, therefore this can prohibit maintaining structural integrity. In many ways structural integrity is our posture. We are designed to have curves in our spine, a forward facing head, balanced weight on either side of our hips, forward facing toes, etc... We are also designed to have a wide range of motion around these joints. Take into consideration a new born baby, the purest form of nature in the human race. A new born baby is born with more cartilage than bones, roughly 300-350 parts of cartilage. By the time they have finished adolescence and are in their mid twenties they have 206 bones that have fused together via cartilage. This allows the baby to be very flexible as they have no rigid structures preventing this... However I invite you to imagine this scenario. By the age of ten, that once new born baby has developed a restriction of motion when bending down to touch their toes, however when that ten year old was five he made it look easy! Well the reason he could touch his toes at five and not ten is because his refined and under developed muscles have created muscular imbalances that have prevented this action occurring. Well at such a young age, increasing range of movement at a joint isn't too difficult. However, how many of you can touch your toes?
This blog isn't to have a go at you, and I say touch your toes because its a basic movement to show flexibility. However for those of you who can't whats happened is you have most likely developed lower cross syndrome. Sounds scary right? Well it's not and in fact with a little more care and therapy on your anatomy it can be cured. Lower cross syndrome is when you have hypertonic (short and over active) muscles and the opposite muscles being either your antagonist or agonist muscles have switched off making them hypotonic (long and weak). However this is where it can have a detrimental effect on our anatomy pulling our anatomy out of alignment. For example it may be having hypertonic hip flexors and hypotonic glutes pulling our pelvis forward, creating an anterior pelvic tilt. You could also have tight pectorals and traps and weak neck flexors and rhomboids creating a hyper kyphotic curve within the thoracic spine. Essentially the muscle that is hypertonic means that the opposite muscle slowly becomes hypotonic and therefore our hypertonic muscles pull the body out of alignment.
I touch upon this issue as its more often than not overlooked and in fact if we give our anatomy therapy it will help us maintain structural integrity, and maintain full range of motion around our joints like most of us could when we were younger thus ironing out these muscular imbalances. How, you might be asking? Well I touched on it briefly in a previous blog, and its quite simple. Things such as massage therapy are great as it irons out all those muscular imbalances. Also yoga is a great healer of the body and allows for a greater range of motion around our joints. Or something as simple as stretching and not sitting down in one place for too long is an easy and effective activity to do. I'd also invite you to do this. Be conscious of your anatomical shape as often as possible and if it needs altering then make those changes instantly. This will allow you to develop good habits and iron out bad habits through good practice. A key area to stretch is your hip flexors as most of us sit down at some part of the day, some of us may work in offices and therefore we are sitting down most of the day. This will create tension in your gluteal muscles when stretching preventing them from becoming hypotonic and restrict tension in your hip flexors preventing them from becoming hypertonic.
MAINTAIN STRUCTURAL INTEGRITY!
We have learned that there are many joints in the body and by now you should understand the structure, functions and importance of these joints. However let me touch more on the importance of maintaining the structural integrity of these joints. What do I mean by structural integrity? Well our body is a complex and intricate structure as you know by now... Therefore when I mention structural integrity I am referring our anatomical shape. During the evolution of the human race our anatomy evolved to adapt to its environment. Therefore this meant obtaining an upright spine enabling us to walk upright on two legs. It also meant obtaining the use of our thumbs to use tools, etc... Therefore we have essentially self designed our anatomical shape through evolving to meet the means of our environment. That's structural integrity! The hard job is maintaining it.
Over time, as we get older and grow, our body shapes can change based on our environment or the tasks we undergo on a daily basis, therefore this can prohibit maintaining structural integrity. In many ways structural integrity is our posture. We are designed to have curves in our spine, a forward facing head, balanced weight on either side of our hips, forward facing toes, etc... We are also designed to have a wide range of motion around these joints. Take into consideration a new born baby, the purest form of nature in the human race. A new born baby is born with more cartilage than bones, roughly 300-350 parts of cartilage. By the time they have finished adolescence and are in their mid twenties they have 206 bones that have fused together via cartilage. This allows the baby to be very flexible as they have no rigid structures preventing this... However I invite you to imagine this scenario. By the age of ten, that once new born baby has developed a restriction of motion when bending down to touch their toes, however when that ten year old was five he made it look easy! Well the reason he could touch his toes at five and not ten is because his refined and under developed muscles have created muscular imbalances that have prevented this action occurring. Well at such a young age, increasing range of movement at a joint isn't too difficult. However, how many of you can touch your toes?
This blog isn't to have a go at you, and I say touch your toes because its a basic movement to show flexibility. However for those of you who can't whats happened is you have most likely developed lower cross syndrome. Sounds scary right? Well it's not and in fact with a little more care and therapy on your anatomy it can be cured. Lower cross syndrome is when you have hypertonic (short and over active) muscles and the opposite muscles being either your antagonist or agonist muscles have switched off making them hypotonic (long and weak). However this is where it can have a detrimental effect on our anatomy pulling our anatomy out of alignment. For example it may be having hypertonic hip flexors and hypotonic glutes pulling our pelvis forward, creating an anterior pelvic tilt. You could also have tight pectorals and traps and weak neck flexors and rhomboids creating a hyper kyphotic curve within the thoracic spine. Essentially the muscle that is hypertonic means that the opposite muscle slowly becomes hypotonic and therefore our hypertonic muscles pull the body out of alignment.
I touch upon this issue as its more often than not overlooked and in fact if we give our anatomy therapy it will help us maintain structural integrity, and maintain full range of motion around our joints like most of us could when we were younger thus ironing out these muscular imbalances. How, you might be asking? Well I touched on it briefly in a previous blog, and its quite simple. Things such as massage therapy are great as it irons out all those muscular imbalances. Also yoga is a great healer of the body and allows for a greater range of motion around our joints. Or something as simple as stretching and not sitting down in one place for too long is an easy and effective activity to do. I'd also invite you to do this. Be conscious of your anatomical shape as often as possible and if it needs altering then make those changes instantly. This will allow you to develop good habits and iron out bad habits through good practice. A key area to stretch is your hip flexors as most of us sit down at some part of the day, some of us may work in offices and therefore we are sitting down most of the day. This will create tension in your gluteal muscles when stretching preventing them from becoming hypotonic and restrict tension in your hip flexors preventing them from becoming hypertonic.
MAINTAIN STRUCTURAL INTEGRITY!
Tuesday, 4 November 2014
The Anatomy of the Elbow, Wrist and Hand
I thought I'd cover these three joints in one piece as they are already similar to the ones we have covered in previous entries, so by now you should be familiar with the type of joints we have.
Lets begin with the elbow joint...
The elbow is made up of three bones. We have the humerus (upper arm), ulna and radius (bones of lower arm). The articulation between the distal end of the humerus and the proximal end of the ulna means like the knee it is a synovial hinge joint and aids movements such as flexion and extension. However unlike the knee it doesn't aid movements such as medial and lateral rotation as those movements occur at the shoulder joint. Now like all bones it is possible to dislocate the elbow joint and what happens is the humerus shunts forwards and sits on the superior anterior surface of the ulna. Not pretty right...
Well let me run a few bony prominences past you to help you understand the structure further. The elbow bone is anatomically referred to as the olecranon. Along with the olecranon we have a medial and lateral epicondyle which are the bony surfaces of the elbow found on either side of the elbow joint. I presume the term 'funny bone' rings a bell with you. In case you're confused, it's that really annoying tingling sensation you can feel sometimes when you hit the medial aspect of your elbow against something. What essentially happens is when you strike the medial epicondyle, the ulnar nerve causes this tingling sensation of the inside of your elbow. The reason it's so easy to strike your 'funny bone' is because it protrudes posterior to the humerus and makes it easier to strike in comparison to the lateral epicondyle.
The elbow also consists of numerous ligaments similar to the knee. Firstly we have internal ligaments known as our ulna collateral ligament and radial collateral ligament. These ligaments connect our ulna and radius to our humerus and maintain lateral and medial stability of the joint. We also have an external ligament called our annular ligament which wraps around the anterior aspect of the radius and attaches to the ulna, aiding stability in the joint. This allows movements such as pronation and supination to occur. These movements occur in our radioulnar joint which is a pivot joint.
Pronation is palm downward (radius crosses over ulna)
Supination is palm upward
The annular ligament aids the pronation between the joint, allowing the radius to cross over the ulna as shown in the picture (right). We then have two more joints on the posterior surface of the humerus and ulna called the humeroulnar joint and we also have a joint between the humerus and radius called the humeroradial joint. These joints prevent our elbow falling into hyper extension.
At the wrist we have two more bony prominences which can be palpated on the medial and lateral aspect. These are called our styloid processes also referred to as our ulnarstyloid and radialstyloid processes. We then have our scaphoid process which is the first carpal in our hand and can be palpated when we extend our fingers laterally to the tendon in our thumb. It's a common injury that can occur in our everyday lives, and usually as a result of falling and landing on the palm of our hands. This sort of injury can take a while to heal due to the bad blood supply to the bone and often requires surgery. The movements we get at the wrist are flexion, extension, abduction and adduction.
In the hand we have our carpals, metacarpals and phalanges. In total we have eight carpals all with different names which I won't bore you with. We then have five metacarpals and three phalanges in each finger except the thumb in which we only have two, like the foot. The opposable thumb allows us to grip, hold and pick up objects, it is a milestone in the evolution of human beings. Now the joints...
Well, between each section I just mentioned we have a joint. The first joint is our radiocarpal joint which can be palpated between the radius and carpals. We then have our carpometacarpal joint which is located between the carpals and metacarpals. The third joint we have in the hand is our metacarpophalangeal joint (a mouthful I know) which is located between the metacarpals and the phalanges. Finally we have interphalangeal joints, just like the foot. Therefore using anatomic terminology we can distinguish each one. The joints between our second and third phalanges are our distal interphalangeal joints. That means the ones between our first and second are our proximal interphalangeal joints. Now as we know our thumb only has two phalanges so the joint between these two is simply just our interphalangeal joint.
Like the foot the hand has palmer fascia which helps hold everything in place and stretches across the palms of our hands. As well as palmer fascia our fingers are made up of numerous medial and lateral collateral ligaments connecting each phalangeal bone to eachother.
The elbow, wrist and hand are very similar to the other joints I've covered in my previous blogs... In addition to the hand though I'd like to leave you with this thought. The hand very much similar to the foot is a tool we use every day of our lives. For example right now as I type this I am putting strain on the tendons and ligaments of my hand, thus having a knock on effect to the muscles that move the tendons in my hand making them tighter and causing muscular imbalances. We all put strain on the tendons, ligaments and joints of our hands every day yet we forget to aid these joints with therapy. Similarly to the foot our hands our always under tension, whether it be pulling, pushing, twisting or typing, etc... Most of us forget to do the basic movements such as stretching them. In order for our anatomical shape to maintain structural integrity it is vital that we give our bodies therapy and medicine through natural basic activities such as stretching. Whether you find your therapy through yoga, pilates, massage therapy etc... It's vital we give our bodies down time and therapy time!
Lets begin with the elbow joint...
The elbow is made up of three bones. We have the humerus (upper arm), ulna and radius (bones of lower arm). The articulation between the distal end of the humerus and the proximal end of the ulna means like the knee it is a synovial hinge joint and aids movements such as flexion and extension. However unlike the knee it doesn't aid movements such as medial and lateral rotation as those movements occur at the shoulder joint. Now like all bones it is possible to dislocate the elbow joint and what happens is the humerus shunts forwards and sits on the superior anterior surface of the ulna. Not pretty right...
 |
| meded.ucsd.edu |
The elbow also consists of numerous ligaments similar to the knee. Firstly we have internal ligaments known as our ulna collateral ligament and radial collateral ligament. These ligaments connect our ulna and radius to our humerus and maintain lateral and medial stability of the joint. We also have an external ligament called our annular ligament which wraps around the anterior aspect of the radius and attaches to the ulna, aiding stability in the joint. This allows movements such as pronation and supination to occur. These movements occur in our radioulnar joint which is a pivot joint.
 |
| anatomystudybuddy.wordpress.com |
Pronation is palm downward (radius crosses over ulna)
Supination is palm upward
The annular ligament aids the pronation between the joint, allowing the radius to cross over the ulna as shown in the picture (right). We then have two more joints on the posterior surface of the humerus and ulna called the humeroulnar joint and we also have a joint between the humerus and radius called the humeroradial joint. These joints prevent our elbow falling into hyper extension.
At the wrist we have two more bony prominences which can be palpated on the medial and lateral aspect. These are called our styloid processes also referred to as our ulnarstyloid and radialstyloid processes. We then have our scaphoid process which is the first carpal in our hand and can be palpated when we extend our fingers laterally to the tendon in our thumb. It's a common injury that can occur in our everyday lives, and usually as a result of falling and landing on the palm of our hands. This sort of injury can take a while to heal due to the bad blood supply to the bone and often requires surgery. The movements we get at the wrist are flexion, extension, abduction and adduction.
 |
| hqinfo.blogspot.com |
 |
| sketchymedicine.com |
Like the foot the hand has palmer fascia which helps hold everything in place and stretches across the palms of our hands. As well as palmer fascia our fingers are made up of numerous medial and lateral collateral ligaments connecting each phalangeal bone to eachother.
The elbow, wrist and hand are very similar to the other joints I've covered in my previous blogs... In addition to the hand though I'd like to leave you with this thought. The hand very much similar to the foot is a tool we use every day of our lives. For example right now as I type this I am putting strain on the tendons and ligaments of my hand, thus having a knock on effect to the muscles that move the tendons in my hand making them tighter and causing muscular imbalances. We all put strain on the tendons, ligaments and joints of our hands every day yet we forget to aid these joints with therapy. Similarly to the foot our hands our always under tension, whether it be pulling, pushing, twisting or typing, etc... Most of us forget to do the basic movements such as stretching them. In order for our anatomical shape to maintain structural integrity it is vital that we give our bodies therapy and medicine through natural basic activities such as stretching. Whether you find your therapy through yoga, pilates, massage therapy etc... It's vital we give our bodies down time and therapy time!
Sunday, 2 November 2014
The Anatomy of the Shoulder
I can already hear you screaming a question at me, "I dislocated my shoulder and its never recovered, why!"
Lets see if this helps...
The shoulder consists of three bones, The clavicle, scapula and humerus. The shoulder joint is very similar to the hip joint as they are both ball and socket joints. However the key difference between the two is the fact that the hip is a much larger irregular structure that makes it harder to dislocate the joint in comparison to the shoulder. By now you must be excellent on learning joint names... It's simple just merge two bone names to form the joint name (look back over the knee, and foot and ankle entries).
Firstly I should make it clear we have numerous bony prominences protruding around our shoulder joint. We have our acromial and coracoid process which can both be palpated. We also have the spine of the scapula which is the only surface of the scapula you can feel along your back. Right, now that's cleared up we can move on to the joint names.
We have a joint situated between the superior and lateral surface of the sternum and the medial third of the clavicle. This is called our sternoclavicular joint. Also between the last lateral third of our clavicle and the acromion process is our acromioclavicular joint. Finally we have our main joint of the shoulder which is known as our glenohumeral joint. This joint is formed between the humeral head (head of the humerus) and the proximal surface of the glenoid fossa. The glenohumeral joint is a synovial joint (ball and socket). We have a substance called hyaline cartilage which covers the bony ends of the joint and hyaline membrane that holds the joint in place, aiding stability.
The shoulder joint is all about sacrificing stability for mobility. Here's why... The head of our humerus is 2/3 the size of our glenoid fossa which it inserts into, therefore it is only in contact with the glenoid fossa for 1/3 of the time. This decreases the stability within the joint however increases the mobility. The shoulder joint however is quite a deep socket joint that increases stabillity. Labrum (a source of fibrocartilage) adds to stability by increasing the depth round the glenoid fossa, this is called glenoid labrum.
I briefly touched upon the dislocation of the shoulder earlier telling you its easier to dislocate than the hip, however I never told you why... The glenoid labrum that surrounds the socket can wear away when a dislocation is present within the joint. Therefore when the joint is back in place its much easier to pop out. Sounds gross? Well that's cause it is! The glenohumeral joint allows us to perform many movements, such as; rotation, flexion, adduction, abduction, medial and lateral rotation. However in an individual with worn glenoid labrum these movements become hyper movements and can fall quickly into dislocation again.
We also have a shoulder girdle which is often confused with the glenohumeral joint joint. The shoulder girdle is made up of the scapula and clavicle and allows us to perform; elevation, depression, protraction and retraction.
There are numerous ligaments in the shoulder joint. These ligament names are very similar to the joint names and are a combination of two or more bone names. The first ligament we have in the joint is the acromioclavicular ligament which connects the supra lateral third surface of the clavicle and the acromion process. We then have the coracoacromial ligament which attaches the coracoid process to the clavicle. This ligament sits on the superior surface of the coracoid and attaches on to the anterior surface of the clavicle. Finally we have our coracoclavicular ligament which attaches the medial surface of the coracoid to the acromion. These ligaments are known as our static stabilisers and keep the joint in place.
In addition to these stabilisers are another set known as our dynamic stabilisers. These are what allow movement within the joint. We can abbreviate these stabilisers as 'SITS'. These are a group of muscles that all work together to enable rotation of the shoulder, also referred to as our rotator cuff muscles.
S - Supraspinatus
I - Infraspinatus
T - Teres Minor
S - Subscapularis
If you play tennis or badminton or any sport/activity that require many arm over the head motions you will be familiar with rotator cuff problems. These often occur in the sports above because our dynamic stabilisers become tight and hypertonic (short and over active). Therefore when the muscles become extremely hypertonic it limits movement around the shoulder and actually causes extreme pain on this area in the picture (right). Therefore these hypertonic muscles cause muscle impingement which means a task such as putting your hand up in class or stretching to get something out of the cupboard or playing a sport such as badminton becomes difficult. Therefore our muscles become weak as they are hypertonic and makes it much easier to tear tendons.
Well how do we avoid it? Unfortunately theres not a lot you can do. I'd like to invite you to imagine this. Above the spine of our scapula is a tendon that attaches the clavicle to the supraspinatous which inserts onto the supra surface of the humeral head. Therefore when we perform these discomforting activities our tendon gets crushed between our clavicle and humeral head. Doesn't sound nice right? Its not very pleasant at all...
Solution?
Well like I said there's not a lot we can do, however if you are familiar with these problems, such activities such as massage therapy may be a good start or if you can't afford that, then daily stretching exercises of our dynamic stabilisers and our deltoids and pectoral muscles to avoid any upper cross syndrome of our upper appendicular extremities may too be a good place to start.
Lets see if this helps...
The shoulder consists of three bones, The clavicle, scapula and humerus. The shoulder joint is very similar to the hip joint as they are both ball and socket joints. However the key difference between the two is the fact that the hip is a much larger irregular structure that makes it harder to dislocate the joint in comparison to the shoulder. By now you must be excellent on learning joint names... It's simple just merge two bone names to form the joint name (look back over the knee, and foot and ankle entries).
Firstly I should make it clear we have numerous bony prominences protruding around our shoulder joint. We have our acromial and coracoid process which can both be palpated. We also have the spine of the scapula which is the only surface of the scapula you can feel along your back. Right, now that's cleared up we can move on to the joint names.
 |
| bosshin.com |
We have a joint situated between the superior and lateral surface of the sternum and the medial third of the clavicle. This is called our sternoclavicular joint. Also between the last lateral third of our clavicle and the acromion process is our acromioclavicular joint. Finally we have our main joint of the shoulder which is known as our glenohumeral joint. This joint is formed between the humeral head (head of the humerus) and the proximal surface of the glenoid fossa. The glenohumeral joint is a synovial joint (ball and socket). We have a substance called hyaline cartilage which covers the bony ends of the joint and hyaline membrane that holds the joint in place, aiding stability.
The shoulder joint is all about sacrificing stability for mobility. Here's why... The head of our humerus is 2/3 the size of our glenoid fossa which it inserts into, therefore it is only in contact with the glenoid fossa for 1/3 of the time. This decreases the stability within the joint however increases the mobility. The shoulder joint however is quite a deep socket joint that increases stabillity. Labrum (a source of fibrocartilage) adds to stability by increasing the depth round the glenoid fossa, this is called glenoid labrum.
I briefly touched upon the dislocation of the shoulder earlier telling you its easier to dislocate than the hip, however I never told you why... The glenoid labrum that surrounds the socket can wear away when a dislocation is present within the joint. Therefore when the joint is back in place its much easier to pop out. Sounds gross? Well that's cause it is! The glenohumeral joint allows us to perform many movements, such as; rotation, flexion, adduction, abduction, medial and lateral rotation. However in an individual with worn glenoid labrum these movements become hyper movements and can fall quickly into dislocation again.
We also have a shoulder girdle which is often confused with the glenohumeral joint joint. The shoulder girdle is made up of the scapula and clavicle and allows us to perform; elevation, depression, protraction and retraction.
 |
| www.coringroup.com |
There are numerous ligaments in the shoulder joint. These ligament names are very similar to the joint names and are a combination of two or more bone names. The first ligament we have in the joint is the acromioclavicular ligament which connects the supra lateral third surface of the clavicle and the acromion process. We then have the coracoacromial ligament which attaches the coracoid process to the clavicle. This ligament sits on the superior surface of the coracoid and attaches on to the anterior surface of the clavicle. Finally we have our coracoclavicular ligament which attaches the medial surface of the coracoid to the acromion. These ligaments are known as our static stabilisers and keep the joint in place.
In addition to these stabilisers are another set known as our dynamic stabilisers. These are what allow movement within the joint. We can abbreviate these stabilisers as 'SITS'. These are a group of muscles that all work together to enable rotation of the shoulder, also referred to as our rotator cuff muscles.
S - Supraspinatus
I - Infraspinatus
T - Teres Minor
.jpg) |
| www.nlm.nih.gov |
If you play tennis or badminton or any sport/activity that require many arm over the head motions you will be familiar with rotator cuff problems. These often occur in the sports above because our dynamic stabilisers become tight and hypertonic (short and over active). Therefore when the muscles become extremely hypertonic it limits movement around the shoulder and actually causes extreme pain on this area in the picture (right). Therefore these hypertonic muscles cause muscle impingement which means a task such as putting your hand up in class or stretching to get something out of the cupboard or playing a sport such as badminton becomes difficult. Therefore our muscles become weak as they are hypertonic and makes it much easier to tear tendons.
Well how do we avoid it? Unfortunately theres not a lot you can do. I'd like to invite you to imagine this. Above the spine of our scapula is a tendon that attaches the clavicle to the supraspinatous which inserts onto the supra surface of the humeral head. Therefore when we perform these discomforting activities our tendon gets crushed between our clavicle and humeral head. Doesn't sound nice right? Its not very pleasant at all...
Solution?
Well like I said there's not a lot we can do, however if you are familiar with these problems, such activities such as massage therapy may be a good start or if you can't afford that, then daily stretching exercises of our dynamic stabilisers and our deltoids and pectoral muscles to avoid any upper cross syndrome of our upper appendicular extremities may too be a good place to start.
Subscribe to:
Comments (Atom)