Chapter 8: Introduction to clinical biomechanics

INTRODUCTION

The term ‘biomechanics’ can be used in a variety of ways. In this book, biomechanics refers to the description, analysis and assessment of human movement during sporting activities.¹ Broadly, biomechanics can be broken into three categories, including ‘kinematics’ (movement we can see), ‘kinetics’ (forces driving the movement) and ‘neuromotor’ (muscle function controlling forces and movement). This chapter will focus primarily on the actual movement occurring in the body segments (kinematics). Our approach can be referred to as ‘subjective biomechanical analysis’. We aim to describe movement such as running or squatting as it appears to visual observation. This reflects how clinicians assess and treat, and it can be done with the assistance of video analysis and without expensive laboratory equipment.

The aims of this chapter are to:

• outline the basics of ‘ideal’ lower limb biomechanics

• explain the ideal biomechanics with running

• describe lower limb biomechanical assessment in the clinical setting

• outline how to clinically assess footwear

• review the best available evidence associating biomechanical factors with injuries, as well as sharing clinical opinions as to which technical factors in sports contribute to specific injuries

• discuss how to manage biomechanical abnormalities detected in the assessment

• explain normal and abnormal upper limb biomechanics.

We address lower limb and upper limb biomechanics separately for the learner’s convenience, but the experienced clinician will consider the close relationship between the upper and lower limbs during a variety of functional tasks. Ultimately, biomechanical evaluation should be completed based on task specificity to ensure the clinician is confident in the accuracy of information obtained.

‘IDEAL’ LOWER LIMB BIOMECHANICS—THE BASICS

Here we discuss ideal structural characteristics, including available joint range of motion and stance position. Note that each individual has his or her own mechanical make-up due to structural characteristics (anatomy), and may never achieve the ‘ideal’ position or biomechanical function. Table 8.1 and Figure 8.1 provide reference for ideal joint range of motion and planes of movement respectively.