MUSCLE FUNCTION

MUSCLE TENSION
• The most important characteristic of a muscle is its ability to develop tension
and to exert a force on the bony lever.
• Tension can be either active or passive, and the total tension that a muscle
can develop includes both active and passive components.
• Total tension, is a vector quantity that has
(1) magnitude,
(2) two points of application (at the proximal and distal muscle at tachments),
(3) an action line, and
(4) direction of pull.
 PASSIVE TENSION
• Passive tension refers to tension developed in the parallel elastic component
of the muscle.
• Passive tension in the parallel elastic component is created by lengthening
the muscle beyond the slack length of the tissues.
• The parallel elastic component may add to the active tension produced by
the muscle when the muscle is lengthened.
• The total tension that develops during an active contraction of a muscle is a
combination of the passive (noncontractile) tension added to the active
(contractile) tension (Fig. 3–13).
 ACTIVE TENSION
• Active tension refers to tension developed by the contractile elements of the
muscle.
• Active tension in a muscle is initiated by cross-bridge formation and
movement of the thick and thin filaments.
• The amount of active tension that a muscle can generate depends on neural
factors and mechanical properties of the muscle fibers.
• The neural factors that can modulate the amount of active tension include
the frequency, number, and size of motor units that are firing.
• The mechanical properties of muscle that determine the active tension are
the isometric length tension relationship and the force-velocity relationship.
 ISOMETRIC LENGTH-TENSION
RELATIONSHIP

• There is a direct relationship between isometric tension development in a

muscle fiber and the length of the sarcomeres in a muscle fiber.
• There is an optimal sarcomere length at which a muscle fiber is capable of
developing maximal isometric tension.
• Muscle fibers develop maximal isometric tension at optimal sarcomere length
because the thick and thin filaments are positioned so that the maximum
number of cross-bridges within the sarcomere can be formed.
• If the muscle fiber is lengthened or shortened beyond optimal length, the
amount of active tension that the muscle fiber is able to generate when
stimulated decreases.
• When a muscle fiber is lengthened beyond optimal length, there is less overlap
be tween the thick and thin filaments and consequently fewer possibilities for
cross-bridge formation.
• However, the passive elastic tension in the parallel component may be
increased when the muscle is elongated. This passive tension is added to the
active tension, resulting in the total tension.
• A similar loss of isometric tension or diminished capacity for developing
tension occurs when a muscle fiber is shortened from its optimal sarcomere
length.
• When the sarcomere is at shorter lengths, the distance between the Z discs
decreases and there is interdigitation of the filaments.
• The interdigitation of the thick and thin filaments may interfere with the
formation of cross-bridges from the myosin molecules, thus decreasing the
active force.
• It must be remembered that the sarcomere length tension relationship was
determined with isometric contractions and therefore should apply, in the
strict sense, only to isometric muscle contraction.
 APPLICATION OF THE LENGTH-TENSION
RELATIONSHIP

• For example, sarcomere length is not homogeneous throughout the muscle,

let alone between muscles with similar functions.
• This means that for any particular whole muscle length at a particular joint
position, there may be sarcomeres at many different lengths corresponding
to different points on the length-tension relationship.
 FORCE-VELOCITY RELATIONSHIP
• Another factor that affects the development of tension within a muscle is the
speed of shortening of the myofilaments.
• The speed of shortening is the rate at which the myofilaments are able to
slide past one another and form and re-form cross-bridges.
• Remember that the speed of shortening is related to muscle fiber type as
well as muscle fiber length.
• From the experiments on isolated muscles, the force-velocity relationship states
that the velocity of muscle contraction is a function of the load being lifted but,
from a clinical perspective, it may also be stated with the variables reversed (the
force generated is a function of the velocity of the muscle contraction).
• For example, in a concentric muscle contraction, as the shortening speed
decreases, the tension in the muscle increases.
• In an isometric contraction, the speed of shortening is zero and tension is greater.
• In an eccentric contraction, as the speed of lengthening increases, the tension in
the muscle increases.
• Not only is this relationship seen in experimental conditions with isolated muscles
lifting a load, but it is also seen, to some degree, in intact muscle moving bony
levers.
 TYPES OF MUSCLE ACTION
• Muscle actions (or contractions) are described as-
1. Isometric contraction (constant length) –
• An isometric contraction occurs when the muscle is activated and the
sarcomere does not change in length.
• No work is done by the muscle.
• 2. Dynamic contractions consisting of concentric contraction (shortening of
the muscle under load) –
• a concentric contraction occurs when the sarcomere shortens.
• During a concentric contraction, the bones move closer together as the
whole muscle shortens.
• Positive work is being done by the muscle because the joint moves through a
ROM.
3. Eccentric contraction (lengthening of the muscle under load) –
• an eccentric contraction occurs when the sarcomere lengthens.
• During an eccentric contraction, the bones move away from each other as the
muscle tries to control the descent of the weight.
• The muscle lengthens as the joint moves through the ROM.
• The work that is being done during an eccentric contraction is called negative
work because the work is done on the muscle rather than by the muscle.
4. Isotonic contraction - is not used here because it refers to equal or constant
tension, which rarely, if ever, occurs during normal human movements
 PRODUCTION OF TORQUE

• As clinicians, we often assess the patient’s muscle strength.

• Whether we assess that strength by using an instrument (such as an
isokinetic device) or by simple manual pressure, we are actually determining
the amount of joint torque that the muscle can produce.
• The Moment Arm of the muscle can change with joint position, thereby affecting
the torque being produced.
• For example (Fig. 3–21).
• Remember that as the joint moves, the muscle length changes.
• From the discussion of the length-tension relationship of the muscle, we know
that the muscle force will vary as the muscle is lengthened or shortened.
• There fore, at different joint positions, both the Moment Arm of the muscle and
the length of the muscle affect the amount of joint torque that can be produced.
• In addition, during dynamic movements, the velocity of the shortening or
lengthening affects the amount of force that the muscle produces, thus affecting
the torque production.
 INTERACTION OF MUSCLE AND TENDON

• For example, During an isometric contraction, the muscle actually shortens

slightly and the tendon lengthens slightly. In many muscles, the fibers may
shorten and the tendon may lengthen by as much as 10% of their resting
length during an isometric contraction .
• The compliance of the tendon (or ability to lengthen under load) is important
in augmenting the torque production of the muscle.
• This is the basis for plyometric exercises, in which the muscle/tendon
complex is stretched before a forceful concentric contraction.
• The stretch immediately before the concentric contraction helps produce a
much greater torque during the concentric contraction.
 ISOKINETIC EXERCISE AND TESTING
• In isokinetic exercise and testing, the angular velocity of the bony component
is preset and kept constant by a mechanical device throughout a joint ROM.
• Because the speed of joint motion is controlled by the isokinetic device, the
resistance is directly proportional to the torque produced by the muscle at all
points in the ROM.
• Therefore, as the torque produced by a muscle increases, the magnitude of
the torque of the resistance increases proportionately.
• This provides an excellent means of testing muscle strength.
• Isokinetic devices such as a Biodex, Cybex, or Kin Com are commonly used in
many clinics.
• As long as the preset speed is achieved, the isokinetic device provides
resistance that exactly matches the torque produced by a muscle group
throughout the ROM.
• For example, the least amount of resistance is provided by an isokinetic
device at the point in the ROM at which the muscle has the least torque-
producing capability.
• The resistance provided is greatest at the point in the ROM at which the
muscle has the largest torque-producing capability.
 SUMMARY OF INTRINSIC AND EXTRINSIC
FACTORS INVOLVING ACTIVE MUSCLE
TENSION
The velocity of muscle contraction is affected by:
• recruitment order of the motor units: Units with slow conduction velocities
are generally recruited first.
• type of muscle fibers in the motor units: Units with type II muscle fibers can
develop maximum tension more rapidly than units with type I muscle fibers;
rate of cross-bridge formation, breaking, and re-formation may vary.
• the length of the muscle fibers: Long fibers have a higher shortening velocity
than do shorter fibers.
The magnitude of the active tension is affected by:
• size of motor units: Larger units produce greater tension.
• number and size of the muscle fibers in a cross-section of the muscle: The
larger the cross-section, the greater the amount of tension that a muscle may
produce number of motor units firing: The greater the number of motor units
firing in a muscle, the greater the tension.
• frequency of firing of motor units: The higher the frequency of firing of motor
units, the greater the tension.
• sarcomere length: The closer the length is to optimal length, the greater the
amount of isometric tension that can be generated.
• fiber arrangement: A pennate fiber arrangement gives a greater number of
muscle fibers and potentially a larger PCSA, and therefore a greater amount of
tension may be generated in a pennate muscle than in a parallel muscle.
• type of muscle contraction: An isometric contraction can develop greater
tension than a concentric contraction; an eccentric contraction can develop
greater tension than an isometric contraction.
• speed: As the speed of shortening increases, tension decreases in a
concentric contraction. As speed of active lengthening increases, tension
increases in an eccentric contraction.
 CLASSIFICATION OF MUSCLES

• Individual muscles may be named in many different ways, such as

• according to shape (rhomboids, deltoid),
• number of heads (biceps, triceps, quadriceps),
• location (tibialis anterior),
• combination of location and function (extensor digitorum longus, flexor
pollicis brevis).
• When muscles are categorized on the basis of action, muscles that cause
flexion at a joint are categorized as flexors.
• Muscles that cause either extension or rotation are referred to as extensors
or rotators, respectively.
• When muscles are categorized according to role, individual muscles or
groups of muscles are referred to as the agonists, antagonists, or synergists
for a particular motion.
1. Based on the Role of the Muscle in Movement
2. Based on Muscle Architecture
3. Based on Length of the Moment Arm
1. BASED ON THE ROLE OF THE MUSCLE IN
MOVEMENT

• The term prime mover (agonist) is used to designate a muscle whose role is
to produce a desired motion at a joint.
• If flexion is the desired action, the flexor muscles are the prime movers and
the extensor muscles that are directly opposite to the desired motion are
called the antagonists.
• The desired motion is not opposed by the antagonists, but these muscles
have the potential to oppose the action.
• Ordinarily, when an agonist (for example, the biceps brachii) is called on to
perform a desired motion (elbow flexion), the antagonist muscle (the triceps
brachii) is inhibited.
• If, however, the agonist and the potential antagonist contract
simultaneously, then co-contraction occurs (Fig. 3–23).
• Co-contraction of muscles around a joint can help to provide stability for the
joint.
• Co-contraction of muscles with opposing functions can be undesirable when
a desired motion is prevented by involuntary co-contraction, such as occurs
in disorders affecting the control of muscle function (e.g., cerebral palsy).
• Muscles that help the agonist to perform a desired action are called
synergists.
• Synergists may assist the agonist directly by helping to perform the desired
action, or the synergists may assist the agonist indirectly either by stabilizing
a part or by preventing an undesired action.
 2. BASED ON MUSCLE ARCHITECTURE
• However, muscles can change roles. A potential antagonist in one instance
may be a synergist in another situation.
• For example, the extensors and flexors on the ulnar side of the wrist are
antagonists during the motion of radial deviation, but during ulnar deviation,
these same muscles are synergists.
• Despite this apparent change in role, muscles that have similar functions also
have similar architectural characteristics.
• In the lower extremity, the knee extensors (Quadriceps) have a short fiber
length and large Physiological Cross Sectional Area, as opposed to the knee
flexors, which have a longer fiber length and smaller PCSA.
ARRANGEMENT OF FASCICLES
 3. BASED ON LENGTH OF THE MOMENT
ARM
• The length of the muscle MA is an important component of determining the
joint torque and, in combination with the fiber length, the ROM through which
the muscle can move the joint.
• The ratio of the fiber length to the MA provides a way of identifying which
factor plays a greater role in the production of the joint torque and in
determining the resulting ROM at the joint.
• For example, the ratio of fiber length to the MA is much higher in the wrist
extensor muscles compared to the wrist flexor muscles.
• This suggests that fiber length plays a greater role than does the MA in the
wrist extensors and that the MA plays a greater role than fiber length in the
wrist flexors.
 FACTORS AFFECTING MUSCLE FUNCTION

1. Types of joints and location of muscle attachments

2. Number of joints crossed by the muscle
3. Passive insufficiency
4. Sensory receptors
 1. TYPES OF JOINTS AND LOCATION OF
MUSCLE ATTACHMENTS

• The muscle’s location or line of action relative to the joint determines which
motion the muscle will perform.
• In general, muscles that cross the anterior aspect of the joints of the upper
extremities, trunk, and hip are flexors, whereas the muscles located on the
posterior aspect of these joints are extensors.
• Muscles located laterally and medially serve as abductors and adductors,
respectively, and may also serve as rotators.
• Muscles whose distal attachments are close to a joint axis are usually able to
produce a wide ROM of the bony lever to which they are attached.
• Muscles whose distal attachments are at a distance from the joint axis, such
as the brachioradialis, are designed to provide stability for the joint, because
a large majority of their force is directed toward the joint that compresses the
joint surfaces (Fig. 3–27).
• A muscle provides maximum joint stabilization at the point at which its
compressive component is greatest.
• Disturbances of the normal ratio of agonist antagonist pairs may create a
muscle imbalance at the joint and may place the joint at risk for injury.
• For example, weakness of the hip external rotators causes a strength
imbalance between hip external and internal rotation that may result in
excess hip internal rotation during gait.
• Agonist-antagonist strength ratios for normal joints are often used as a basis
for establishing treatment goals after an injury to a joint.
 2. NUMBER OF JOINTS

• Many functional movements require the coordinated movement of several

joints controlled by a combination of muscles that cross one or many of the
joints.
• One way of providing an efficient movement pattern is through the
coordinated efforts of single-joint and multijoint muscles.
• In many ways, the number of joints that the muscle crosses determines the
muscle function.
• Single-joint muscles tend to be recruited to produce force and work, primarily
in concentric and isometric contractions.
• This recruitment strategy occurs primarily when a simple movement is
performed at one joint, but it may also be used during movements involving
multiple joints.
• Multi joint muscles tend to be recruited during more complex motions
requiring movement around multiple axes.
• For example, the movement of elbow flexion with concurrent supination uses
the biceps brachii (a multijoint muscle) with added contribution of the
brachialis (a single-joint muscle).
• This may seem obvious because of the attachment of the biceps brachii to
the radius, which allows supination, whereas the brachialis attaches to the
ulna and allows only flexion of the elbow.
• If a single-joint motion is desired, a single-joint muscle is recruited because
recruitment of a multijoint muscle may require the use of additional muscles
to prevent motion from occurring at the other joint or joints crossed by the
multijoint muscles.
• For example, elbow flexion with the forearm in pronation is accomplished
primarily with the brachialis, not with the biceps brachii.
• Single-joint and multijoint muscles may also work together in such a way that
the single-joint muscle can assist in the movement of joints that it does not
cross.
• For example, the simple movement of standing up from a chair requires knee
and hip extension.
• The hip extension is accomplished by activation of the single-joint hip
extensor muscles (gluteus maximus) and the multijoint hip extensors
(hamstrings).
• The concomitant knee extension is accomplished by activation of the single-
joint knee extensor muscles (vastus muscles) and the multijoint knee
extensors (rectus femoris).
• An interesting corollary is that the single-joint knee extensors may actually
assist in hip extension in this movement of standing from a chair.
 3. PASSIVE INSUFFICIENCY

• If a person’s elbow is placed on a table with the forearm in a vertical position

and the hand is allowed to drop forward into wrist flexion, the fingers tend to
extend (Fig. 3–29A).
• Extension of the fingers is a result of the insufficient length of the finger
extensors that are being stretched over the flexed wrist.
• The insufficient length is termed passive insufficiency.
• If the person moves his or her wrist back ward into wrist extension, the
fingers will tend to flex (Fig. 3–29B).
• In this example, at the same time that the finger flexors are shortened, the
inactive finger extensors are being passively stretched over all of the joints that
they cross.
• The extensors are providing a passive resistance to wrist and finger flexion at
the same time that the finger flexors are having difficulty performing the
movement (Fig. 3–30).
• Similar examples can be found in the rectus femoris and the hamstring muscles
in the lower extremities.
• The rectus femoris may limit active knee flexion if the hip is in a position of
extension, and the hamstrings may limit active knee extension if the hip is in a
position of flexion.
• Such positions are not usually encountered in normal activities of daily living,
but they may be encountered in sports activities.
 4. SENSORY RECEPTORS

• Normal motor control resulting in voluntary movements depends on the

coordination of descending motor path ways from the cortex, muscle actions,
and a constant flow of sensory information.
• When performing or participating in athletic events, highly skilled dancers
and athletes always seem to make it look so easy.
• In order to achieve this level of skill, the movements were practiced
frequently, requiring constant sensory information from many systems.
• But in the muscle, feedback comes from two important sensory receptors:
the Golgi tendon organ (GTO) and the muscle spindle.
• The Golgi tendon organs, which are located in the tendon at the
myotendinous junction, are sensitive to tension and may be activated either
by an active muscle contraction or by an excessive passive stretch of the
muscle.
• When the Golgi tendon organs are excited, they send a message to the
nervous system to adjust the muscle tension (Fig. 3–31).
• The fine-tuning of muscle tension is not accomplished alone, however,
because other reflex systems (muscle spindles) are also providing feedback
to the muscle.
• The muscle spindles, which consist of 2 to 10 specialized muscle fibers
(intrafusal fibers) enclosed in a connective tissue sheath, are interspersed
throughout the muscle.
• These spindle fibers are sensitive to the length and the velocity of
lengthening of the muscle fibers (extrafusal fibers), they send messages to
the brain (cerebellum) about the state of stretch of the muscle.
• The muscle spindle is responsible for sending the message to the muscle in
which it lies to contract when the tendon of the muscle is tapped with a
hammer (Fig. 3–32).
• The quick stretch of the muscle caused by tapping the tendon activates the
muscle spindles, and the muscle responds to the unexpected spindle
message with a brief contraction.
• This response is called by various names: for example, deep tendon reflex
(DTR), muscle spindle reflex (MSR), or simply stretch reflex.
• Both the Golgi tendon organs and the muscle spindles provide constant
feedback to the central nervous system during movement so that
appropriate adjustments can be made, and they help protect the muscle
from injury by monitoring changes in muscle length.
 EFFECTS OF
IMMOBILIZATION, INJURY,
AND AGING
 IMMOBILIZATION

• Immobilization affects both muscle structure and function.

• The effects of immobilization depend on immobilization position (shortened
or lengthened), percentage of fiber types within the muscle, and length of
the immobilization period.
IN SHORTENED POSITION
A muscle immobilized in a shortened position adapts to the new resting
position through the following structural changes:
• Decrease in the number of sarcomeres with a compensatory increase in
sarcomere length
• Increase in the amount of perimysium
• Thickening of endomysium
• Collagen fibril orientation becoming more circumferential
• Increase in ratio of connective tissue to muscle fiber tissue
• Loss of weight and muscle atrophy
• Changes in function that result from immobilization in the shortened position
reflect the structural changes.
• The decrease in the number of sarcomeres, coupled with an increase in the
length of sarcomeres, adjusts sarcomeres to a length at which the muscle is
capable of developing maximal tension in the immobilized position.
• Therefore, the muscle is able to generate maximal tension in the shortened
position.
• Although this altered capacity for developing tension may be beneficial while
the muscle is immobilized in the shortened position, the muscle will not be
able to function effectively at the joint it crosses immediately after cessation
of the immobilization.
• The muscle that has adapted to its shortened state will resist lengthening
passively, thus potentially limiting joint motion.
• Furthermore, the overall tension-generating capacity of the muscle is
decreased and the increase in connective tissue in relation to muscle fiber
tissue results in an increase in stiffness to passive stretch.
IN LENGTHENED POSITION
• Muscles immobilized in the lengthened position exhibit fewer structural and
functional changes than do muscles immobilized in the shortened position.
• The primary structural changes are an increase in the number of sarcomeres,
resulting in a decrease in sarcomere length at the lengthened position;
increased endomyseal and perimyseal connective tissue; and muscle
hypertrophy that may be followed by atrophy.
• The primary functional changes in muscles immobilized in a lengthened is
increase in maximum tension-generating capacity.
• Prevention of the effects of immobilization in the shortened position may
require only short periods of daily movement.
• With only 30 minutes of daily ROM activities out of the cast, the negative
effects of immobilization in a shortened position were eliminated in animal
models.
• If daily motion is not possible (e.g., due to fracture), then early and intensive
re-mobilization after immobilization reverses the sarcomere number and
connective tissue alterations that occur with immobilization.
 INJURY
OVERUSE
• Overuse may cause injury to tendons, ligaments, bursae, nerves, cartilage,
and muscle.
• The common etiology of these injuries is repetitive trauma that does not
allow time for complete repair of the tissue.
• The additive effects of repetitive forces lead to microtrauma, which in turn
triggers the inflammatory process and results in swelling.
• The tissue most commonly affected by overuse injuries is the Musculo-
tendinous unit.
• Muscle and tendons can fatigue with repetitive submaximal loading, with
rapidly applied loads, and when the active (contracting) musculotendinous unit
is stretched by external forces.
• Bursae may become inflamed with resultant effusion and thickening of the
bursal wall as a result of repetitive trauma.
• Nerves can be subjected to compression injuries by muscle hypertrophy,
decreased flexibility, and altered joint mechanics.
MUSCLE STRAIN
• Muscle strain injuries can occur from a single high-force contraction of the
muscle while the muscle is lengthened by external forces (such as body
weight).
• The muscle usually fails at the junction between the muscle and tendon.
• Subsequently, there is localized bleeding and a significant acute
inflammatory response, resulting in swelling, redness, and pain.
 AGING

FIBER NUMBER AND FIBER TYPE

• Changes As a person ages, skeletal muscle strength decreases as a result of
sarcopenia (the loss of muscle mass). Sarcopenia occurs as result of a loss of
muscle fibers and a decrease in the size of existing fibers.
• After the sixth decade of life, there is a loss of muscle fibers.
• It is commonly thought that there is a gradual decrease in the number and
size of type II fibers, leaving the muscle with a relative increase in type I
fibers.
• The maintenance of the proportion fiber types may occur to a greater degree
in elderly people who stay active, whereas the elderly who are inactive may
have a greater proportion of type I fibers.
• There is also a decrease in the number of motor units.
CONNECTIVE TISSUE CHANGES
• Aging also increases the amount of connective tissue within the extracellular
matrix of the muscle (endomysium, perimysium, and epimysium) of the skeletal
muscle.
• It is generally assumed that the increased connective tissue results in
decreased ROM and increased muscle stiffness.
• All of these changes in the muscle result in decreased muscle strength and,
more important, a loss in muscle power.
• This loss of muscle power, or the ability to contract the muscle with high force
and high velocity, may be a cause of falls in the elderly.
• Resistance exercise training in the elderly appears to have positive effects on
aging muscles, causing an increase in the size of muscle fibers and an increase
in strength and functional performance.