Biomechanics of a Sit Up

Biomechanics of a Sit-up
Discussion cont.
Sit up is a natural movement
Some of the challenges in the sit-up task are solved through coordination, not simple strength
Jubilee Haase and Catarina Orr
Kinematics of Sit-Up
Four Phases
Phase 1
: Flexion of neck and upper trunk, lasts from onset of sit-up to just before lumbar trunk lifting from
surface (posterior pelvic tilt)
Phase 2
: Period between onset of lumbar lifting and anterior pelvic tilt. The "critical period" of sit-up
where is it most likely to fail.
Phases 3 & 4
: period of anterior pelvic tilt, trunk and head lift into sitting position. (Not focused in this study)
Background
Anatomy of musculature Abdomen
Rectus Abdominis
External Oblique
Internal Oblique
Transverse Oblique

Results
Rectus abdominis activity decreased in most subjects,not just for easier sit-ups, but also for those
made more difficult by the interventions. In only one subject did rectus abdominis activity increase
with an intervention (in phases 1 and 2)
neither the amount of trunk flexion or rectus abdominis EMG scaled with sit-up difficulty
local leverage prevents rectus abdominis activity and trunk flexion from exceeding already
maximum allowable levels
All interventions showed no real difference in the use of the rectus abdominis
Rectus abdominis was activated at, or near, the beginning of the sit-up, during phase II, when the
weight being lifted from the support surface is at its max.
SUPINE

The Prone Biomechanical Evaluation

Root described the prone biomechanical examination in detail1 and it has since been interpreted by other examiners
such as Palmer2. It attempts to determine Subtalar Neutral Position and Forefoot Position as an exact number of
degrees claiming to be accurate and reproducible. In fact, the literature has shown prone examination to be
inaccurate and not reproducible3,4. Furthermore, because the patient is facing away from the examiner and cannot
visualize their feet, the prone bio eval is cold, impersonal and cannot be used for education. Even worse, since
it is time consuming and needs an examination table that goes flat (180 degrees), its use on the initial examination,
a critical time for introducing biomechanics to the patient is rare. More and more DPMs fail to perform bio evals and
a shoe clerk, a chiropractor or a podiatry assistant can find STJ Neutral position and using a box of foam or a scan
generate custom orthotics as well as the average DPM. We have allowed biomechanics to become
amateurish.

The Supine Biomechanical Evaluation

When the patient is turned around into supine position seated in a chair, the biomechanical
evaluation becomes personal and allows the examiner to demonstrate to and educate the
patient as they visualize the exam. It allows DPMs renewed ability to separate from the less
educated and skilled players dividing the biomechanical pie.

Separately profiling the rearfoot and forefoot utilizing supinatory and pronatory end range of
motion (SERM and PERM) into one of four types, classify all feet into one of sixteen
functional foot types serves as a neoteric foundation for podiatry to make a custom
diagnosis and allow treatment of feet, the lower extremity and low back and many quality of
life issues, professionally.5,6

Feet within each foot type share common characteristics that allow them to be batched in order to set up guidelines
for care within that type. Since these characteristics are relative, depending on the education, the clinical experience
and the skills of the examiner, patients receive different levels of care.

Podiatrists converted to supine biomechanical evaluation and foot typing once again provide more custom
care, monitoring and professional assistance than others.

In summary, when compared to the prone bio eval, this neoteric supine examination is faster, more accurate,
reproducible and requires more education and skill than its prone ancestor and because the patient can see their
feet and the examiner when it is performed, the examination becomes educational and conducive to being
performed during the initial office visit providing the opportunity for DPMs to retake our place at the top of the
biomechanical pyramid (see Table below).

Prone vs. Supine Bio Eval

Prone Bio Eval Needs a Flat Supine Bio Eval Performed in
Examination Chair or Table Any Chair or Table

Cold and Impersonal Patient Sees the Examiner and Their Feet

Determines Rearfoot and

Tries to Take Exact Measurement
Forefoot Type Independently

Not Educational Educational and Demonstrable

Not Accurate or Reproducible Accurate and Reproducible

20-30 Minutes 4-6 Minutes

Not Performed on the Initial Exam Easily Performed on the Initial Exam