Biomechanics: Lichun Lu, PHD Kenton R. Kaufman, PHD, Pe Michael J. Yaszemski, MD, PHD

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Chapter
Biomechanics
Lichun Lu, PhD
Kenton R. Kaufman, PhD, PE
Michael J. Yaszemski, MD, PhD
Introduction static equilibrium of a rigid body are then developed and

Biomechanics is the science of applying the principles and representative calculations demonstrated. The procedures
methods of engineering mechanics to biologic tissues and for analyzing the strength of materials are discussed.
to the analysis of medical problems. The behavior of the
human musculoskeletal system, although complex and Definitions and Basic Concepts
dynamic, can be described by, and obeys, Newton’s laws of The study of mechanics can be described as the study of
mechanics. Orthopaedic biomechanics focuses on the ef- the conditions of rest or motion of bodies under the ac-
fects, motions, and deformations that result from forces tion of forces. Mechanics can be subdivided into the study
and moments acting on various tissues such as bone, car- of solids and fluids. Solid body mechanics can be further
tilage, growth plate, ligament, tendon, meniscus, synovial subdivided into rigid body mechanics and deformable
fluid, and intervertebral disks. body mechanics.
The study of biomechanics has been important in the
understanding of the normal structure and function of Rigid Bodies
the musculoskeletal system, in the examination of specific If a body, when subjected to externally applied forces or
pathologic conditions, in the development and design of
heat, maintains the relative positions of any two particles
devices used in orthopaedic surgery, in the evaluation of
within it, then that body is defined as being rigid. Actu-
surgical procedures for the restoration of normal mechan-
ally, all structures deform under load, but if the deforma-
ics, and in improving postoperative rehabilitation treat-
tions are small compared with the body size, they can be
ments. For instance, human joints are subjected to a wide
ignored for static equilibrium and motion (dynamics) cal-
range of forces during activities of daily living. Most hu-
culations. The assumption of rigidity is therefore only rel-
man joints can undergo millions of loading cycles per
ative, depending on the circumstances and applications.
year, even under forces that can be several times body
weight during strenuous activities. However, abnormal Rigid body mechanics includes the study of statics and
joint forces are believed to play a central role in cartilage dynamics. Dynamics includes both the study of motion
degeneration that leads to osteoarthritis. In addition, without consideration of the forces that cause that motion
many issues in total joint arthroplasty, such as the wear (kinematics), and the study of the relationship between
forces and the motion that results from their application
under U.S. or applicable copyright law.
and deformation of the articulating surface, the stress dis-

tribution in the implant, the mechanical behavior of the (kinetics).
bone-implant interface, and the load-bearing characteris-
tics of the remaining bone, are intimately related to the Deformable Bodies
joint loads. Therefore, a thorough understanding of joint If a body subjected to external forces or heat demon-
forces is important. strates relative displacements between its component par-
In this chapter, selected fundamental principles of me- ticles, then it is defined as deformable. Deformable body
chanics are reviewed and examples provided of how these mechanics is the study of the internal force density
principles are used in orthopaedic biomechanics. The (stress) and the associated deformation (strain) of a body
chapter begins with a presentation of basic definitions of subjected to various external loading conditions or chang-
forces and moments and their analysis. The concepts of ing ambient temperature.
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Section 1 Basic Principles of Orthopaedic Surgery
Figure 1 A, The addition of the force of the quadriceps FQ

and the force of the patellar tendon Fp, according to the paral-
lelogram law, produces the resultant force R, which tends to
compress the patella against the femur. (Reproduced from Mow
VC, Flatow EL, Ateshian GA: Biomechanics, in Buckwalter JA,
Einhorn TA, Simon SR (eds): Orthopaedic Basic Science: Biology
and Biomechanics of the Musculoskeletal System, ed 2. Rose-
mont, IL, American Academy of Orthopaedic Surgeons, 2000, pp
134-180.) B, The deltoid force F, can be resolved into a stabiliz-
ing component Fx, and a rotatory component Fy, by using the
trigonometric relationships for the right triangle. The angle of
force application is θ. (Adapted with permission from An KW,
Chao EYS, Kaufman KR: Analysis of muscle and joint loads, in
Mow VC, Hayes WC (eds): Basic Orthopaedic Biomechanics, ed 2.
Philadelphia, PA, Lippincott Williams & Wilkins, 1997.)
Fluids with 1 N defined as the force that causes a 1-kg mass to

A fluid is a continuum that is unable to withstand a static accelerate at 1 m/s2.
shear stress. Fluid mechanics, also called fluid dynamics, is Mechanics experiments show that any set of coplanar
the branch of mechanics that studies the properties of liq- forces may be replaced by a single force having the same
uids and gases, such as viscosity and flow conditions, as a effect. This single force, obtained by combining the given
function of space and time. forces according to the parallelogram law of vector addi-
tion, is called the resultant force. Vectors are added by
Vectors and Forces joining the head of one vector to the tail of the next vec-
tor while retaining the magnitude and direction of each
There are several types of physical quantities. Two of these
vector (Figure 1, A). The resultant vector is represented by
are scalars and vectors. Scalars are quantities that are
the distance between the last head and the first tail.
completely specified by a single number, which describes
The original vector may be broken down or resolved
their magnitude. Examples include mass (kg), volume
into several component forces, usually along specified mu-
(m3), density (kg/m3), time (sec), and speed (m/s). Vec-
tually perpendicular coordinate axes. The original vector F
tors are composed of four components: magnitude, direc-
is the sum of its components along these axes (Figure 1, B).

tion, sense, and position (also called point of application).
Examples of vectors are force, stress, strain, velocity, F = Fx + Fy
torque, and displacement. Vectors are denoted by several
different symbols. These symbols include either a boldface The magnitudes of Fx and Fy are denoted by Fx and Fy or
letter or a letter with an arrow (→), or bar (—) over it. |Fx| and |Fy|, respectively. According to the trigonometric
Force represents an interaction between two bodies. relationships of combining and resolving forces, the mag-
Forces can be contact forces (bodies touching each other) nitude and direction of the resultant force may be calcu-
or field forces (bodies separated by a distance, such as lated by:
gravitational, electric, or magnetic forces). The Interna- F2 = Fx2 + Fy2
tional System of Units (SI) unit for force is newton (N), tan θ = Fy / Fx
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Chapter 3 Biomechanics
Figure 2 A, The magnitude of a moment is the product of a force and the

perpendicular distance from an axis of rotation. B, The direction of a moment is
given by the right-hand rule. C, The action arm, a, is the direct distance along
the structure, whereas the moment arm, d, is the perpendicular distance from
the line of action of the force to the axis of rotation.
The values of Fx and Fy also can be obtained if F is known ments applied by muscles that cross the joints on which
by using the sine and cosine functions: they act. A moment is defined as the product of a force
and the perpendicular distance between the line of action
Fx = Fcosθ of the force and the axis of rotation of the motion that
Fy = Fsin θ the force produces (Figure 2, A). The SI unit for a moment
is the newton-meter (Nm). A moment is a vector. Its mag-
In orthopaedic biomechanics, it is often useful to de- nitude is the force-perpendicular distance product men-
scribe forces as tensile, compressive, or shear. Tensile and tioned above. The direction of a moment is defined by the
compressive forces are perpendicular (normal) to the sur- “right-hand rule” (Figure 2, B), where the positive mo-
face under consideration, whereas shear forces are parallel ment direction is identified by the thumb of the right hand
(tangential) to the surface under consideration. The sur- when the fingers of the right hand are curled in the direc-
faces to be considered for force analysis are chosen such tion of rotation caused by the force. The direction of a
that the desired information can be obtained in the most moment is along the axis of rotation (or potential rota-
expeditious mathematical method possible. These surfaces tion) and thus perpendicular to the plane in which the
are the external boundaries of the free body chosen for twisting force is applied. Moment arm, the distance used
analysis, whether the system consists of a rigid body, a de- to calculate the moment, is the distance from the action
formable body, or a fluid. line to the actual or potential pivot point of the system, re-
gardless of the state of motion. The moment arm is chosen
Moments so that it is perpendicular to the action line of the force
A moment represents the turning, twisting, or rotational that is responsible for the motion or potential motion. The
effect of a force. Skeletal motions are the result of the mo- moment arm (d) may or may not be the same as the action
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Figure 3 A, A couple is created by two equal, noncollinear, parallel but oppositely directed forces F and –F. The magnitude of the
couple is Fd, where d is the perpendicular distance between the two forces. B, A single force applied at point A, acting along A-A’,
whose perpendicular distance to point O is d, is equivalent to a force acting at O and a couple of magnitude Fd.
arm (a), which is the shortest distance along the structure Static Equilibrium
from the point of force application to the pivot point (Fig- A rigid body is an idealized model of a real object because
ure 2, C). it assumes that there is no deformation of the body no
When a pair of forces F and –F that have equal magni- matter how large the forces and moments acting on it.
tude, parallel lines of action, and opposite senses act on a Gait analysis uses rigid body models to describe the kinet-
body, the moment created is called a couple (Figure 3, A). ics and kinematics of human locomotion. In the muscu-
The resultant force of a couple is zero. The magnitude of loskeletal system, bones are assumed to be rigid rods, and
the couple is Fd, where d is the perpendicular distance be- joints to be frictionless hinges. The important elements of
tween the two forces. As illustrated in Figure 3, B, any sys- rigid body mechanics are: (1) the magnitude, direction,
tem of forces on a rigid body may be replaced by an equiv- line of action, and point of application of forces acting on
alent system that consists of a single force acting at a the body; (2) the total mass of, and its distribution
chosen point and a couple. The force F at point A is shown within, the body; and (3) the size and geometric form of
in the xy plane with an origin of O. The line of action of F the body.
is closest to O at point A'. The distance d is thus the mo- When the sum of all forces and moments acting on
ment arm relative to point O. A pair of imaginary forces F the body is zero, there will be no linear accelerations be-
and –F can be added to the point O because they cancel cause of unbalanced forces or angular (rotational) acceler-
each other. The pair of forces composed of the original ations because of unbalanced moments. Under these con-
force F at A and –F at O is a couple, which is a free pure ditions, the system is considered to be in equilibrium,
moment acting in the xy plane. Thus, the original force F either at rest or at constant velocity. Because ΣF and ΣM
at A is equal to a couple and a force F at O. The concept of must be zero regardless of the location on a rigid body
couple is very useful in understanding the effects of muscle where one chooses to calculate them, the choice can be
action around a joint. made in a manner that optimizes the ability to perform
the calculations for the equilibrium condition.
Statics is the study of forces acting on an object at
rest. When performing a force analysis of a rigid body, the
Newton’s Laws body or part of a body at equilibrium may be isolated
Newton’s three laws of mechanics form the basis for un- from the environment, and the environment is replaced
derstanding force equilibrium. The first law states that if
by forces acting on the system. This is called a free-body

the resultant force acting on a body is zero, the body is ei- diagram. Because both forces and moments are vectors,
ther at rest, or remains in motion at a constant speed and they must sum to zero in each of the three perpendicular
direction (that is, it has constant velocity). The second law directions (reference system). Thus, there are a total of six
states that if the resultant force acting on a body is not equations of equilibrium, and a maximum of six un-
zero, the body will have an acceleration proportional to knowns may be solved, in a three-dimensional system.
the magnitude and in the direction of the resultant force. Mechanics problems in which the number of un-
The force is equal to the mass multiplied by acceleration known forces and moments is equal to the number of
F = ma. The third law states that the forces of action and available equations are called statically determinate prob-
reaction between bodies in contact have equal magnitude lems. In statically indeterminate problems, however, the
and same line of action but opposite sense. number of unknowns exceeds the number of equations,

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Figure 4 A, Static forces on the glenohumeral joint during

standing. B, Free-body diagram. C, Graphic solution. (Adapted
with permission from An KW, Chao EYS, Kaufman KR: Analysis
of muscle and joint loads, in Mow VC, Hayes WC (eds): Basic Or-
thopaedic Biomechanics, ed 2. Philadelphia, PA, Lippincott Will-
iams & Wilkins, 1997.)
and no unique solution can be found. In virtually all ΣFx = 0

problems in orthopaedic biomechanics that determine and ΣFy = 0
muscle and joint forces, the situations are statically inde-
terminate because of the large number of muscles span- In this notation, a component is positive if it points in the
ning the joint. In these situations, assumptions are often direction of the positive axis and negative if it points in
made to simplify the models to estimate the important the other direction.
muscle and joint forces. For instance, a muscle force is of- Example 1. In the example shown in Figure 4, A, if the
ten assumed to exist only in tension, whereas the joint weight (W) of the upper limb is 50 N and the slope of the
reaction-force is considered to be always compressive. The glenoid fossa at the point of joint contact is 35° from the
line of action of the muscle force is defined by assuming horizontal, calculate the force, P, in the supraspinatus mus-
that it always acts along the center of the cross-sectional cle that is necessary to prevent subluxation of the humeral
area of the muscle mass, and a joint may be modeled as a head. In addition, calculate the glenohumeral joint reac-
simple hinge, thus eliminating two of three possible axes tion force, R.
of rotation and ignoring translations. Solution: A free-body diagram (Figure 4, B) is drawn
Many joint force problems are further simplified into first, with the y-axis parallel to the direction of the force of
a two-dimensional analysis. For the body to be in equilib- gravity. Because the magnitude, the direction, and line of
rium, there are two sets of conditions that must be satis- action of the force due to gravity, W, and the direction and
fied: translational equilibrium and rotational equilibrium. line of action of the muscle force are known, vector analy-
In translational equilibrium, there must be no unbal- sis can be used to determine the magnitude of the muscle
anced forces acting in either the x or y direction. This sit- force and the direction and magnitude of the joint reac-
uation is equivalent to requiring that both the x and y tion force. The direction of the joint reaction force is as-
components of the resultant force acting on the object are sumed to be perpendicular to the joint surface because
zero. The condition for translational equilibrium can be healthy articular cartilage surfaces transmit nearly no fric-
written ΣF = 0. This vector equation is equivalent to: tional forces parallel to the joint surface. The reaction
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Example 2. Consider the flexed arm that is holding a ball,

as shown in Figure 5. The biceps muscle provides force B

to counterbalance the moment exerted by the forces of
gravity on the forearm (G) and the ball (W). With the bi-
ceps muscle supporting the forearm at 90° of elbow flex-
ion, the lever arm is the perpendicular distance from the
tendon to the axis of the elbow joint.
Solution: Suppose the forearm weighs 15 N, its center
of mass is 15 cm from the elbow joint, the ball weighs
20 N and is placed in the hand at 30 cm from the elbow
center, and the biceps muscle has a lever arm of 3 cm. The
elbow joint is the axis of rotation (or potential rotation).
Note that the reaction force produces no moment about
the elbow because its distance from the axis is zero. Thus
the moments produced by each force are added to obtain
rotational equilibrium:
ΣM = ΣMCW − ΣMCCW = 0
(B × 3 cm) – [(G × 15 cm) + (W × 30 cm)] = 0
Thus, 3B = 15G + 30W = (15 cm × 15 N) +
(30 cm × 20 N) = 825 N·cm
B = 275 N
In this example it could instead be assumed that the po-

tential axis of rotation is at the point of application of
force B, and the equation could be solved for the elbow
joint reaction force R. This illustrates that in using the
rotational equilibrium condition, it makes no difference
which axis is used for the purpose of summing moments.
Figure 5 A parallel force system acting on the forearm.
Note also that, by convention, counterclockwise moments
(Adapted with permission from An KW, Chao EYS, Kaufman KR: are positive, and clockwise moments are negative.
Analysis of muscle and joint loads, in Mow VC, Hayes WC (eds): In many situations, the forces acting on a body are
Basic Orthopaedic Biomechanics, ed 2. Philadelphia, PA, Lippin- neither parallel nor concurrent. This is described as a gen-
cott Williams & Wilkins, 1997.)
eral force system. Both translational and rotational equi-
librium need to be maintained in such a system, which
force can be resolved into two components, the horizontal can be described by the following equations, referred to as
component Rx = Rcos35°, and the vertical component the planar equilibrium conditions:
Ry = Rsin35°. The equilibrium equations become:
ΣFx = 0
ΣFx = P − Rx = P − Rcos35° = 0 ΣFy = 0
and ΣFy = Ry − W = Rsin35° − W = 0 ΣM = 0
which give
R = W / sin35° = 50 / 0.574 = 87.1 N To summarize, when an object is known to be at rest, the
and P = Rx = Rcos35° = (87.1)(0.819) = 71.3 N steps in the solution of the equilibrium problem are:
(1) Select the free body appropriate to the solution of

The graphic solution is illustrated in Figure 4, C. the problem.
In rotational equilibrium, there must be no unbal- (2) Draw the free-body diagram to show all forces act-
anced moments that would tend to cause rotation. The ing (both magnitude and direction).
sum of moments (ΣM) about a point must be zero, that is, (3) Choose coordinate axes and the axis to be used for
the sum of the clockwise moments (ΣMcw) must be equal summing moments.
to the sum of the counterclockwise moments (ΣMccw). (4) Resolve each force into orthogonal components
Thus, the condition for rotational equilibrium is: and apply the pertinent equations of equilibrium
(ΣF = 0; ΣM = 0).
ΣM = 0 (5) Solve the equations of equilibrium to obtain un-
or ΣMCW = ΣMCCW known values.

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three orthogonal axes x, y, and z is defined by the three an-

gles θ, φ, and ψ. The humerus may translate in an antero-

posterior (x) direction, toward or away from the glenoid
(joint compression or distraction; y-direction), or in a
superior-inferior (z) direction. Possible rotations of the
humerus are abduction/adduction, θ, in the scapular
plane, flexion/extension, φ, perpendicular to the scapular
plane, or axial rotation, ψ, around the longitudinal axis of
the humerus.
The change of position of a point in space is repre-
sented by a vector called displacement. The displacement
vector is independent of the path of motion, and can be
either linear or angular. Velocity is defined as the change
of position with respect to time. Because velocity is a vec-
tor, the change in velocity could mean a change of direc-
tion or speed (magnitude) or both. Translation is the
movement of a body such that all points in the body
move along parallel paths and have the same velocity and
acceleration at any given instant. Rotatory, or angular,
motion is the movement of a body around an axis, called
Figure 6 Illustration of the six degrees of freedom of a rigid the axis of rotation. During rotatory motion, all parts of
body: the position of the humeral head is specified by the three the body travel in the same direction through the same
coordinates in the xyz orthogonal system, and the position of
angle of rotation. With rotation, all parts of the body, ex-
the humerus relative to the xyz coordinate axes is defined by
the three angular orientations θ, φ, and ψ. cept those that lie on the axis of rotation, move in parallel
planes along concentric circles centered on the same fixed
axis. The angle of rotation is measured on a plane perpen-
Dynamics dicular to the axis. In general, the motion of any rigid
When there are unbalanced forces or moments acting on body can be described as a combination of translation
a rigid body, it is under a nonequilibrium, or dynamic and rotation. At any given instant, the general motion is
condition, resulting in motion. The study of dynamics of equivalent to the sum of translation along and rotation
a rigid body includes kinematics and kinetics. Kinematics about an instantaneous axis.
is used to describe motion without regard to the forces
and moments producing the motion. It is the study of the Hip Abductor Forces
relationships between positions, velocities, and accelera- The free-body method of solution will be illustrated by
tions of a rigid body. Kinetics is the study of the forces calculating the abductor and joint reaction forces at the
that cause motion of a rigid body. hip. Figure 7, A illustrates a free-body diagram of the hip
The position of an object is defined relative to a refer- of a person standing on the right leg. The body and the left
ence frame. In a rigid body, there is no internal deforma- leg weigh 5/6 W, where W is the total weight of the person.
tion and the mutual distances between all particles remain When in equilibrium, the known clockwise moment (Mcw,
constant. Degrees of freedom is a term that describes the negative by convention) created by the gravitational force
number of independent coordinates necessary to describe 5/6 W, which tends to rotate the upper body about the cen-
the motion of a rigid body in space. In three dimensions, ter of the femoral head O, must be balanced by the un-
six coordinates are required to locate and orient the rigid known counterclockwise moment (Mccw, positive by con-
body. Therefore, a rigid body in space without any convention) created by the abductor muscles on the pelvis,
straint has six degrees of freedom. The six coordinates FAB. Because the point of application and direction of the
may be defined as: (1) the three coordinates of a point in abductor force FAB are assumed to be known from the an-
the x, y, z reference frame, and (2) the three orientation atomic data, the magnitude of FAB can be calculated. The
angles of the body relative to the reference frame. In such moment arm for the force FAB is 5 cm (distance “a” in the
a system, a rigid body may translate in any of three mutu- figure) and that for 5/6 W is 15 cm (distance “b” in the fig-
ally perpendicular directions, and may rotate about any of ure). Thus, magnitudes of the corresponding moments are
those same three axes. As an example, shown in Figure 6, Mccw = {(FAB) x (a)} and Mcw = {– (5/6 W) x (b) }. Because
the center of the humeral head is placed at the origin O the sum of these two moments must equal zero at equilib-
defined by the three coordinates (0,0,0) in the x, y, z refer- rium, the magnitude of the abductor muscle force FAB is
ence frame. The position of the humerus relative to the determined to be 2.5W:
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Figure 7 A, A free-body diagram of the hip of a person

standing on the right leg. The body and the left leg
weights 5/6 W, where W is the total weight of the person.
The magnitude of the abductor muscle force FAB (its direc-
tion is known), may be determined by setting the sum of
the moments about point O equal to zero. B, A force trian-
gle may be constructed to determine the joint-reaction
force Fj. (Reproduced from Mow VC, Flatow EL, Ateshian
GA: Biomechanics, in Buckwalter JA, Einhorn TA, Simon SR
(eds): Orthopaedic Basic Science: Biology and Biomechanics
of the Musculoskeletal System, ed 2. Rosemont, IL, Ameri-
can Academy of Orthopaedic Surgeons, 2000, pp 134-180.)
∑ Mccw + ∑ Mcw = 0 This example also illustrates that the force calculation can
be done either graphically, as in the determination of the
{(FAB) x (a)} + {– (5/6 W) x (b) } = 0 joint reaction force, or analytically, as in the calculation of
the hip abductor muscle force.
FAB = (5/6 W) x (b) / (a) = (5)(15) W / (6)(5) = 2.5 W
Shoulder Forces
The hip joint reaction force acting on the right acetabu- The free-body diagram in Figure 8 shows three forces act-
lum, Fj, does not create a moment about the joint center, ing on an extended arm: the weight W that is held in the
similar to the reaction force at the hinge in a seesaw. To hand, the deltoid muscle force Fd, and the joint-reaction
calculate Fj, the force equilibrium condition is applied, force Fj between the humeral head and the glenoid fossa.
which stipulates that the sum of all forces acting on the For the purposes of this example, the weight of the arm
pelvis must equal zero. Figure 7, B illustrates the force tri- has been neglected in the determination of the deltoid
angle based on the parallelogram law of vector addition. muscle force and the glenohumeral joint force resulting
With the two known forces, 5/6 W and 2.5 W, drawn to from the weight held in the hand. This free-body diagram
scale, the third unknown force Fj can also be drawn to is obtained by using the following four modeling assump-
scale, with the length of the third side of the triangle being tions for the unknown forces: (1) a two-dimensional plane
the magnitude of the force Fj and the direction of the ar- model is chosen; (2) the location of the deltoid force is at
row being the direction of Fj. In this example, the magni- the centroid of the muscle (d = 5 cm from the center of the
tude of Fj is calculated to be 3.3 W. Both the muscle force humeral head); (3) the deltoid force is tensile; and (4) the
and the joint-reaction force are considerably greater than glenohumeral joint force is compressive. The held weight
the weight of the body and leg they are supporting because W is 100 N in the direction of gravity, and is located 60 cm
of the lever action of muscle forces around the hip joint. from the center of the humeral head O.
The joint reaction force is the compressive force between When the arm is in equilibrium, the three forces and
the opposing cartilage surfaces of the femoral head and the their moments must sum to zero. Because the clockwise
acetabulum. This is the force that the cartilage must bear moment of the deltoid muscle force about the point O
in carrying out its function as the joint-bearing surface. [-(Fd) × 5] must equal the counterclockwise moment of

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Figure 8 A person holds a weight W at a distance of 60 cm from the center of rotation of the humeral head. After determining the
magnitude of the deltoid muscle force Fd (its direction is known) by summing the moments about point O, Fj may be found from the
force triangle. (Adapted from Mow VC, Flatow EL, Ateshian GA: Biomechanics, in Buckwalter JA, Einhorn TA, Simon SR (eds): Ortho-
paedic Basic Science: Biology and Biomechanics of the Musculoskeletal System, ed 2. Rosemont, IL, American Academy of Ortho-
paedic Surgeons, 2000, pp 134-180.)
the weight [+ (W) × 60], then Fd = 1,200 N, which is 500-N upper body weight produces only 800 N in Fe. The
about 1.5 times the average body weight of an adult. The transverse force acting on the vertebral body (and disk) is
joint-reaction force Fj can be found by using the force tri- Ft. This would be the force that tends to produce a spondy-
angle concept described earlier. By drawing the two known lolisthesis, for example.
sides of the triangle proportional to the length of the For the upper body to be at equilibrium, the sum of
forces, Fj is found to be 1,150 N in the direction shown. the vertical components of all forces must equal to zero:
Fncosθ − Fecosθ − W − W1 + Ftsinθ = 0. In addition, the
Spine Forces horizontal components of all forces must add to zero:
Fnsinθ − Fesinθ − Ftcosθ = 0. If θ = 60°, then the two
The free-body diagram in Figure 9 is used to show how the
equations can be solved to give Ft = (W+W1) sin60° =
musculoskeletal lever system can magnify the compressive
520 N and Fn = Fe + (W+W1) cos60° = 2,100 N. Hence,
force acting on the spine during an ordinary daily activity
the compressive force acting perpendicular to the face of
such as holding a weight W1 with an outstretched hand.
the vertebral body Fn is many times the weight supported,

The moment equilibrium condition about the center of a which derives mostly from the extensor muscle force
vertebral body O can be used to calculate the compressive (1,800 N), and the major component of that force
force Fn in the spine. The clockwise moment is produced (1,000 N) is a result of holding a relatively small weight
by both the held weight W1 [-(W1) x b] and the upper (100 N) at a 50 cm distance from the spine. The normal
body weight [-(W) x c], while the counterclockwise compressive force Fn acting on the vertebral body can be
moment is generated by the extensor muscle force reduced dramatically if the distance b is reduced by hold-
Fe [+(Fe) x a]. Assume W = 500 N (2/3 of a body weight of ing the weight closer to the body. This example illustrates
750 N), W1 = 100 N, a = 5 cm, b = 50 cm, and c = 8 cm, that large forces may be generated in the spine from sim-
then Fe = (1,000 + 800) N. Note that the 100-N weight ple activities, causing fracture in some patients, especially
held at 50 cm produces a 1,000-N force in Fe while the those with osteoporosis.
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Figure 10 Prismatic bar with an initial length of L and cross-

sectional area of A under tensile forces F.
tion mn) is isolated as a free body. To balance the tensile

load F at the left end, the forces at the other end represent
the action of the removed part of the bar upon the free
body. The force per unit area is defined as the stress σ. As-
suming a uniform distribution of force over the cross- sec-
tional area A, the stress is written σ = F/A.
When the force acts perpendicular to the surface, the
resulting stress is called normal stress. It is further classi-
Figure 9 A free-body diagram of the spine. The normal com-
fied as tensile stress if the bar is stretched by the force,
pressive force Fn acting on the spine is 2,100 N even during an
ordinary daily activity such as holding a 100-N weight by an out- and as compressive stress if the bar is compressed by the
stretched hand at a 50-cm distance. (Adapted from Mow VC, force. In SI units, the stress is expressed as N/m2 or pas-
Flatow EL, Ateshian GA: Biomechanics, in Buckwalter JA, Ein- cals (Pa). In order for the equation σ = F/A to be valid,
horn TA, Simon SR (eds): Orthopaedic Basic Science: Biology and the stress must be uniformly distributed over the cross
Biomechanics of the Musculoskeletal System, ed 2. Rosemont, IL,
American Academy of Orthopaedic Surgeons, 2000, pp 134- section of the bar. This is realized if the axial force F acts
180.) through the centroid of the cross-sectional area. The cen-
troid is the geometric center of an area and is a single
point that represents the entire cross section such that a
Mechanical Properties of Materials force applied at the centroid would tend to translate, but
The study of mechanics of deformable bodies is also not rotate, the entire cross section. It is equivalent in con-
known as the mechanics of materials or strength of mate- cept to the center of gravity of a three-dimensional object
rials. This topic includes the study of externally applied that is under the influence of a gravitational force. If the
forces, internal constraint forces, deformation associated force on a prismatic bar acts at a point other than the
with the forces, material properties, and physical laws to
centroid, then bending occurs.

relate the forces and deformations based on the material In the example given, the uniform stress condition ex-
properties of the specimen. ists throughout the length of the bar except near the ends.
If the load F is applied over a small area, high localized
Normal Stress and Strain stresses will result in stress concentrations. Moving away
Consider the example given in Figure 10. An axial force F from the ends of the bar, the stress distribution gradually
produces a uniform stretching of a prismatic bar of cross- approaches the uniform distribution. It is usually as-
sectional area A, resulting in an elongation of δ. A pris- sumed that the formula σ = F/A is valid for distances
matic bar is a bar that has a constant cross section along its larger than d from the ends, where d is the largest trans-
entire length. To investigate the stress and strain, the part verse dimension of the bar.
of the bar to the left of an imaginary cut section (cross sec- The axially loaded bar undergoes a change in length,

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Figure 11 Load-deformation (F-δ) and the corresponding

stress-strain (σ-ε) curves of three different structures made from
the same material.
Figure 12 Stress-strain diagram for a typical structural steel in
tension (not to scale).
becoming longer in tension and shorter in compression. the equation σ = Eε can be rewritten as:
The change in length is denoted by δ, which is the cumu-
lative result of the stretching of all elements of the mate- F/A = E (δ/L) or F = k δ
rial throughout the length L of the bar. Assuming that the
material is homogeneous, the strain, or the elongation per Where k = AE/L is the structural stiffness of the specimen
unit length, can be expressed as: ε = δ/L. The strain that is (in N/m), depending on both its geometry (A and L), and
associated with normal stress is called normal strain. It an intrinsic property (Young’s modulus) of the material
can be further classified as either tensile strain or com- from which it is made. The three structures made of the
pressive strain as a result of the corresponding tensile or same material shown here have different F- δ curves but
compressive forces applied. each of them has an identical σ-ε curve.
Forces can be applied to any structure, which results
in stresses and strains within the structure. The analysis
method presented here requires that the deformation of Stress-Strain Diagrams
the bar is uniform, which in turn requires that the bar is The structural and/or material properties of a device are
prismatic, loads act through the centroid, and the mate- typically determined by mechanical testing. For tests done
rial is homogeneous. The resulting state of stress and at different sites and at different times to be comparable,
strain is called uniaxial stress and strain. The stress and the dimensions of test specimens and the methods of ap-
strain obtained by calculations using the initial geometry plying loads have been standardized for many commonly
of the specimen are called nominal stress and strain. encountered materials and structures. The American Soci-
However, after the loads are applied, the surface area A ety for Testing and Materials (ASTM) is a volunteer stan-
becomes smaller under the action of tensile forces and dards organization that produces such standardized test
larger under the action of compressive forces, and the cor- conditions. During a static test, the load is applied very
responding length L is respectively either larger or slowly and the rate of loading need not be measured.
smaller. If these actual areas and lengths are used in the However, during a dynamic test, the rate of loading may
calculations, the true stress and strain are obtained. be high and because it can affect the material properties,
it must be specified and recorded.
As an example, the stress-stain diagram of structural
Structural Versus Material Properties steel under tension is presented in Figure 12. The point A
The relationship between the load, F, and the elongation, is called the proportional limit, and because the curve
δ, can be considered a structural property because it de- from origin O to A is linear, the slope of this straight line is
pends on both the material and the geometry of the spec- the modulus of elasticity. As the stress increases, the slope
imen. The relationship between stress σ and strain ε, on of the stress-strain curve becomes smaller, until it reaches
the other hand, provides a characterization of a material point B, the yield point. The corresponding stress is the
property of the specimen, independent of its size and yield stress. This is the transition point between elastic and
shape. plastic deformation. From this point on, the stress does
As illustrated in Figure 11, the slope of the load- not increase or increases only slightly, while considerable
deformation (F-δ) curve for a linear elastic material is k elongation occurs up to point C. This phenomenon is
(rigidity) and the slope of the stress-strain (σ-ε) curve is E called yielding and the material has demonstrated plastic
(modulus of elasticity). Using the definitions of σ and ε, behavior from point B to point C. Beyond point C, the
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The amount of necking is measured by the percent re-

duction in area defined by:

Ao − Af × 100%
Percent reduction in area =
Ao
where Ao is the original cross-sectional area and Af is the

final area at the fracture surface. The reduction is about
50% for ductile steels.
When a material exhibits no obvious yield point, yet
undergoes large strains after the proportional limit, an off-
set method is often used to determine an arbitrary yield
stress. A line is drawn on the stress-strain curve parallel to
Figure 13 Stress-strain curves of brittle versus ductile materials. the initial linear portion of curve, but offset by some stan-
dard amount of strain, such as 0.002 or 0.2%. The inter-
material starts to strain harden, during which period the section of this line with the curve is defined as the yield
atomic and crystalline structures of the material change, point, and the corresponding stress is the yield stress. Be-
resulting in increased resistance to further deformation. cause this stress is not an inherent physical property of the
This is shown as a positive slope from point C to D, reach- material, it is referred to as the offset yield stress.
ing a maximal stress called ultimate stress at point D. If the A brittle material exhibits very little plastic deforma-
material is further stretched, the stress is decreased and tion before fracture, and fails in tension at relatively low
fracture or failure of the material eventually occurs at strain. Brittle materials include concrete, stone, cast iron,
point E. glass, ceramic materials, and many common metallic al-
Because of lateral contraction, the cross-sectional area loys. Some of these materials, such as glass fibers, demon-
of the specimen decreases during stretching. The reduc- strate large strengths and can resist high stresses.
tion in area is usually negligible to about point C, beyond The stress-strain curve under compression may differ
which it starts to affect the calculated stress. In the vicin- from the tension curve. For ductile materials, the propor-
ity of the ultimate stress, the reduction in area is clearly tional limits in compression are very close to those in ten-
visible, creating a phenomenon called necking of the ma- sion, and therefore the initial regions of their compression
terial. When the actual cross-sectional area is used to cal- curves are similar to the tension curves. However, when
culate the stress, the true stress-strain curve that follows yielding begins, instead of necking as would occur under
the dashed line is obtained. From this curve, it is clear tensile loading, the material bulges outward on the sides,
that the material withstands an increase in stress up to and flattens out as the load increases, thus offering in-
failure point E'. Practically, the conventional stress-strain creased resistance to further shortening. The stress-strain
curve OABCDE provides satisfactory information for curve therefore has a positive slope in its plastic deforma-
most design purposes. tion region. For brittle materials, the compression stress-
Based on the characteristics of the stress-strain curve, strain diagram has a shape similar to that of the tensile
a material can be classified as either ductile or brittle (Fig- diagram. However, brittle materials usually reach much
ure 13). Ductile materials undergo large strains during higher ultimate stresses in compression than in tension.
plastic deformation before failure, and include mild steel, Unlike ductile materials, brittle materials in compression
aluminum, copper, magnesium, lead, nickel, brass, bronze, actually fracture or break at the ultimate stress.
nylon, Teflon, and many others. The ductility of a material
in tension can be characterized by its elongation and the Elasticity and Plasticity
percent reduction in area at the fracture section. The per- As described previously, when the specimen is statically
cent elongation is defined by: loaded in tension or compression, the corresponding
stress-strain diagrams can be obtained. The behavior of the

Lf − Lo material during unloading when the load is slowly re-
Percent elongation = × 100%
Lo moved is also an important characteristic of the material.
As an example, in Figure 14, a tensile load is applied to a
where Lo is the original gage length during tension testing specimen and the stress-strain curve goes from point O to
and Lf is the distance between gage marks at fracture. The A. When the load is removed, the material follows exactly
gage length is the distance between the attachment points the same curve back to the origin O, meaning it returns to
of the extensometer to the specimen during testing. Be- its original dimensions after unloading. Such a material is
cause the elongation is usually concentrated in the region considered elastic, and this behavior is called elasticity. The
of necking and is not uniform over the length of the spec- curve OA needs not to be linear in order for the material
imen, the percent elongation depends on the gage length. to be elastic.

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Figure 14 Stress-strain diagrams illustrating A, elastic behavior and B, partially elastic behavior.
If the material is loaded to a much higher point B on

the diagram (Figure 14, B), the material follows line BC
during unloading. The unloading line is typically parallel
to the initial portion of the loading curve (that is, parallel
to a line that is tangential to that portion of the curve near
O). The strain OC that remains in the material is called the
residual strain or permanent strain. The strain CD is that
part of the strain that resolves after unloading and is called
the elastic recovery. A material that behaves in this manner
returns partially to its original shape and is said to be par-
tially elastic. The upper limit of the elastic region is known
as the elastic limit of the material, and is very close to the
proportional limit. The behavior of a material that under-
goes inelastic strains beyond the elastic limit is called plas-
Figure 15 Toughness is the area under the stress-strain curve
ticity. When large deformations occur in a ductile material up to the failure point.
loaded into the plastic region, the material is said to un-
dergo plastic flow.
loading cycle. The number of loading cycles required to
Toughness cause failure is determined by performing a cyclic stress-
The amount of energy per volume a material can absorb strain experiment. A stress-cycle (σ-n) curve is generated
before failure defines the intrinsic toughness of the mate- by plotting the number of loading cycles (n) required to
rial (Figure 15). It is calculated as the area under the stress- cause failure against the maximum stress level attained
strain curve up to the failure point. Materials such as ce- during those n loading cycles (Figure 16). As the number
ramics and cast iron are brittle and are easily fractured. of cycles increases, the stress at failure decreases. When a
Although they are stiff, these materials are not tough be- stress is reached such that the material will not fail no
many how many cycles are repeated, that stress is called
cause they cannot absorb much energy. Ductile steel and

cortical bone are intrinsically stiff and tough because they the endurance limit σE.
fail only after significant stretching. Plastics and rubber are
intrinsically soft and tough because they stretch a great Linear Elasticity
amount before failure. Collagenous tissues are soft and not Many materials have an initial region on the stress-strain
particularly tough. diagram in which they behave both elastically and linear-
ly. The material behavior in this region is called linearly
Fatigue elastic. Many materials are designed to function at these
When materials are subjected to a large number of load- levels to avoid permanent deformation or plastic flow.
ing cycles, they will fail at a stress lower than their ulti- The linear relationship between stress and strain for a bar
mate stress, which is the stress at failure from a single in simple tension or compression is expressed as: σ = Eε
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Directional Properties
Materials having the same properties in all directions are

called isotropic. Their intrinsic material properties do not
depend on the direction of loading. Typically, the internal
structure of such materials is randomly dispersed and its
characteristic repeating geometric units (for example,
grains in a metal) are small. The elastic properties of iso-
tropic materials can be fully characterized by only two
material constants: Young’s modulus (E) and Poisson’s ra-
tio (ν).
A material is called anisotropic if its intrinsic proper-
ties differ in various directions. The internal structure of
such materials is typically composed of large units that
are arranged in an orderly fashion. Almost all materials in
Figure 16 The number of loading cycles, n, required to cause
failure of the specimen, plotted against the maximum stress lev- the musculoskeletal system are anisotropic. As a special
el σ attained during the cyclic test. Cyclic fatigue failure will oc- case of anisotropy, when material properties are identical
cur at n1 cycles of stress σ1, or n2 cycles of stress σ2. in a particular direction throughout the material, and the
properties in all directions perpendicular to that direction
where E is the modulus of elasticity, also called Young’s are identical to each other, but different from the proper-
modulus. This equation, which describes the bar’s mate- ties in the first direction, the material is classified as
rial properties in the linearly elastic region, is an analog of orthotropic. For example, articular cartilage and meniscus
Hooke’s law for a spring. Hooke’s law describes the linear are considered orthotropic and their elastic modulus in
relationship between the applied load and the resulting the direction parallel to the predominant collagen fiber
deformation. direction is different from that in all directions perpen-
The modulus of elasticity is specific for a particular dicular to the collagen fiber direction.
material. It is the slope of the stress-strain curve in the
linear elastic region, and has the same units as stress, be- Creep and Stress Relaxation
cause strain is a dimensionless quantity. As the Young’s A material may fail because of the phenomenon called
modulus of a material increases, so does the stiffness of a creep. Creep occurs as a material deforms when it is
structure made from it. The moduli of some common loaded at a constant load for a long time. The greater the
materials, arranged from lower to higher values are: liga- load, the faster the material will deform. Stress relaxation
ments, cartilage, cancellous bone, ultra-high molecular is similar to creep, in that it is a time-dependent phenom-
weight polyethylene, polymethylmethacrylate bone ce- enon. It occurs when a material is strained (deformed) to
ment, cortical bone, titanium, stainless steel, cobalt- a given dimension and then maintained at that strain. In
chromium-molybdenum alloy, zirconium, and aluminum. this situation, the stress within the material gradually de-
creases with time.
Poisson’s Ratio The difference between creep and stress relaxation is
When a prismatic bar is loaded in tension, the axial elon- that creep occurs with a constant load applied and strain
gation is accompanied by a lateral contraction. In the lin- increases (Figure 17, A), whereas stress relaxation has a
early elastic region, the lateral strain is proportional to the constant strain and stress decreases (Figure 17, B).
axial strain. For the lateral strain to be the same through-
out the bar, the material needs to be homogeneous. This Viscoelasticity
means that the composition needs to be identical at all Linear elasticity has previously been discussed as an ideal-
points throughout the specimen. In addition, the speci- ized model for analyzing the stress-strain behavior of some
men’s elastic properties need to be identical in all direc- real materials. Such a structure is often designated by a
tions perpendicular to its longitudinal axis. The ratio of spring (Figure 18, A) with the relationship between load F,
the lateral strain to the axial strain is known as Poisson’s deformation x, and stiffness k expressed as: F = kx. This
ratio, denoted by the Greek letter ν: behavior does not depend on time or the rate of loading.
Soft collagenous tissues such as articular cartilage, in-
lateral strain
ν=− tervertebral disk, ligament, and tendon, however, exhibit
axial strain
viscoelastic behavior that does depend on time and rate of
For many metals and other materials, the Poisson’s ratio is loading. This behavior can be modeled by a linear viscous
in the range of 0.25-0.35. Concrete has values of 0.1-0.2, dashpot (Figure 18, B) the following relationship: F = ηs
whereas rubber is between 0.45-0.5, approaching the the- where F is the applied force, η is the viscosity, and s is the
oretical upper limit of Poisson’s ratio of 0.5. rate of deformation.

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Figure 17 Stress (σ) and strain (ε) as a function of time during A, creep and B, stress relaxation.
Figure 18 A, A linear elastic spring element and its linear

load-deformation (stretch) response. B, A linear viscous dashpot
element and its linear load-rate of deformation (speed) re-
sponse. C, A Maxwell viscoelastic fluid modeled with a spring
and dashpot linked in series and a Kelvin-Voigt viscoelastic solid
modeled with a spring and dashpot linked in parallel.
Actual viscoelastic materials are often modeled by eled with the spring and dashpot linked in series, and a
combining elastic springs and viscous dashpots (Figure Kelvin-Voigt solid with the spring and dashpot linked in
18, C). For example, a Maxwell viscoelastic fluid is mod- parallel.
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Summary Selected Bibliography

Loading issues are almost always considered in the care of

patients who have musculoskeletal conditions. These is- Beer FP, Johnston ER Jr: Vector Mechanics for Engi-
sues may include physiologic loads that occur during the neers: Statics, ed 6. New York, NY, McGraw-Hill, 1996.
activities of daily living, or traumatic loads that the body
experiences during accidents, strenuous athletic activities, Beer FP, Johnston ER Jr, Clausen WE: Vector Mechan-
or injuries. The load-deformation relationships that occur ics for Engineers: Dynamics, ed 7. New York, NY,
between the human body and these physiologic or trau- McGraw-Hill, 2004.
matic forces all obey Newton’s laws of mechanics. The
postinjury assessment of the direction of force application Gere JM, Timoshenko SP: Mechanics of Materials, ed
that occurred at the moment of injury may help predict 3. Boston, MA, PWS-KENT, 1991.
likely bony and ligamentous injury patterns. The Allen-
Ferguson classification of cervical spine fractures is an ex-
Lardner TJ, Archer RR: Mechanics of Solids. New
ample of such a system. The intraoperative assessment of
York, NY, McGraw-Hill, 1994.
corrective force application to the spine or extremities
helps to predict whether the desired fracture reduction or
spine deformity correction will occur, or whether an addi- Mow VC, Hayes WC (eds): Basic Orthopaedic Biome-
tional injury is more likely to happen. Postoperative in- chanics, ed 2. Philadelphia, PA, Lippincott-Raven Pub-
structions for brace or cast wear, weight-bearing restric- lishers, 1997.
tions, and the gradual resumption of work, home, and
recreational activities are all based on an assessment of Panjabi MM, White AA III: Biomechanics in the Mus-
the musculoskeletal system’s ability to safely bear the culoskeletal System. Philadelphia, PA, Churchill Living-
loads that each of these activities will impose on it. There- stone, 2001.
fore, an understanding of methods of newtonian mechan-
ics analysis that are applicable to the musculoskeletal sys- Schmid-Schönbein GW, Woo S-LY, Zweifach BW
tem will contribute to the effective care of both surgical (eds): Frontiers in Biomechanics. New York, NY,
and nonsurgical orthopaedic patients. Springer-Verlag, 1986.

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3

Introduction static equilibrium of a rigid body are then developed and

and deformation of the articulating surface, the stress dis-

Figure 1 A, The addition of the force of the quadriceps FQ

Fluids with 1 N defined as the force that causes a 1-kg mass to

is the sum of its components along these axes (Figure 1, B).

50 Publishing : eBook Academic

Figure 2 A, The magnitude of a moment is the product of a force and the

by forces acting on the system. This is called a free-body

52 Publishing : eBook Academic

Figure 4 A, Static forces on the glenohumeral joint during

and no unique solution can be found. In virtually all ΣFx = 0

Example 2. Consider the flexed arm that is holding a ball,

as shown in Figure 5. The biceps muscle provides force B

In this example it could instead be assumed that the po-

(1) Select the free body appropriate to the solution of

54 Publishing : eBook Academic

three orthogonal axes x, y, and z is defined by the three an-

gles θ, φ, and ψ. The humerus may translate in an antero-

Figure 7 A, A free-body diagram of the hip of a person

56 Publishing : eBook Academic

the vertebral body Fn is many times the weight supported,

Figure 10 Prismatic bar with an initial length of L and cross-

tion mn) is isolated as a free body. To balance the tensile

centroid, then bending occurs.

58 Publishing : eBook Academic

Figure 11 Load-deformation (F-δ) and the corresponding

The amount of necking is measured by the percent re-

duction in area defined by:

where Ao is the original cross-sectional area and Af is the

stress-strain diagrams can be obtained. The behavior of the

60 Publishing : eBook Academic

If the material is loaded to a much higher point B on

cause they cannot absorb much energy. Ductile steel and

Materials having the same properties in all directions are

62 Publishing : eBook Academic

Figure 18 A, A linear elastic spring element and its linear

Summary Selected Bibliography

Loading issues are almost always considered in the care of

64 Publishing : eBook Academic

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