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Rehabilitation Research and Practice
Volume 2012, Article ID 853037, 9 pages
Review Article

Kinetic Chain Rehabilitation: A Theoretical Framework

Lexington Clinic, Shoulder Center of Kentucky, 1221 South Broadway, Lexington, KY 40504, USA

Received 15 September 2011; Accepted 7 March 2012

Academic Editor: Gül Baltaci

Copyright © 2012 Aaron Sciascia and Robin Cromwell. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Sequenced physiologic muscle activations in the upper and lower extremity result in an integrated biomechanical task. This sequencing is known as the kinetic chain, and, in upper extremity dominant tasks, the energy development and output follows a proximal to distal sequencing. Impairment of one or more kinetic chain links can create dysfunctional biomechanical output leading to pain and/or injury. When deficits exist in the preceding links, they can negatively affect the shoulder. Rehabilitation of shoulder injuries should involve evaluation for and restoration of all kinetic chain deficits that may hinder kinetic chain function. Rehabilitation programs focused on eliminating kinetic chain deficits, and soreness should follow a proximal to distal rationale where lower extremity impairments are addressed in addition to the upper extremity impairments. A logical progression focusing on flexibility, strength, proprioception, and endurance with kinetic chain influence is recommended.