OpenCap Monocular: 3D Human Kinematics and Musculoskeletal Dynamics from a Single Smartphone Video

Reconstructing biomechanically realistic 3D human motion - recovering both kinematics (motion) and kinetics (forces) - is a critical challenge. While marker-based systems are lab-bound and slow, popular monocular methods use oversimplified, anatomically inaccurate models (e.g., SMPL) and ignore physics, fundamentally limiting their biomechanical fidelity. In this work, we introduce MonoMSK, a hybrid framework that bridges data-driven learning and physics-based simulation for biomechanically realistic 3D human motion estimation from monocular video. MonoMSK jointly recovers both kinematics (motions) and kinetics (forces and torques) through an anatomically accurate musculoskeletal model. By integrating transformer-based inverse dynamics with differentiable forward kinematics and dynamics layers governed by ODE-based simulation, MonoMSK establishes a physics-regulated inverse-forward loop that enforces biomechanical causality and physical plausibility. A novel forward-inverse consistency loss further aligns motion reconstruction with the underlying kinetic reasoning. Experiments on BML-MoVi, BEDLAM, and OpenCap show that MonoMSK significantly outperforms state-of-the-art methods in kinematic accuracy, while for the first time enabling precise monocular kinetics estimation.

Joint contact forces govern implant longevity, cartilage health, and rehabilitation outcomes, shaping who develops osteoarthritis, who recovers well from joint replacement, and who benefits from biomechanical interventions. Yet they remain measurable only invasively, in a few dozen patients with instrumented implants. I present a physics-free pipeline to predict instantaneous 3D hip and knee contact forces from an uncalibrated monocular video: no markers, force plates, electromyography, subject-specific imaging, or musculoskeletal model. Parametric body meshes are recovered per frame, encoded as kinematic features, and decoded into forces by a transformer whose pose stream is adaptively modulated at every layer by body shape, joint, side, activity text, and self-supervised video tokens (V-JEPA 2), unifying hip and knee in a single model. Under leave-one-subject-out cross-validation across 26 patients and 25 activity categories from the in vivo OrthoLoad database, the pipeline matches the accuracy of subject-specific musculoskeletal simulations ($0.32 \pm 0.08$ BW RMSE for hip; $0.23 \pm 0.03$ BW for knee) and resolves peak force changes smaller than those reported for gait retraining and osteoarthritis progression. Applied zero-shot to an independent instrumented cohort, it rivals or outperforms prior published methods. Even without curated activity labels, video features alone preserve accuracy and enable end-to-end inference on raw footage. Driven by the predictor, a generative motion prior produces biomechanically plausible variants with reduced peak loading, rediscovering strategies from the predictive simulation literature. This pipeline establishes uncalibrated monocular video as a viable modality for estimating joint loading, opening a path toward retrospective analysis of archived clinical recordings, primary-care screening, and at-home rehabilitation tracking.

Chronic pain diminishes quality of life by decreasing functional ability, yet objectively measuring this functional impact remains challenging in real-world settings. While optical motion capture provides high precision for assessing altered movement quality, it is costly and restricted to laboratory environments. We aimed to develop and validate Quantitative Movement Testing (QMT), a computer vision pipeline extracting 3D kinematic biomarkers from standard monocular smartphone video, balancing clinical accessibility with biomechanical accuracy. We validated the QMT pipeline, utilising deep learning-based 3D pose-estimation, against gold-standard optical motion capture in healthy controls (N=13). Following leave-one-subject-out calibration to correct systematic bias, we deployed QMT in two prospective clinical cohorts to assess real-world utility: a pre- and post-intervention trial for fibromyalgia patients, and a 30-day longitudinal at-home monitoring study of chronic sciatica patients and healthy controls. In laboratory validation, QMT extracted clinical kinematic metrics with high agreement to optical motion capture, yielding strong correlations (r > 0.85) and low mean absolute errors. QMT demonstrated high test-retest reliability (r > 0.86) in fibromyalgia patients and successfully tracked day-to-day movement fluctuations in chronic sciatica. While real-world home settings introduced higher measurement variance than lab settings, QMT found group-level differences between healthy controls and sciatica patients based entirely on remote recordings. Monocular 3D pose estimation offers a scalable alternative to traditional assessments. QMT provides an objective, accessible biomarker for tracking disease progression and treatment response in clinical trials, though further research is needed to optimise reliability in home environments.