Exercise Science Section 4: Bone and Muscle Injuries and Joint Mechanics and Joint Injuries

* Review Bone Injuries: Types of Fractures  Stress fracture – most difficult to detect  Simple fracture – no separation (hairline fracture)  Compound fracture – bone breaks into separate pieces  Comminuted fracture – bone shatters into many pieces Simple fracture Compound fracture Comminuted fracture

* Stress Fracture * Exact MOI is unknown * Possible MOIs: * Overload caused by muscle contractions * Altered stress distribution in bone due to muscle fatigue * Change in ground reaction forces * Performing rhythmic, repetitive movements

* Comminuted Fracture * 3 or more fragments * MOI: * Hard, direct blow * Fall in awkward position

* Impacted Fracture * Bone is compressed * MOI: * Fall from a height * Immediate splinting and traction are required

* Spiral Fracture * S-shaped separation of bone * MOI: * Foot is firmly planted and the body is rotated in the opposite direction

* Contrecoup Fracture * Fracture that occurs on the side opposite of the trauma site

* R est * I mmobilize * C old * E levation

*M*M uscles are made up of bundles of muscle fibers, called fascicles *F*F ascicle is a bundle of muscle fibers *A*A muscle fiber is a muscle cell….made up of many small myofibrils *M*M yofibrils contain filaments *T*T wo types of protein filaments TIssueTIssueTIssueTIssue AnatomyAnatomyAnatomyAnatomy Muscle Filaments Myofibrils Muscle Fibers Fascicle

D C B A * What parts do you remember? 1. Muscle 2. Fascicle (bundle of fibers) 3. Muscle fiber (muscle cell) 4. Myofibrils

* A sprain is a wrenching, twisting or stretching injury to a ligament. Sprains often affect the ankles, knees, or wrists. Sprain Result in pain, swelling, redness, bruising, and difficulty using injured joint.

* A strain is an injury to a muscle or tendon, and is often caused by overuse, force, or stretching. * Injured area experiences: * pain and soreness * swelling * warmth, bruising, or redness * difficulty using or moving the injured area in a normal manner Strain

* There are three degrees of muscle ruptures * A muscle tear may be partial or complete and caused either by a direct blow or by overexertion. * A first-degree strain involves less than 5 percent of the muscle. * mild pain and not much loss of strength or range of motion. * Mild tears referred to as pulled muscles. * A second-degree tear is a greater rupture that stops short of a complete tear. * Any contraction of the torn muscle will cause pain. * There may be a defect of the muscle - a bump or an indentation - at the site of the most pain. * You should be able to partially contract the muscle, but not without pain * A third-degree rupture is a complete tear across the width of the muscle * You will be unable to contract the muscle. * This is what happens when someone suddenly drops while sprinting. * The torn end of the muscle may ball up and form a large lump under the skin, and a great deal of internal bleeding occurs. * Severely torn muscles may require surgery to heal properly. Muscle Ruptures

* Muscle pull- very slight tear * Chronic tear- gradual onset of pain * Acute tear- sudden dramatic pain Muscle Pull Muscle Tear Muscle Tears

* Shin splints is pain resulting from damage to the muscles along the shin. Pain is felt in different areas, depending on which muscles are affected. Shin splints Shin splints represent an "overuse injury" and occur most commonly in runners.

* R.I.C.E. * Rest: Stop all activities which cause pain. * Ice: Helps reduce swelling. Never ice more than min. at a time. Protect the skin. * Compression: Wrap the strained area to reduce swelling. * Elevation: Keep the strained area as close to the level of the heart as is conveniently possible to keep blood from pooling in the injured area. Treatment for Muscle Injuries

* Types of Joints Cartilaginous jointFibrous jointSynovial joint

* Types of Synovial Joints Ball-and- socket joint Hinge joint Saddle joint Gliding joint Pivot joint Ellipsoid joint

* The Characteristics of a Synovial Joint Bone Blood vessels Nerve Synovial membrane Joint cavity (filled with synovial fluid) Fibrous capsule Joint capsule Bursa Tendon sheath Tendon Articular cartilage Fibrous layer Membranous layer Periosteum

* Tissue Properties  Tendons:  Composed of collagen (bundles of white, fibrous protein)  Attach muscle to bone  Vascular  Ligaments:  Tough bands of white, fibrous tissue  Attach bone to bone  Avascular

* Common Sport Injuries of Joints  Strains, pulls, and tears  Terms used to describe injuries to all joint tissue types  Tendinitis  Inflammation of a tendon  Dislocations  Bone displaced from its original location  Separations  Fibrous ligaments that bind the bones tear and separate  Cartilage  Torn cartilage  Shin splints  Tearing of the interosseous membrane or the periosteum Tendinitis

* Dislocation * Result due to forces that cause the joint to go beyond its normal anatomical limits * Two classes: * Subluxations * Luxations

* Subluxation * Partial dislocation * Incomplete separation between 2 articulating bones

* Luxation * Complete dislocations * Total separation between 2 articulating bones

* The Shoulder Joint Clavicle Coracoclavicular ligament Coracoid process Scapula Acromioclavicular ligament Acromion Coracoacromial ligament Glenohumeral ligaments and joint capsule Tendon of biceps brachii (long head) Humerus

* Shoulder Joint Injuries  Biceps tendinitis  Caused by overuse of the biceps brachii muscle  Shoulder separation  Tearing of the acromioclavicular ligament  Shoulder dislocation  Occurs when the humerus “pops out” of the glenoid fossa  Rotator cuff tears  An injury to one of the rotator cuff tendons Shoulder separation

* The Knee Joint – Anterior Patella Medial (Tibial) collateral ligament Patellar ligament Tibial tuberosity Tibia Quadriceps tendon Fibula

* The Knee Joint Anterior (deep) Femur Lateral (Fibular) collateral ligament removed Medial (Tibial) collateral ligament removed Lateral Meniscus Tibial Tuberosity Fibula Lateral CondyleMedial Condyle Medial Meniscus Tibia Posterior cruciate ligament Anterior cruciate ligament

* The Knee Joint – Posterior Femur Adductor magnus tendon Medial head of gastrocnemius tendon Semimembranosus tendon Medial (Tibial) collateral ligament Lateral (Fibular) collateral ligament Fibular head Lateral head of gastrocnemius tendon Oblique popliteal ligament Fibula Tibia

* The Knee Joint – Posterior (deep) Anterior cruciate ligament Popliteal tendon Lateral meniscus Lateral (Fibular) collateral ligament Medial (Tibial) collateral ligament Medial meniscus Posterior cruciate Femur Fibula Tibia Posterior meniscofemoral ligament

* Knee Joint Injuries  Knee ligament tears  Q-angle may contribute to the predisposition of ACL tears  Osgood-Schlatter syndrome  Affects the epiphyseal plate of the tibial tuberosity  Patellofemoral Syndrome (PFS)  Gradual onset of anterior knee pain/pain around the patella Osgood- Schlatter syndrome

* The Ankle Joint – Medial View Tibia Medial malleolus Calcaneal (Achilles) tendon Long plantar ligament Deltoid ligament

* The Ankle Joint – Lateral View Tibia Fibula Posterior tibiofibular ligament Lateral malleolus Anterior tibiofibular ligament Anterior talofibular ligament Calcaneus Posterior talofibular ligament Anterior talofibular ligament

* Ankle Joint Injuries  Inversion sprains  “twisted ankle”  Eversion sprains  Occurs to the deltoid ligament  Pott’s Fracture  A force on the medial side of ankle causing the deltoid ligament to rip off the tip of the medial malleolus; and a break of the fibula Inversion sprain

* Proper Treatment of an Injury S.H.A.R.PP.I.E.R. Principle Swelling: instantly or over timePressure: tensor wrap Heat: increased temperature in the area Ice: placed on affected area Altered: tissue will not function properly Elevate: to reduce swelling Red: in colourRestrict: tensors, slings, or crutches Painful: to touch or move