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Joint Mechanics & Joint Injuries
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Joints are the points at which bones connect
Joints are the points at which bones connect. Vitally important because they play a critical role in human movement Are also points of great stress and can be a common source of injury. The articular system is a term that refers to the joints and the surrounding tissues that make connections, and therefore movement, possible. Joint’s are classified according to their structure (what they are made of) or their function ( the type and extent of movement they permit). The structural classification recognizes three main types of joints: 1. Fibrous Joints (immovable joint) aka- synarthrosis Cartilaginous Joints (slightly movable joint aka- amphiarthrosis 3. Synovial Joints (freely movable joint aka- diarthrosis The Different Types of Human Joints:
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Types of Joints Fibrous joint Cartilaginous joint Synovial joint
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Fibrous Joint Bound tightly together by connective tissue- allow no movement These joints can be found between the interlocking bones of the skull Also known as “Sutures” What happens to these joints after birth? Become immobile- fuse together Fibrous joint
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Fibrous Joint
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Cartilaginous Joints (Fibrocartilaginous Joints)
The body of one bone connects to the body of another by means of cartilage Allow for slight movement, but typically lack large ROM The intervertebral discs 23 Hard elastic outer ring, with a soft core permitting some movement while at the same time providing protection against severe jolts What is the purpose of having discs when jumping? Discs=shock absorbers… stable for up and down movements, not very stable for blows to the side Cartilaginous joint
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Cartilaginous Joints (Fibrocartilaginous Joints)
Discs=shock absorbers… stable for up and down movements, not very stable for blows to the side
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Synovial Joints These joints allow the most movement
Characterized by capsules surrounding the articulating surfaces and the lubricating synovial fluid within those synovial cavities Knee, shoulder, ankle Synovial joint
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Types of Synovial Joints
Joints allow the bones coming together to form the joint to move relative to one another in various ways and to various extents Synovial joints are the only joints that allow significant movement and for this reason we are interested in synovial joints as they are important in our understanding of human movement Distinguished by the kind of movement the joint permits- 6 types…
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Types of Synovial Joints
Gliding joint Ball-and-socket joint Hinge joint Pivot joint Ellipsoid joint Saddle joint
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Types of Synovial Joints
Ball-and-socket (spheroidal) joints: most manoeuvrable of joints- allows for; forward, backward, and circular movement. (tri-axial) “ball” at one bone fits into the “socket” of another, allowing movement around 3 axes Hip- femur rests in the acetabulum of the pevis Shoulder- humerus rests in the glenoid cavity
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Types of Synovial Joints Cont…
2. Gliding (or plane or arthrodia)Joints: Connects flat or slightly curved bone surfaces that glide against one another Joints in the foot between the tarsals and the hand among the carpals
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Types of Synovial Joints Cont…
3. Hinge (ginglymust) Joints: Have a convex portion of one bone fitting into a concave portion of another Allow movement in ONE plane (uni-axial) Joints between the bones of the fingers (phalanges) and between the ulna (inner bone of forearm) and the humerus (upper arm)
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Types of Synovial Joints Cont…
4. Pivot (or trochoid) Joints: allows rotation in one pane (uni-axial)- a rounded point of one bone fits into a groove of another Atlas- axis first two cervical vertebra- allow rotation of the head- no-yes
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Types of Synovial Joints Cont…
5. Saddle Joints: Like ellipsoid joints, allow movement in two planes(bi-axial) i.e. flexion-extension, abduction-adduction, but do not allow for rotation like your ball-and-socket joint Example- carpo-metacarpal articulation of the thumb
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Types of Synovial Joints Cont…
6. Ellipsoid Joints: Allows movement in two planes(bi-axial) Wrist, second metacarpal and first phalanx of the second finger
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Task Read page 70 of the text and take notes on;
The characteristics of synovial joints Complete the workbook exercise 4.3 on the knee joint.
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Synovial Joint Structure
Bone WORKBOOK EXERCISE 4.3 Blood vessels Nerve Joint cavity (filled with synovial fluid) Joint capsule Synovial membrane Fibrous capsule Articular cartilage Bursa Articulating cartilage Joint capsule Synovial membrane Fibrous capsule Joint cavity Bursa Tendon sheath Membranous layer Tendon Periosteum Fibrous layer Label Label & Define!
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Characteristics of Synovial Joints:
Articulating Cartilage Located at the ends of bones that come in contact with one another- protects the ends of bone and allows for smooth contact surface for the bone to move- act as a shock absorber Joint Capsule Fibrous structure that consists of the synovial membrane and fibrous capsule. Synovial Membrane- allows certain nutrients to pass through Fibrous Capsule- keeps synovia fluid from leaking 3. Joint Cavity Located between the two bony articulating surfaces- filled with synovial fluid- acts as a lubricant for the joint- lubricant is essential in reducing friction and providing nutrients for the articulating cartilage 4. Bursae small, flattened fluid sacs found at friction points between tendons, ligaments, and bones 5. Intrinsic Ligaments Thick bands of fibrous connective tissue that helps thicken and reinforce the joint capsule 6. Extrinsic Ligaments Help reinforce the joint by attaching bones together
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Wear and Tear on Joints Continuous, heavy use of the joints over many years can result in wear and tear on the articular cartilage at the ends of bones, leading to the erosion of the surfaces of bones at the articulations where bones come together. This process is known as osteoarthritis, is common for older individuals and athletes or anyone active Results in joint pain and stiffness and restricted mobility Osteoarthritis- commonly occurs in the larger weight-bearing synovial joints i.e. hips, knees- but can affect hands, feet, and even spine Is a degenerative disease- is irreversible- results in decreased effectiveness of articular cartilage both as shock absorber and lubricated surface Treatment= pain medication- joint replacement
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Wear and Tear on Joints cont…
Because of heavy continual use sheer strength of the forces that are generated at joints, they are a common site for injuries. Most sport related injuries included; twisted ankle, sprained wrist, overextended elbow, damaged knee ligaments, or bursitis- inflammation of the fluid sacs (bursae) at the friction points between tendons, ligaments, and bones. How do we decrease injuries? Warming up properly prior to exercise, by exercising correctly and stretching during recovery.
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Joint-Related Injuries:
Joints allow movement and make our skeleton flexible Without them, we would not be able to move our bodies. Because of the wear and tear joint-related injuries can occur 3 Types of Cartilage” Hyaline Cartilage Occurs at the ends of long bones as well as in the ear, fetal skeleton, nose, larynx, trachea and bronchi Weakest and most common type of cartilage in the body Fibrocartilage Found in disks between vertebrae, pubic symphysis, skull Strongest cartilage in the body Elastic (yellow) Cartilage Flexible, interlacing, branching fibres Found in epiglottis and external ears Cartilage Damage Cartilage= connective tissue found at the end of bones and free-moving joints Is avascular- nutritional needs of cartilage are NOT met through the blood- no blood vessels Cartilage damage or injuries- “torn cartilage”- is common in the knee because of sports that need vigorous lateral movement and when contact is common i.e. basketball, football Arthroscopy- surgical procedure- small incisions made so that small fibre optic camera devices can assess the extent of the damage
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Tissue Properties Tendons:
Composed of collagen (bundles of white, fibrous protein) Attach muscle to bone, dynamic stabilizer of joints Vascular (has a blood supply) Strains occur in muscle and tendons Ligaments: Tough bands of white, fibrous tissue Attach bone to bone(one or more bones together), static stabilizer of joints Avascular (no blood supply) (Cartilage is avascular as well) When they reach their threshold, will stretch minimally, but usually will tear. Sprains occur when a ligament is overstreched
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Tissue Properties Strains, sprains, and tears
Are terms used to describe all joint injuries- this will usually include: tendons, ligaments, and muscles Injury Severity- strain(muscle/tendons) and sprain(ligaments) grading classified by degrees: 1st Degree Sprain: mild injury, a few days of recovery- treated easily since only a few ligament fibres are stretched- minimal swelling and some pain 2nd Degree: result of partially torn ligament fibres, result in bruising, swelling and pain more considerable- require diagnosis by doctor + treatment 3rd Degree: entire ligament is completely or nearly completely torn- severe, require a diagnosis by doctor + may require surgery(ligament back to bone), 6-12 months for full recovery
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Common Sport Injuries Strains, pulls, and tears Tendinitis
Terms used to describe injuries to all joint tissue types (1st to 3rd degree) 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 on medial and lateral side of tibia- shin bone. Tendinitis
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Proper Treatment of an Injury
S.H.A.R.P P.I.E.R. Principle Swelling: instantly or over time Pressure: tensor wrap, slings, cruches Heat: increased temperature in the area Ice: placed on affected area- first 48 hrs- every few hours Altered: tissue will not function properly Elevate: to reduce swelling- higher than heart- especially at night Red: in colour Rest: activities need to be put on hold, stop activity that causes pain, used tensors, splints, slings to help rest injured body part Painful: to touch or move
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Dislocations Dislocations occurs when a bone is displaced from its joint- i.e. shoulder dislocation – humerus “pops out” of the glenoid fossa, resulting in a tear of the ligament and joint capsule. Most common- finger joint Don’t attempt to put back in place on your own- seek medical attention Signs of a Dislocation: Significant pain- inability to move the appendage from its current position Numbness, no feeling of appendage Square appearance of the joint area and/or visibly noticeable lack of bone in the injured joint area.
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The Shoulder Joint – Workbook Exer.4.4
Clavicle Acromioclavicular ligament Coracoclavicular ligament Acromion Coracoacromial ligament Coracoid process Glenohumeral ligaments and joint capsule Scapula Tendon of biceps brachii (long head) Humerus
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Shoulder Dislocation
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Separations: Does not directly affect the joint itself, but rather the connecting tissue i.e. should separation- the ligaments attaching your collarbone (clavicle) and shoulder blade (scapula) are disrupted. When the ligaments are torn, the bones ma separate Separations are classified from grades I-IV according to severity and the position of the injured bone Symptoms: Pain at the end of the bone or over the joint Swelling and obvious lump where the joint has been disrupted Pain on moving
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Shoulder Joint Injuries
Biceps tendinitis Caused by overuse of the biceps brachii muscle (back to shoulder diagram) Shoulder separation Tearing of the acromioclavicular ligamenthttp:// Shoulder dislocation Occurs when the humerus “pops out” of the glenoid fossa(see next slide) Rotator cuff tears An injury to one of the rotator cuff tendons( teres minor, subscapularis, infraspinatus, supraspinatus) Shoulder separation
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The Knee Joint – Anterior- Workbook Exer. 4.4
Quadriceps tendon Patella Medial (Tibial) collateral ligament Patellar ligament Fibula Tibial tuberosity Tibia
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The Knee Joint Anterior (deep)
Femur Posterior cruciate ligament Lateral (Fibular) collateral ligament removed Medial (Tibial) collateral ligament removed Lateral Condyle Medial Condyle Anterior cruciate ligament Lateral Meniscus Medial Meniscus Tibial Tuberosity Fibula Tibia
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The Knee Joint – Posterior
Femur Adductor magnus tendon Medial head of gastrocnemius tendon Lateral head of gastrocnemius tendon Semimembranosus tendon Oblique popliteal ligament Medial (Tibial) collateral ligament Lateral (Fibular) collateral ligament Fibular head Fibula Tibia
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The Knee Joint – Posterior (deep)
Femur Anterior cruciate ligament Posterior meniscofemoral ligament Medial meniscus Medial (Tibial) collateral ligament Popliteal tendon Lateral meniscus Posterior cruciate Lateral (Fibular) collateral ligament Fibula Tibia
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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
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The Ankle Joint – Medial View
Tibia Medial malleolus Deltoid ligament Calcaneal (Achilles) tendon Long plantar ligament
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The Ankle Joint – Lateral View
Tibia Fibula Lateral malleolus Anterior tibiofibular ligament Posterior tibiofibular ligament Posterior talofibular ligament Anterior talofibular ligament Calcaneus Anterior talofibular ligament
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Ankle Joint Injuries Inversion sprains “twisted ankle”
Eversion sprains Occurs to the deltoid ligament Pott’s Fracture A force on the lateral side of ankle causing the deltoid ligament to rip off the tip of the medial malleolus; and a break of the tibia Inversion sprain
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Reading Pages Joint Assignment
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