1. Synovial Joints  Tendon and Ligaments  Knee & Hand ligament  Cartilage and Arthritis  Hip Replacement  Bursa  Synovial Capsule and Fluid  Ankle Sprains – Type 1, 2,3  Sprain Treatment  Post Sprain Rehab  Return to competion

2. Tendons and Ligaments Tendons very strong and will tear before stretching. Ligaments very strong and can stretch a tiny amount before tearing. Neither tendon or ligament heal well on their own and surgical repair may be needed in severe trauma.

3. Knee & Hand Ligaments

4. Cartilage and Arthritis  Cartilage between the joints act to stabilize, absorb shock and allow the bones to slide without friction when moved. Arthritis occurs when the cartilage wears or roughens (due to age, injury or genetics). It decreases the space between the bones reducing range of motion and increases the friction, irritation resulting in pain around the joint.

5. Hip Replacement

6. Bursa  In your body there are more than 150 bursae. These small, fluid-filled sacs lubricate and cushion pressure points between your bones and the tendons and muscles near your joints. They exist to help your joints move with ease. Bursitis occurs when a bursa becomes inflamed. When inflammation occurs, movement or pressure is painful.

7. Synovial Capsule and Fluid  The synovial capsule is a thin membrane surrounding the joint. It is filled with a fluid called synovial fluid. The fluid helps reduce friction and absorb shock around the joint. It also helps to provide Oxygen and nutrients to the tissues in the joint.

8. In a sprain the joint is forced to move beyond its range of motion resulting in damage to tissues. Swelling, pain and loss of function result.  Type one Sprain – micro tears of ligaments, sore but no loss of movement  Type 2 Sprain – partial tear of ligament, loss of function, swelling & pain, will heal but will not regain full stability or strength  Type 3 Sprain – total tear of ligament, loss of function, pain and swelling, requires surgery to repair

9. Ankle Sprains Type 1,2,3 Type 1Type 2Type 3

10. RICE – helps reduce initial swelling and speeds up the recovery time after the sprain occurs  R = Rest which slows the heart and reduces blood flow, thus reducing swelling and pain around the joint. It also reduces risk of further injury  I = Ice or cold application, which causes the blood vessels to constrict around the injury and reduce blood flow and swelling  C = Compression or pressure applied over the swollen joint which helps to constrict the blood vessels and reduce swelling  E = Elevate the injury higher than the heart to slow blood flow to the injured area

11. Sprain Treatment R I C E = Rest, Ice, Compression, Elevate

12. Post Sprain Rehab  Most ankle sprains heal enough after 14 days to return to activity. After a bad sprain the ligaments may be loose and the ankle less stable. Taping can help by holding the foot in proper position for running and jumping. This reduces the risk of landing in an awkward position. Taping alone will not stop the ankle from injury should the ankle twist under torque again.

13. Return to competition A general plan for coaches to return a player after joint / muscle injury is OK – pain but it goes away during warm up OK – after warm up there is soreness but no altered function (movement is good) NOT OK – after warm up there is pain and altered function (movement is impaired)