Synovial Joints Tendon and Ligaments Knee & Hand ligament Cartilage and Arthritis Hip Replacement 6 types of synovial joints Bursa Synovial Capsule and Fluid Ankle Sprains – Type 1, 2,3 Sprain Treatment Post Sprain Rehab Shin Splints Osgood Shlatter Disease ACL tears and Q Angle Dislocations Return to competition

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.

Knee & Hand Ligaments

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.

Hip Replacement

A cartilaginous joint is where two bones connect by means of cartilage A cartilaginous joint is where two bones connect by means of cartilage. Slight movement is possible. The vertebrae and the cartilage disc between each is an example. Synovial Joints have a lot of movement, have a capsule filled with synovial fluid that lubricates and have ligaments holding the joint in place. Cartilage is found on the ends of the bones to allow for smooth contact. An example is the knee.

6 Types of Synovial Joints Gliding Joints – connects flat surfaces and the bones slide or glide between each other, like found in between the vertebra.

6 Types of Synovial Joints Pivot Joint – allows rotation in one plane. Like the turning your head, pivots around the C1 vertebra (called the Atlas pivoting on C2 called the Axis).

6 Types of Synovial Joints Ellipsoid – allows for movement in two planes. An example is the wrist.

6 Types of Synovial Joints Saddle Joint – very like an ellipsoid joint, allows for movement in 2 planes. The thumb is an example.

6 Types of Synovial Joints Ball and Socket Joint – allows movement around 3 axes. Circular motions like in the shoulder or hip.

6 Types of Synovial Joints Hinge Joint – allows for movement in one plane only. Convex bone fits into a Concave bone, like the elbow.

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.

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.

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

Ankle Sprains Type 1,2,3 Type 1 Type 2 Type 3

Sprain Symptoms SHARP Swelling, Heat, Altered Movement, Red, Pain

Sprain Treatment PIER – Pressure, Ice, Elevation and Rest

PIER – helps reduce initial swelling and speeds up the recovery time after the sprain occurs P = Pressure applied over the swollen joint which helps to constrict the blood vessels and reduce swelling (as in a compression bandage) I = Ice or cold application, which causes the blood vessels to constrict around the injury and reduce blood flow and swelling E = Elevate the injury higher than the heart to slow blood flow to the injured area 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

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.

A shin splint is an overuse injury often caused by running on hard surfaces, poor insole support and over use. The membrane located between the tibia and fibula begins to tear from the tibia causing pain on contraction or weight bearing. It can result in bone fractures in extreme cases.

Osgood Shlater Disease affects the knee Osgood Shlater Disease affects the knee. Specifically the tibial tuberosity begins to tear away from too much repeated torque or pressure during the growth periods (teen years). A pronounced bump forms below the knee cap where the patelar tendon attaches to the tibia. It can become very tender and sore both to touch and to exercise. It usually goes away as the teen’s bones mature and strengthen.

ACL Tears of the Knee and Q Angle

The ACL is a common knee ligament tear The ACL is a common knee ligament tear. People who are more prone to this have a wider Q angle (Q stands for Quadraceps). The angle is measured as shown below. The wider the hip or more knock kneed a person is will widen the angle. Females suffer more ACL tears on average compared to men because of their wider Q angle which puts their knee in a more unstable position.

Dislocations Dislocation – the joint has separated and the bones no longer are in alignment in the joint capsule:

Treatment of Dislocated Joints Only trained medical persons should attempt to relocate the joint as it is possible to damage nerve and tissues around the joint Dislocated Joints should be immobilized (as in a broken limb) Make them as comfortable as possible (support the joint) Don’t let people stare or gawk (it is disturbing to see and shock for both victim and on lookers may occur)

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)

Exit Pass Write one sentence to describe the function for each of the following joint parts: Ligament, Cartilage, Synovial fluid, Bursa Give one example of each of the following joints: hinge, saddle, pivot. What causes the pain in a shin splint? Explain how Pressure, Ice, Compression and Elevation work to reduce swelling after a sprain.