Exercise ScienceExercise ScienceSection 4: Bone and Muscle Injuries andSection 4: Bone and Muscle Injuries and

Joint Mechanics and Joint InjuriesJoint Mechanics and Joint Injuries

Stress fracture – most difficult to detectSimple fracture – no separation (hairline fracture)Compound fracture – bone breaks into separate

piecesComminuted 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

*Rest

*Immobilize

*Cold

*Elevation

*Muscles are made up of bundlesof muscle fibers, called fascicles

*Fascicle is a bundle of muscle fibers

*A muscle fiber is a muscle cell….made up of many small myofibrils

*Myofibrils contain filaments

*Two types ofprotein filaments

TTIIssssuuee

AAnnaattoommyy

MuscleMuscle

FilamentsFilaments

MyofibrilsMyofibrils

Muscle FibersMuscle Fibers

FascicleFascicle

DD

CC

BBAA

*What parts do you remember?1. Muscle

2. Fascicle (bundle of fibers)

3. Muscle fiber (muscle cell)

4. Myofibrils

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*A sprain is a wrenching, twisting or stretching injury to a ligament.

Sprains often affect theankles, knees, or wrists.

SprainSprain

Result in pain, swelling, redness, bruising, and difficulty Result in pain, swelling, redness, bruising, and difficulty using injured joint.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

StrainStrain

* 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 RupturesMuscle Ruptures

*Muscle pull- very slight tear

*Chronic tear- gradual onset of pain

*Acute tear- sudden dramatic pain

Muscle PullMuscle PullMuscle TearMuscle Tear

Muscle Muscle TearsTears

*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 splintsShin splints

Shin splints represent an "overuse injury" and occur most commonly in runners.

*R.I.C.E.*Rest: Stop all activities whichcause pain. *Ice: Helps reduce swelling. Never ice more than 10-15 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 InjuriesTreatment for Muscle Injuries

Cartilaginous jointFibrous joint Synovial joint

Ball-and-socket joint

Hinge joint

Saddle joint

Gliding joint

Pivot joint

Ellipsoid 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

Tendons:Composed of collagen

(bundles of white, fibrous protein)Attach muscle to boneVascular

Ligaments:Tough bands of white, fibrous tissueAttach bone to boneAvascular

Strains, pulls, and tearsTerms used to describe injuries

to all joint tissue typesTendinitis

Inflammation of a tendonDislocations

Bone displaced from its original location

SeparationsFibrous ligaments that bind the

bones tear and separateCartilage

Torn cartilageShin 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

Clavicle

Coracoclavicular ligament

Coracoid process

Scapula

Acromioclavicular ligament

Acromion

Coracoacromial ligament

Glenohumeral ligaments and joint capsule

Tendon of biceps brachii (long head)

Humerus

Biceps tendinitisCaused by overuse of the

biceps brachii muscleShoulder separation

Tearing of the acromioclavicular ligament

Shoulder dislocationOccurs when the humerus

“pops out” of the glenoid fossaRotator cuff tears

An injury to one of the rotator cuff tendons

Shoulder separation

Patella

Medial (Tibial) collateral ligament

Patellar ligament

Tibial tuberosity

Tibia

Quadriceps tendon

Fibula

Femur

Lateral (Fibular) collateral ligament removed

Medial (Tibial) collateral ligament removed

Lateral Meniscus

Tibial Tuberosity

Fibula

Lateral Condyle Medial Condyle

Medial Meniscus

Tibia

Posterior cruciate ligament

Anterior cruciate ligament

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

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 ligament tearsQ-angle may contribute to the

predisposition of ACL tearsOsgood-Schlatter syndrome

Affects the epiphyseal plate of the tibial tuberosity

Patellofemoral Syndrome (PFS)Gradual onset of anterior knee

pain/pain around the patellaOsgood-Schlatter syndrome

Tibia

Medial malleolus

Calcaneal (Achilles) tendon

Long plantar ligament

Deltoid ligament

Tibia

Fibula

Posterior tibiofibular ligament

Lateral malleolus

Anterior tibiofibular ligament

Anterior talofibular ligament

Calcaneus

Posterior talofibular ligament

Anterior talofibular ligament

Inversion sprains“twisted ankle”

Eversion sprainsOccurs to the deltoid ligamentPott’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

S.H.A.R.P P.I.E.R. Principle

Swelling: instantly or over time Pressure: 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 colour Restrict: tensors, slings, or crutches

Painful: to touch or move