Hey, friends!  So, you have pain...have you ever wondered what actually hurts and why?  One of my main focuses in physical therapy is to educate my patients on the problem that I am treating.  Some basic knowledge of the problem can really go a long way in healing and compliance with a therapy program.  When you understand why you’re doing something, it feels a lot easier to push through and get it done consistently.  I have decided to do a series on the basics of orthopedic injuries joint by joint!  I will go over the shoulder, neck, back, hip, knee and ankle over the next few weeks.  My intention during this blog series is to educate you on the joint structure, the types of injuries and problems that I commonly see, and some prevention strategies to keep that area healthy. 

Today, in order to set the stage a bit, I will talk about some basic anatomy of the orthopedic “system” from a physical therapy perspective.  Physical therapy as a whole treats movement disorders and looks at the  body’s ability to function in the environment.  However, in orthopedic physical therapy we generally specialize in the musculoskeletal system related to physical injury, abnormal movement patterns that may cause pain, and post-surgery for orthopedic problems.  The musculoskeletal system includes different types of connective tissue, such as bones, cartilage, muscles, tendons, fascia, and ligaments.  Read on to learn a bit more about the parts of the musculoskeletal system.

1. Skeletal system - The skeletal system includes bones that form the basic framework of your body.  Two of its primary functions are to protect your vital organs and allow for movement.  The bones of this system come together to form “joints”.  In therapy, we may see broken or fractured bones or problems where two bones come together (this is the “joint”).  You might know them as the knee bone or the ankle bone, but a therapist is required to learn these bones by their scientific name (ever heard of the femur or the fibula?) and understand how they fit into the big picture of getting you well.  Fun fact:  There are 206 bones in the human body.  

2. Cartilage - Cartilage is a type of connective tissue that can be found in many parts of the body (that bendable ear on either side of your head?  Yep, it’s cartilage.).  For today’s purposes, let’s focus on the cartilage that lies on the ends of bones and between joints.  Cartilage is made up of a blend of collagen and different types of proteins.  It often serves as a middle man between the bones to allow for protection and cushioning of the joints.  It is strong and smooth in nature and allows for nice gliding and movement of the  bones back and forth when it is healthy.

3. Muscles - Muscles are a dynamic type of tissue in your body that attach to bones to help your body move.  They are “dynamic” in the sense that they are controlled by messages from the brain...we can make them activate in order to pick up our cup of coffee or push on the gas pedal.  Muscles contract and relax, allowing for us to ultimately move throughout our day with ease and grace.  When we contract our muscles in specific ways repetitively, our brain develops motor patterns that allow us to move without thinking too much about how we are doing it (ie. learning to play the piano, make a sandwich, or drive).  Muscles also help to provide us the maintenance of our posture, helping us to keep our head upright, sit in a chair unsupported, etc.  

4. Tendons - Tendons are actually extensions of the muscle and serve to attach the muscle to the bone.  They assist in the active control of the body’s movement patterns.  They are strong structures that are deeply embedded into the bone where they insert, allowing them to work in conjunction with the muscle to move and stabilize a body part.  Tendons are surrounded by a sheath that protects them from friction.  You’ll learn a bit more about tendons as I move into types of injuries over the next few blog posts.

5. Ligaments - Ligaments are made of strong collagen and give the body stability by attaching one bone to another bone.  They are known as “static stabilizers”, in that we don’t have active control of the ligaments.  They are a built-in protection in our bodies to give us a stable framework.  They can be either stretched or torn during injury, which destabilizes the affected joint and can cause pain, swelling, and difficulty functioning normally (maybe you’ve heard of an ACL tear, which is a tear of the anterior cruciate ligament in the knee).

6. Fascia - Last but not least is a connective tissue known as fascia (pronounced “fasha”).  Sometimes fascia is easy to forget, as it doesn’t get the same attention as some of the other big names.  It is, however, a critical component of our musculoskeletal system (and honestly, our body as a whole).  It is a bit like a spider web of connective tissue that weaves its way in and out of structures to allow for interconnection of all parts of the body.  During times of injury or abnormal movement and pain, the myofascial system (where the muscles and fascia intertwine) can become overstressed and tight, contributing to ongoing pain and a cycle of continued problems.  

Ok, ok…I think that’s enough “sciency" stuff for today. LOL.  If you already know that you have trouble with your own musculoskeletal system and live in the Cedar Park or Leander areas, you can schedule a free consultation call or a Physical Therapy Initial Evaluation here.  Not sure what services I offer at ALEYA?  Start here.  Check back over the next few weeks for a continuation of the Basic Breakdown of Orthopedic Injuries Joint by Joint.  See you back here soon!  

Xo,

Jill

References:  

1. Textbook of Disorders  and Injuries of the Musculoskeletal System, 2nd Edition.  Robert B. Salter, MD.

2. https://www.myofascialrelease.com/about/fascia-definition.aspx.