If you are experiencing musculoskeletal pain or injury, and are in the process of seeking or having treatment, it is useful to have a basic understanding of the relevant anatomy and terminology you are likely to hear through the process. Whilst your doctor will explain in detail everything in detail too, here we cover the basics about bones, joints, cartilage, meniscus, labrum, muscles, ligaments and tendons.
BONES & BONE INJURIES
The adult skeleton has 206 bones in total.
Injury to bones is common and you are highly likely to know at least someone in your family or a friend that has broken a bone.
When a bone breaks it is referred to as a fracture and the amount of separation between the broken pieces of bones is called displacement. If a bone is minimally displaced then setting a fracture can be straightforward, and can even be performed closed, meaning without surgery. An example of this is a wrist fracture, which may just require a cast or a splint and then to be immobilised in a sling whilst it heals.
However, some fractures are more complex and require surgery, using pins, screws, rods or plates to stabilise the broken pieces of bone whilst they fuse again.
Fortunately, our bones are made of active tissue and have a fresh supply of blood, enabling them to heal.
Sometimes bones don’t heal though, which is known as non-union, or if it heals crooked then it’s referred to as malunion.
An open fracture or compound fracture is the term used when the bone breaks and pierces through the skin. This is by far the most serious fracture and typically requires urgent treatment to minimise infection risks.
Successful treatment of bone fractures depends largely on:
- your age
- your general health
- whether you smoke, or not
- any medical problems
- the location of the fracture
- the amount of soft tissue injury involved
- the level of displacement
JOINTS & JOINT INJURIES
The adult human body contains 230 joints in total.
A joint is where two bones meet, with the bearing surface of the joint being made from articular cartilage. To help with stabilisation, ligaments often surround joints.
Common joints that get injured are:
- elbow
- shoulder
- hand
- hip
- knee cap
A dislocation is the term used when a joint comes out of position.
A subluxation is the term used if a joint partially comes out of position.
Joint instability can occur when a joint dislocates and then keeps on dislocating.
In these instances, surgery or braces may be required but often by using traction and relaxation techniques, or alternative therapies, a dislocated joint can be successfully treated.
CARTILAGE & CARTILAGE INJURIES
The bearing surface of a joint is made of articular cartilage.
Unlike other tissues, cartilage doesn’t have a blood supply, so it is unable to self-repair.
Damage to the cartilage may occur from overuse, general degeneration or from trauma.
One common disease related to cartilage is arthritis, with osteoarthritis being the most common. If arthritis develops to a stage which is causing signifiant levels of pain, a joint replacement can sometimes be the best option.
This involves replacing the cartilage surfaces in the damaged joint using various metals and plastics. Other injuries to cartilage can be treated either with surgery or through non-operate methods.
MENISCUS
The meniscus is found only in the knee and provides a cushion, plus stability. Each knee has two, one medial on the inside and one lateral on the outside.
It is very common to experience meniscus tears through trauma or degeneration and often the tear clearly relates to either the medial or the lateral meniscus.
If you think you have torn a cartilage, it is most likely you have torn your meniscus!
One common treatment of a meniscus tear is called a meniscectomy, which involves repairing or trimming the meniscus.
Partial meniscectomy is the most common orthopaedic treatment and if performed using key-hole surgery is relatively straightforward with, normally, a quick recovery.
Meniscal loss is linked to arthritis though, so careful diagnosis is required. If the tissue has a high chance of healing then repairs can be performed so for young, active patients this is typical.
LABRUM
The labrum can be found in just two locations in the human body:
- The shoulder socket – the glenoid
- The hip socket – the acetabulum
The labrum helps to stabilise the joint, among other functions and typically gets torn as a result of a dislocation.
Degeneration is also possible.
Like the meniscus, the labrum can be repaired or trimmed through surgery. Although, it is capable of self-healing as it contains blood vessels and nerves that makes this possible.
MUSCLE & MUSCLE INJURY
The human body has 640 muscles in total.
Injuries to muscles are called strains and they are extremely common. Overuse is normal, partially for sports people, as well as single injuries.
Strains can often heal on their own, although sometimes a problematic muscle may cause repeat pain through scarring.
Surgery is rarely required to treat a muscle injury.
LIGAMENT
Ligaments connect bones to bones and help to stabilise joints.
If a ligament is injured, it is referred to as a sprain. Sprains are common particularly the medial collateral ligament, which is found in the knee, and lateral ligaments of the ankle.
The anterior cruciate ligament, found in the knee is a non-so common ligament sprain, but this can be difficult to heal effectively.
Sprains range from Grade | to Grade |||, with the latter indicating a complete tear.
Repair and reconstruction are the treatments associated with ligament damage. If possible, a repair will re-join the ligament to the bone. Reconstruction is for more difficult cases, like the anterior cruciate ligament, where a tissue graft is used as a replacement.
TENDONS
Tendons connect muscles to bones.
Injuries to tendons are also called strains and are very common, from various causes.
Tendons can get inflamed, which is called tendinitis. They also degenerate, called tendonosis.
Other common tendons to get affected are:
- rotator cuff tendons – in the shoulder
- distal biceps tendon – in the elbow
- quadriceps – in the knee
- patella tendons – also in the knee
- achilles tendon – in the ankle
Tendon issues can be treated using therapy, medication, braces, injections or, in severe cases, with surgery.
If you have an injury or any long-term pain it is essential to seek the advice from specialists that can help to diagnose the exact issue and recommend the best course of treatment for you.
