Massage Therapy Journal Spring 2024

Spring 2024 • 31

to some sort of pathology or injury to the joint or the tissues around the joint. The joint may be hypomobile or hypermobile. Hypomobility occurs when the mobility of a joint is less than the usually expected range, and may be caused by bone or cartilage damage creating barriers, fibrotic tissue, ligament stiffness, musculature contractures, or injury/trauma to associated structures. Hypermobility occurs when a range of motion of a joint is more than appropriate or normally expected, which may cause joint instability, increased risk of trauma to the joint or injury. Hypermobility may also increase the possibility of injury to associated structures around the joints such as muscles, tendons or ligaments. How Ligaments Work Ligaments are strong, dense bands of fibrous connective tissue that attach bone to bone in the body. They work to provide stability, support and structure for the joints. They can help prevent excessive or abnormal movements that may otherwise lead to injuries. Ligaments are very important for maintaining the integrity of joints and facilitating controlled movement. See Figure 1 . Ligaments are composed of dense fibrous collagen that are arranged in a parallel or crisscross

pattern. This arrangement gives ligaments their flexibility and strength, and helps stabilize joints by preventing extreme movements, such as moving beyond the physiologic range of motion. This stability is crucial for maintaining joint function and preventing injuries. Ligaments can also provide reinforcement to the joint capsule, increasing its structural integrity, and they contain specialized sensory receptors called proprioceptors. These receptors send sensory signals to the brain about the joint’s position, movement and tension. This information is important for preserving balance and coordinating movements. Ligaments are categorized into two different categories based on their location and function: extrinsic and intrinsic. See Figure 2 . 1. Extrinsic ligaments are located on the outside of the joint capsule and provide support and stability to the joint. Examples include the tibial and fibular collateral ligaments in the knee. 2. Intrinsic ligaments are located within the joint capsule and play a role in inhibiting too much movement of the joint. The anterior and posterior cruciate ligaments of the knee are two examples. How Bursa Work A bursa is a small fluid filled sac that is used to prevent friction and provide some cushion

Knee Joint Structure

Anterior View

Figure 1

Figure 2

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