Physio Talks

Why Swollen Joints are Tight
Joints are held inside semirigid balloons called joint capsules. The capsules are attached to the bones on either side of the moving joint and are made of ligament material. Those are the basics. Now, so what?
Well, the so what has a lot to do with what you do with a joint that is stiff because it is swollen. People who have had total knee replacements are well acquainted with this phenomenon. So are people who have been playing volleyball and caught the ball on the end of one or more fingers, people who have sprained a wrist, and elbow, and ankle. Lots of people, which means I get to say this little treatise a lot to people coming to the physio clinic.
First, the ligament material. If you have been reading many of these pieces, and several of you have, you will now be able to recite the mantra I have started, ligaments don’t stretch, they break. If the tissue preventing full joint movement is ligament in substance, stretching it is not an option.
Now, let’s examine the balloon encasing the joint itself. It is able to bend, fold and twist allowing the joint to move in different directions, and holds in the synovial fluid that bathes the joint surfaces and feeds the cartilage covering the bone ends. That’s the cartilage that disappears with age and makes for sore joints when it’s not there. The fluid is produced by a synovial membrane that lines the inside of the capsule and has tons of lovely pain nerves. So, when the joint is traumatized by accident or surgery the synovial membrane produces lots and lots of extra fluid because it has been severely stimulated. Assuming the capsule has no holes in it, it traps the fluid inside, and blows up like, a what? a balloon. Ligaments don’t stretch. So as the balloon inflates it pulls the attachments, the bones, with it. Now, when you try to move the joint the tight capsule prevents the movement and the pain makes you wish you hadn’t tried.
Stretching the tight joint is not an option, right? What is limiting the motion? The extra fluid inside the capsule and pain. Get rid of the extra fluid and the movement will increase and the pain decrease. Some relatively simple solutions to extra joint fluid are compression, cold application and anti-inflammatory medication. Another solution not usually considered is motion. Pain free motion of the joint will help decrease the swelling. If you are the typical Taranaki “push through the pain” sort, you might have trouble with the moving without pain suggestion, but stop and consider one moment please. The swelling is there because of an overactive synovial membrane. Why stir it up more when you are trying to get rid of the swelling you’ve got? Another thing I can count on Taranaki people for is common sense, once the information is available.
So, to increase the amount of motion a tight swollen joint has, decrease the swelling first, and don’t push through the pain to get there either.
These comments are general in nature. Be sure to check with your physio or doctor if you are not sure whether they apply to your situation.

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