How do joints work?

Joints are connections between at least two bones. Each joint is made up of the surfaces of the bones involved, a joint cavity and a joint capsule.

The joint surfaces (articular surfaces) of the bones are covered with a layer of cartilage. It provides a smooth surface to stop the bones in movable joints from rubbing against each other too much. The cartilage passes the pressure in the joint on to the bone underneath it. This is especially important in joints that bear heavier loads, such as hip or knee joints.

The thickness of the cartilage is different in different joints. For instance, it is between 0.2 and 0.7 mm thick in the interphalangeal joints (in the middle of your fingers), and up to 6 mm thick on the kneecap.

Illustration: Structure of a joint

Protective joint capsules

The surfaces of the joint are separated by a thin space. The joint capsule seals the joint airtight from the outside. The space that results is called the joint cavity (or synovial cavity). The joint capsule has an inner and an outer layer. In the inner layer there are blood vessels and nerves. The nerves pass on information about what position the joint is in, and send pain signals to the brain.

The outer layer of the joint capsule is made up of firm fibrous tissue. If a joint is immobilized (kept still) for a long period of time, these fibers may become shorter: The joint capsule shrinks and the joint is no longer as moveable. This is why it’s important to do mobilizing exercises to keep moving joints after injury or when confined to bed for a longer time.

Many different shapes and well-lubricated

Some joints have other structures inside of the joint cavity, such as the cruciate ligaments in the knee joint and cartilage discs like the meniscus in the knee joint. Other joints have a special shape. In the hip joint, for instance, the hip socket almost completely surrounds the top of the thigh bone (the femoral head).

Cells of the inner joint capsule layer produce synovial fluid. This thick fluid nourishes the cartilage, makes sure that the surfaces of the joint glide smoothly over one another, and acts as a shock absorber by spreading out the pressure put on the joint.

Direction of movement and flexibility

The direction that a joint can move in is determined by the shape of the joint surfaces. The joints are moved by muscles. A joint's range of motion also depends on the soft tissue, ligaments or bones that are part of it.

The flexibility of some joints can be improved by doing stretching exercises. Your overall flexibility is also determined by your build, age, level of fitness and other individual factors.

Pschyrembel Online. 2021.

Brandes R, Lang F, Schmidt R. Physiologie des Menschen: mit Pathophysiologie. Berlin: Springer; 2019.

Lippert H. Lehrbuch Anatomie. München: Urban und Fischer; 2017.

Menche N. Biologie Anatomie Physiologie. München: Urban und Fischer; 2016.

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Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

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Updated on August 24, 2021
Next planned update: 2024

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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