Tendons and

Ligaments

• Ligaments are structure which connect bones to other bones

• Assist in Stabilization of Joint

• Restrict Movement and resisted applied force

• Prevent Excessive Motion and guide it

 Tendons
• Attach muscles to the bones and transmission of tensile loads

• Transmit tensile loads

• Position of muscle relative to joint

• Flexible to allow changes in direction of muscle pull

Both are Dense connective tissues
Similar in structural composition and mechanical behavior

Tendons Ligaments
1. Longer & narrower 1. Short and wider
2. Connect muscle to bone 2. Connect bone to bone
3. Load transmitting structures. 3. Load-bearing structures
4. Collagen more 4. Less collagen & more
ground substance
5. longitudinally arranged
5. collagen arrangement more
variable
Mechanical Behavior of Tendons and
Ligaments
• Strength
• Stiffness
• Both are viscoelastic tissues
• Visco - a small amount of load results in quite a bit of deformation
(relative)
• Elastic - refers to Elastic Region
• Will return to their original length after being stretched
 Tendon composition:
Extracellular component:
• Water
• Collagen ( type I and type III ) -> 90%
• 1-5% proteoglycan (decorin & aggrecan)
• 0.2% inorganic components copper,manganese and calcium
• Tendons are basically group of collagen bundles Separated by
endotenon and covered by epitenon
 Cellular component:
• Tendon cells or Tenocytes
• Tenocytes are fibroblast-like differentiated cells that form the
mature tendon. Tenocytes synthesize the extracellular matrix,
inducing assembly of early collagen fibers, which are the basic units
of the tendon
 • TENOCYTES PROPERTIES :
• Are spindle shaped cells arranged in direction of muscle loading in
arrays
• Secrete collagen type I predominantly (95 %) but also secretes type
III collagen in small amounts
• Help in healing of tendons
 Ligament Composition:
Extracellualr component:
• Water
• Type I collagen(70% of dry weight)
• Elastin
• proteoglycans
 Cellular Component:
• Ligaments have fibroblasts that are found within the ligament
substance aligned with the collagen fibrils
• Like tenocytes, ligamentous fibroblasts also form an extensive
network with other cells via cytoplasmic extensions that are linked
by gap junctions
• The fibers are not parallel and are multidirectional
 Ligament VS tendons:
As compared to tendons, ligaments have
• Lower percentage of collagen
• Higher percentage of proteoglycans and water
• Less organized collagen fiber
• Round fibroblasts
• Higher elastin percentage provides more tensile strength
Response of ligament and tendons to Loads
Stress-strain curve:
• Load-elongation curves have several regions that characterize the
behavior of the tissue.
• The first region of the load-elongation curve is called the “toe”
region.
• In this region, the tissue stretches easily without much force, the
collagen fibers become straight and lose their wavy appearance,
• when collagen is stretched to approximately 2% of its
original length
Elastic or linear Region:
• As loading continues, the stiffness of the tissue increases and there
is a resultant change in the tissue elongation.
• when collagen is stretched to 2-4% of its original length
• linear relationship between deformation and load
• Tissue will return to its original state when stress is
removed
• Yield:
• The region presented as mid point between elastic and plastic
region.
• load past 4% causes a plateau effect on the curve
• this point represents the ultimate tensile strength of the tendon
and is termed the ‘yield point’
•  Fibrils do not return to normal length on release, known as plastic
deformation
• Failure:
• With the attainment of maximum load, the load-supporting ability
of the ligament is substantially reduced
• The tissue is elongated then until it ruptures. This point is called as
failure
• there would be an inability to support load or function
Factors That Affect the Biomechanical
Properties of Ligaments
• Maturation and aging
• Pregnancy and the postpartum period
• Mobilization and immobilization
• Diabetes mellitus
• Steroids
• Nonsteroidal anti-inflammatory drugs
• Hemodialysis
• Grafts
Common injuries to tendon and ligament
Ligament:
• When a ligament is over stretched or torn, it is know as sprain.
• Sprain happen suddenly , with a blow, fall or awkward movement
• Symptoms include pain, swelling and bruising
• Joint may feel loose, weak nad unable to bear weight
• Common sites are ankle, wrist and knee
• Doctors classify sprains into three categories:
• Grade 1: Mild sprains in which the fibers of the ligament stretch,
but the ligament does not tear.
• Grade 2: Moderate sprains where the ligament partially tears.
• Grade 3: Severe sprains in which the ligament completely tears.
This type of sprain renders the joint completely unstable and often
requires surgical treatmen
 Tendon:
• When a tendon is overstretched or torn, it is known as strain
• It results from some habitual movements and in athletics.
• symptoms are pain and bruising
• Muscle may experience weakness and cramping
• Repetitive low magnitude loads on tendon result in inflammation
at teno-osseous junction – Tendinitis
• In tennis players, there is tendinitis at insertion of wrist extensor.