Ligaments and tendons are specialized tissues that hold bones and muscles together. These structures, along with the muscular and visceral fascia, consist of dense sheets or chords of connective tissues. This connective tissue is the extracellular secretion of fibroblasts and is primarily composed of collagen and elastin proteins.
Sprians and Strains
Sprains and strains are the most common injuries to the tendons and ligaments, usually due to sports or accidental injuries. When the physiological limits of joint motion or the capacity of a muscle is exceeded there is usually damage to the ligaments and tendons connected to that joint. Repetitive stress can also weaken a ligament or tendon so that stresses that would normally not cause injury damage these tissues.
Additionally, untreated injury or chronic injury can alter the normal function of the joints and lead to a cycle of damage and injury that causes significant changes in joint function and increases the potential for further sprains and strains. These types of chronic dysfunctions can lead to permanent changes in entire activities such as walking gait or ability to lift.
Tendinitis and Tendonosis
Tendinitis and similar disorders occur when there is inflammation of tendons and ligaments. When there is even mild damage to these tissues, such as often is experienced with heavy lifting or repetitive stress, the tissue becomes inflamed as blood flows to the area. Because tendons and ligaments are very dense tissues with poor vascularization the effects of inflammation can take longer to subside than normal and can have the effect of actually weakening the tissues.
Chronic tendinitis is also called tendonosis. Normally inflammation is a process that clears injured tissues so that new tissue can repair the damage. In dense connective tissues like tendons and ligaments, the inflammation process can end up weakening the tissues because these tissues grow slowly and are normally under constant stress which doesn't allow the necessary rest for full repair. This can lead to weakened structures that are actually more prone to sprains and strains.
Tendosynovitis
In addition to general damage to tendons due to direct inflammation, many tendons pass through a synovial sheath. A synovial sheath is a covering that allows the tendon to slide smoothly through other body structures such as the carpal tunnel or between muscles. When there is inflammation in this sheath extra pressures and friction affect the tendon and can lead to dysfunctions as described previously.
Fibromyalgia
Although fibromyalgia is not limited to tendons and ligaments, it often causes pain and discomfort in these structures. The cause of fibromyalgia is unknown. Along with general joint pain, firomyalgia can lead to joint dysfunction through the chronic misuse of painful joints.
References
- "Gray's Anatomy: The Anatomical Basis of Clinical Practice;" Susan Standring (Editor); 2008
- "Basic Pathology;" Kumar, Contran and Robins; Sixth Edition
- Merck Manual: Online Medical Library
