Tendon: Function, Anatomy & Common Injuries - Cleveland ...

A tendon is a cord of strong, flexible tissue, similar to a rope. Tendons connect your muscles to your bones. Tendons let us move our limbs. ThinkyoumayhaveCOVID-19? Findoutwhereyoucangettested Needavaccineorbooster? Scheduletoday ComingtoaClevelandCliniclocation? Visitationandmaskrequirements Home / HealthLibrary / BodySystems&Organs Tendon Tendonslinkyourmusclestoyourbones.Theyletyourbonesmoveasyourmusclestightenandrelax.Overuse,injury,agingandhealthconditions,suchasarthritis,candamageyourtendons.Youcanlessenthechancesoftendonproblemswithabalancedexerciseroutine. Appointments216.444.2606 Appointments&Locations RequestanAppointment Overview Function Anatomy ConditionsandDisorders Care FrequentlyAskedQuestions Tendon Overview Function Anatomy ConditionsandDisorders Care FrequentlyAskedQuestions BackToTop Overview Whatisatendon? Atendonisacordofstrong,flexibletissue,similartoarope.Tendonsconnectyourmusclestoyourbones.Tendonsletusmoveourlimbs.Theyalsohelppreventmuscleinjurybyabsorbingsomeoftheimpactyourmusclestakewhenyourun,jumpordoothermovements. Yourbodycontainsthousandsoftendons.Youcanfindtendonsfromyourheadallthewaydowntoyourtoes.TheAchillestendon,whichconnectsyourcalfmuscletoyourheelbone,isthelargesttendoninyourbody. Tendonsarehighlyresistanttotearingbutaren’tstretchy.Thismeanstheycanbeeasilyinjuredwhenstrained(stretchedtopointpartialtearingofropefibers)andmaytakealongtimetoheal. Function Whatdoesatendondo? Whenyoucontract(squeeze)yourmuscle,yourtendonpullstheattachedbone,causingittomove.Tendonsessentiallyworkasleverstomoveyourbonesasyourmusclescontractandexpand. Tendonsarestifferthanmusclesandhavegreatstrength.Forinstance,theflexortendonsinyourfootcanhandlemorethaneighttimesyourbodyweight. Anatomy Whereareyourtendons? Tendonsarelocatedalloveryourbody.Forinstance,tendonsconnectyourmusclestoyourbonesinyourelbow,heel,knee,shoulderandwrist. Howbigaretendons? Tendonshavedifferentshapesandsizesdependingonwhichmusclesthey’reattachedto.Widerandshortertendonsusuallyconnecttomusclesthatgeneratealotofforce.Thinnerandlongertendonsusuallyconnecttomusclesthatperformmoredelicatemovements. Whatistheanatomyofatendon? Tendonsaremostlycollagen,oneofthemostabundantproteinsinyourbody.Tendonsalsocontainbloodvesselsandnerves. Collagenfibersareflexible,strongandresistanttodamage.Atendon’sstructureissimilartoafiberopticcableorarope,withsmallcollagenfibersarrangedinbundles.Thisbundlingreinforcesthetendonandmakesitstronger. Thecollagenfibersinatendongroupinto: Primaryfiberbundles(subfascicles),thesmallestbundle. Secondaryfiberbundles(fascicles)madeofgroupsofsubfascicles. Tertiary(third)fiberbundlescontaininggroupsoffasciclesthatformthetendonitself. Whatarethepartsofatendon? Atendonconsistsof: Endotenon:Connectivetissuethatsurroundstheprimary,secondaryandtertiaryfiberbundles.Helpsthebundlesglideagainsteachotherinsidethetendon. Epitenon:Thinlayerofconnectivetissuethatsurroundstheentiretendon. Paratenon:Looselayerofconnectivetissuethatletsthetendonmoveagainsttheepitenonandothertissuesthatthetendontouches.Locatedoutsidetheepitenon. Sharpeyfibers:Collagenfibersthatattachthetendontothebone. Sheath(synovium):Sometendonsinthehandandfoothaveasheath(synovium).Thisistheprotectiveoutercoveringofthetendon.Producesalubricatingfluidcalledsynovialfluid,whichhelpsthetendonslidesmoothlywhereitmeetsmuscleandbone. Howdotendonsconnectmusclestobones? Tendonsconnectyourmusclestoyourbonesatthefollowingpoints: Musculotendinousjunction(MTJ):Thepointwherethetendonattachestoyourmuscle.Notethisisafrequentsiteofinjury. Osteotendinousjunction(OTJ):Thepointwherethetendonattachestoyourbone. TheSharpeyfibersthatarepartofthetendonextendintothebone.Thetendonofthehandandfootcommonlyslidesthroughaconnectioncalledareflectionpulleythathelpsholditinplace.Small,fluid-filledpadscalledtendonbursae(pluralofbursa)cushiontendonswheretheymeetthebone. ConditionsandDisorders Whatconditionsanddisorderscanaffecttendons? Becausetendonsconnecteverymuscleinyourbody,awiderangeofinjuriesanddisorderscancausetendonproblems.Tendonissuesaremorecommonwithage.Aspeoplegetolder,tendonsbecomethinner,havelessbloodflowandaccumulatemicroscopicdamagetofibersthatweakenthetendon. Mostcommonly,disordersthataffectthetendonsinclude: Strains:Strainsoccurwhenyoutear,twistorpullatendon.Tendonstrainsoftenhappeninyourarmsandlegs. Tendonitis:Tendonitisresultswhenyourtendonsbecomeinflamed,usuallyduetorepetitiveactivities,overuseoraging.Tendonitis(alsocalledtendinitis)oftenoccursinyourAchillestendon,elbow,hip,knee,shoulderorthumb.Themostcommontypesoftendonitisinclude: Patellartendonitis:Patellartendonitishappenswhenyouinjurethetendonthatconnectsyourkneecap(patella)toyourshinbone(tibia).Thisconditionusuallyresultsfromoveruse. Rotatorcufftendonitis:Rotatorcufftendonitisoccurswhenshouldermusclesbecomeinflamed.Thisconditioncanbeduetorepetitiveactivitiesorinjury. Tenniselbow(lateralepicondylitis):Tenniselbowresultswhenyoumicroscopicallytearthetendonsaroundtheoutsideofyourelbow.Overuseofyourforearmmusclescancausetenniselbow. Tenosynovitis:Tenosynovitisoccurswhentendinitiscombineswithinflammationofthetendonsheath.Thiscommonlyoccursinthehandandfeet.Twocommontypesare: DeQuervain’stenosynovitis:DeQuervain’stenosynovitiscausesswellinginthethumbtendons.Itcanresultfromoveruse,repetitivegraspingorinflammatoryconditions,suchasarthritis. Triggerfingerortriggerthumb:Triggerfingerortriggerthumboccurswhenyourfingerorthumbbecomesstuckinabentposition.Inflamedandirritatedtendonscausethiscondition. Othertendondisordersinclude: Bicepstendoninjuries:Bicepstendoninjuriesoccurduetomicrotearsinthetendon.Theycanoccurintheshoulderorelbowduetorepetitivemotionorinjury. Posteriortibialtendondysfunction:Theposteriortibialtendonsupportsyourfootwhenyouwalk.Itcantearorbecomeinflamedduetoinjuryoroveruse.Thistendonconnectsyourcalfmuscletothebonesontheinsideofyourfoot. Rotatorcufftears:Rotatorcufftearshappenwhenyourshouldertendonspartiallyoffullydetachfromtheupperpartofyourarmbone(humerus).Thesetearsmaybeduetoinjuryoroveruse. Tendinosis:Tendinosis,achroniccondition,occurswhencollageninyourtendonshasaccumulatedmanytornfiberswithinthetendonwhichweakensthetendonthusdeterioratesthetendonstructure.Tendonoverusecausestendinosis.Itmostcommonlyhappensintheelbow,heel,knee,shoulderorwrist. Whattestscancheckthehealthofyourtendons? Yourhealthcareproviderwillfirstdoaphysicalexamination.Thekeycomponentsareevaluatingthejointsconnectedbytendon,palpationoftendonforpainordefects,evaluatingthetendonsflexibility,andmanualstrengthtest.Theymayaskyoutomovethejointsnearyourinjuredorinflamedtendon.Youmayexperiencepainwhenyourprovidermovesorpressesyourtendon.Yourtendonmayalsobeswollenorwarm.Yourproviderwillalsotestyourrangeofmotionaroundyourareaofpain.Sometimestheareasaroundyourjointsmayalsofeelstifforweak. Yourhealthcareprovidermayalsousetestsincluding: Arthrocentesis(jointaspirations). Magneticresonanceimaging(MRI). Ultrasound(sonography). X-rays. Howaretendonproblemstreated? Healthcareproviderstreattendonproblemsindifferentways,dependingonthecondition: Strains:Rest,ice,compressionandelevation(RICE),followedbyexercises,canofferrelief.Strainsrarelyneedsurgery. Tears:Rest,anti-inflammatorymedicationseasediscomfortasatendontearheals.Youmayneedsurgerytorepairatear. Tendinitis:Tendinitiscanimprovewithrest,iceorheat,anti-inflammatorymedications,splintsandexercise.Theconditionsometimesrequiressurgery,followedbyphysicaltherapy. Tendinosis:Providersmayadviserest,iceorheat,braces,exerciseandphysicaltherapy.Youshouldavoidanti-inflammatorymedicationsorsteroidinjections,whichcanslowdowncollagenrepair. Tenosynovitis:Rest,splintsandanti-inflammatorymedicationscantreattenosynovitis,butsomepeopleneedsurgery. Care HowcanIkeepmytendonshealthy? Tohelpreduceyourriskoftendonconditions: Balancecardioexercise,strengthtrainingandflexibility:Keepingyourbodymovinginavarietyofwayscanpreventyoufromovertaxingyourtendons. Listentoyourbody:Takingiteasywhenyou’retiredorstressedcanlessenyourriskofinjuries. Stopanactivityifpainoccurs:Ifyouexperienceanypainduringanactivity,stopdoingitandtryagainlatertoseeifthepainreoccurs. Stretchafterexercise:Stretchingyourmuscleswhenthey’remorepliableafterexercise,andnevertothepointofpain,canhelppreventtendoninjury. Warmupbeforeyouexercise:Doingsomelightaerobicactivitiesorrunninginplacebeforemoreintenseexerciseincreasesbloodflowratesandloosensuptendons. Wearproperathleticshoes:Makingsureyourshoesfitwellandaredesignedforthesportyou’replayingcanhelpkeepyourbodyinalignment. Workinrestdays:Schedulingregulardaysoffcanlessenthechancesofoverstressingyourtendons. FrequentlyAskedQuestions WhenshouldIcallahealthcareprovideraboutmytendons? Talktoahealthcareproviderrightawayifyouexperience: Jointormusclepainthathappenssuddenly. Painthatgetsworse. Inabilitytoliftormovepartofyourbodyasyouusuallydo. Withoutpropertreatment,continuedoveruseofyourtendonscanleadtotendinosis.Ifyounoticeongoingdiscomfort,talktoaproviderabouthowtoprotectyourtendons. AnotefromClevelandClinic Tendonsconnectyourmusclestoyourbones.Theyletyourbonesmoveasyourmusclestightenandrelax.Conditionsthataffectyourtendonsincludestrains,tendinitisandtears,includingrotatorcufftearsandbicepstendoninjuries.Youcanhelpkeepyourtendonshealthybymonitoringyourexercisehabitsandnotpushingyourselfpastthepointofpain.Besuretoseeyourhealthcareproviderifyouhavepainthatdoesn’tgoawayorcomesback. Share Facebook Twitter LinkedIn Email Print Getuseful,helpfulandrelevanthealth+wellnessinformation enews ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. Policy RelatedInstitutes&Services Orthopaedic&RheumatologicInstitute ClevelandClinicoffersexpertdiagnosis,treatmentandrehabilitationforbone,jointorconnectivetissuedisordersandrheumaticandimmunologicdiseases. ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. Policy Morehealthnews+info ShowMore Appointments216.444.2606 Appointments&Locations RequestanAppointment Facebook Twitter YouTube Instagram LinkedIn Pinterest Snapchat