Tendons and ligaments are fibrous bands of connective tissue. Both play roles in stabilizing the skeleton and allowing movement.

Tendons and ligaments commonly sustain injuries, which usually have similar symptoms and treatments. Both of these types of structure may get weaker with age, and injury may become more common as people get older.

In this article, we look at the differences between tendons and ligaments, including possible injuries and how to treat them.

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Tendons and ligaments both play a key role in allowing movement.

Tendons and ligaments are thick bands of tissue comprising collagen. They both help stabilize body structures and facilitate body movements.

The main difference between tendons and ligaments is that they connect different parts of the anatomy. Tendons connect muscles to bones, while ligaments connect bones to other bones.

In addition, there are some other minor anatomical differences.

Tendons contain bundles of fiber, which a type of tissue called endotenon surrounds. This tissue enables bundles of tendon fibers to move against one another, supporting body movement.

Ligaments are typically more elastic than tendons. There are two different types of ligament: white and yellow. White ligaments are rich in sturdy collagen fibers, which are not very elastic. Yellow ligaments contain more elastic fibers, which allow more movement.

Ligaments are located at joints, whereas tendons provide the connection between muscle and bone that allows the muscles to move different parts of the body.

Ligaments and tendons can stretch or tear relatively easily. The symptoms of tendon and ligament injuries tend to be very similar.

Tendon and ligament injuries are common. Several factors can increase the risk of injury, including:

  • overuse, such as through playing sports
  • trauma from a fall or blow
  • twisting the tendon or ligament into an awkward position
  • weakness in the surrounding muscles due to a sedentary lifestyle

Some common injuries include:

Tendon injuries

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A person may sustain a tendon injury while playing sports.

Tendon injuries are relatively common, especially in people who play sports. An estimated 30–50% of sporting injuries involve tendon problems.

A common sports injury is a strain, which is damage to a tendon or the muscle to which it connects. The injury can be very painful. Severe strains may take weeks or months to heal.

Trauma from falling or suddenly twisting a tendon can cause a strain. People who are inactive may be more vulnerable to strains, especially if they suddenly become active or experience muscle weakness because of inactivity.

Tendinitis happens when a tendon becomes inflamed and irritated. Tendinitis can develop following trauma, such as a strain, but it is most commonly an overuse injury. People with tendinitis may notice that the area is painful, swollen, and warm to the touch.

Tendinosis is a type of tear that is similar to a strain, but it usually happens over many months or years because of overuse or incorrect athletic technique.

Subluxation happens when a tendon moves out of place. A person might hear a popping or snapping sound when it happens and then experience pain and weakness in the affected joint. Sometimes, the pain will come and go. Subluxation is more likely in people with certain genetic anatomical differences, but tendons can also snap out of place as a result of an injury.

Tendon ruptures can also occur. These injuries may be due to a combination of immediate trauma and chronic trauma. Ruptures commonly affect the Achilles tendons, biceps, knees, and quadriceps.

Ligament injuries

A sprain occurs when a ligament stretches or tears. It can be a temporary, minor inconvenience or a debilitating injury that takes months to heal. The knees, ankles, and wrists are highly vulnerable to sprains from falls, especially if a person lands in an awkward position that stretches and twists the ligament.

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 treatment.

Some types of ligament injury are more common than others. For example, a torn anterior cruciate ligament (ACL) is a common type of knee sprain.

At some point after a ligament injury, the joint may feel unstable. This instability is very common with sprained ankles and knees.

Read more about the difference between sprains and strains here.

Other soft tissue injuries

Aside from strains and sprains, people can also bruise the tendons or ligaments, along with the surrounding tissue.

Bursitis is a type of inflammation that may feel like an injury to the tendon or ligament. Bursitis happens when bursae— small, gel filled sacs that cushion the bones, tendons, and muscles near the joints — become inflamed. This inflammation often happens because of overuse or extreme stress on the joint. Many people experience bursitis alongside tendinitis.

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Applying a compress may help treat a ligament or tendon injury.

The treatments for ligament and tendon injuries are very similar.

For minor strains, sprains, inflammation, and other injuries, most doctors will recommend the RICE method:

  • Rest the injured area and avoid putting weight on it.
  • Ice the injury to reduce swelling and pain.
  • Compress the injury with a compression garment or wrap to reduce swelling and promote healing.
  • Elevate the injury above the height of the heart to ease pain and reduce swelling.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help with the pain. However, it is important not to use pain relievers as a way to ignore the pain and return to daily activities. Pain relievers do not cure the underlying condition, and putting too much weight on an injured tendon or joint can make the injury worse.

For more severe injuries, a person may need additional treatment. Some people find relief from physical therapy, especially if they suffer from chronic or overuse injuries.

When a ligament or tendon tears completely, a doctor may need to repair it surgically.

Bursitis and tendinitis often heal on their own, but in some cases, an inflamed bursa can become infected. When this happens, a doctor might drain the fluid or even remove the bursa.

Treatment for subluxation depends on its severity and the underlying cause. In many cases, a person will need surgery and physical therapy. If a person has an underlying condition that increases the risk of subluxation, a doctor may recommend additional treatments or lifestyle changes.

Tendinitis often heals on its own, but some people find relief from corticosteroid injections. When tendinitis is chronic or severe, a doctor may recommend surgery to remove inflamed or damaged tissue.

Injuries to tendons and ligaments can be very painful. A person may even mistake the injury for a broken bone. It is very difficult to self-diagnose the injury or to tell the difference between tendon and ligament injuries based on the symptoms alone.

Although many minor tendon and ligament injuries heal on their own, an injury that causes severe pain or pain that does not lessen in time will require treatment.

A doctor can quickly diagnose the problem and recommend an appropriate course of treatment. Untreated tendon and ligament injuries increase the risk of both chronic pain and secondary injuries. People should seek prompt medical care rather than ignoring the pain.