Tendons

Tendons are soft connective tissues which connect muscle to bone to transmit force, and are capable of withstanding tension. They serve an essential role for the function of musculoskeletal system [1]. The coordinated motion of joints enables a person to walk, run, jump, carry, lift or perform other physical activities. So, tendons should be strong, healthy and free from harm for enhanced body movement. Each tendon has two attachment points, namely proximal and distal. The proximal or Myotendinous Junction (MTJ) is the point of union with a muscle, while the Distal or Osteotendinous Junction (OTJ) is the point of union with a bone.

Composition of Tendons
Tendons are much like gelatin, but harder and not as elastic. They are made of special cells called tenocytes (fibroblasts), water, and fibrous collagen proteins. Millions of these collagen proteins weave together to form the strong strand of flexible tissue [2]. Tendons are rich in collagens, with the most abundant tendon component being type I collagen, which constitutes about 60% of the dry mass of the tendon and about 95% of the total collagen. The remaining 5% consists of types III and V collagens. Other collagens, including types II, VI, IX, X, and XI, are present in trace quantities in tendons [3].

Structure of Tendons
The primary function of tendons is to transmit tensile forces. They can bear tensile load of 50150 MPa. The variation is due to location, aging, mobilization, etc. The fibers run parallel to direction of tensile force, larger collagen fibers contributing to the strength of the tendon.

Figure 1: Structure of tendon

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Injuries
Despite their incredible strength, tendons can be damaged if overstrained or improperly cared for. Overuse can cause the collagen fibers to form small tears, a condition called tendonitis. Damage most often occurs in the knee, ankle, shoulder, wrist, bicep, and back of the heel [2].

Healing
Tendons cannot easily heal from damage, which makes medical intervention necessary when one is injured. The healing process can be classified into: Inflammation phase: From the first day of injury to the fourth through seventh day Proliferative phase: From the seventh through twenty first day Maturation or remodeling phase: From three weeks to one year

Reference
[1] Ho-Joong Jung, Matthew B Fisher and Savio L-Y Woo, Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology (2009) [2] http://www.wisegeek.org/what-are-tendons.htm accessed on May 02, 2013 [3] James H. C. Wang, Mechanobiology of tendon Journal of Biomechanics (2006), pp 15631582

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