I am frequently asked this question by my patients and thought it would be useful to provide a blog article about it.
The simplest explanation is that a ligament is a connective tissue that connects one bone to another bone. Conversely, a tendon connects a muscle to a bone.
Both are made of collagen fibres but the layout of those fibres are different between the two. In a tendon, the fibres are laid in parallel, allowing for more elasticity which if you think about the way muscles work and the amount of movement involved, this makes them more suited to connecting the muscle to the bone. The fibres in ligaments however are laid in a criss-cross fashion to create structural stability to the ligament and ultimately to support, stabilize and strengthen joints.
Since ligaments are strong and rigid by nature, their primary role is to keep a joint stable. However, strains and sudden forces can cause them to rupture and tear which is a common sports injury. The severity of the injury will depend on how significantly the fibres are torn. Ligaments are poorly supplied with blood so they heal very slowly and sometimes come permanent. Also, if a ligament is stretched past a certain point, it can result in the ligament never returning to its original state. This explains why if you have ever had a severe ankle sprain, very often you become a repeat ‘sprainer’.
Similarly when tendons are over strained, they can become damaged and even snap. A partially torn tendon can cause swelling and discomfort but can be healed over time. A complete tear in a tendon can cause total loss of function and movement and may even result in permanent damage. The traditional treatment for an injured tendon would be to follow the R.I.C.E principle initially of rest, ice, compression and elevation…however, ice is a bit of a controversial topic in the rehab realm lately. My recommendation is that if you can truly see some swelling then go ahead and apply ice for the first 2 days. If the injury is more serious a splint may be necessary in order to aid the healing process whether that be through a proper athletic tape job or the use of supports or braces.
It can be difficult to be able to distinguish between a ligament and tendon injury and sometimes the only way to do this will be to visit your doctor, chiropractor or physiotherapist who can perform specific orthopedic tests or order and X-ray or ultrasound test to confirm the diagnosis if necessary.
The most critical thing is to make sure you do not leave any injury untreated to prevent further damage. And don’t be a hero and try to play through an injury! Prompt and proper treatment with manual techniques, modalities like ultrasound or laser therapy, supports and taping, and progressive exercises will get you back in the game sooner!
Until next time,