Massage & Bodywork

JULY | AUGUST 2018

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A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 93 channeling forces between them in order to coordinate movement of the fingers and toes. Attempting to move a finger or toe independently of the others illustrates how this connecting network functions. Some tendons are also surrounded by a synovial sheath. Tendons surrounded by a synovial sheath are generally located in the distal extremities where the tendons take sharp angular turns and are held close to the joint by a binding retinaculum (Image 3). The primary function of the sheath is to reduce friction between the tendon and the retinaculum during movement. Tendons are primarily for transmitting forces. Ligaments, on the other hand, are mainly for establishing skeletal stability. The primary function of the ligament is to connect bones to each other and to guide appropriate movement at each joint. Guiding movement at the joint helps maintain the most optimal joint contact surface and prevent excessive wear between bones, as there are substantial friction forces from movement and weight bearing. Ligaments are generally smaller and shorter than most tendons. They usually only span one joint, and it is important for 2 3 their attachment points to be relatively close together to guide movement and give the joint the greatest degree of stability. Ligaments, similar to tendons, have their collagen fiber orientation primarily in a parallel direction from one end of the ligament to the other. However, there are also numerous fibers running in multiple directions within the ligament (Image 2). Fibers running in multiple directions indicate that ligaments can withstand forces that are in multiple directions even though they are mainly designed to resist force in one particular direction. Ligaments also have a higher concentration of elastin than tendons, which also allows them to be more pliable than tendons. The ligament needs to have a certain degree of pliability to absorb joint loads with a little bit of give in multiple conditions. Unlike tendons, ligaments don't need synovial sheaths because they don't span multiple joints with sharp turns and they aren't sliding back and forth like tendons. COMMON PATHOLOGIES Tendon and ligament injuries are both relatively common soft-tissue disorders. However, their injuries differ in how they occur and what happens to the tissue in these injuries. Tendons are most commonly injured by repetitive loads over time, while ligaments are mostly injured from sudden high-force loads. Let's take a look at both of these injury processes. Tendinitis The most common tendon disorder that people are familiar with is tendinitis. As its name implies, tendinitis would be an inflammatory condition of the tendon. However, in recent years research has indicated there may be very little, if any, inflammation associated with these common overuse tendon disorders. If not inflammation, what is occurring? Instead of inflammation, there may be a degree of structural breakdown of the collagen matrix within the tendon in these overuse disorders. For that reason, the terms tendinosis or tendinopathy (which simply Ligament Tendon sheath Retinaculum Tendon Tendon sheaths and their binding retinacula. Image is from 3D4Medical's Complete Anatomy application. Collagen fibers in the tendon are much more parallel aligned. In ligaments, they are looser and also run in multiple directions.

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