Ligaments and tendons are both made up of fibrous connective tissue, but that’s about where the similarity ends.

Ligaments appear as crisscross bands that attach bone to bone and help stabilize joints. For example, the anterior cruciate ligament (ACL) attaches the thighbone to the shinbone, stabilizing the knee joint.

Tendons, located at each end of a muscle, attach muscle to bone. Tendons are found throughout the body, from the head and neck all the way down to the feet. The Achilles tendon is the largest tendon in the body. It attaches the calf muscle to the heel bone. The rotator cuff tendons help your shoulder rotate forward and backward.

Read on to learn more about ligaments and tendons.

How do ligaments and tendons work?

You can think of ligaments as rope, with a series of tough, intertwined cords that bind bones. Ligaments also have some elastic fibers that allow the joint to move, but not so much that it moves beyond its capacity.

The knee joint, for instance, has four major ligaments, one on each side of the knee and two that run diagonally across the front and back of the kneecap. These ligaments help stabilize the knee and keep it from moving too far to the left or right, forward or backward.

Tendons are also tough cords, but they have a little more give than ligaments. As a muscle contracts, the attached tendon pulls the bone into movement. Think of what happens to your bicep when you bend your elbow. Tendons also help absorb some of the impact muscles take as they spring into action.

Illustration of ligament vs. tendon

Ligament vs. Tendon

What injuries are commonly seen in ligaments and tendons?


When a ligament is overstretched or torn, it results in what’s technically known as a sprain. Many sprains happen suddenly, either from a fall, awkward movement, or blow.

Sprains commonly happen in the ankle, knee, or wrist. For example, a misstep can cause you to twist your ankle in an awkward position, snapping a ligament and causing your ankle to be unstable or wobbly. You might hear a pop or feel a tear when the injury occurs. A wrist is often sprained when you reach out your extended hand to break a fall, only to have the wrist hyperextend back. That hyperextension overstretches the ligament.

Symptoms of a sprained ligament generally include pain, swelling, and bruising in the affected area. The joint may feel loose or weak and may not be able to bear weight. The intensity of your symptoms will vary depending on whether the ligament is overextended or actually torn.

Doctors classify sprains by grades, from grade 1 (a mild sprain with slight stretching of the ligament) to grade 3 (a complete tear of the ligament that makes the joint unstable).


When a tendon is overstretched or torn, it’s known as a strain. Common areas affected by strains are the leg, foot, and back.

Strains are often the result of habitual movements and athletics. Athletes who overtrain their bodies without adequate time for rest and muscle repair in between workout sessions are at increased risk.

Much like a sprain, symptoms include pain and swelling. You may also experience muscle cramping and weakness.

What’s tendonitis?

Tendonitis, another tendon injury, is an inflammation of the tendon. This can occur as a result of the natural aging process. Like other parts of the body, tendons weaken as we age, becoming more prone to stress and injury.

Tendonitis can also occur from overuse of a tendon. Golfers and baseball pitchers, for instance, often experience tendonitis in their shoulders.

Symptoms of tendonitis include pain when the muscle is moved and swelling. The affected muscle may feel warm to the touch.

How to treat tendon and ligament injuries

Telling the difference between a ligament or tendon injury on your own can be hard. Whenever you have pain and swelling, see your doctor for a skilled diagnosis and effective treatment plan.

In the meantime, however, whether it’s a strain or a sprain, immediate treatment is generally the same. Doctors recommend:

  • Rest. Try to keep your injured body part immobilized until healing is well underway. This may be easier with the use of immobilization braces and crutches, if needed.
  • Ice. Wrap ice in a towel to protect the skin and then ice the injured area for 20 minutes at a time, several times a day, while you recover.
  • Compression. Reduce swelling by wearing a compression bandage. Wrap the bandage so it’s snug but not uncomfortably tight.
  • Elevation. Keeping your injured body part higher than your heart can help reduce swelling and promote healing.
  • Medication. Over-the-counter anti-inflammatories and pain relievers, taken as needed, may help reduce your pain and swelling.

Preventing sprains and strains

Some injuries, like a sudden stumble or whacking your knee on a dashboard during a car accident, aren’t always preventable. But others are. Take these precautions to protect your tendons and ligaments:

  • Warm up before exercising. Do light aerobic activities to warm up your body for about 10 minutes before you start exercising. For example, walk a lap or two before you run around a track.
  • Start out slowly and build gradually. This also helps warm up your muscles.
  • Wear shoes that fit well and are made for the sport you are playing.
  • Maintain a healthy weight.
  • Vary your routine. Get a good balance of cardio exercise and strength training.
  • Take a day off after an intense workout session or at least switch to a different activity. That can help you reduce your risk for overstressing the same ligaments and tendons.
  • Listen to your body. If you’re in pain or feeling tired, rest. Many injuries happen when your body is already overtired or stressed.
  • Stretch. Most experts recommend stretching after exercise, when your body is warm and more pliable. Hold a stretch for no more than and do each stretch only once. Never bounce or stretch to the point of pain.

The outlook

There are thousands of ligaments and tendons throughout the body. Ligaments and tendons are both made of connective tissue and both can be torn or overstretched, but they differ in function.

Ligaments attach one bone to another. Tendons attach a muscle to a bone. Both, however, are essential to proper body mechanics. Recognizing ligament and tendon problems before they become major injuries is key to enjoying an active and pain-free life.