While the ligament and tendon share some properties, they are very different structures. The ligament is considered a passive structure and only provides support to the joint. Compared to the tendon, which is an active structure, they are involved in moving the bone and muscle. Additionally, the location of these structures is distinct.
While ligaments are attached between joints, the tendon lies at the two ends of the muscle, connecting to the bone. Due to these differences, the rehabilitation and treatment required after injury to these structures will vary.
Golfer’s and tennis elbow (medial and lateral epicondylitis)
Weightlifter’s elbow (triceps tendonitis)
Jumper’s knee (patella tendinopathy)
Achilles tendonitis or tendinopathy
Achilles tear or rupture
Biceps tendon tear or rupture
Rotator cuff tendinopathy.
Sprains, tears or ruptures to the knee’s anterior cruciate ligament (ACL), medial collateral ligament (MCL), posterior cruciate ligament (PCL) and lateral collateral ligament (LCL)
Lateral and medial ankle ligaments
Ligaments around the thumb and fingers
Elbow’s ulnar and radial collateral ligaments
Ligaments of the sacroiliac joint
Long ligaments that span along the spine
It can be difficult to self-diagnose whether your pain is caused by a tendon or ligament injury because of their similar locations and causes. However, the table below will outline ways to tell if your pain is caused by a tendon or ligament injury.
| Tendon Injuries | Ligament Injuries | |
|---|---|---|
| Onset | Either gradually or immediately | Usually immediately |
| Causes | Overuse from repetitive movements or activities | Direct trauma to the affected area |
| Sudden and unexpected movements - especially during forceful activities (e.g. deadlifts, sprinting, etc.) | Sudden and unexpected movements that lead to overstretching of the joints (e.g. changing directions, rolling the ankle, etc.) | |
| Lacerations or deep cuts into the tendon | Ligament injuries typically do not happen over time. | |
| Symptoms | Presence or absence of swelling and bruising. Depends on the type of tendon injury sustained. | Immediate swelling and bruising over time. |
| No movement in the muscle if the tendon has ruptured. | Typically some degree of movement, albeit painful and stiff. |
There are several options when it comes to diagnosing tendon and ligament injuries. The most common approach is to be assessed by a qualified physiotherapist. They will perform a medical screening and physical examination to determine which structure is likely to be injured. However, investigative images (e.g., x-rays, ultrasounds, MRIs, etc.) may be referred for further analysis.
If you are suffering from any pain or injury, it is important to get help early to avoid further problems.
A period of rest or reduced activity of the affected area.
Use ice to help reduce pain and/or swelling. Apply ice packs for no more than 20 minutes and up to four sessions a day.
Use compression to minimise swelling and support the injured region.
Use a brace over the injured area to provide stability and to minimise additional stress/strain.
Crutches can be used to lower limb tendon and ligament injuries if walking is too painful or challenging.
Overall, tendons and ligaments can be challenging to distinguish from the untrained eye. As a result, an injury to either of these structures requires the attention of a qualified physiotherapist. Recovery time and the appropriate treatment will be determined based on the type and severity of the injury.
