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What are tendons

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Tendons are thick strands or sheets of tissues that attach a bone to a muscle.

Tendon, tissue that attaches a muscle to other body parts, usually bones. Tendons are the connective tissues that transmit the mechanical force of muscle contraction to the bones; the tendon is firmly connected to muscle fibres at one end and to components of the bone at its other end. Tendons are remarkably strong, having one of the highest tensile strengths found among soft tissues. Their great strength, which is necessary for withstanding the stresses generated by muscular contraction, is attributed to the hierarchical structure, parallel orientation, and tissue composition of tendon fibres.

A tendon is composed of dense fibrous connective tissue made up primarily of collagenous fibres. Primary collagen fibres, which consist of bunches of collagen fibrils, are the basic units of a tendon. Primary fibres are bunched together into primary fibre bundles (subfasicles), groups of which form secondary fibre bundles (fasicles). Multiple secondary fibre bundles form tertiary fibre bundles, groups of which in turn form the tendon unit. Primary, secondary, and tertiary bundles are surrounded by a sheath of connective tissue known as endotenon, which facilitates the gliding of bundles against one another during tendon movement. Endotenon is contiguous with epitenon, the fine layer of connective tissue that sheaths the tendon unit. Lying outside the epitenon and contiguous with it is a loose elastic connective tissue layer known as paratenon, which allows the tendon to move against neighbouring tissues. The tendon is attached to the bone by collagenous fibres (Sharpey fibres) that continue into the matrix of the bone.

The primary cell types of tendons are the spindle-shaped tenocytes (fibrocytes) and tenoblasts (fibroblasts). Tenocytes are mature tendon cells that are found throughout the tendon structure, typically anchored to collagen fibres. Tenoblasts are spindle-shaped immature tendon cells that give rise to tenocytes. Tenoblasts typically occur in clusters, free from collagen fibres. They are highly proliferative and are involved in the synthesis of collagen and other components of the extracellular matrix.

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