The influence of physical activity on ligaments and tendons

Using either a bone-ligament-bone or a muscle-tendon-bone preparation, numerous investigators have demonstrated that the usual site of separation is in the transitional zone between the ligament (or tendon) and bone; hence, the term junction strength or load at separation is used to describe functional changes in these preparations. Junction strength is decreased with inactivity (immobilization) and increased with chronic activity (training) provided that the exercise program is of an endurance nature. Training also increases junction strength in thyroidectomized and hypophysectomized rats. Besides in junction strength, training results in heavier ligaments and higher ligament weight/length ratios. However, water content, collagen concentrations/dry weight or collagen concentration per weight/length unit are not significantly influenced by repeated bouts of exercise. Although immobilization is associated with lower elastic stiffness values (kg/mm), training appears to have little influence on this measure in normal animals. Rats and dogs with surgically repaired ligaments are weaker and the strength results are markedly lower if the leg is immobilized. Exercise training improves the repair strength of ligaments but does not result in normal values twelve weeks after the surgery. Exogenous administration of ICSH or testosterone results in higher repair strength whereas TSH, thyroxine, ACTH and growth hormone decreases this measure. It was concluded that the mechanical stress produced by chronic exercise is an important determination of the strength of repaired ligaments and of the junctions between ligaments (or tendons) and bones.