Soft tissue mechanics

Credit: 3 Hrs/week
Course conducted by:
01
1
Hozzatul Islam Sayed
Lecturer
Dept. of Medical Physics & Biomedical Engineering,
Gono University
10/27/2024
Soft tissues are defined as the tissues that support and connect body
structures. They include –
• Skin
• Tendons
• Ligaments
• Muscles
• Fat
• Blood vessels
• Nerves
• Cartilages
In some cases, they are simply defined as body tissues that exclude
hard tissues such as bones, teeth, and nails. Soft tissues are known for
high flexibility and soft mechanical properties, differentiating them
from mineralized tissues, such as bones. 10/27/2024 2
Tendon: Tendon is a tough band of fibrous connective tissue that
usually connects muscle to bone and is capable of
withstanding tension.
Ligaments: Ligaments join one bone to bone, while tendons connect
muscle to bone for a proper functioning of the body.

10/27/2024 3
10/27/2024 4
Tendon and ligament are composed largely of water and collagen
fibrils. In keeping with the functional role of these tissues, the collagen
fibrils are organized primarily in long strands. The collagen fibrils,
which may be hollow tubes combine in a hierarchical structure, with
the 20–40-nm fibrils being bundled into 0.2–12-μm fibers. These fibers
are birefringent under polarized light, reflecting an underlying wave
or crimp structure with a periodicity between 20 and 100 μm. The
fibers are bundled into fascicles, supported by fibroblasts or
tenocytes, and surrounded by a fascicular membrane. Finally, multiple
fascicles are bundled into a complete tendon or ligament encased in a
reticular membrane.
10/27/2024 5
10/27/2024 6
Functions:
 Tendons carry tensile forces from muscle to bone
 They carry compressive forces when wrapped around bone like a
pulley
 Ligaments connect one bone to another
 Guide movement
 Transmission of load
 Joint stabilizer
 Motor control

10/27/2024 7
Tendons and ligaments are viscoelastic structures with unique mechanical
properties. Tendons are strong enough to sustain the high tensile forces that
result from muscle contraction during joint motion, yet they are sufficiently
flexible. The ligaments are pliant and flexible, allowing natural movement of
the bones to which they attach, but are strong and inextensible so as to offer
suitable resistance to applied forces.

The biomechanical properties of tendons and ligaments are often evaluated

by using mounted specimens such as a bone-ligament-bone specimen.
10/27/2024 8
However, recent advances have allowed for some instrumentation to
be used in the measurement of in situ forces in humans. These include
the use of buckle transducers, instrumentation at insertion sites,
magnetic resonance imaging, kinematic linkage measurements, and
implantable transducers. Advances in other techniques such as finite
element modeling (FEM), elastographic imaging.

Structural and mechanical properties for tendons and ligaments are

then analyzed by using the above techniques to obtain load-
elongation curves and stress strain diagrams.

10/27/2024 9
Load-elongation curve: A load-
elongation curve offers information
regarding the tensile capacity of a
tendon-ligament structure after
loading a tendon or a ligament to
failure. In a load-elongation curve the
stiffness of the structure (N/nm) is the
slope of the curve between two limits
of elongation. It represents how much
load and or elongation the structure
can sustain before it fails.
10/27/2024 10
The ultimate load (N) is the highest
load placed on the structure before
failure. The ultimate elongation
(mm) is the maximum elongation of
the complex at failure. Finally, the
energy absorbed at failure (N/mm)
is the area under the entire curve,
which represents the maximum
energy stored by the complex.

Load-elongation curves have several regions that characterize the behavior of

the tissue. The first region of the load-elongation curve is called the “toe” region.
The elongation reflected in this region is believed to be the result of a change in
the wavy pattern or crimp of the relaxed collagen fibers.
10/27/2024 11
In this region, the tissue stretches easily without much force, the
collagen fibers become straight and lose their wavy appearance, and
sliding occurs between fibrils and fascicles as the loading progresses.
As loading continues, the stiffness of the tissue increases and there is a
resultant change in the tissue elongation. This region is called the
elastic or linear region of the curve. It follows the toe region and it is
observed as a sudden increase in the slope of the curve. When the
linear region is surpassed, major failure of fiber bundles occurs in an
unpredictable manner. The curve can end abruptly or curve
downward as a result of irreversible changes (failure). With the
attainment of maximum load that reflects the ultimate tensile strength
of the specimen, complete failure occurs rapidly, and the load-
supporting ability of the tendon or ligament is substantially reduced
(complete failure).

10/27/2024 12
Figure description:
Load-elongation curve of a tendon-ligament
structure after loading to failure. The X-axis is
the elongation the structure suffers as a result of
loading, measured in mm. The Y-axis is the
tensile load applied to the tissue measured in
newtons (N). The stiffness of the structure
(N/nm) is the slope of the curve between two
limits of elongation. The ultimate load (N) is the
highest load placed on the structure before
failure. The ultimate elongation (mm) is the
maximum elongation of the complex at failure.
The energy absorbed at failure (N/mm) is the
area under the entire curve, which represents
the maximum energy stored by the complex

10/27/2024 13
Stress-strain curve: In a stress-strain diagram, the elongation is often
expressed as strain (ε), which is the deformation of the tissue
calculated as a percentage of the original length of the specimen. The
force per unit of area (in this case, the total tensile load per unit by the
cross-sectional area of the tendon or ligament under analysis) is
expressed as the stress (σ). From stress-strain curves, a modulus
(N/mm2 or MPa) is obtained from the linear slope of the stress-strain
curve between two limits of strain (deformation) where the tensile
strength (N/mm2) is the maximum stress achieved, the ultimate strain
(in percentage) is the strain at failure, and the strain energy density
(MPa) is the area under the stress-strain curve.

10/27/2024 14
Figure description:
A stress-strain curve of a tendon/ligament
structure under tensile loading. The X-axis is the
percentage of deformation (elongation)
expressed as strain (ε) and the Y-axis is the
stress or load per unit of area (MPa) expressed
as stress (σ), which refers to the tensile strength
of the tissue. A modulus of elasticity (N/mm2 or
MPa) is obtained from the linear slope of the
stress-strain curve between two limits of strain
(deformation). The tensile strength (N/mm2) is
the maximum stress achieved, the ultimate
strain (in percentage) is the strain at failure, and
the strain energy density (MPa) is the area
under the stress-strain curve.

10/27/2024 15
An example of ligament failure
Progressive failure of the anterior
cruciate ligament from a cadaver
knee tested in tension to failure at
a physiologic strain rate. The joint
was displaced 7 mm before the
ligament failed completely. The
force-elongation curve generated
during this experiment is
correlated with various degrees
of joint displacement recorded
photographically;
photos correspond to similarly
numbered points on the curve.

10/27/2024 16
Maturation and aging
Pregnancy and the postpartum period
Mobilization
Comorbidities
Diabetes mellitus
Connective tissue disorders
Renal disease
Pharmacological agents
Steroids
NSAIDs
10/27/2024 17
Structure of skin: The skin is the largest organ of the body, with a total
area of about 20 square feet. The skin protects us from microbes and
the elements, helps regulate body temperature, and permits the
sensations of touch, heat, and cold.
Skin has three layers:
 The epidermis, the outermost layer of skin, provides a waterproof
barrier and creates our skin tone.
 The dermis, beneath the epidermis, contains tough connective tissue,
hair follicles, and sweat glands.
 The deeper subcutaneous tissue (hypodermis) is made of fat and
connective tissue.

10/27/2024 18
Figure: Schematic view of cross section of the human skin showing the distinct layers

10/27/2024 19
Nonlinear stress–strain relationship:
The mechanical response of skin tissue is
highly nonlinear due to the makeup of its
microstructural constituents. Under uniaxial
tension, skin is relatively soft, and much of the
structural response of the skin at low strain
levels (Stage I) is carried through the elastin
components as the collagen fibers are slack
(sometimes referred to as wavy) and non load-
bearing. When the skin is stretched to higher
strain levels (Stage II), the stiffness of the
material increases rapidly as the collagen
fibers are recruited, straightened, and begin
to carry the major part of the load. In the third
phase, all collagen fibers are straight and the
system has its highest stiffness (Stage III). 10/27/2024 20